Standard of care in the first hours after presentation

Presentations we review most often

Emergency medicine claims usually turn on what was knowable at a specific minute, not on the eventual diagnosis. Our reviews focus on the information actually available to the treating clinician at each decision point.

• Missed or delayed stroke and large-vessel occlusion
• Head and cervical spine trauma workup
• Spinal cord injury and cauda equina presentations
• Altered mental status and sepsis recognition

Timelines rebuilt from the primary record

We reconstruct the encounter from EMS run sheets, triage vitals, nursing notes, physician documentation, order and administration times, imaging acquisition and read timestamps, and transfer paperwork.

Discrepancies between narrative documentation and machine-generated timestamps are identified rather than smoothed over, because they frequently determine whether a delay was clinically meaningful.

Standard of care, breach and causation kept separate

Our opinions distinguish clearly between what the standard of care required, whether it was met, and whether any deviation caused the claimed harm.

Where an adverse outcome would likely have occurred regardless of the care provided, we say so — for either side.

• Applicable standard for the setting and resources available
• Adequacy of screening, workup and reassessment
• Disposition, observation and discharge instructions
• Causation and apportionment of downstream harm

Where emergency care and neuroimaging intersect

Many acute-care disputes are ultimately imaging disputes: whether a study was indicated, whether the right protocol was ordered, and whether the finding was there to be seen.

Working alongside our neuroradiologists, we can address both the ordering decision and the interpretation in a single coordinated review.

How to start a review

Send the ED chart, imaging and any depositions taken to date. We provide a preliminary verbal impression before any written work product is generated, so counsel can decide how to proceed.

Initial consultations are complimentary, and we accept both plaintiff and defense engagements.