Certified Legal Nurse Consultant's Pain and Suffering Analysis Spurs Record Settlement   by Vickie Milazzo RN, MSN, JD

When an attorney takes on a medical-related lawsuit, the attorney is confronted with enormous volumes of medical records crammed with esoteric terminology, inexplicable shorthand and indecipherable handwriting. Yet his client's (plaintiff or defense) future depends on the attorney understanding those records and using them to support the case effectively. That's why being a Certified Legal Nurse Consultant is the healthiest thing that will ever happen to your attorney-client's practice.

On a sunny Virginia morning, meter maid Beverly Adams was severely burned over 50% of her body when her three-wheeled motorcycle turned over and caught fire. "She was making a slight turn on dry pavement," says her attorney, Rob Walker of Robert Walker and Associates, Richmond. "The vehicle was defectively designed with the driver sitting right on top of the gas tank." That arrangement almost proved lethal for Adams.

"Under Virginia law," continues Walker, "you can't sue an employer for an on-the-job injury that takes place in the course of employment. Instead, we took on the engineering firm and the foreign corporation that designed and distributed the vehicle."

According to Walker, his 42-year-old nonsmoking client sang in her church choir and was a 15-year veteran of the police force. Adams had a reputation for going by the book and writing more tickets than most of her peers. "She was the perfect plaintiff," he says.

The accident changed Adams' life completely and permanently. "In addition to her severe burns," says Walker, "she lost four fingers on one hand, lost her eyelids, ears, nose and most of her hair. She spent three months in the hospital, almost a year in rehab, and needed 32 reconstructive surgeries and other surgical procedures. For the rest of her life she'll have to use prosthetic devices and special creams for her damaged skin."

How does the attorney make sense of a year's worth of complicated medical records describing such devastating injuries? How does he even begin to grasp the pain and suffering Adams endured, much less make it real for a jury? Walker's answer is simple: He doesn't. He calls in an expert. His expert of choice was Sharon Scott, RN, CLNC.

The Certified Legal Nurse Consultant Is the Key to Understanding the Medical Issues

For the Adams case, Scott tapped both her 19 years of nursing experience and her extensive training as a Certified Legal Nurse Consultant. "I developed a detailed chronology of the case and explained all the medical procedures in lay terms," she says. "My services included indexing the records and explaining the difference between second and third degree burns. I also pulled out every recorded instance of Adam's pain and suffering and prepared a chart listing all the pain medications, sedatives, etc., she took."

Walker explains the value of Scott's Certified Legal Nurse Consultant services. "I had no idea what was being done to the plaintiff because much of it was in medical shorthand. Sharon indexed the records so we could find what we were looking for. Then on a daily basis she summarized Adams' condition, treatments, surgeries, medications and outcome." This detailed summary made it easier for Walker to answer defense interrogatories and to decide which witnesses to call.

"We were most concerned about Adams' pain and suffering," he continues. "We needed a handle on that. Sharon put all the procedures and surgeries into words we could understand. For example, debridement is just a medical term to me. Sharon explained that meant scrubbing off the dead skin. When you see how often they did that, you understand how much my client suffered."

Scott's next step was to make the actual amount of painkiller Adams received real for people. Walker explains, "Sharon tallied all the dosages for the first six weeks of treatment, then concluded by saying my client had received enough medicine to relieve the pain of 850 heart attacks or 1,700-3,400 hours of labor. That vivid picture of what Adams went through gave us an advantage over the defense attorney when we started talking about damages."

Although the case was pending in federal court, local rules required Walker and the defense to attempt a good-faith settlement. "Both sides chose mediation," he says, "and we settled in about a day. Sharon's summary made the damages so evident, we never had to discuss them. This made for a cleaner conference focused on the liability issues."

The result was a $14,000,000 settlement, at that time (2000) one of the largest out-of-court settlements ever reached for a personal injury case in Virginia. "One reason we got this settlement," Walker acknowledges, "was the understanding of the medical records Sharon gave us." An indirect result of this case was that the vehicle in which Adams nearly died has been redesigned to move the gas tank and its opening to the back.

Certified Legal Nurse Consultants Save Attorneys Time and Money

I have a small office," Walker says. "I can't read 4,000 pages of medical records. Having the services of someone like Sharon allows me to take on complex cases that I could not handle otherwise."

Scott's status as an independent Certified Legal Nurse Consultant in private practice is an advantage for Walker. "I trust her judgment and her opinions more than I would a nurse working in my own office. An independent consultant doesn't have an ax to grind with you. If you get a case of questionable merit, Sharon will tell you not to pursue it."

Another benefit of working with a Certified Legal Nurse Consultant is cost savings. "You can lose a lot of money on cases with complex medical issues if you're not on firm ground," says Walker. "My out-of-pocket expenses on the Adams case were around $240,000. Sharon can quickly and economically identify whether you have a case, and she can cut down on your staff time going through medical records. If you're in a small or medium-sized firm and you need help indexing records or understanding complex medical issues, a Certified Legal Nurse Consultant is indispensable."