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Proof of physician negligence may appear in the medical records

In Maryland and elsewhere, the medical records are the key bedrock that plaintiff's counsel will use to prepare the proof of negligence in a medical malpractice case. Electronic records present several issues for investigation by plaintiff's counsel in trying to prove physician negligence. Tampering with records by nurses and doctors is one area that is always reviewed as a possibility.

With electronic records, there are standard ways to track the handling and revisions of the documents. These may be seen at first glance or they may be revealed in the process of discovery where all records must be produced and can be investigated for authenticity and any suspicious changes. In many cases, the determination of negligence by the physician or nursing personnel may not require such investigatory prowess.

In fact, careless actions or omissions may be clearly revealed in the surgeon's report of the surgical procedure or in the voluminous nurses notes that may give clues to where the treatment of the patient went off track. Complaints by the patient are often memorialized in the nurse's notes. The plaintiff's malpractice attorney will also get important clues and conclusions from having the records turned over to an examining independent expert early in the process.

Your Maryland malpractice attorney will also use the records in detailed questioning of the defendant physicians and other medical personnel to establish or support physician negligence through the oral depositions. The main thing for the malpractice victim to remember is that these records are an important element of the case. Where possible, it's beneficial for the patient to obtain his or her own copy early after discharge. The plaintiff's attorney will obtain all records as a matter of course, but the case may be enhanced if the patient has an early printed copy of his or her records to give counsel at the initial conference.

Source:, "Malpractice suits often tap electronic health records", Judy Greenwald, Oct. 28, 2014

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