When an individual gets injured either as a result of some accident or negligence on the part of medical professionals, they usually file a court case with the help of an attorney, seeking compensation arising out of their injuries. The medical review of a patient’s record generally plays an important role in constructing a solid case for the injured client of a law firm. These reviews allow the attorneys to understand the extent of the injuries sustained, the treatment required thereafter, and how the person’s life will be affected.

The following blog contains 11 case scenarios where complete medical record reviews have won the case for the client. These are representative case studies of how important thorough medical record review is in personal injury, workers’ compensation, and mass tort cases.

Example 1: Missed Diagnosis

A patient, in the course of a medical malpractice case, presented to his doctor with symptoms of a heart attack. The doctor did not order appropriate tests and sent the patient home. A few days later, the patient suffered a major heart attack, leading to permanent damage. For the case to be won for the patient, the medical record review showed evidence that the doctor had overlooked the signs of a heart attack and deprived him of appropriate treatment.

Example 2: Determining Causation in a Personal Injury Case

A victim suffered injury to his neck and back due to a motor vehicle collision. The carrier claimed that the injury was a pre-existing condition. A medical record review provided evidence that the client was pain-free for years prior to the accident. The medical record review was able to establish the injury was consistent with the type of accident. This evidence proves causation for the injuries stemming from the accident, which proved favorable to the client in settlement.

Netmark Business Service provides professional medical record reviews, underlining key information such as pre-existing injuries/conditions or the consistency of injury with the type of accident. This forms a critical basis for establishing causation that greatly enhances the client’s claim.

Example 3: Determining Discrepancies in a Workers’ Compensation Case

The employee alleged his back injury resulted from heavy lifting and from a process inherent in his work. The employer disagreed and claimed the back injury occurred outside of the workplace. Upon careful medical record review on the computerised system, a number of discrepancies were identified in the employee’s medical history.

One crucial thing that was discovered was a prior back injury of the employee that he had not revealed. These facts that were uncovered served to erode his credibility and lent support to his employer’s case all along.

Example 4: Identifying Medication Errors in a Nursing Home Case

It was due to negligence that this resident of the nursing home developed pressure ulcers. The nursing home blamed the resident’s poor health for the occurrence of ulcers. However, once the medical record review was done, it was determined that the medications of the resident were not adequately administered, contributing to the formation of ulcers. This presented evidence helped to win this case for the resident’s family.

Example 5: Proving Extent of Injuries in a Personal Injury Case

Medical record reviews are most important in correctly assessing the severity of an injury, especially in complex cases involving traumatic brain injuries.

Case Summary:

Incident of Accident: A man was involved in a car accident, where he received multiple injuries that included a traumatic brain injury.Contested Issues of Insurer: The insurer felt that the injury was minor in nature and consistent with those normally sustained in that type of incident, thereby minimizing the actual injury.

The Key Results of Medical Record Review:

Detailed Neuropsychological testing showed understanding of the review and the full range of the brain injury was recorded.

Severity Outlined: Gross cognitive and emotional functional deficits were identified; thus, the results proved the report of the insurance company wrong.

Outcome:Medical record reviews, particularly those handled by professionals such as Netmark Business Service, play a very important role in ensuring the claims of injury reflect the impact the incident has caused in the life of a victim.

Example 6: Identifying Patterns of Negligence in a Mass Tort Case

Following a toxic exposure, health problems began developing among thousands of individuals. It was medical record review from the sample of cases that allowed patterns of similar symptoms and diagnoses to be realised, thereby linking the toxic exposure with health problems and substantially strengthening the plaintiffs’ case.

Example 7: Prove that the so-called injuries in a personal injury case had pre-existing conditions.

The victim of a car accident claimed injury and a resultant backache due to the accident. They filed a claim against their insurance company, insisting that the accident was the sole cause of the injuries. However, it was to be quite a different story after the thorough medical record review was conducted. It showed the person in question had received treatments related to back pain for several years before the accident occurred. This vital information now changed the case scenario.

With such evidence in their possession, the insurance company proved that the back pain existed earlier than claimed. The amount claimed then was drastically reduced as the person’s obligation drastically came down. This case therefore shows how medical record reviews are a crucial part of personal injury claims given the fact that they reveal important information relating to the cases.

Example 8: Identifying Missed Opportunities for Early Intervention in a Medical Malpractice Case

Medical record review is one of the significant ways of establishing some of the crucial mistakes, which result in adverse patient outcomes, especially during litigation processes due to malpractice.

Summary of Case:

Patient Symptoms : The patient presented himself to the physician’s office with symptoms suggesting a serious disease.
Failure to Act : Physician’s failure to order proper tests and sent him away without a further diagnosis.
Delay in Diagnosis : Onset of the actual disease was diagnosed at a much later stage when it had become advanced.

Key Findings from Medical Record Review:

Missed Intervention: Missed opportunities for early intervention in the disease process that could have prevented further progression were noted.
Impact on Case: Critical evidence showed evidence of negligence by the doctor to support the claim of the case made by the patient.

Outcome: Medical record reviews, especially those conducted by experts like Netmark Business Services, are invaluable in uncovering overlooked errors and providing strong support for legal claims.

Example 9: Establishing Quality of Life Impairment Due to Injuries at a Personal Injury Trial

A man was in an automobile accident in which he experienced many injuries, including that his leg was broken. The insurance company claimed his injuries were no worse than to warrant a high settlement. However, medical record review, including the testimony of the person’s doctor and a physical therapist, showed the impact of these injuries on the individual’s ability to work, handle activities of daily living, and enjoy an acceptable quality of life. It was this evidence that helped the individual get a larger settlement to accommodate continued treatment and lost wages.

Example 10: Identifying Fraud Patterns in a Case of Workers’ Compensation

A worker claimed injury at work and could no longer return. By medical records reviews and combining the action with toe-to-head surveillance, a discrepancy emerged between these claimed injuries and the true physical activities of a worker, which allowed the employer to defeat a fraud claim and cease unwarranted payouts in compensation—a great case for expert medical review services, like those available at Netmark Business Services.

Example 11: Future Medical Damage in a Personal Injury Case

A person had a road accident and received multiple injuries, which also included a spinal cord injury. The insurance company claimed that the person attained maximum medical improvement and did not require any future treatment. A medical record review, with testimony from the individual’s doctor, determined the individual would have to undergo future treatment and rehabilitation throughout their lifetime. This helped substantiate and increase the person’s settlement to include future medical care.

The Essential Role of Medical Record Reviews in Winning Legal Cases

These case studies epitomise the integral place that comprehensive medical record reviews hold in personal injury, workers’ compensation, and mass tort cases. Deep medical record analysis enables law firms to strengthen their cases, establish causation, and identify patterns of negligence so that their clients can receive the compensation they deserve.

By partnering with reputable providers like Netmark Business Service, law firms tap into the best medical reviews that bring forth important details that can make or break a case. Using their expert in-depth analysis, Netmark Business Service constructs compelling evidence to present to legal teams and therefore secures better results for their clients.