A medical merit review is a clinician evaluation of whether the medical record supports the core elements of a case, typically standard of care, causation, and damages, before counsel commits to expert retention. These articles explain how that review works and what to do with the answer.
42 articles
A medical merit review is a clinician evaluation of whether the record supports standard of care, causation, and damages before counsel commits to expert retention. Here is what the review covers, what you receive, and what happens next.
Dr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP ·
When a medical merit review does not support a case, Case Veritas physicians are available, at no additional cost, to help counsel explain the medical reasoning to the client or family.
Dr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP ·
Most plaintiff attorneys track their hard case costs carefully. What most do not track is what their intake process costs them annually in cases that should never have been taken. That number is almost always significantly larger than it would be with a different intake structure.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP ·
Several states require an affidavit or certificate of merit from a qualified professional at or shortly after filing a medical malpractice claim. Examples from primary sources, and where a pre-litigation merit review fits.
Dr. 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.
Dr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Retaining a testifying expert to find out whether a case has merit is often the most expensive way to get that answer. Expert review rates and retainers vary widely by specialty and market, and when the review finds no viable case, those fees are typically unrecoverable on a contingency matter.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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?
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. 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.
Dr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Here is exactly what is offered and what it costs. Dual-clinician review by a board-certified physician and a registered nurse and legal nurse consultant.
Dr. Andrew Tisser, DO MBA CPE CLCP & Gina Marra, RN LCSW LNC CLCP
Talk it through with the physician and nurse clinicians who would work the file.