Th e Legal Nurse Consultant as Expert Witness ............................................................ Mariann Cosby, MPA, MSN, RN, CEN, NE-BC, LNCC, CLCP, CCM, MSCC and Tricia West, RN, BSN, MBA/HCM, CHN, PHN, LNC

Contents Objectives ................................................................................................................................... 2 History of the Nurse as an Expert Witness .................................................................................. 2 Desirable Characteristics of an Expert Witness ............................................................................ 5 Legal Culture versus Healthcare Culture ...................................................................................... 6 Obtaining Cases for Review ........................................................................................................ 7 Accepting a Case ......................................................................................................................... 8

Check for Confl icts ............................................................................................................ 8 Establishing Your Role ........................................................................................................ 9 Expert Witness or Consultant ............................................................................................. 9 Note Taking and Written Reports ....................................................................................... 9 Timelines/Deadlines ........................................................................................................... 9

Discuss the foundation for nurses serving as expert witnesses ◾ Describe routes by which nurses may assume the role of expert witness ◾ List steps for record review and analysis by expert witnesses ◾ Delineate expectations for communications by nurse experts ◾ Relate the legal defi nition of “standard of care” to the clinical defi nition ◾ Explain the testifying nurse expert’s role in deposition and trial ◾

History of the Nurse as an Expert Witness Legal proceedings employing expert witnesses date back seven centuries. Even then, courts called upon persons with special knowledge or experience to assist them. Early courts, however, did not

Standard of Care Considerations .......................................................................................10 Establishing Expert Relationship .......................................................................................10

After Accepting a Case: Th e Case Review ...................................................................................11 Elements of a Case Review ................................................................................................11 Inventory of Documents ....................................................................................................11 Organizing the Medical Records ....................................................................................... 12 Extracting the Medical Record Information ...................................................................... 12 Chronologies .....................................................................................................................13

Formulating the Expert Opinion ................................................................................................13 Determining the Standard of Care .....................................................................................13 Deciphering the Medical Record .......................................................................................14 Documentation Scrutiny ...................................................................................................15 Reviewing Depositions ......................................................................................................16 All Depositions ..................................................................................................................16 Plaintiff Deposition ...........................................................................................................17 Percipient Witness .............................................................................................................17 Opposing Nurse Expert Deposition ...................................................................................17 Witness Statements and Other Documents .......................................................................18 Communication with the Attorney ....................................................................................18

Initial Report to the Attorney .....................................................................................................18 Written Reports ..........................................................................................................................19 Deposition Process and Trial Testimony for the Nurse Expert Witness .......................................19