Carr Legal Nursing Consulting: You Don’t Know What You Don’t Know

Melinda Carr

A young construction worker, let ’s call him Tony, was crushed on a construction site when heavy equipment fell on him. He suffered multiple broken bones and internal injuries and sustained several life-threatening injuries. Yet when he walked into a personal injury lawyer’s office, he had a slight limp and was suffering chronic pain from a spinal injury.

As is the case in similar traumatic accidents, Tony didn’t remember much, had no idea of the severity of his injuries or the risky life-saving procedures that were performed. It left his attorney somewhat in the dark about the value of the case.

Enter Melinda Carr, a Raleigh legal nursing consultant. Carr leveraged her 35 years as a nurse in critical care and trauma to train as a legal nurse consultant and launch Carr Legal Nurse Consulting. She applies her medical knowledge as a consultant.

Carr reviews a patient’s medical records on a consulting basis and guides the attorney through the client’s care. In a personal injury case, she explains the extent of the injuries and the impact the accident may have on the victim for the rest of their life. In a medical malpractice case, she investigates for a breach in the standard of care or the cause of a wrongful death; opining on if, in her opinion, the case has merit. Most attorneys heed her opinion, some do not. “It’s just my opinion, they need not follow it.” In the nurse consultant role, her reports are not discoverable, however she may be a fact witness after her record review, if needed.

DETECTIVE WORK

“What I do is a type of detective work,” Carr said. “Someone unfamiliar with medical records and how flow sheets are generated won’t understand that if a code blue happens the regular nursing flow sheets and the regular nursing assessments are not the only documentation to that event. A code blue flow sheet is generated. Diagnostic data is another type of information stored in multiple pieces of bedside equipment.

“It is a classic ‘you don’t know what you don’t know,’ situation,” Carr added. “I know the cause, effect, and consequences of actions or inactions by doctors or hospital staff and where that data is stored. I expressed to Tony’s attorney that in my opinion his life was saved at several different points by decisions made by his health care providers, starting with the EMT at the construction site.”

MISSING MEDICAL RECORDS

Having someone familiar with medical records is vital in determining if significant parts of the records are missing.

“If medical records are missing or I feel there are additional data that may support their case, I will give the attorney discovery guidance by suggesting the acquisition of films, staffing records, histology reports, and Pyxis records, to name a few.”

Most medicines a hospital patient receives comes from a Pyxis machine, which is like a medicine vending machine. “If you have a question about the medication a patient has received, the Pyxis has an abundance of data, such as who removed the medicine, how often the care giver removed the medicine, and dosages. There’s a lot of information that is not available unless you know you need to look for it,” said Carr.

“When partnering with an attorney, I provide a complete medical summary in terms they understand. Throughout the report I may share my opinion about the care or highlight important details that may be pertinent to the case or what may be argued by the opposing counsel,” said Carr. She also helps attorneys prepare for deposition by providing education on the medicine and discussing questions to pinpoint pertinent issues in the case.

She has a network of colleagues and experts she can recommend to attorneys for any issues that would require a medical or nursing expert. Because Carr organizes and Bate stamps the records for easy reference, she recommends passing along her reports to the medical experts, saving the attorney money by decreasing the experts time of review.

THE JURY NEEDS TO KNOW

“The victim sitting in the courtroom with their attorney may not look so bad. However, I can help the attorney flesh out the story and paint the picture for the jury of the pain and suffering their client has experienced, time spent at rehab appointments, doctor’s appointments, and testing.”

Carr explained that if a plaintiff’s attorney can present a complete story with all the details in a clear, concise manner, the result can be a higher value settlement for the injured client or the family of the victim of wrongful death.

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