Tort Reformand the Legal Nurse Consultant

Tort Reformand the Legal Nurse Consultant

legal nurse consultant at workDoes tort reform limit opportunities for legal nurse consultants? Absolutely not. As the pioneer in the field of legal nurse consulting, I have watched this profession grow and flourish during the last 21 years. Throughout that time many states have implemented some kind of reform, mostly involving non-economic damages (pain and suffering). Yet in every state where tort reform is in place, legal nurse consultants are actively and successfully practicing and growing their businesses by leaps and bounds. We will continue to enjoy even more electrifying growth over the next ten years.

Here’s why:

1. The number of U.S. attorneys continues to increase annually. Currently there are 1,058,662* attorneys in the U.S. and, as the Houston Chronicle states, at least “25 percent deal with medical malpractice and personal injury cases.”

2. At the national level, the U.S. Senate said “no” to a tort reform bill that sought to limit non-economic damages (pain and suffering) in malpractice suits to $250,000. Even if the Senate bill had passed, legal nurse consultants would still have plenty of cases to work on.

3. Most medical malpractice cases legal nurse consultants consult on involve significant economic damages, such as medical expenses and lost earning capacity. These high-dollar cases will continue to keep legal nurse consultants busy.

4. Legal nurse consultants don’t just consult on medical malpractice cases. We consult on general personal injury, products liability, toxic tort, criminal and a variety of other cases. Injury cases of all kinds will be with us as long as Americans breathe. Recovery for negligent injuries and the lost wages, medical bills and the like resulting from those injuries is the American way and is an ancient right that goes back to Mesopotamia in 2100 B.C.

5. In states that limit non-economic damages, attorneys are a bit more selective, concentrating on cases with significant physical and psychological damages (not just emotional distress or pain and suffering). That means both plaintiff and defense attorneys increasingly rely on legal nurse consultants for assurance that they’re making the best business decision in each case they take on. I even see a day when it will be considered legal malpractice for an attorney not to have legal nurse consultants working behind the scenes on their cases.

Medical malpractice cases simply aren’t going away. According to a March 3, 2003 article in BusinessWeek, the National Center for State Courts found that, despite tort reform, the national volume of medical malpractice cases filed has not changed over the last five years.

One factor contributing to the ongoing flood of litigation: Medical errors in hospitals kill up to 98,000 people each year, according to a 1999 study by the National Academy of Sciences Institute of Medicine. That’s 268 patients per day, or the equivalent of a fully loaded jumbo jet crashing every other day. This death toll is higher than the number of people who die from AIDS, breast cancer and car accidents combined. All of the legal nurse consultants I know would actually welcome a shortage of these cases.

Where’s the Real “Crisis”?

Isn’t this “attack on America” with so many people being killed in hospitals what we should be reforming? Instead of worrying about tort reform, we should be concerned about the Dark Ages of Healthcare perpetrated by managed care and the negligent providers who kill 268 hospital patients every day.

In spite of this boom in hospital “victims,” according to the BusinessWeek article mentioned above, the National Practitioner Data Bank (NPDB) reported that over the past ten years malpractice payouts have grown an average of only 6.2% per year. Yet the Journal of Health Affairs showed that the average rate of medical cost inflation over that same ten-year period was 6.7%. This doesn’t sound like an explosion in malpractice awards to me.

legal nurse consultant medical recordsWe are not experiencing a crisis of litigation but a crisis of malpractice. The NPDB reported that from 1990 to 2002, 5% of U.S. doctors were responsible for 54% of medical malpractice payouts, including jury awards and out-of-court settlements. The NPDB breaks this down further: Of 35,000 doctors with two or more payouts during that period, only 8% were disciplined, and of the 2,774 doctors who made payments in at least five cases, only 463 were disciplined.

The severity of that “discipline” is open to question. On August 28, 2003, the Houston Chronicle reported on the case of a Houston doctor who had been sued 78 times and made payouts in 45 cases totaling more than $13.3 million. His punishment? The temporary suspension of his license. I find this especially appalling since I myself consulted on many cases against this doctor as far back as the early 1980s.

Even these “bad apples” in the medical profession don’t significantly increase malpractice insurance premiums for the rest of the doctors. The truth is that insurance companies do not make their money from premiums, but from investing those premiums. When interest rates and returns are high, the companies prosper and often reduce premiums in competition with one another. When interest rates are low (as they are now), the companies’ returns suffer, and they must raise premiums to make up for the loss of investment income. In June 2003, the General Accounting Office issued a report to Congress (GAO-03-702, available at which found that insurers’ pricing decisions were affected not only by their losses on malpractice claims, but also by their loss of income from investments, prior premium history and other market conditions such as market share and the level of competition.

The bottom line on tort reform is this: Research has shown that there is no evidence of rising jury awards or the so-called high cost of litigation, and that the economy is the key to rising malpractice insurance premiums.

As unfortunate as they are, high-profile litigants like Linda McDougal (the woman whose doctor conducted an unwarranted double-mastectomy) and Jessica Santillan (the 17-year-old whose doctors failed to match her organ donor) may help to educate the public. The tragedy is that the healthcare system can disfigure or kill someone and still have the nerve to ask for a cap on damages, a concept that in effect frees these paid professionals and for-profit institutions from personal accountability. Try explaining that to the injured person and their family.

As long as the healthcare industry fails to police itself, there will be plenty of work for all of us.

Inc. Top 10 Entrepreneur Vickie L. Milazzo, RN, MSN, JD is the founder and president of Vickie Milazzo Institute (, the oldest legal nurse consultant certification company. Pioneered the legal nurse consulting profession in 1982. She is the author of the self help book for women, Inside Every Woman (

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What is a Legal Nurse Consultant?

What is a Legal Nurse Consultant

A Legal Nurse Consultant is a member of a legal team. The Legal Nurse has a vast knowledge acquired during years as a professional nurse with additional education and training combined with clinical experience to speak authoritatively about the evaluation of causation, standard of care, damages and other medical related issues in legal-medical claims or cases.

A deep and thorough understanding of the critical analysis of healthcare records and medical literature is the primary area of knowledge for the legal nurse consultant to assist in the resolution or evaluation of medical legal claims and cases.

Legal Nurse Consultant News

How is a Legal Nurse Consultant Different?

Beginning in the early 1980s, legal nurse consultants have provided needed strategies and collaboration with legal teams for support of medically related litigation and other legal matters involving health care including by not limited to:

  • Medical Malpractice
  • Long-term care litigation
  • Elder Law
  • Personal Injury
  • Worker’s Compensation
  • Toxic Tort Law
  • Risk Management Law
  • Life Care Planning
  • Forensic Law
  • Criminal Law
  • Regulatory Compliance Law
  • Civil Rights Violations
  • Medicare Set-Aside Law
  • Employment Discrimination

The Legal Nurse Consultant’s training, education, experience and resourcefulness provided extensive clinical understanding and interpretation of a variety of medical legal arenas.

AALNC - American Association of Legal Nurse ConsultantsAdditionally, you should seek an LNC (Legal Nurse Consultant) that is professional trained and in good standing by an organization certified by the American Association of Legal Nurse Consultants (AALNC).  Board certification is required for each AALNC member via an accredited LNCC program.  These certifications demonstrate the experience, knowledge and commitment the the Legal Nurse has achieved.  Also, the AALNC nonprofit organization assures specific guidelines for the enhancement of the nurses in a consulting arena within the legal field.

Common Symptoms Of Diabetes

Diabetic symptoms progress with systemic approaches according to the type and progression of a diabetic condition and the duration of high levels of blood sugars. Common symptoms of higher blood sugar durations include excessiveness of thirst and hunger, weight loss and frequent periods of urinary urgencies. These conditions are known to be associated with rapid onset of diabetes type II and should be symptoms that prompt medical testing or diabetes.

These particular symptoms are the result of the actual progressive nature of diabetes. Problematic symptoms like incessant thirst and hunger, to growing urgencies for urination, indicate a serious inclination towards a diabetic condition. Undiagnosed and left untreated, these conditions may lead to pathological conditions dealing with urological, pancreatic, kidney, liver and other internal organ pathological conditions. Weight loss symptoms displayed in a diabetic condition is a result of an imbalanced metabolic system.

Severe weight loss needs immediate medical attention. Diabetic symptoms that display themselves as excessive thirst and hunger need appropriate medical testing to rule out any digestive conditions like Chron’s Disease and diverticulitis. These three symptoms closely mimic the symptoms of diabetes insipidus, which is otherwise unrelated to diabetes mellitus. Frequency and the urge to urinate are symptoms of a diabetic condition known as polyuria. Conditions like dehydration can result in these cases, and medical evaluation should be prompt.

Most diabetic symptoms are results of a prolonged duration of high blood sugars, and start mildly, like unhealed sores and derma abrasions that do not go away. Unhealed sores and abrasions of the skin include abscesses, skin rashes, and infections of the skin, skin boils, and eventually debiticus ulcers (bedsores). These areas will fill up with pus and surround the tissues in hollowed cavities of the body. This inflammation is indicative to bacterial infections or parasitic infections. These infections can lead into internal abscess infections like abscesses on the brain, lungs, kidneys, and rectum, and breast, liver, spinal and oral abscesses. Skin rashes, infections of the skin and skin boils are open sources of viral and fungi portals. All of these signs of poor skin healing are milder symptom of a diabetic condition, but can cause a variety of other problematic conditions.

Additional symptoms include fatigue, blurred vision along with sores and abrasions that do not heal. Diagnostic evaluations should be performed to properly diagnose a diabetic condition. These symptoms require medical interventions that could prevent conditions known to be associated with diabetes. Blurred vision and fatigue are two other symptoms of a diabetic condition. Diabetic symptoms of blurred vision can lead to diabetic retinopathy and diabetic lens osmosis. A marked degree of eyesight changes occur with the aging process and are normal.

A certified physician should, immediately check out sudden blurred vision, spots and hairline shadows and loss of peripheral vision. Fatigue symptoms displayed in a diabetic condition is a signal that glucose levels may be dangerously low in the body. Chronic fatigue left untreated in a diabetic patient can be a serious sign of heart disease, which is linked to diabetes.

Healthy Eating Habits for a Richer Life

If you manage to develop right kind of eating habits, it will have a positive impact on your health, appearance and lifestyle. Below you will find few tips that can help you in developing a healthy eating regimen.

Eating breakfast

Make sure that you never skip the breakfast. If experts are to be believed, breakfast is the most important meal in the day as it gives your body a necessary fuel to work throughout the day and maintain your energy levels.


Another significant thing that you need to do is to drink at least ten glasses of water on a daily basis. When you do this, your body will remain hydrated. Even better, nutrients will be processed in your body in a much better way. If you are living in a location where climate is pretty warm, you can increase the number of glasses of water that you need to drink on a daily basis.

Choosing snacks

Healthy Eating - Tips from a NurseIt is your responsibility to ensure that you opt for your snacks very carefully. In an ideal scenario, you should go for light snacks that can provide you with extra dose of energy. This can come in handy when you are working non-stop and are facing issues in terms of maintaining your energy level. If your main objective is to lose weight then in this scenario, you need to opt for fruits and vegetables.


Even when your work schedule is quite hectic, make sure that you do not skip your lunch. Often, when you miss your lunch, you eat so much in the evening that it can have a negative impact on your digestion. To avoid such situation, eat your lunch on a timely manner.


Rather than delaying your dinner, take it as early as possible. When you eat dinner late, you are going to face issues in digesting food. In some cases, you may not be able to sleep properly because of this. Therefore, try to eat at least two hours before you go to sleep.

Too Funny….

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