Site Content

FAQs

I’m new to medical malpractice. Can you help me get started?

Absolutely.  We can discuss your case with you over the phone to ensure you understand the case issues, and give you some idea of the types of experts you need. We can go the next step and do a full Case Merit – where you’ll get much more detail. We can even help you with the Statement of Claim/Defence to ensure you capture the essence of the issues, and name all potential defendants.

Why should I use your service? I can do this myself!

You probably can do this by yourself – but is it time well spent?  We have a roster of current experts that other lawyers have used (and recommended), and we support the expert through the process potentially saving you time and money. Focus your time on what really makes financial sense.

And are you getting the quality of expert you need?  We've found (and mentored) hundreds of experts, for hundreds of lawyers.  We work consistently with many of the top litigators across Canada.  They continue to use us – because it is time well saved and money well spent.

How much does this cost?

The cost is dependent on the type of expert required.

  • For doctors we have a fixed location fee of $1250, and an administration fee of 25% for the support we provide to the expert (and yourself) as the case proceeds.  The hourly rate for the physician is set by them – and can vary significantly (between $300 - $1200 per hour)
  • For nurses and other allied healthcare professionals, there is no location fee – just a straight hourly fee, again varying on the type of specialty required and the experience of the expert.  Fees generally range from $200 to $300 per hour.
  • For larger scale work – such as bulk medical record review (e.g. class action), the cost varies depending on the volume of work and the expertise of the expert.  We try to use cheaper resources for administrative work where possible to keep your costs contained and have IT and project management resources available.  The cost for Legal Nurse Consultants is from $80 - $150 per hour.

What if I’m not satisfied with the expert provided?

This does occur – rarely, but has happened. We have received requests for particular specialties, where it becomes apparent that a different specialty is required. 

If you don't get the opinion you wanted, that is unfortunate but likely that you are getting the opinion you need.

For the second expert on the same case, we do charge half price.

I have a case – but not sure of the type of expert I need. Can you help?

Absolutely.  Our Expert Locators are all well experienced nurses with a thorough knowledge of many types of specialties. Give us a call – we can generally determine your needs with a discussion over the phone.

I need an opinion supportive of my side. Can you guarantee I’ll get one from your expert?

Connect Experts does not ‘shop’ for specific opinions. We have not, and will not.  Our experts are unbiased and objective.  They have the skills/experience/education to analyze adverse events and provide an objective opinion on actual care vs the standard of care.  We strongly support our experts and their integrity as healthcare professionals.

OK – I’m convinced. What now?

Give us a brief description via our online “Find me an Expert” form, call at 855-278-9273, or email us at .

Do you do other types of litigation besides medical malpractice?

Certainly.  We’ve done many personal injury cases, class action (pharma, institutional, medical device, etc.) criminal, OH&S, Long Term Care, government inquiries, corrections, human rights, and other types of litigation.

When is it best to engage Connect Experts?

We certainly prefer that you get us engaged early.  We can help ensure your case has merit, and have the time to locate the best expert(s) for your case.  Good experts tend to be very busy with their clinical work – the earlier we can engage them the more likely is that they will have time to spend the time required on your case.

I have a rush case – I need an expert opinion NOW!

We do understand your desire to limit disbursements – but at the same time, finding a suitable expert at the last second – one that has the credentials and experience required, no conflicts, and has the time to even do a verbal opinion - can be a significant challenge.

We do rush locations.  There is an additional charge for this service.  There may be an increased hourly rate for the expert too.

I can’t afford to pay you until after settlement. Is that acceptable?

No. Connect Expert does not work on contingency, or take delayed payment for our services. Payment is due on completion of the expert’s work. Interim payments may be required on cases that are lengthy.

Can I tell my client to call Connect Experts directly?

Connect Experts provides services to lawyers and not to the public.

This type of litigation is not something we recommend that individuals try to pursue without the guidance of a well experienced litigator.

A lawyer will understand the challenges that are faced, and the 'burden of proof' that is required to be successful.

We are here for lawyers requring an objective and unbiased opinion on the care provided.

What if am not sure what kind of medical expert my client needs?

Talk to our expert location specialists.  They're experienced RNs who have helped lawyers find experts for hundreds of cases.  They are well versed in all aspects of healthcare and can help you narrow your search to the perfect specialty and specialist. We can leverage our network of hundreds of specialists to ensure your report gets the expertise your client deserves.

What kind of litigation has Connect Experts handled in the past?

Connect Experts has provided opinion on more than 1,500 cases in Canada, the U.S.and the Caribbean including numerous class actions, government inquiries and countless other cases. We've worked with lawyers from Australia and the U.K. as well.

FAQs - cost of care

Are nurses accepted as experts by the Canadian courts?

Absolutely.  Nurse experts are accepted as Cost of Future Care Experts in our courts, including some very significant cases (cit. Ediger v Johnston, 2009).

Why use Nurses as experts vs. other healthcare workers?

Nurses have the broadest scope of practice in healthcare - especially as Case Managers. They deal - first hand - with the vast variety of health and social issues and treatments of patients including mental health, sexual health, family issues, etc.

Why does Connect Experts use nurses for Cost of Care?

We believe nurses are the best specialty to develop most cost of care reports, as do US lawyers.

  • Nurses do this work for Federal and Provincial Governments today. They have education and years of experience focusing on the case management and developing care plans.
  • OTs, PTs, and Kinesiologists focus on function – a very important and skilled specialty. Nurses take the treatment plans of these specialists (as well as neuropsychologists, speech language pathologists and other rehabilitation specialists) to create a comprehensive and cohesive life care plan, then detail this plan into a cost of care report.

Canada is unique in having OTs develop cost of care reports. In the US, nurses are the default provider of Cost of Care reports – outnumbering OTs by a ratio of over 50 to 1.

My client does not live in a major centre, can we still hire your expert?

We have experts across Canada. Our Nurse Experts are based in Ontario, British Columbia, Alberta and Nova Scotia. They are available to meet with lawyers and/or their clients almost anywhere across Canada. As well, they can draw on the expertise of Connect Experts vast database of experts from across the country.

Do your cost of care consultants have special areas of expertise?

Yes. All our nurses have experience in Case Management, as well as particular skills in areas such as Pediatrics, Traumatic Brain Injury, Spinal Cord Injury, Mental Health, Home Care, Burns, Wound Care, Palliative Care and Military. Should your case warrant specific expertise, Connect Experts can provide that unique skill set.

Are your Nurses trained in litigation?

Yes, our Nurses have training on Canada’s litigation process, and the expectations of expert witnesses. Most have attended a mock trial (featuring top Canadian plaintiff and defence lawyers).

What makes Connect Experts Cost of Care experts unique?

  • Firstly, our nurses are long term case managers – educated and well experienced in developing care plans for the seriously injured.  
  • Secondly, our nurses all receive specialized training through the most respected Cost of Care courses (called Life Care Planning in the US).
  • Thirdly, Connect Experts continues to develop our experts and their reports with continuous improvement practices as well as training by Canadian lawyers (defense and plaintiff) and experts.
  • Fourthly, we participate in conferences and membership/certification/best practices from the Cost of Care/Life Care Planning associations (American Association of Nurse Life Care Planners and the International Association of Life Care Planners).

Shift. Change

"Shift. Change.  Empowering Nurses with Medical Legal Knowledge"

"This book is a must read for all nurses. You need to get it into the schools of nursing as part of the curriculum.
Nurses need to know and you do it brilliantly!"

Nurse Clinical Educator

ShiftChangeCover Small

As a Legal Nurse Consultant and the president of one of the largest medical legal expert and education companies, Chris Rokosh RN, PNC(C) offers unique insight into the world of medical malpractice and nursing negligence.

Chris has analysed hundreds of malpractice lawsuits and appeared as an expert witness in court multiple times. Her career is now focused on sharing the medical legal lessons learned with nurses everywhere.

"Shift. Change. Empowering Nurses with Medical Legal Knowledge" is not only a great read, it offer an accessible opportunity for nurses to learn invaluable lessons about the legal risks of their job.

"Shift. Change." is based on the belief that legal knowledge can improve healthcare outcomes and promotes an understanding of nursing responsibility as a way to improve patient safety.

This is your opportunity to:

  • Learn about the medical legal landscape and the process of a lawsuit
  • Learn how the courts will both view and judge your nursing practice
  • Identify the most frequently sued nursing specialty areas
  • Identify the top five issues in nursing negligence
  • Learn valuable tips to minimize the legal risks in nursing
  • Work through a nursing negligence case study
  • Improve your medical legal knowlede

This book is eligible for continuing education for nurses from all specialty areas including RNs, RPNs, LPNs, NPs, NAs, Midwives, student nurses, risk managers, policy makers, nursing managers and nursing and clinical educators. Check with your professional association.

The price is $40 including taxes and shipping.

For bulk rates, further information or bookstore sales contact .

U.S Buyers

Canadian Buyers

 

ShiftChangeBack Small

Invite Chris Rokosh to speak at your event

Chris is an engaging, humorous and motivating speaker. Her captivating stories move the audience with real life medical malpractice cases that offer practical lessons for all nurses.

The knowledge gained will inform, help to improve nursing practice and documentation.

Thousands of nurses and healthcare professionals who attended Chris's seminars said that they left more confident, motivated to improve their practice and documentation and assured of the value of patient centred care.

Chris is available for keynote speeches, ½ or full day presentations, workshop leader, and panel participant at nursing, leadership, healthcare and business conferences.

Partial list of engagements:

  • Alberta Nursing College/Association Centenial Conference, Edmonton
  • American Association of Legal Nurse Consultants Annual Conference, Denver, Pittsburgh
  • Nova Scotia RN/LPN Annual General Meeting, Halifax
  • Canadian Obstetrical Malpractice Conference, Vancouver
  • Birth Trauma Conference (in partnership with Thomson Rogers), Toronto, Calgary, Vancouver
  • Canadian Association of Neonatal Nurses Conference, Montreal
  • Legal Issues in Nursing, Ottawa, Guelph, London, Peterborough, Toronto, Hamilton, Calgary, Edmonton, Winnipeg, Saskatoon, Prince George, Fort McMurray, Lethbridge, Vancouver
  • Canadian Bar Association, Calgary, Edmonton
  • AWHONN International Conference, Los Angeles
  • International Home Health Conference, Chicago

For availability and pricing, email us or call toll-free at 855-278-9273.

Education FAQs

What is a Legal Nurse Consultant?

The Legal Nurse Consultant (LNC) is a licensed, registered nurse who performs a critical analysis of clinical and administrative nursing practice, healthcare facts and issues and their outcomes for the legal profession, healthcare professions, consumers of healthcare and legal services, and others as appropriate. With a strong educational and experiential foundation, the legal nurse consultant is qualified to assess adherence to standards and guidelines of healthcare practice as it applies to the nursing and healthcare professions.

What does a Legal Nurse Consultant do?

A Legal Nurse Consultant can provide invaluable input in just about every type of medical event or issue. LNCs provide an unbiased analysis of adverse events or contentious medical/legal situations. They provide general assessment and opinions on nursing care in medical malpractice cases; interpretation of medical records, assessment of physical injuries, and determination of future care and costs in vehicle, property and workplace personal injury cases; they provide opinion on rehabilitation and work issues in Occupational Health and Safety; they assess trauma and comment on injuries in criminal cases; they assess incidents and abuse in government or care facilities and much, much more.

The skills learned in this course can be applied in risk management, patient safety, nursing administration and quality assurance roles.

Minimally - the skills learned in this course will help you be a better nurse - and that is very valuable in itself.

Who is suitable for this work?

You must be a registered nurse, preferably with 8-10 years of clinical experience. You must be thorough in your analysis of the case facts and able to provide a completely unbiased assessment of the situation. You will need to have excellent written communications skills and good computer skills - especially word processing. Self motivation and the ability to work alone is key. You should be inquisitive and skilled at analysis.

Why would I want to be a Legal Nurse Consultant?

This work is fascinating and you will be upholding the standards of care. Imagine receiving a box of documents and a basic description of an adverse event. Your job is to determine exactly what occurred, how and why it occurred and to provide expert opinion on the issues that contributed to the adverse event and the resultant outcome.

You will continue to learn as you research standards of care and delve into the details of each case. Your opinion must be based on a thorough analysis of the case facts based on accurate knowledge of nursing standards of care and practices.

This work is very important. The outcome of the legal action or investigation can have a profound impact on the people involved. You will have the opportunity to use your nursing expertise to make positive changes in healthcare delivery.

Legal Nurse Consulting can be an excellent change to your career and your life. You will have flexibility with when (no shift work!) and where (at home!) you work. The pay can be significantly better than nursing wages.

What qualifications do I need to be a Legal Nurse Consultant?

Many of us have the critical asset to be an LNC; that is to be a Registered Nurse, in good standing with your professional association, with 8-10 years of experience. Thorough knowledge within a single area of clinical expertise can be helpful, but general nursing experience is also extremely useful. You must be well versed and confident in the standard of care applicable to your area of nursing expertise. You must be able to provide a thorough, unbiased, defendable opinion on the nursing care.

There is no minimum experience to qualify as an LNC, but your level of confidence in your practice will improve over time and your nursing opinion is more likely to be valued in the courts as you gain experience. At least 3 to 5 years of general nursing experience followed by 3 to 5 years in a clinical specialty area is ideal. If you have less experience, you CAN take the LNC course and build your business while you continue to gain clinical experience.

There is work for all kinds of nurses: Diploma, Bachelors, Master, PhD and all sizes and levels of hospitals and care facilities. Lawyers need advice from all types of nurses!

The most important education you need is solid clinical nursing experience – in any background. Lawsuits occur in all areas of medicine; acute care hospitals, outpatient/day surgery clinics, long term care facilities, telephone advice lines, school nurses, home care, community health, air ambulance and doctors' offices and all types of personal injury.

I'm just about to retire after many years as a clinical nurse. Is Legal Nurse Consulting suitable for me?

There is no doubt that your education and considerable nursing experience you will be valued. You are in a well respected position to provide opinions on standards of nursing care. Legal Nurse Consulting is a perfect career for this time in your life and will provide you with a whole new way to use all of your acquired nursing knowledge. Many of the cases you will be asked to review will have occurred 5-10 years ago (cases in the Canadian courts move very slowly!) when you would have still been practicing as a nurse and very qualified to speak to the standards of care. You may also choose to use your nursing experience and specialized LNC knowledge to provide much needed education to nurses on the medical/legal aspects of their care or to personal injury lawyers who require general nursing knowledge.

How much work is there in Canada?

There are published statistics of at least 960 medical malpractice cases against physicians each year in Canada. The statistics for nurses are not known. Commonly, each case has three sides that require expert opinion; the plaintiff, the doctors and the nurses. The lawyer for each 'side' of the lawsuit may require one or more nursing opinions on the standards of care. This equals 3-4000 expert nursing opinions required yearly. Many more cases, which may not make it to the trial or settlement stage, will require nursing opinion to determine merit.

The bulk of the work in Canada is in the medical malpractice area where LNCs provide education and opinion on adverse events that occur in the clinical setting. This area continues to grow - steadily - as lawyers learn more about the Legal Nurse Consultant role, and how they can contribute.

We believe that the Canadian situation will mirror the U.S. situation - albeit on a smaller scale. In the U.S., there are as many LNCs working in personal injury as there are in medical malpractice. Personal injury cases include slips and falls, traffic accidents, work place injuries and other events that occur outside of the hospital. In personal injury, LNCs provide information on some mechanics of injury, are injuries consistent with the event, care provided, long term impact and future care costs to the injured.

There are also insurance companies, risk management companies, government agencies and Long Term Care Facilities that require expert opinion on the standards of care. Some law firms in Canada are now hiring 'in house' Legal Nurse Consultants as well.

Using the US as a guide, we estimate that there are 40,000 nurses trained as LNCs (22,000 by one facility alone), so far!

The rate of pay for LNC's in Canada ranges from $50 to $250 an hour depending on your nursing qualifications/experience, your experience as a Legal Nurse Consultant and the specific duties for the job.

What if I have to go to trial! Even the thought of that frightens me!

The good news is that, in Canada, approximately 90% of medical/malpractice lawsuits settle 'out of court' and never proceed to trial. Your written nursing opinion will be one of the very valuable tools that lawyers use in their settlement negotiations. However, you need to be prepared for the possibility that you will be asked to attend trial as an expert witness with most cases you review. While there is no doubt that this is a challenging experience, it also presents significant learning opportunity!

An entire day of the Introduction to Legal Nurse Consulting conference is spent preparing you for your role as an expert witness in court. A nurse/lawyer explains the language and definitions of the legal system while discussing the expectations of the nurse expert witness. A half day is spent in a mock trial - with top practicing lawyers, a judge, a court clerk and 2 expert witnesses putting on a mock malpractice trial. This will be a valuable exposure to the experience of 'being on the stand'. You will have the opportunity to ask questions and experience, first hand, what a trial looks like.

I understand Connect Experts provides opportunities for Legal Nurse Consultants. How much work can I expect to get?

Connect Experts has been providing opportunities to Legal Nurse Consultants since 2005. With our excellent reputation providing nurses (and physicians) to law firms, we continue to have a growing demand for LNCs. When we get requests our priority is always to try to find an LNC that has taken our courses.

It is impossible for Connect Experts to predict the type and number of requests that we will get. And it is important to note that ultimately, the lawyer will choose which nursing expert to retain. Although we do our very best to find work, there is no guarantee that we will have work for you once you've signed onto Connect Experts. We encourage you to pursue your own business while we continue to look for opportunities to get you started in your new career as an LNC.

And we continue to work at exanding the role of the LNC - similar to what we have seen in the U.S.  This is not a trivial change - the legal environment is steeped in tradition and they are not quick to change.  We are learning more of their challenges and work processes and do expect that we will see continued expansion of the LNC role in Canada.

Where can I get more information?

Check out the Legal Nurse Consulting Association of Canada at www.LNCAC.ca. The LNCAC has made some excellent progress on recognition of the Canadian Nursing regulation bodies. 

Also look at the American Association of Legal Nurse Consultants at www.aalnc.org. They are excellent resources for information on Legal Nurse Consulting and what may happen with the Canadian environment.  Legal Nurse Consulting is far more established in the U.S. with recognition by the American Nursing Association and by numbers of state Bar Associations. 

In the U.S. the majority of LNCs work directly for law firms - something that has only recently started happening in Canada.  There are also some differences due to the private healthcare vs public as we have in Canada.

You can also contact us by emailing us at . We're happy to answer your questions!

Case Outcome

The lawyer representing Dave in this malpractice lawsuit asked a Legal Nurse Consultant to review the medical record to provide expert opinion on whether Nurse Donna and Nurse Lucinda had met the standards of care. Their opinion was that Donna and Lucinda had not meet the standards in two important areas; first by not assessing Dave’s leg as thoroughly and frequently as required by hospital policy. Secondly, by not communicating his pain, weakness, colour change and sensory loss to the doctor in a timely manner.

Their opinion was that Nurse Donna should have called the doctor no later than 2 a.m., when she documented that that Dave had severe weakness and tingling in his right leg. Since this did not happen, their opinion was that Nurse Lucinda should have performed a full assessment of the leg at the start of her shift at 8 a.m. and asked the doctor to see Dave immediately.

The Legal Nurse Consultant said that nursing documentation in the medical record indicated a lack of nursing knowledge and critical thinking, as well as a failure to meet the standard of care surrounding both assessment and communication. The opinion was that the lack of communication contributed to a delay in accessing medical attention, which the medical experts stated ultimately contributed to the loss of Dave’s leg. Based on this, the case settled out of court for an undisclosed amount of money.

The doctor who performed Dave’s surgery was also sued, but later released from the lawsuit when it was discovered that the nurses had not communicated significant clinical information to him. By the time the Orthopedic resident examined Dave, and contacted the surgeon on the morning after surgery, Compartment Syndrome had already caused irreversible damage. The opportunity to prevent or minimize the injury was lost.

 

compartment syndrome

What is Compartment Syndrome?

Compartment Syndrome is a potentially life-threatening condition caused by high pressure in a closed fascial space. The most common site of compartment syndrome is the lower leg (Abramowitz and Schepsis 1994) and young men with traumatic soft tissue injury are known to be at particular risk (McQueen et al 2000). It is a potentially devastating complication of tibial fractures which requires prompt recognition and intervention; as early intervention is critical to avoid permanent damage to the muscles and nerves.

Symptoms of compartment syndrome can include pain that is disproportionate to the injury, pallor of the affected limb, altered sensation (numbness, tingling), tension of the affected muscles, pulselessness below the level of the swelling and, as a late sign, paralysis. Post-operative narcotic administration may mask or dull pain, which is often the first symptom of compartment syndrome. Therefore, careful monitoring for the other symptoms is important.

The nursing plan of care for a patient with a traumatic fracture must include, among other things, knowledge and awareness of the possible development of compartment syndrome. Monitoring of color, warmth sensation, movement and pulse strength may be required as frequently as every 15 to 60 minutes, but certainly every four hours in the early post-operative period.

Depending on the lines of communication in your department, signs and symptoms of compartment syndrome must be reported immediately to the charge nurse and/or responsible physician. Based on the expected knowledge that early intervention is key, the nursing standard of care would be to notify the physician immediately, provide an accurate clinical picture of patient status, request a ‘hands-on’ assessment of the patient. If the physician does not respond promptly to the request for assessment, the nurse may be required to raise the level of concern, act in the best interest of the patient and persist in finding appropriate medical attention. This may require repeated pages/phone calls to the physician, refusing to take doctors’ orders over the phone, notifying the nursing supervisor or accessing the appropriate chain of command.

 

Chris Rokosh is a popular speaker on medical legal issues in nursing across Canada and the U.S. She is an RN and founder of Connect Medical Legal Experts, a Calgary-based leader in Expert Witness Services, with a database of hundreds of medical, nursing and cost of future care experts across the country. Explore this website for more information on courses and books on Legal Issues in Nursing and the role of the Legal Nurse Consultant.

Subcategories

Find an Expert

FIND MY EXPERT

Lawyers - give us a brief description of your case. We'll quickly advise you of the availability of suitable experts.

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Newsletter for Lawyers

Subscribe

to get valuable information and to keep up with news about Connect Experts.