The 2009 National Educational Conference Recordings!

New for 2009! AALNC is pleased to offer online and on-demand access to the 2009 National Educational Conference Sessions. These sessions have been recorded, fully synchronized to PowerPoint presentations, and are now available for year-round access. By purchasing access, you will receive the following for each conference session:

Have you ever been locked in a glass coffin? Completely paralyzed? Able to see, hear and feel everything but completely unable to tell anyone that you were alive? Who was there to defend you - not just treat you, but defend your right to the best treatment possible - to defend your right to live? The double pontine stroke that thurst Kate Adamson into total paralysis ("Locked-in Syndrom") forced her husband Steven into the role of patient advocate. As the patient's husband and attorney, Steven had to deal with the legal, personal, spiritual, moral and medical ramifications of his wife's "journey" through the dark tunnel of total paralysis, overcoming one-in-a-million odds against survival to emerge into the light of her new life. This session is a deeply inspirational reminder of why medical and legal professionals initially entered their professions and how powerful combining these professions can be. Once considered "dead" - her life not work saving - Kate Adamson now travels the country as the only professional speaker to have recovered from Locked-in Syndrome. Kate doesn't just understand what you do; she is why you do what you do. Without the lgeal and medical experts that saved her, she would be warehoused in a long-term care facility - or dead.

Part 1 of 2: A well-known and respected plaintiff attorney who has won many multimillion dollar vedicts in the arena of Long Term Care (LTC) and elder abuse cases will go head-to-head with a defense attorney who represents a number of nationally recognized long-term care providers and physician groups. With Hon. Person moderating, the panel will review regulatory history and complaint investigation, corporate ratifiction, staffing issues, neglect and recklessness, causation and tips for depositions and trials to help the right side win the case. This is an audience participatory program with on-the-fly discussions wecome. The panel will discuss recent developments in long-term care law and identify fundamental LTC litigation skills.

This session focuses on case law concerning pressure ulcer and the documentation of nurses and healthcare facilities. It also presents an oversight to the pathophysiology of wounds and gives the LNC an insight to what documentation and information is important when reviewing the medical record. Key elements needed to properly document pressure ulcers will be discussed, as well as an analysis of the different tools used for the documentation of pressure ulcers.

The Centers for Disease Control and Prevention (CDC)reports that almost 1.5 million people in the United States sustain a traumatic brain injury (TBI) each year. Of those, 50,000 die, approximately 250,000 are hospitalized and 1.1 million seek treatment in emergency rooms. It is unknown how many individuals seek alternative medical care or no care at all following head trauma. In addition, it is estimated that someone suffers a TBI every 15 seconds in the United States, either as a result of a fall, motor vehicle accident, assault, gunshot wound or some other direct blow to the head. Many brain injured individuals seek legal representation as the impact on their lives becomes more and more prominent in their activities of daily living. The legal nurse consultant is an integral part of the legal team, especially in dealing with clients with traumatic brain injury. More importantly, the lgeal nurse consultant, as a result of his or her education and experience, becomes an essential member of the litigation team assisting the attorneys in representing clients with TBIs. This presentation will provide a general overview of traumatic brain injuries and the role of the LNC involved in these types of cases. It will cover the signs and symptoms of TBI, diagnostic and neuropsychological testing, and finally, the impact a TBI has on the medical, cognitive and social components of an individual's life with a traumatic brain injury: the good, the bad, and yes, even the ugly.

Concurrent Session #210
How Al Gore Won an Oscar: Bringing Your Case Alive In Mediation with POWERPoint®
Barbara A. Boschert, RN BSN
Kurt E. Wolfgram, JD

Taking the sights, sounds and people of your case to the audience allows you to expand their understanding of the evidence and enhance the ultimate outcome of the case. This multimedia presentation will deomonstrate exactly how to dramatize any case for trial or mediation using easily accessible technology. It will cover exactly how to outline, build and present a multimedia work at mediation. Through the use of video, audio clips and still pictures from actual cases, attendees will learn what works and what doesn't in building a winning presentation. Handouts outlining the basic technology and software necessary to build and present a multimedia project will be provided, as well as references to helpful Web sites, publications and authoritative sources. The expectation is that the audience will see a presentation not unlike that depicted in Al Gore's movie, An Inconvenient Truth, combining animated POWERPoint to enhance the speaker's message.

Concurrent Session #221
Elder Law Face-off: Why the Other Side is Just Wrong! Part 2
Stephen Garcia, JD
Michael LeVangie, Esq., LLM
Hon. Victor H. Person

Part 2 of 2: A well-known and respected plaintiff attorney who has won many multimillion dollar vedicts in the arena of Long Term Care (LTC) and elder abuse cases will go head-to-head with a defense attorney who represents a number of nationally recognized long-term care providers and physician groups. With Hon. Person moderating, the panel will review regulatory history and complaint investigation, corporate ratifiction, staffing issues, neglect and recklessness, causation and tips for depositions and trials to help the right side win the case. This is an audience participatory program with on-the-fly discussions wecome. The panel will discuss recent developments in long-term care law and identify fundamental LTC litigation skills. Part 2 will teach attendees how to apply strategies in preparing a LTC case and testimony. Also, it will define the differences between elder abuse, neglect and recklessness.

Concurrent Session #222
Demystifying Your Clients Hospital Billing
Allen Shane, RN BSN CMAS CCM CLNC LHRM

Gain an introduction into the world of hospital billing. Emphasis will be placed on recognizing and interpreting data on the itemized bill and UB04 hospital claim billing form. A comprehensive review of ICD9 and CPT coding will be addressed as it applies to billing. Current topics related to Medicare and private insurance billing (i.e., "newer events") and other issues will be discussed. At the conclusion of this presentation the legal nurse consultant will recognize the impact that analyzing the patient's billing will have on the overall case workup and value to the attorney.

Concurrent Session #230 
Managing the Assisted Living Case
Lynn Bowers, BSN BA RN LNCC

Understand what defines "assisted living" and identify those that are considered part of its population. Attendees will discover whta ALF stands for, the standard of care for ALFs and the liability issues associated with ALFs. Also, learn how to defend/prove the breach in standards of care for ALFs.

Concurrent Session #240 
The Agency and Travel Nurse: Impact on Patient Outcomes
Cheryl Gatti, RN BSN LNCC
Jude Lark, RN BSN CCRN

The travel and agency nurse has been employed in the healthcare system to supplement regular staff members. There have been a number of studies related to patient outcomes and the travel nurse. This session will open with an overview of patient safety studies. Through the use of actual case studies, obstacles to safe practice will be identified and discussed. Malpractice also will be explored using complaints, medical records and deposition testimony. Measures to promote safe practice will be discussed using actual policies developed and excerpts of interviews with nurse managers, risk managers, attorneys and travel nurses.

Concurrent Session #300 
To INTEND or Not to INTEND: That is the Question. Sedatives, Behavior and Intent
Robert Julien, MD PhD

Ethanol, at a level of 0.25 grams, produces amnesia while one can still be behaviorally intact. Date rape drugs (benzodiazepines, GHB, etc.) add to this effect. Thus, a "victim" who does not remember sexual activity claims rape and the partner is charged with having sex with an unwilling and unconscious victim. The defendant has no means of assessing the "victim's" ability to form memory and claims the victim was awake and an active participant in sexual activity. Who is the jury to believe? Pharmacology explains what happened by delineating the biological mechanisms that result in formation of memories, how this is affected by sedative drugs and how this is clearly differentiated by behavioral actions. One simple example involves Versed for a colonoscopy procedure: the patient is fully awake, but amnesic. This session will descrive the biology of memory formation as production of new "memory proteins" from DNA within glutamate neurons. It also will illustrate how blockade of memory formation is clearly differentiated from one's ability to act, behave, or participate in behaviors such as sexual activity.

Concurrent Session #301 
E-Discovery and the Electronic Medical Record: A Practical Review for the Legal Nurse Consultant
John Flattery, BSN RN

This session will rewview the laws and standards surrounding the concept of e-discovery. The review will discuss all laws and regulations pertinent to discovery of electronic documentation of varying forms. Electronic medical records, instant messaging, e-mail, Blackberry and cell phone communications, e-prescription, fax and others will be reviewed. This review will look at two aspects of e-discovery: from the side of the lgeal team attempting to access the documentation as well as from the perspective of the reviewing facility with organizational procedures to limit liabilty. Other items that will be discussed include equipment and the formats and programs used by corporations and legal teams for maintaining and sharing the electronic documenation.

Concurrent Session #302 
Advanced Directives: Self-Determination, Legislation and Litigation
Pamela Daguro, Esq., JD
Eileen Watson, EdD MSN RN ANP GNP LNCC

An individual's right to refuse or remove lifesustaining treatments is well established by federal and state laws. Under the fundamental right of self-determination, advanced directives enable competent individuals to give medical instructions or appoint an agent to make healthcare decisions should the individual become incompetent. Even with state immunity statutes for healthcare providers for withdrawing or not implementing life-sustaining treatments in accordance with an advanced directive, lawsuits and research studies demonstrates that healthcare providers often don't implement a patient's advanced directives. Reasons postulated for nonimplementation of advanced directives will be discussed with specific cases cited. Relevant guidelines for healthcare providers to implement to reduce potential liability when dealing with end-of life care issues will be discussed. In addition, guidelines for use by an LNC when evaluating a medical record and associated documents for a case alleging damages casused by a healthcare provider's failure to implement a patient's advanced directive will be explained.

Concurrent Session #320 
Complex Regional Pain Syndrome
Mary Alice McLarty, JD

Gain insight into the lgeal nurse consultant's role in maximizing damages from an attorney's perspective. Discussion points will include how to help an attorney maximize the damages of an CRPS/RSD client and how to emphasize the best qualities of the client and the case.

Concurrent Session #321 
Silent Angels: Shaken Baby Syndrome vs. Medical Malpractice
Susan Smith, RN,C BS MS CNA CEN CCRN

The presenter of this session has worked for two years as the legal nurse consultant for the defense of homicide against parents accused of committing shaken baby syndrome. In every case the client was successfully defended against the charges when it was determined medical malpractice was the real cause of the child's death. This session will review the complexities involved when working on such a case and the modalities of injury generally faced in this type of situation. An actual case will be referenced throughout the presentation.

Concurrent Session #322 
Emerging Forensic Issues of Chronic Traumatic Encephalopathy in American Athletes
Bennet Omalu, MD MBA MPH

Learn about the remote historical background of Chronic Traumatic Encephalopathy (CTE) in sports in the United States and how Footballer's Dementia was discovered in 2002 in American football players. The clinical profile, symptoms, signs and manifestations of CTE in American athletes, especially in retired football players, will be presented. The requirements for definitive forensic diagnoses of CTE will be discussed as well as the emerging common features of CTE in the football players and wrestler examined. The emerging socio-cultural and medico-legal issues surrounding CTE in professional and nonprofessional athletes also will be covered.

Concurrent Session # 
Obstetrics & Litigation
The session Obstetrics & Litigation will include the climate of healthcare, risk management issues, reportable perinatal/neonatal events, basic fetal monitoring & use of Pitocin during labor. Other topics of the presentation will include obstetrical nursing standard of care, importance of documentation & interventions for non-reassuring fetal heart tones. The presenter will also define cerebral palsy & discuss occurrence statistics & the latest ACOG/Neonatal Tak Force criteria to define an acute intrapartum hypoxic event as sufficient to cause cerebral palsy.

Concurrent Session #332 
Legal Nurse Consultants Developing Partnership with Elder Abuse Litigation Team
Kathryn Stebner, Esq.
Lorrie Thomas, RN
Mitzi Wortman, RN,C CCM LNCC

The legal nurse consultant is increasingly valuable in elder abuse cases. A legal nurse consultant team and an experienced elder law attorney will present the current issues and concerns of plaintiff long-term care and elder abuse cases. This session will present the process of how to prepare and litigate elder abuse and neglect case examples. The speakers will explain how these issues are found in acute care settings, home care settings, residential care and skilled nursing facilities. The presentation will include explanations of the CA Welfare and Institutions Code as it applies to elder abuse and the inclusive of punitive damages.

Concurrent Session #340
Proficient LNC Use of Technology and Data Management
Rosie Oldham, BS RN LNCC
Brian Oldham, MCP MCSA A+ N+

Learn about systems integration for the LNC practice, including ways to differentiate between independent practice and in-house practice and how current technology can increase efficiency and productivity. The presenters will discuss the imporatnce of selecting the right equipment for business operations and external client needs, data management and storage and online repository design and usage. Online security and the effect of redundant backup systems also will be covered.

Concurrent Session #341 
Never Events and Other Public Healthcare Report Cards: Medical Error or Avoidable Consequence?
Janet Swanson, RN JD CPHRM

This session will identify the National Quality Forum's list of Serious Reportable Adverse Events, also known as "Never Events," and how these relate to the CMS list of hospitalacquired conditions. On October 1, 2008, the CMS institued a law that Medicare will no longer pay hospitals at a higher rate for increased costs when a patient is harmed by one of several conditions not present on admission and determined to be reasonably preventable. The presenter will discuss the impact of this payment rude on hospitals and the process hospitals must utilize to reduce the incidence of such events to improve patient safety and avoid nonpayment. Further discussion on other mandatory and voluntary public healthcare reporting, the balidity of such reports, and the impact on healthcare delivery and payment systems and healthcare consumers' choices also will be covered. Lastly, the presenter will discuss relevant discovery trails and the potential admissibility of these healthcare reports.

Concurrent Session #342 
Notes on Neonatal Negligence: Aspects of Clinical Practice Liability
Beth Diehl-Svrjcek, RN MS CCRN NNP CCM LNCC

The neonatal ICU is an area fraught with high risk for the clinician. However, careful attention to the fundamentals of neonatal care can serve to limit liability and multiple risks. This presentation is based on specific case studies involving clinical issues such as glucose homeostasis, airway management and mechanical ventilation, resuscitation algorithms and intravenous therapy.

Concurrent Session #350
New Challenges in Wound Care Litigation: An Expert Witness Prospective
Shishir Shah, DO CWS

Due to our aging popluation and advanced medical interventions, the incidence of pressure ulcers and iatrogenic wounds are on the rise. This has a direct correlation with a rise in wound-care-related litigation. This discussion will focus upon new developments in wound forensics, utilizing an expert witness and case studies citing chart analysis methodology. Particular focus will be based on hurdles in causation analysis. The attendee will gain a better understanding of standard of care in this arena and a better understanding of approaching wound-related cases.

Concurrent Session #351
The Disposition of Abandoned Embryos: An LNC Special Project
Tamara Ellinghausen, RN

The vast increase in the technolgoy and demand of reproductive medicine has created ethical and complex legal challenges regarding indefinite embryo storage and abandonment issues. The speaker will present a broad overview of how an exciting LNC project was developed and completed when working in-house at a law firm to assist an attorney with providing legal counsel to a client inquiring about potential abandonment of frozen embryos. This session will discuss how an LNC's diverse and invaluable skill set can be utilized for much more than completing medical record chronologies!

Concurrent Session #352 
Understanding PTSD and Impact on Settlement Negotiation
Molly Feliciano, MSN APRN-BC LNCC

The World Health Oragnizaiton (WHO) predicts that motor vehicle accidents, war and violence will be the third-, eighth- and twelfth-leading causes of disability worldwide by the year 2020. Post Traumatic Stress Disorder (PTSD) is recognized as a sequelae of war, violence and accidents, including personal injury. It significantly impacts not only physical health and its associated healthcare costs, but also quality of life, degree of disability and pain and suffering. As these traumatic events increase, so follows the incidence of disabling PTSD; therefore, it is important that legal nurse consultants be familiar with the presenting symptoms and diagnosis of PTSD to enable them to appropriately advise attorneys seeking adequate compensation for their clients. This session will discuss diagnostic assessment tools and criteria for PTSD.

Concurrent Session #400 
Bariatric Surgery: Reivew and Complications
Stephen Katsis, MD

For 97 million Americans - more than one third of the adult popluation - being overweight or obese is a problem they face every day. But for 5 to 10 million people, the problem is much more serious. For these individuals considered morbidly obese, their weight is a serious impediment to their health, their activities and literally every aspect of their lives. The decision to have bariatric surgery involves working closely with the healthcare team to determine whether the patient is a good candidate for surgery, and whether he/she has a life-long commitment to lifestyle changes focused on health, nutrition, exercise and healthy living. This session will discuss how to screen patients for surgery, the latest procedures, the anatomy of the digestive system and post-operative complications in the immediate post-operative phase.

Concurrent Session #401 
A Legal Nurse Consultant in the Field of Workers Compensation Case Management
Victoria Powell, RN CCM LNCC CNLCP MSCC CEAS II

Many nurses want to leave the clinical area and use their knowledge outside the hospital. Workers Compensation case management can assist the nurse in developing skills as a legal nurse consultant, educating him/her about this interesting area of law and developing critical skills as interviewing and time management.

Concurrent Session #402 
Assisting Attorney Clients with Locating an Expert Witness: What Every LNC Needs to Know
Catherine Beasley, MS BSN LNCC
Lauren Welp, MSN BSN RN

This presentation will assist the LNC in learning how to locate the best qualified expert witnesses. Topics will include: the role of the LNC locating witnesses, critical steps in the location process, compliance with state statutes, how to approach and screen potential experts, communicating with attorneys to ensure an understanding of needs and managing expert witness data.

Concurrent Session #410 
Triaging Trials: The Role of the In-house LNC for the Defense
Laura G. Nissim, RN MS CNS LNCC
Suzanne Smithwick, RN LNCC

The defense LNC's role is multifactorial in that it involves identification, preparation and guidance to attorneys and experts prior to and during trial. THe LNC also provides a unique ability to identify pertinent exhibits and interpretation of testimony for defense use. The LNC's role has evolved from simple interpretation of the medical documentation to one of application of the analysis directly for trial use. This evolution of working hand-in-hand with the attorneys as part of the trial team affords the opportunity to provide an effective defense in all aspects of damage arguments. This session will discuss the issues above as well as compare the differences in how damages for trial purposes are distinguished from pre-tiral findings.

Concurrent Session #411 
Opioid Delivery Systems: An Update for LNCs
Kathleen Colfer, MSN RN-BC

This session will review current and novel opioid delivery systems. It will highlight the potential liability issues that can arise with the use of these technologies and discuss the implications for LNCs. There will be several case examples and a brief discussion of emerging pain management standards.

Concurrent Session #412 
Current Economic Trends, Tort Reform & You
Mindy Cohen, MSN RN LNCC
Madeline Good, MSN RN LNCC
Karen Huff, BSN RN LNCC
Julianne Lawless
Sharon K. McQuown, MSN RN LNCC

Hear from AALNC Board of Directors in a panel presentation on finding work in a down economy. The panelists will address how the current economic environment has affected in-house work as well as independents, including suggestions for how to adapt to changing times. Board members from varied backgrounds will share their personal experiences, commenting on what has or has not worked for them. Questions and discussion are invited from audience members.

Concurrent Session #420 
Mayhem Mary vs. Mistress of Mirth: In Showdown at the Med-Mal Corral
Teddylen Guffey, MHSA BSN RN LNCC
Mary Lanz, RN LNCC

Hear an overview, in a point/counter point format, of the LNC role on opposing sides of a medical malpractice case, based on the real life experiences of two LNCs who have lived the roles. This humorous presentation will give examples of how varied an LNC's responsibilities can become. Educational discovery handouts will be provided. The practice differences between opposing LNCs in support of their attorney's litigation goals will be discussed.

The 2008 National Educational Conference Recordings!

New for 2008! AALNC is pleased to offer online and on-demand access to the 2008 National Educational Conference Sessions. These sessions have been recorded, fully synchronized to PowerPoint presentations, and are now available for year-round access. By purchasing access, you will receive the following for each conference session:

This workshop will explore the principles and practices that will help you get started in the profession. Experienced LNCs will discuss lawsuite processes, research, practice areas, medical record review and business principles.

Giving expert testimony, whether at a deposition or at trial, can be a challenging experience. Testifying effectively involves characteristics and skills that are very specific. The purpose of this workshop is to highlight the requisites that characterize best practices of the most effective testifying experts. The topics presented are divided into three categories: preparation before testifying, behaviors during testimony and responsibilities after testimony. A few of the aresa discussed in detail include: document review, defining the issues ofthe case, working with the attorney, interacting with the judge and jury, how to respond to loaded questions, anticipating testifying pitfalls and professional demeanor when under pressure. Familiarity with the topics presnted will enable the legal nurse consultant to be a more effective and confident witness.

This workshop will summarize a number of actual lawsuits from the speaker's own experience with telehealth litigation. Emphasis will be placed on red flags and lessons learned. Among these cases will be a number of unfavorable outcomes that could possibly have been prevented by adherence to standards, recognition of life-threatening emergencies, improved communication with the provider and the other critical elements of care.

Case law is passing in various states on entering bills into medical evidence. Combined with determinations and appropriate methodologies in pricing your life care plan, today's LNC must be ready to address both reimbursement issues as well as making usual and customary determinations. This workshop will address these issues for consideration along with pitfalls to avoid in order to become a successful life care planner.

Pre-Conference #104
Joint Commission Update for Legal Nurse Consultants
Susan Mellott, PhD RN CPHQ FNAHQ CLNC
(Optional - Ticket Required)

The LNC works with medical records and healthcare facilities in reviewing cases for the attorney. It is important for the LNC to understand how the Joint Commission is changing and what this means for the healthcare facilities that it accredits. This workshop will enable the LNC to better understand the current processes utilized by the healthcare facilities to meet these standards. The speaker will help the LNC to identify the processes within the healthcare facility that may be useful to the case being reviewed. The LNC then will be ready for the planned changes that the Joint Commission is currently developing.

James Riley was first condemned to death during the early 1980s when racial tensions in Dover were common. At the time, Delaware's sole method of execution was by hanging. After years of unsuccessful appeals and a landmark ruling by the Superme Court, Mr. Riley wona new trial when the court ruled that the prosecution had imporperly excluded African-Americans from the jury. During the second trial, Mr. Riley represented himself with assistance of stand-by counsel. He was acquitted of intentional murder but still faced the death penalty for felony-murder. Mr. Riley's counsel, with the assistance of a forensic psychologist, was able to spare his client a death sentence by a thorough review of more than 30 boxes of investigative materials and 25 years of prison records demonstrating his client's chnging mental health status and the phenomena of "aging out." Mr. Gabay will explain the importance of a global review of a defendant's life and history in preparing a mitigation case and explain how "bad" evidence may actually be good for the client. Additionally, he will discuss the effects of culture on a criminal tiral and participants will learn the importance of changing mental status and the "aging out" phenomenon.

Pre-Conference #106
"Your Image is YOU" - Successful Image and Marketing Creation 
Jacqueline Chiudioni, RN
(Optional - Ticket Required)

Your communication skills and the image you present create the first impression - often the lasting impression- on the people you meet. Creating a successful image strategy involves coordinating all of the elements of your marketing message ot achieve a consistent, memorable impression. This workshop will analyze the essential elements necessary to create a successful business image.

Opening Keynote #200
The Phoenix Factor: Transforming Life's Challenges into the Foundation for Future Success
John O'Leary, Professional Speaker and Author

The phoenix is one of the most celebrated creatures in world mythology. As it senses its own death approaching, this great bird builds a nest, lies in it, ignites it and burns itself to ashes. From these ashes it rises, soaring even higher, beginning another cycle of life. As the result of a childhood fire, John O'Leary was burned as completely as a person could be without dying. However, John survived the fire and in many ways feels as if he were reborn into another existence. Such can be the nature of our disasters, if we permit ourselves to accept what happened, learn its lessons and resolve to take flight into new life. The Phoenix Factor proposes not that we can avoid tough times, but that each of us can grow from them, change our direction, rise to new heights and soar in life.

Concurrent Session #201 
Orthopedic Complications
Sharon Rennick, RN BSN CLNC

Ms. Rennick will present case studies of multiple orthopedic complications and discuss how they relate to medical malpractice cases from an expert witness point of view. Participants will learn the important symptoms related to Cauda Equina Syndrome and recognize documentation that is significant to changes in patient status and is related to orthopedic complications.

Concurrent Session #202 
Risk Management View of Disclosure - A Must
Cheryl Long, RN CPHRM

Disclosure of adverse events and appropriate documentation of the disclosure is needed to provide patients the information required to plan for healthcare. The Join Commission now requires accredited facilities to have a process in place for the disclosure of unanticipated outcomes. Physicians and healthcare providers daily disclose information about diagnoses, prognoses or complications of anticipated complications; however, there is a hesitancy regarding disclosure of adverse events based on fear of malpractice claims. Many healthcare providers who believe in the honesty of disclosure nonetheless are unsure how to proceed and where to document the disclosure. The speaker will explain the what, why, when and how of disclosure and its impact on patient safety.

Concurrent Session #203 
Secrets from the Trenches
Dolly Curley, RN BS BSN DABFN LNCC
Ilene Warner-Maron, RND CWCN MA MLSP CALA NHA PhD (ABD)

This highly interactive session uses the extensive experiences of both a consultant and an expert in the field of legal nurse consulting to demonstrate the techniques necessary for success. The experiences of the speakers, which cannot be found in a textbook or journal, will enhance the skills of the participants. The speakers will provide illustrations to the salient points relative to investigation, analysis, research, financial implications and legal principles. Also, two case studies will be discussed.

Power Lunch Session #210 
My Reality: A Self-discovery Matrix
Beryl Byles, Executive Coach/Leadership and Management Consultant
(Optional - Ticket Required)

This program will describe and demonstrate the rationale, the specific process and the benefits of using the discipline of the self-discovery process to make choices, both personal as well as professional, that uniquely reflect an individual's strengths, preferences and values. It will help to adjust the reality of the expression, "My insides want what your outsides look like." The takeaway will be a sample matrix to serve as a model for individual use toward the goal of achieving clarity and energy as a result of the discipline of this evaluation process.

Concurrent Session #220 
Developing an "Eye" for an Eye Case
Joel Confino, MD

Even experienced trial lawyers, consultants and reviewers of medical-legal matters have difficulty interpreting, comprehending and evaluating medical records and issues related to eye care and potential litigation. Ophthalmology has its own language, format and unique variables as related to legal consulting. Dr. Confino, an experienced ophthalmologist/surgeon/medical-legal consultant, will explain how to understand and interpret eye care medical records and terminology, discuss issues of damages and liability unique to eye care matters and cite several examples of cases involving some of the common areas of litigation, such as cataract surgery, laser vision correction, traumatic injuries and others.

Concurrent Session #221 
From Hospital to Courtroom - Managing a Premier Legal Nurse Consulting Practice for 20 Years
Jenny Beerman, RN BS MN

This session will begin with an overview of what it takes to grow and maintain a very successful nurse consultant and expert witness practice for 20 years. It will include the need for current practice, professional writing, networking, organization and client referral. Ms. Beerman will then present two case studies, including both the plaintiff and expert perspectives. Medical records and trial testomony will give insight on this topic to the most experienced LNC.

Concurrent Session #332 
Healthcare Fraud in the Emerging eHealth World
Rebecca Busch, RN MBA CCM CFE FHFMA

This session will discuss emerging themes for an LNC to be aware of in an eHealth world. Topics will include how fraud and abuse materialize in health records in the provider setting, payer setting and employer setting. Ms. Busch will discuss an overview of fraud and abuse and how to look for it, and will define practical applications of fraud and abuse in its detection.

Concurrent Session #230 
The Acute Abdomen: When Emergency Department & General Surgeons Come to Blows
L. Peter Fielding, MD FRCS FACS

The "golden hour" to achieve maximum benefit for trauma victims is well recognized. Similarly, the "door to cath-lab time" is an important measure of service quality for pateients with suspected myocardial infarction. The pathophysiology ofr the great majority of patients with an "acute abdomen" is the same or similar to these two examples. The speaker will discuss the importance of patient history and physical exams as the basis of surgical referral decisions. Learn what Dr. Fielding believes could increase the quality of patient care, reduce complications, imporve results and greatly diminish the opportunity for medical malspractice litigation.

Concurrent Session #231 
Expert Witness Testimony: Clips and Tips
Kathleen Ashton, PhD APRN BC

Using an interactive format with actual videotaped deposition testimony, the speakers will engage the audience in discovering some useful ways to deliver testimony and avoid common pitfalls. In addition to viewing the video clip, participants will be guided through a critique of the testimony and will be challenged to develop alternate strategies for handling various types of opposition. Geared to the advanced practitioner, this session will offer useful tips for LNCs at all levels.

Concurrent Session #240 
Untangling Anesthesia Issues
Deborah Dlugose, RN CCRN CRNA

The dynamic nature of rapidly moving anesthesia and surgical events, patient variability, and a broad spectrum of medications, techniques and monitoring create an environment with complex challenges for case analysis. Case review may focus on whether anesthesia providers anticipated difficulty at the time of assessment and planning. However, potential for unexpected events is always present, leaving anesthesia providers in a reactive position. The speaker will discuss how factors such as economic production pressure and patients with increasingly complex health issues bring increased risk to the table. The Anesthesia Care Team (usually Anesthesiologist and CRNA) is the most common model of care, requiring that responsibility for decision-making and actions be delineated. Learn about the inherent risks associated with anesthesia care. Ms. Dlugose will sort out these complicated strands from case documents, including the often-cryptic anesthesia record, which requires careful analysis.

Concurrent Session #232
The Trifecta of a Medical Malpractice Case - Part 1
Rose Clifford, RN LNCC
Karen Krooswyk, MSN RN
Sandra Sprugeon, JD

Part 1 of 2: This session focuses on the dual roles of the independently practicing LNC and how nurses assisted the attorney to achieve a successful outcome for the plaintiff's family. The session will be centered on an actual case in which the attorney utilized both a cosulting expert and a testifying expert. This case will be presented first by the attorney, then the consulting expert will speak on her role and how the initial medical chronology was completed.

Concurrent Session #241 
Rompilla v. Beard: New Opportunities for the Legal Nurse Consultant
Brenda Ewen, MSN RN D-ABMDI CFC
Joseph A. Gabay, Esq.

In Rompilla v. Beard the Supreme Court expanded the duty of the defense to investigate a capital defendant's background at both trial and on post-conviction review. It is no longer sufficient to present anecdotal evidence about school or behavioral problems or abusive childhoods. Capital case mitigation preparation now requires investigation into healthcare issues which may cause cognitive deficits such as prenatal care, prenatal substance abuse and exposure to circumstances and substances affecting brain development or damage. Psycho-forensic evidence is critical in the case for life. Knowledge of legal and healthcare systems and expertise in interview and documentation skills allow the LNC to assist in the thorough development of the mitigation case. LNCs can provide attorneys with the knowledge and skills, as well as the critical record analysis, to translate those records into words and exhibits that will resonate with a jury.

Concurrent Session #242 
The Trifecta of a Medical Malpractice Case - Part 2
Rose Clifford, RN LNCC
Karen Krooswyk, MSN RN
Sandra Sprugeon, JD

Part 2 of 2: This session focuses on the dual roles of the independent practicing LNC and how nurses assisted the attorney to achieve a successful outcome for the plaintiff's family. The session will be centered on an actual case in which the attorney utilized both a consulting expert and a testifying expert. Part 2 will focus on the role of the nursing expert through the deposition phase and how this role interfaced with the consulting expert role. Ms. Krooswyk will speak to various aspects of the case and how issues were resolved prior to the deposition being taken. She also will speak to some of the issues that occurred with the defense nursing experts during their depositions and how the case concluded.

Concurrent Session #401
Role of the Legal Nurse Consultant in Correctional Healthcare Litigation
Joseph Paris, PhD MD CCHP Fellow of the SCP

The LNC has much to offer in the field of correctional healthcare litigation. However, basic principles must be understood, such as the difference between civil rights (deliberate indifference) and malpractice suits, prison or jail, NCCHC or CA standards and the unique documentation in use in correctional healthcare. Dr. Paris will share his field experience of over 75 correctional healthcare cases for either the plaintiff or the defense and will highlight the various litigation phases, including discovery, preparation of summaries, depositions and trial appearances.

Concurrent Session #301
Gadolinium-based Contrast Agents: Liability Overview
Karen Kahle, BS JD

The Food and Drug Administration (FDA) has issued several alerts in recent years requesting that manufacturers of Gadolinium-based contrast agents include certain warnings in the drug's labeling, primarily related to the development of nephrogenic systemic fibrosis in a narrow category of patients. This session will examine this class of drugs, the history and substance of the FDA alerts and how FDA actions such as this impact potential liability in tort actions. Likely defenses to such tort actions and the likely injury claims also will be discussed.

Concurrent Session #302 
Pressure Ulcers: Prevention, Treatment and the Nutrition Connection
Martie Hawkins, RN BSN CWOCN CCM
Janet McKee, MS RD LD

Every pressure ulcer is unique and various articles, wound care books, textbooks and medical supply companies present many different treatment options for pressure ulcers. Therefore, it is essential to become familiar with the literature and best practices that are supported by evidence-based research which validates different prevention and treatment options. The speakers will discuss the causes of pressure ulcers in elderly adults and best practices in the prevention and treatment of pressure ulcers. Also, discussion will include the new changes to the staging definitions of pressure ulcers and the various treatment options for those stages, avoidable versus unavoidable pressure ulcers and the role of nutrition in the treatment of pressure ulcers. The speakers will identify the preventive and treatment measures for pressure ulcers that nursing nutrition experts use in defending or making a claim against a long term care facility. The importance of appropriate and timely documentation in defending against, or making, a pressure ulcer claim will also be discussed.

Concurrent Session #313 
LNCC® Certification Workshop
ALNCCB Members

Ask members of the American Legal Nurse Consultant Certification Board (ALNCCB) any questions you may have regarding the LNCC exam or recertification process.

Concurrent Session #320 
Understanding the Importance of the Multidisciplinary Approach to the Mangement of Spinal Cord Injuries
Cathy B. Thomson, MD
Billie Sillis, RN MSN ARNP

Spinal cord injuries are one of the most clinically complex situations that face members of the healthcare team. From the onset of injury, acute care, rehabilitation and reintroduction to everyday living, the journey is full of challenges, setbacks and more challenges, not only for the patient, but also for the physicians, nurses, therapists and family that make that journey with the individual. The speakers will review the anatomy, physiology, appropriate diagnostic testing for spinal cord injuries, the role of the nurse caring for this type of patient throughout the acute and rehabilitation phase and various problems and potential problems the patient may experience and the role of the LNC in evaluating the standard of nursing care the individual has a right to expect.

Concurrent Session #322 
Colleagues on Opposite Sides of the Fence
Kathleen Colfer, MSN RN BC
Elisabeth Ridgely, BSN RN LNCC

This session will be given by opposing expert witnesses on a medical malpractice case. There will be a brief description of the facts of the case and then each expert will discuss the development of her opinions. After reporting the outcome of the case the experts will discuss issues that may arise when colleagues and friends are on opposing sides of the same case.

Concurrent Session #324 (Repeat) 
Orthopedic Complications
Sharon Rennick, RN BSN CLNC

Ms. Rennick will present case studies of multiple orthopedic complications and discuss how they relate to medical malpractice cases from an expert witness point of view. Participants will learn the important symptoms related to Cauda Equina Syndrome and recognize documentation that is significant to changes in patient status and is related to orthopedic complications.

Concurrent Session #330 
Pharmaceutical Litigation Discovery and How Its Lessons Can Be Applied to Other Litigation
Russell Thornton, JD

Mr. Thornton will address key elements of discovery in pharmaceutical cases and the importance of evidence obtained from these sources for the three parties generally involved in pharmaceutical cases: claimants, manufacturers and prescribing physicians. In addition, Mr. Thornton will discuss how discovery resources commonly utilized in pharmaceutical litigation can provide important evidence for use in any personal injury claim.

Concurrent Session #331 
The Use of Evidence-based Clinical Practice within the Role of the Legal Nurse Consultant
Daniel Berman, RN MSN PsyD CPHQ

This session will discuss how the use of evidence-based practice and accepted National Standards of Care can be incoprorated in the practice of Legal Nurse Consulting. Participants will learn how to research and delineate evidence-based practice based on the medical discipline in question and present salient points related to the research to the attorney.

Concurrent Session #222 
Undermanagement of Pain in the Elderly
Margaret Wacker, RN BSN MS MA PhD

Undermanagement of pain in the elderly, particularly in long term care facilities, has reached public health reportable proportions. Understaffing and significant knowledge deficits in professional and assistive personnel are two key elements in this scenario. The speaker will discuss the negligent undermangement of pain and the morbidity of mismanagement of pain in an elderly population. Ms. Wacker will present case studies from her experience as a plaintiff expert witness and help attendees recognize the early signs of negligence in chart reviews.

Concurrent Session #340 
Liability Issues in OB/Neonatal Nursing
Camille DiCostanzo, RNC MS NNP

This session will inlcude an overview of hot topics in OB and neonatal nursing. Additionally, it will include areas of risk and strategies to mitigate these risks; specifically neonatal resuscitation, vaccuum extraction, Pitocin pitfalls, Hyperbilirubinemia and Kernicterus.

Concurrent Session #341 
Elder Abuse: Assessment and Litigation
Mitzi Wortman, RN

Ms. Wortman will review the legal documents associated with elder abuse issues and discuss how to identify signs of elder abuse and understand the purpose for restraining orders. This session will include definitions of financial, physical and emotional abuse. Additionally, the speaker will provide an outline on how to proceed in litigation involving elder abuse.

Concurrent Session #342 
Pitfalls for the Nurse Expert
Rebecca Cady, RNC BSN JD

Today's nurse expert is faced with potential pitfalls in expert practice. These pitfalls include issues related to qualifications, billing and records, preparation and testimony, as well as ethical and potential repercussions. When the expert does not avoid these it can impact the expert's practice and license. This session will identify the specific pitfalls facing the nurse expert, the consequences of failing to avoid them and will discuss ways in which the nurse expert can avoid them.

Concurrent Session #350 
Expedition for the Legal Nurse Consultant: Maps to Guide Your Internet Search
Kara DiCecco, MSN RN LNCC

Just as the stethoscope is an essential tool in nursing, the Internet is an essential tool in your LNC practice. With all the information available on the Web, LNCs who have the ability to locate and look into credible sources quickly, efficiently and in a cost-effective manner are undeniably respected and highly marketable. Regardless of your practice setting, independent or in-house/expert or consultant, the dynamic medical-legal environment requires the LNC to continuously adapt, optimize and organize their database of resources. Whether you are looking fo the secrets to medical-legal research, pearls of wisdom only the medical residents know, how to find reliable standards of care, the mysteries of "cybersleuthing" or just want to find that great website again, this fun and interactive session is for you!

Concurrent Session #351 
Life Care Planning and End of Life Issues
Valerie Parisi, RN CRRN CLCP

This session will address the use of life care planning in cases of oncology and other terminal illnesses such as HIV/AIDS or end stage diseases such as renal disease or cardiac failure. The speaker will demonstrate why a life care plan is essential in these cases to promote quality of life, even as life expectancy is significantly diminished. It can also help all interested parties understand the needs of those clients who are facing a terminal illness for the purpose not only of education, but also the consideration of medically appropriate and compassionate medical care when considering damages in these cases.

Concurrent Session #352 
Oh, The Places You'll Go: Taking Your Legal Nurse Consultant Career in New Directions
Melanie Osley, RN BS BSN MBA CPHRM DFASHRM

"Oh, the Places You'll Go" will increase the awareness of opportunities for the LNC that expand into the field of healthcare regulatory affairs. Today's promulgation of requirements with which healthcare entities must comply requires LNCs to interpret the overlapping disciplines of risk, quality, compliance, patient safety and patient satisfaction.

Concurrent Session #400
Preventing Abusive Head Injuries through Hospital-based Parent Education: The Pennsylvania Shaken Baby Syndrome Prevention and Awareness Program
Kelly Cappos, RN BSN CPUR CLNC
Carroll Rottmund, RN BSN CCRN CLNC

The speakers, two Pennsylvania Nurse Coordinators for the Shaken Baby Syndrome Prevention and Awareness Program, will address the history, incidence, cause, risk factors, signs and symptoms, diagnosis, treatment, consequences and most importantly, recommendations for the prevention of infant abusive head inuries, including shaken baby synmdrome. SBS program implemenation, roadblocks, investigation techniques, legal implications, common legal defenses, and documentation requirements for compliance to PA Act 2002-276, The Pennsylvania Shaken Baby Syndrome Education Act, will be discussed.

Concurrent Session #300
Surviving Sepsis
Sandra Bogenrief, RN BSN CLNC

Unfortunately, confusion between infection and sepsis is responsible for delays in identifying sepsis. This delay can and often does result in tragic outcomes. There are better defined standards in this area now being encouraged. Sepsis is found in every venue of nursing. Ms. Bogenrief will examine what we must know to understand, identify and treat sepsis. In addition, she will describe the five symptoms of Systemic Inflammatory Response Syndrome (SIRS) and explain the key differences between SIRS Sepsis, Severe Sepsis, and Septic Shock. This knowledge will help an LNC to better evaluate whether standards of care were followed.

Concurrent Session #402
Deposition and Trial Testimony: The Good, the Bad and the Ugly - Part 1
Patricia Calhoun, ASN BA JD
Suzanne Collins, PhD JD MPH
Daneil McAuliffe, LHCRM BSN JD
Cynthia Mikos, BSN MBA JD

Part 1 of 2: Members of the Tampa Chapter of the American Association of Nurse Attorneys will provide a panel session on preparing and testifying at depositions and trials as a fact witness, defendant or expert. The session will include mock testimony of a nurse at deposition and trial. Also, the panelists will discuss the special concerns applicable to licensed individuals such as nurses and the risk of licensure complaints and criminal charges associated with adverse incidents, alleged malpractice and testimony.

As long term care cases continue to gain in popularity in the legal arena the legal nurse consultant is increasingly more valuable in investigating, evaluating and preparing cases for trial. A current in-house legal nurse consultant team and an experienced long term care trial attorney will present current trends in the nursing home and assisted living industry and the process of how they prepare and defend these long term care cases.

Concurrent Session #411
Deposition and Trial Testimony: The Good, the Bad and the Ugly - Part 2
Patricia Calhoun, ASN BA JD
Suzanne Collins, PhD JD MPH
Daneil McAuliffe, LHCRM BSN JD
Cynthia Mikos, BSN MBA JD

Part 2 of 2: Members of the Tampa Chapter of the American Association of Nurse Attorneys will provide a panel session on preparing for and testifying at depositions and trials as a fact witness, defendant or expert. The session will include mock testimony of a nurse at deposition and trial. Also, the panelists will discuss the special concerns applicable to licensed individuals such as nurses and the risk of licensure complaints and criminal charges associated with adverse incidents, alleged malpractice and testimony.

Concurrent Session #412
Forensics and the Link to Violence, Trauma and Injury
Ellen Plummer, DL MJ RN BSN CCRN

The relationships between violence, traumatic injury and the healthcare environment are recognized as significant problems throughout the world. Interpersonal violence is identified as a serious publich health concern, yet profound deficits exist in the healthcare environment to deal with this epidemic. Road traffic injuries alone are on the rise and are becoming a leading cause of the global disease burden. This two-part session will emphasize the differences between blunt and penetrating trauma using the principles of physics and forensics in the analysis of clinical injuries. Part 1 will address violence and intentional injury, ballistics, wound identification and the importance of forensic evidence collection and preservation. Part 2 will address non-intentional inuries, crash and fall dynamics, missed injuries and the use of forensics in identifying blunt traumatic injuries and in evidence collection. Short case studies will be threaded throughout each session.