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Case Stories

Pain and Suffering Analysis

Jane F. alleged her physician missed diagnosing her cancer. OnPoint assisted the plaintiff attorney to present a description of Jane’s pain and suffering. Our research and medical records review aided us in developing an illustrated report. We delineated the events of the medical care and provided an explanation of the symptoms the plaintiff experienced as a result of the physician’s failure to diagnosis the patient’s cancer earlier. Our trial testimony as an expert fact witness allowed the jury to understand the injuries, the patient’s symptoms and treatment and how she was affected. The plaintiff received a 6 figure verdict at trial.

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Billing Audit Plaintiff

Juan M. was injured in a motor vehicle accident. Our client asked us to evaluate the medical expenses, which exceeded $1.5 million from 10 healthcare providers including 2 hospitals and surgery. The certified medical auditor evaluated each charge and provided a report to our client, the plaintiff’s attorney, substantiating the usual, customary, and reasonable fee schedules. As a result, our medical auditor’s findings permitted the attorney to respond appropriately to defense challenges of the charges the client incurred. Our client used the comprehensive report to go to mediation and recover over $1 million for medical care.

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Billing Audit Defense

We are often asked to evaluate if charges incurred by an insured plaintiff are reasonable based on the injury and the prior medical history of the patient. Our certified medical auditors analyze each charge, utilizing the medical records, to identify those charges which are related to the accident and those charges that are related to prior medical history. In a recent defense case, Susan W. claimed she was injured on public property. She asserted she had $1.2 million in medical expenses. Our auditor demonstrated the relevant charges related to the accident totaled only $9,000. Based on our recommendations, the defense attorney was able to successfully argue that over $1,191,000 in charges were not related to the accident.

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Expert Witness Location

Robert W’s spouse filed a claim asserting her husband died of heart failure after a liver transplant. The plaintiff attorney asked us to locate a cardiology expert to review the case for causation. After researching minimal records and authoritative literature associated with liver transplants, we found the plaintiff was appropriately cleared for surgery without evidence of negligent treatment pre or post operatively. We discussed some of the common complications of this procedure, which included heart failure. The attorney appreciated the candid discussion, and decided not to invest in a physician expert review.

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Merit Screen – Nursing Home Case

Minnie M’s daughter contacted our client, a plaintiff attorney, because her mother fell and developed several Stage 2 pressure sores in a subacute facility. Our client asked us to perform a nursing malpractice merit screen. We reviewed records to identify strengths and weakness regarding liability, presence of pre-existing conditions, any pertinent charting inconsistencies, and missing records. We concluded there was minimal liability for the fall, wounds that never progressed and healed, and no substantial permanent damages. The attorney decided not to pursue the case.

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Research

7-year-old Jason W. died following an acute asthma attack. The plaintiff attorney asked us to research medical literature to identify National Asthma Guidelines and compare them with the care given by the defendant provider. We highlighted many safety violations and evidence of substandard care rendered by the treating pediatrician prior to and on the date of death. The attorney used our research to create questions for the defendant’s deposition addressing liability.

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Personal Injury Medical Case Evaluation

Our client asked us to look at the case of George G., a man who fell and was later involved in a motor vehicle accident. Our client wanted us to define which injuries and symptoms resulted from the MVA versus those that could be attributed to the fall. We developed an injury list and performed an analysis of the case’s strengths and weaknesses. Our client settled this case for the policy limits.

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