Insights
Clinical and litigation insights for plaintiff attorneys navigating life care planning, future medical damages, catastrophic injury, and medically complex cases.
Showing 51 posts
Dr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
A medical cost projection and a life care plan answer different questions. The difference is scope, not case value. Here is how to select the appropriate level of analysis before the engagement begins.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP
Life care planning standards contemplate collaboration with qualified professionals when recommendations extend beyond the planner's scope. Here is what that means for specialist-supported life care plans.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Real catastrophic care is delivered by a team of clinicians, not one person. So why are so many life care plans still built by a single planner working alone? This is the thinking behind the Case Veritas model.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Gathering opinions from several specialists is not the same as producing an integrated life care plan. The difference is reconciliation, and it is what determines whether a plan holds together under scrutiny.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
A defensible life care plan establishes what a person will clinically need before it assigns a single dollar figure. Reverse that order and the whole plan becomes vulnerable.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
It is tempting to assume a bigger life care plan is a better one for the plaintiff. In front of a skeptical defense expert and jury, the opposite is often true.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
A great physical therapist and a great life care planner are not the same thing. Here is what the CLCP credential adds when a specialty clinician also holds it, and why that combination changes a plan.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
A life care plan is a comprehensive, dynamic document that projects the future medical and non-medical needs of a catastrophically injured person, with costs. Here is what it is, what it includes, and when your case needs one.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Not every injury case needs a life care plan, and commissioning one too early or too late both carry costs. Here is how to decide whether a case warrants a formal life care plan and when to build it.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
A defensible life care plan is built through a disciplined methodology that ties every projected need to the medical evidence and every cost to a documented source. Here is how a comprehensive, multidisciplinary plan comes together.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Catastrophic injury and nursing home cases produce the largest and most contested future-care claims in plaintiff practice. A well-built life care plan is often what separates a full-value recovery from an undervalued settlement.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Many states require a physician to certify the merit of a medical malpractice claim before or shortly after filing. Here is how independent pre-litigation screening supports that process.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
AI tools identify what happened. They cannot tell you whether it should have happened differently. The standard of care question requires clinical judgment, not algorithms.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Medical expert witnesses charge between $350 and $500 per hour for file review. The median upfront retainer is $2,000. And in the majority of cases they review, they find no basis for a claim.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
There is a well-documented problem in clinical diagnosis that medical literature calls anchoring bias. Most screening services do nothing to protect against it.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
The single most expensive mistake in plaintiff-side medical malpractice practice is committing to a case before the fundamental clinical questions have been answered.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
When an attorney describes a clinical scenario, the legal instinct is to evaluate the narrative. A clinical read starts somewhere else entirely.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
The best plaintiff attorneys I know share one trait. They are brutally honest with themselves about what they do not know.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
The plaintiff firm down the road from you is screening cases before they retain experts. They are not going to tell you about it.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
You are going to spend money this year on a case that has no clinical foundation. Maybe you already have.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
The cases most likely to collapse are not the ones with thin facts. They are the ones with the most emotionally compelling intakes.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Here is the clinical read that happens in the first fifteen minutes of reviewing a medical malpractice chart.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
You have a case with four months left on the statute. The records are voluminous. What do you do?
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Every objection attorneys raise to pre-litigation screening has an answer. Here they are.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Somewhere in your market right now, a plaintiff attorney is twelve months into a case that was never going to file.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
You are not qualified to decide if a medical malpractice case has merit. Neither is anyone else, without reviewing the chart.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
The deviation was on page 412. Not in the physician notes. Not in the discharge summary. Not anywhere an attorney reading for the highlights would find it.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Last year you spent money on a case that did not file. You know the number.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
This post is for the attorney who is really good at personal injury and occasionally takes a medical malpractice case because the intake looked too strong to pass on.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
There is a version of the hard call that happens at month two. Then there is the version that happens at month eighteen.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
You know the feeling. You are reviewing records at 9pm. Something is wrong in this chart. You cannot articulate it clinically but you cannot shake the feeling.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Here is the truth about pre-litigation clinical screening that nobody says plainly. You already know you need it.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Let us talk about what a bad med mal case actually costs a plaintiff attorney. Not the expert fee. The whole number.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Large plaintiff firms have in-house nurses on staff. Solo attorneys and small firms do not have that.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Here is the clinical checklist that should be run on every potential medical malpractice case before expert retention is considered.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Early in this work, an attorney called after he had already retained a different expert. He had spent $11,000. The expert said the case was defensible. Something felt off.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
There is one question that determines whether most medical malpractice cases are viable. Not what went wrong. What was knowable at the time.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Emergency medicine cases are the cases most likely to be misread at intake. In both directions.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Five things plaintiff attorneys learn after their first bad med mal retain. Usually the expensive way.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Here is exactly what is offered and what it costs. Dual review by a board-certified emergency physician and a licensed legal nurse consultant.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Obstetric malpractice cases are among the most emotionally charged intakes in plaintiff practice. The intake narrative is almost always compelling. The clinical picture is almost always complicated.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
There is one distinction in medical malpractice litigation that determines whether a case exists before any other analysis matters. It is the distinction between a bad outcome and a deviation from the standard of care.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Neurological malpractice cases carry some of the highest damages in plaintiff medicine and some of the highest costs to develop incorrectly. Getting the initial screening right is not optional.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Medical records are not written for attorneys. They are written by clinicians communicating with other clinicians, using shorthand and clinical conventions that are entirely opaque to someone without medical training.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Anesthesia malpractice is a specialized area of medical liability with its own documentation conventions and standard of care framework. These cases are among the most technically demanding and most expensive to develop incorrectly.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Pre-litigation case screening and retained expert witness work are not interchangeable. They are sequential. Doing them in the wrong order is one of the most expensive mistakes in plaintiff med mal practice.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Delayed cancer diagnosis is one of the most common and emotionally compelling intakes in plaintiff practice. The distinction between a compelling intake narrative and a viable case is almost entirely a causation question.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
In medical malpractice litigation, the physician note gets most of the attention. It is also frequently not where the most important findings are. The nursing record tells a different story from a different perspective.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Cardiac cases represent a significant portion of plaintiff medical malpractice intake and a wide spectrum of viability. At one end are missed MI cases with clear documentation failures. At the other end are cases where an adverse outcome occurred despite care within the standard.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Most attorneys think of pre-litigation case screening as a gate. That understates what a clinical screening finding actually gives you when the answer is proceed. A well-executed screening is a strategic document that changes every conversation that follows.
Read MoreDr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Surgical malpractice cases span an enormous range of viability. At one end are never events: wrong-site surgery, retained foreign bodies. At the other end are disclosed complications from procedures performed within the standard of care.
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