Litigation Management

Book Review

Lewis, Randine A. Techniques of Medical Litigation: A Professional's Handbook for Plaintiffs, Defendants, and Medical Consultants. Westport, Connecticut: Quorum Books, 1997. Hardcover: 307 pages, $75.00.

The performance of a comprehensive review of patient records is a necessity in litigation arising from medical malpractice, personal injury, wrongful death, product liability, toxic exposure, and worker's compensation. For the reader requiring an organized, step-by-step approach to medical information management in litigation, Randine Lewis dispenses guidance in all facets of the process including medical record acquisition, medical research, record analysis, selection of medical experts, and conduct of the medical lawsuit.

Although the title states that this work is a handbook for both plaintiffs and defendants involved in medical litigation, the author notes in her preface that portions of the text may appear more oriented to plaintiff counsel. However, as the author also indicates, understanding plaintiff counsel strategy in medical litigation will prove to be extremely critical to defense counsel who must respond to, reverse, and counter these tactics.

In medical claims and litigation, the acquisition of records from healthcare providers can be time-consuming and costly. Techniques of Medical Litigation brings order to the process of obtaining medical records, and includes a sample tracking form that could be easily adapted to a computer software application. Also included are a number of useful formats for correspondence requesting medical records from clinical providers.

An overview of the contents of medical records is presented, accompanied by illustrations of generic patient data forms. Lewis' discussion of the contents of these various medical documents will assist the attorney in conducting a focused medical record review. Descriptions of specialty records for dental, intensive care, emergency room, and obstetrical practice have also been included. For the latter practice specialty, graphic displays of fetal monitoring strips are accompanied by explanations that define elements one should note when reviewing labor room records for symptoms of fetal distress. The medical record chapter concludes with an overview of pharmacological agents typically encountered during reviews of physician orders.

Lewis overviews winning strategies for locating and selecting medical experts and consultants. The critical aspect of defendant performance within or below professional standards for clinical practice is explained, along with an analysis of what type of expert witness could most effectively appraise and testify regarding these standards. The author concludes this discussion with a listing of resources for further investigation of experts and professional standards.

Part II of Techniques consists of selected individual case scenarios for medical malpractice; cancer malpractice; product liability, chemical exposure, and toxic torts; workers' compensation; and personal injury claims. Subsections explain the relevant issues of informed consent, statutes of limitations, loss of chance for recovery, current and future damages, life care planning, and lost wages/loss of earning power.

The second half of this work is an introductory course for lawyers on the integrated aspects of anatomy, pharmacology, and medical terminology. As each body system is presented--cardiovascular, respiratory, digestive, urogenital, endocrine, nervous, and musculoskeletal-disorders and injuries, diagnostic procedures, medications, and therapies are described that are pertinent to the individual system. Easily understood anatomical illustrations enhance the systems descriptors. There is an extensive listing of medical abbreviations as a companion to these medical chapters.

Techniques of Medical Litigation will be of value to legal professionals and paraprofessionals requiring an introductory perspective on medical information management in litigation. This work would also be well suited as a course textbook in classes designed for medical paralegals or legal nurse consultants.

Reviewed by:	Elizabeth Juliano
	James R. Fell

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