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.