What We Offer
Services
Expert Review & Consultation
In all of our medical forensics cases, we start with an expert medical records review and any other necessary discovery. Then we set up a time to speak to the client. During that call, the expert will provide opinions and answer questions. From the call, the client and the expert work together to determine the best plan of action: Written report, trial questions, trial support, expert location services, or testimony. Sometimes the case will require all four services to be completed by us. But everything begins with this expert medical records review and consultation.
Our experts are all from highly reputed hospitals and have a strong clinical background to support their forensic expertise. All of our nurses have emergency or trauma background. When they work for Godoy Medical Forensics, they learn how to apply that clinical background to criminal cases. For our civil cases, they are adept at summarizing medical conditions and explaining clinical procedures as well; but knowing what to look for in a criminal case is something that has to be learned through experience and mentoring.
Expert Written Reports
As testifying experts, we are often asked to create expert written reports summarizing our opinions. In criminal cases, we call these reports Initial Analysis reports, and in civil cases we call them Merit Screen reports. In both criminal and civil law, we may offer a third option, called a Mitigation Report. We pride ourselves on the professional quality of our expert written reports and strive to provide a work product that exceeds our client’s expectations. In all our reports, we will reference the medical records or other documentation/discovery that has been provided to us. We combine it all into an appendix, and footnote the page numbers so the attorney can find the source of the information quickly and efficiently.
Initial Analysis Reports (Criminal)
Our Initial Analysis reports start with a summary of the case and the facts on which we base our opinions. We provide a glossary of terms related to the case for easy reference by the attorney. This glossary is a bulleted list and defines the medical conditions, terms or injuries relevant to the case. Along with the definition, the glossary will also briefly summarize cause, treatment, and possible complications. The last part of the Initial Analysis report is the summary of opinions. This portion is a compact narrative of professional and expert opinions that neatly combines the facts of the case, the expert’s clinical and educational experience, and relevant literature.
In this Sample Initial Analysis Report, we were hired by the defense to review a case in which the defendant was charged with DUI and Great Bodily Injury (GBI); GBI is a felony strike in the state of CA. Other states have similar charges called Significant or Serious Bodily Injury (SBI). In many cases, a fracture will be enough to cause the jury to find for GBI. The attorney’s tactic on this case was to have the defendant admit to the DUI but argue against the GBI, in a “pick your battle” type approach. As you can see in the Sample Initial Analysis Report, a large part of the opinion provided focused on the pain and suffering that the victim experienced: There was little to none. Another part of the opinion was related to the recovery: At trial, both the forensic nurse retained by the defense and the orthopedic surgeon retained by the prosecution testified that the victim would recover fully if she completed her physical therapy as ordered. This led to a not-guilty verdict on the GBI count and a reduced sentence for the defendant.
Merit Screen Reports (Civil)
In our merit screen report, we start with a short statement of merit, consisting of 2-3 sentences summarizing the opinion of the expert. Then a case summary lays out the facts of the case. One of the largest sections is the list of issues: This is where the expert will list out the breaches in the standard of care in medical malpractice cases, or the issues identified in the personal injury cases. These may be past medical history, non-compliance of the patient, or any number of things identified as an issue in the case. Each issue will provide supporting facts, literature, and expert opinions. When appropriate, the report may also include damages or a list of additional defendants to be named.
As you can see in the Sample Merit Screen Report, the nurse analyzed a complex case where pressure ulcers were not assessed or treated properly. This resulted in the pressure sores advancing to Stage III and the patient suffered from underlying infections. The original report was 16 pages long and detailed 7 different issues where the standards of care were not met. The expert provided references to standards of care and listed each incidence where there was a breach in the standard of care, complete with references back to the medical records.
Mitigation Reports (Criminal or Civil)
A third type of expert written reports that we offer are called Mitigation Reports. These are reports that summarize the medical conditions of a patient and anticipated medical needs and complications. When possible, we include a prognosis/life expectancy. These reports are often used in criminal cases to assist the courts in determining BOP placement and sentencing. In civil cases, they are used to negotiate settlements related to damages and anticipated costs and needs in the future.
Our Sample Mitigation Report was originally 7 pages long and demonstrates the level of detail that the expert goes into in order to accurately present the complexity of the defendant’s medical conditions. The case summary reviews the events leading up to the hospitalization, and includes an overview of the patient’s main procedures and injuries. The summary of health status discusses the current condition of the defendant and reviews the healthcare needs that will be required during incarceration. Finally, the expert provides a summary of opinions that puts it all together and provides a prognosis.
Doctor’s Attestation Reports
As an additional option, we are often able to provide an Attestation Report; where one of our doctors will review the nurses report and sign an attestation that they agree with the opinions of the nurse. This allows the attorney to list both the nurse and the doctor as an expert in their case without incurring significant costs that are often related to physician experts.
Our experts are often asked to testify, and all of them are happy to do so! We have a reputation of providing unbiased opinions and present well on the stand. One benefit of having a nurse on your case is that our nursing program includes training in patient education, including assessing learning ability and how to educate at a high school level or lower: According to the US Census Bureau, 88% of the population completed high school. We are taught how to explain medical conditions in laymen’s terms which results in better jury appeal and understanding of the facts of the case as stated by the medical expert witness testimony.
One complaint we often hear about medical forensic expert witness testimony is that the expert can come across as arrogant when testifying. All of the experts at Godoy Medical Forensics, Inc. are professional, respectful and provide their opinions in a manner that doesn’t come across as pompous. We hand-pick our experts and attitude is a consideration before hiring.
Legal Support Services
If you need trial support, our nurses are prepared to assist you during any stage of the case development, up to and including trial. Our nurses can attend the trial, either in person or virtually, to provide immediate access to a medical professional who has an intimate knowledge of the case. In the midst of testimony, our nurses can provide real time trial support with questions and assist the attorney in re-routing a line of questioning that is not going in the desired direction.
In one case, our nurse attended virtually on a child dependency case to listen in to the opposing counsel’s expert. Once the direct examination was over, the attorney requested a break to consult with the nurse prior to starting cross-examination. Over the phone, the nurse was able to advise him on questions for cross-examination. She also emailed him questions that she had prepared during the expert’s testimony as further trial support.
In another case, the nurse attended in person on an abusive head trauma case. She sat next to the defense attorney and provided notes and comments on her laptop, with her screen shared.
Having a nurse listen in on medical expert testimony is a huge benefit and can be cost-effective! The nurse can either come to court to observe excerpt testimony in person, or they can listen in through zoom or other telephonic means. Regardless, they send comments and recommended questions for direct or cross examination questions electronically to your laptop or phone, in real time!
If live trial support isn’t an option then trial questions are the next best thing. Our nurses are practiced in providing direct or cross-examination trial questions to help prepare your witness or prepare for cross-examination of the opposing counsel’s witness. Our nurses will become knowledgeable about the facts of the case and are able to write questions to elicit the information from the expert, even when the expert is resistant. By providing appropriate and credible sources such as peer-reviewed research articles or commonly accepted online resources, the nurse prepares the attorney for anticipated rebuttals. Just like our other written reports, we cite the discovery so the attorney can find the information in those documents quickly and in the moment.
Simple Fact Chronology
The Simple Fact Chronology is generated by a Registered Nurse. The nurse will review the records and identify which portions of the records are pertinent to the case. The records are then entered into Lexis-Nexis CaseMap Software and a spreadsheet is generated. The relevant records are linked to the facts which allows the expert to pinpoint their review and reduce their time, and thus cost, significantly.
In this Simple Fact Chronology sample, we organized the records and created a chronology of facts related to an abusive head trauma case. When you open the report, it takes you to the instructions for the expert and you can see the bookmark panel on the left hand side of the screen. If you click on “Fact Chronology,” you will see the spreadsheet that contains all of the facts the nurse determined were related to the case. It includes Bate numbers, the date and time, and the person who documented the fact. The Fact Text column includes the exact documentation as it is presented in the discovery (medical records, police reports, or other documents). On the far left side there is a paperclip – this opens the document that has the fact text. Note: Paperclip link does not work in the sample.
The next section of the simple fact chronology is the issue summaries. The nurse works with the attorney to identify the issues in the case and separates the facts that relate only to that issue. In this case the issues included the possibility that the child had a rare pediatric stroke. The issue summaries allow the expert to review and form an opinion on that issue quickly and efficiently. Note: There are no new facts in the issue summaries – they are repeated from the fact chronology section.
The full set of organized records are included in the simple fact chronology. Once again you see that there are paperclips on the left side which will open up the document described.
Sample Simple Fact ChronFull Fact Chronology
Once the Simple Fact Chronology is created, the attorney client can opt to have a nurse also provide an analysis of the case. We recommend this for complex medical cases as it is like having “a nurse in your pocket.” Both the simple and the full fact chronologies are fully customizable and any issues identified by the nurse or the attorney client can be pulled out as a separate sub-chronology called “issue summaries.” One benefit of this is the ability for a specific expert to only review the portions of the records that are relevant to their area of expertise. Every fact in the sub-chronologies is included in the main chronology and is part of the Full Fact Chron report.
The Full Fact Chronology is not discoverable and is designed for the attorney as a case development and trial tool. It includes comments, summaries and opinions from the nurse. The nurse also writes up individual issue summaries which allows the attorney-client to gain a higher level of comprehension regarding the individual issue in their case. In the Sample Full Fact Chronology you can see that we have added the “Case Summary” section, which is an overview report of the case, and then each “issue summary” has a report specific to that issue; all written by a qualified forensic nurse expert.
With the Full Fact Chron, you also get a copy of the Simple Fact Chron to provide to any testifying experts you have on your case. We do this so that the expert’s opinions are not affected by the nurse’s comments and summaries.
Additional options that can be included in the Full Fact Chronology are:
- Medication list – a list of medications the patient was on and their indications, side effects and any other pertinent information.
- Terms – a list of medical terminology or abbreviations found within the case
- Works Cited – Bibliographical reference to appropriate scientific literature and resources, with notes from the nurse that indicates the relevance of the citation, and a link to full-text articles.
We will look for experts based on your input regarding specialty, location, costs and trial date availability. The nurse will prescreen each expert, briefly discussing the facts of the case, and provide you with a letter summarizing the nurse’s impressions and his/her recommendation as to which expert he/she recommends.
I have worked with Tara from Godoy Medical Forensics for over a decade now, and can say unequivocally that she is as good as it gets for review of, and consultations about, all manner of medical records. She is thorough, provides excellent insight and is always there to provide assistance on my criminal cases.
