AALNC 2010 National Educational Conference
Invest in Yourself
March 24-27, 2010
Westin Pittsburgh
Pittsburgh, PA

Concurrent Session Descriptions

Thursday, March 25
Friday, March 26
Saturday, March 27

THURSDAY, MARCH 25 10:15 a.m. - 11:15 a.m. Concurrent Session #201 Litigation Focus: Medication Side Effects and Dangerous Adverse Reactions Cathy Weitzel, MSN ARNP BC, Advocates for Behavioral Health, PA & Wichita State University (Instructor) Weitzel will discuss the side effects of psychotropic and other medications, centering on akathisia, extrapyramidal symptoms (EPS) and tardive dyskinesia. Other topics that will be covered include FDA black box warnings about the induction of suicidal thoughts with Singulair®, all antiepileptics, and selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRI) antidepressants. Also, Weitzel will review dangerous adverse events such as Steven-Johnson's Syndrome.   Concurrent Session #202 Technology in the Courtroom R. Matthew Hanak, JD MBA, Precise, Inc. Hanak will provide an analysis and exploration of juror expectations in modern trials, and will discuss ways to meet such expectations with the use of presentation technology. He will outline the use of demonstrative aids, including medical illustrations and animations, and the best practices to employ them. Finally, Hanak will present a myriad of samples from recent trials, including current technological developments in the use of videotaped discovery deposition testimony and digital medical records.   Concurrent Session #203 No One Should Ever Die From Acute MI - Fact or Fantasy? Jerome E. Granato, MD, Allegheny General Hospital Gain an introduction to the pathogenesis of acute MI and current treatment modalities. This presentation will discuss the physiologic mechanism that results in myocardial infraction. Granato will develop the basis of using the various reperfusion strategies, including thrombolytic therapy and emergent angioplasty. A review of the current outcomes data for treatment of acute myocardial infraction will be conducted. Clinical context will be applied to the AHA/ACC recommendations for treatment as they might apply to the standard of care. 11:15 a.m. - 1:15 p.m. Networking Lunch Session #210 Growing Your Network Dana Jolly, BSN RN LNCC, Jolly Consulting, LLC (Optional; Ticket Required; $50 per person) Jolly will discuss best practices for building and expanding your professional network, including strategies for expanding your client base and networking etiquette. Increase your "networking confidence" by participating in impromptu role-plays moderated by the speaker. You may just get a new client out of it! 1:15 p.m. - 2:15 p.m. Concurrent Session #220 Mediation as an Alternate Form of Dispute Resolution Richard M. Golomb, Golomb & Honik, PC Golomb will provide an overview of Alternative Dispute Resolution, review trends resulting in the increased use of this mediation process and discuss how the process is used in medical malpractice cases. He will summarize the goals of mediation and the differentiation between the plaintiff and defense perspective. Additionally, Golomb will review the roles of an LNC in the mediation process, including literature research, medical exam observation, liability analysis and best practices for reviewing economic and non-economic damages. Golomb currently serves as Secretary of the American Association of Justice, the professional national association for Trial Attorneys. In addition to serving on their Leadership Team, Golomb has served on the AAJ Board of Governors for the past six years.   Concurrent Session #221 Welcome to the Emergency Room: Have a Seat and Call Your Lawyer Michael Frank, MD, TMP Medical practice risk managers are turning their attention to emergency department processes that lead to bad results, as well as liability claims. Incidents of patients dying in emergency waiting rooms have garnered national media attention and have forced hospitals and emergency medicine groups to reassess the operational processes that lead to such results. Frank will address these and other operational issues.   Concurrent Session #222 Forget Me Not: An Overview of Alzheimer's Disease and its Associated Legal Conundrums Jonathan Liss, MD, Medical Research & Health Education Foundation, Inc. Dr. Liss will present an overview of Alzheimer's disease and discuss the effect of Alzheimer's on the family unit, along with the many reasons why lawsuits surround patients with this disease. As the population ages, many families across the country will be affected by Alzheimer's Disease. Yet, most people have very little understanding of its presentation and course. This lack of knowledge often creates strained relationships between family members. These strains are often projected on the healthcare provider and/or the assisted living environment. The emotional and financial burden of this disease often wrecks havoc on the family unit. This presentation will give an overview of the disease and through real life examples and show how and why the legal system is frequently involved. 2:45 p.m. - 4:00 p.m. Concurrent Session #230 The Joint Commission - Changes Just Keep Coming Susan Mellott, PhD RN CPHQ FNAHQ, Mellott & Associates The Joint Commission has once again reorganized their accreditation standards. In addition to adding five new chapters they have changed the numbering and scoring systems and the National Patient Safety Goals are included in these changes. Mellott will discuss these changes, the standards that are most frequently cited and how all these changes impact the LNC.   Concurrent Session #231 Life Care Planning: A Reality Show Patricia Costantini, RN MEd LPC CRC CCM CLCP LNCC D-ABVE, Costantini Rehab, Inc. Reality television features ordinary people in sometimes unusual or extraordinary situations. The life care plan focuses on an individual who has a catastrophic injury or complex medical condition. Life care planning reports and testimony involve a variety of ordinary people, including the plaintiff, the life care planner, the medical professionals, the attorneys, the judge and the jury. Costantini will examine the practice of life care planning in complex legal, medical and ethical situations. Discussion will focus on the challenges a life care planner faces in providing expert testimony about people with disabilities, who actually live in the real world. There will be lively conversation regarding the strategies and alliances used by life care planners to "get the votes."   Concurrent Session #232 The Criminal Prosecution of Healthcare Providers: Implications for Nurse Attorneys and Legal Nurse Consultants Edie Brous, RN MS MPH JD. Recent criminal charges against nurses create worrisome implications for patient safety. Unintentional human errors occur in clinical practice and are inevitable. The vast majority of errors reflects system problems that need to be addressed. Harm to patients can be reduced or avoided only when modern safety theory is used to respond to adverse events. While it is essential that errors be reported and analyzed, punitive approaches deter error reporting and endanger patients by allowing latent failures to continue. The fear of criminal charges undermines an organization's attempts to create a culture of safety and improve dangerous systems. Criminal prosecutions have a potentially chilling effect on error reporting and analysis and accelerate the shortage of healthcare providers. A review of several cases will demonstrate the political nature of these indictments and the destructive impact they have on patient safety. Brous will present ways for AALNC and TAANA to become involved in this issue. 4:15 p.m. - 5:15 p.m. Concurrent Session #250 The Case of Too Many Complaints Robert L. Bell, MD MA FACS, Yale-New Haven Hospital Co-Speaker: John C. Conti, Esquire A physician expert and defense attorney will demonstrate how to analyze a case and diminish damages using plaintiff's complaints versus anatomy.   Concurrent Session #251 Why Are ICD-10-CM and ICD-10-PCS Important to the LNC? Jennifer Hutter, RN, MedSearch Legal Nurse Consultants ICD-10-CM and ICD-10-PCS will be improved tools for the LNC who is reviewing the medical records related to billing and medical necessity. These new tools will increase the detail that will help him/her clarify the connection between a provider's performance and a patient's condition. In addition, ICD-10-CM greatly expands the codes for medical complications and medical safety issues. The increased specificity of the codes will make it easier to compare reported codes with clinical documentation, check for consistency between diagnosis and procedure codes and check for illogical combinations of diagnoses. The use of ICD-10-CM and ICD-10-PCS thus also may help reduce opportunities for fraud and improve fraud detection capabilities.   Concurrent Session #252 Criminal Law: Job Security in America Brenda Ewen, RN MSN D-ABMDI CFC CFN, Forensic Nurse Consultants Co-Speaker: Joseph A. Gabay, Esquire Legal nurse consultants wishing to increase their case load may find a niche in criminal law. Nurses can provide critical input to prosecutors and defense attorneys when dealing with criminal offenders and victims, trauma and autopsy record analysis, expert witnesses and trial strategy development. Ewen and Gabay will review cases involving murder, rape, domestic violence and child abuse as examples. They also will discuss the necessary base of knowledge to begin working in the criminal field, the basics of the trial procedure and strategies for getting started in the field. Back to top FRIDAY, MARCH 26 8:00 a.m. - 9:00 a.m. Concurrent Session #300 Opportunities for the LNC within the Insurance Industry Kathy Ferrell, BS RN LNCC, Ferrell Consulting Mrs. Ferrell will explain why and how insurance contracts are written for certain insurance carriers (e.g., life, health, auto). A brief description of the term "contract benefits" will be presented, then discussion will move to the roles that legal nurse consults can play in interpreting contract benefits and facilitating allowed services to be provided and paid by the insurance company. Ferrell will clarify the impact that fraud and abuse has on this unique industry and ways in which insurance bills are examined for fraud. Additionally, she will share some ways in which her experiences in the insurance industry have enriched her legal nurse consulting practice.   Concurrent Session #301 Wound Care Litigation: An Analysis of Real-world Defense and Plaintiff Cases Diane L. Krasner, PhD RN CWCN CWS BCLNC FAAN, WOCN/Special Projects RN Rest Haven Co-Speakers: Karen Lou Kennedy-Evans, RN CS NP Mary T. Bruno, RN CWS CFCN FACCWS DAPWCA This panel of wound experts, who also serve as expert witnesses for wound care, will analyze three defense and three plaintiff wound care cases. Discussion will focus on issues surrounding federal regulations, such as the Hospital/Acquired Conditions/Present on Admission Policy for Acute Care and Tag F314 for Long Term Care. Other areas to be addressed include two new documents: EPUAP/NPUAP International Guidelines for Pressure Ulcers (2009) and Skin Changes at Life's End (SCALE): Final Consensus Statement (October 1, 2009).   Concurrent Session #302 Patient Safety, Risk Management and Evidence-based Practice Guidelines Cynthia Lacker, RN MS LNCC, ECRI Institute; Lacker & Associates Risk management and patient safety often are separate specialties in hospital settings, sometimes with seemingly competing interests. While risk management aims to reduce facility liability, improving patient safety often incurs significant facility cost. This session will include a discussion of how these disciplines interact, how LNCs can use their knowledge of risk management and patient safety principles to evaluate both plaintiff and defense cases and where evidence-based guidelines fit in. 9:15 a.m. - 10:15 a.m. Concurrent Session #303 Whistle-blower Litigation and Risk Management: What You Need to Know David Douglass, Esquire, Partner and Co-Chair of the Government Enforcement and Compliance Practice, Shook, Hardy & Bacon Douglass will provide an overview and explanation of federal and state whistle-blower laws to educate legal nurse consultants on legal, practical and policy issues in whistle-blower litigation and risk management. Douglass serves as Secretary on the Governing Council of the ABA Health Law Section.   Concurrent Session #304 Common Issues Surrounding IV Negligence Suits Holly Bedgio, RN-BC BSN CRNI CWS CLNC The administration of intravenous therapy subjects patients to numerous risks, some of which can be life threatening. Many complications can be prevented with early detection, thorough monitoring and meticulous catheter care. Due to the growth and increasing complexity of IV nursing, the greatest level risk for nurses practicing this specialty is negligence. The specialized therapies and equipment variations needed to serve patients receiving IV services in both the acute care and alternative care setting (i.e. home health care) has generated an evolution in the infusion equipment market. Nurses must be knowledgeable about the equipment and therapy modalities administered and, in the alternative care setting, are responsible for teaching the patient/caregiver self administration. The role of the LNC is to be knowledgeable with the potential areas of negligence related to intravenous therapy and be familiar with the myriad of applicable standards involved in delivering safe, competent intravenous nursing care. The location where the care is provided, qualifications of the nurse, therapy administered and type of products/devices involved all influence the applicability of the standard.   Concurrent Session #305 The LNC and the Accident Reconstructionist Pat Carroll, RN BSN LNC CAISS, Exponent Failure Analysis Associates Discover how the LNC works with biomechanics engineers and accident reconstructionists to provide pertinent information for the investigation of personal injury claims resulting from various types of events. Carroll will discuss how the LNC can develop medical chronologies and injury diagrams for use by the engineering expert in the investigation of the event and accident reconstruction. 10:45 a.m. - 11:45 a.m. Concurrent Session #310 Proving Medical Causation in Product Liability Cases Kathleen Guilfoyle, Esquire, Campbell Trial Lawyers Guilfoyle will explain the significance of medical causation in product liability cases and identify two roles for legal nurse consultants in product liability. Guilfoyle is an active member of International Association of Defense Council (IADC), a preeminent organization of lawyers providing litigation services and counsel to corporations and insurers worldwide.   Concurrent Session #311 Living Will, Do Not Resuscitate...Dead People Don't Sue Janet Colville, MSN RN, CCAC Allegheny Campus Robert Colville, JD, Superior Court Judge The Colvilles will examine advanced directives and use of the do not resuscitate directive, and will present case law that addresses these end-of-life issues. They also will provide information regarding the differences between these directives, and discussion will center on the ethical and legal consequences of misinterpreting, and failure to comply with, advanced directives.   Concurrent Session #312 Importance of Medico-Legal Illustrations in Case Presentation Jon Coulter, MA, Certified Medical Illustrator, Coulter Medical Art Case-specific medical-legal illustration can make complex scientific issues understandable to the juror. While generic images can be valuable, especially when demonstrating common anatomy or injuries, they also can be misleading. The physical condition of the plaintiff at trial time can be misconstrued, as the injury may be internal and/or healed. Additionally, images drawn directly from textbooks or other sources seldom address a plaintiff's actual problems, as they frequently provide too much visual clutter for the juror, or they may not even begin to address the range of issues involved in a complex case. Surgical processes seldom follow the precise steps outlined in a textbook due to variations in anatomy and medical problems being addressed. Illustrations based on diagnostic images and operative reports provide a much clearer idea of what actually transpired during a procedure. 11:45 a.m. - 1:15 p.m. Power Lunch Session #313 (Optional; Ticket Required) Polish Your Writing: Reports with Impact Pat Iyer, MSN RN LNCC, Med League Support Services, Inc. Attorneys judge LNCs by their work product. Are your reports well-written, professional and detailed? This presentation will help you critique and improve your work. Improved reports can lead to more cases and greater client satisfaction. 1:15 p.m. - 2:30 p.m. Concurrent Session #320 The Future of Litigation: Trends, Economics and the Impact on LNCs Henry M. Sneath, Esquire, Picadio Sneath Miller & Norton, PC Litigation is changing. Tort filings are down in many places. Companies are more cost conscious than ever. What are the latest litigation trends and how will they impact the staffing of litigation matters? How can legal nurse consultants find opportunity in this changing environment, and where can they find new avenues of business? Sneath is the First Vice President of DRI, The Voice of the Defense Bar - the world's largest organization of civil litigation defense attorneys. He brings a national perspective to the issue of the future of litigation and will present the results of studies conducted by DRI regarding trends and legal economics and their impact on litigation strategy and cost. He also will speak about marketing techniques, business development best practices and strategies for LNCs to capitalize on market trends.   Concurrent Session #321 Bad Baby Cases: What the Non-OB LNC Needs to Know Joellen Klohn, RNC-OB C-EFM LNCC, Hill Country Consulting This presentation is designed for LNCs without an OB background. Klohn will discuss medical documents that are vital to any perinatal case, general areas of liability, applicable standards of care and the importance of statute of limitations in any OB case. By understanding the important issues related to OB cases, non-OB LNCs can assist attorneys in obtaining relevant documents and locating nursing experts.   Concurrent Session #322 End-of-Life Care and Decision Making in Dementia Ilene Warner-Maron, PhD RN-BC CWCN CBN CALA NHA, Alden Geriatric Consultants, Inc. In this presentation, Dr. Warner-Maron will discuss three ethical principles which are the foundation of ethics and show how ethical issues can arise in the care of demented patients. This presentation will also discuss the components of the ethics committee. The role of the Ombudsman and federal/state regulations in the use and development of ethics committees will be examined. Moreover, this session will examine how recent media issues shape society's views of end of life decisions, who and how end of life issues should be disseminated, and how end of life policies and procedures should be formulated. 4:15 p.m. - 5:30 p.m. Concurrent Session #340 There is Always a Flip Side: Evaluating Both Sides of a Case Donald Fann, JD, Fann & Petruccelli Co-Speaker: Madeline Good, RN MSN LNCC To defend or prosecute a case, the LNC must step aside, examine the opposition and readily acknowledge the allegations. Additionally, he/she cannot dismiss other options, discovery findings and legal issues when analyzing the case for the attorney. Rather, the LNC must utilize medical records, evidence and discovery information to develop a case defendable from both the plaintiff and defense sides to ensure there are no surprises during the litigation process. Using that information, the LNC can assist the attorney with developing case strategies for trial.   Concurrent Session #341 Nutrition: A Key To Successful Case Evaluation and Merit Janet McKee, MS RD CSG LD/N DAPWCA, Nutritious Lifestyles, Inc. Nurses are very aware that nutrition affects all aspects of life, from beginning to end. Unfortunately, 40-85% of patients and residents in healthcare settings experience protein-calorie malnutrition, which negatively affects patient or resident outcomes. McKee will provide the nurse expert with the knowledge and tools to determine if nutrition is a key issue in case evaluations and the merit process.   Concurrent Session #342 Medicare Compliance: What the LNC Needs to Know Bridget Smith, MA JD, Dickie McCamey & Chilcote Co-Speaker: Charles Brown, Esquire, JD Smith and Brown will explain what Medicare compliance means and how it impacts the handling of the medical and legal elements of a case. Back to top SATURDAY, MARCH 27 8:00 a.m. - 9:15 a.m. Concurrent Session #400 Eye Injuries: Understanding and Evaluating Visual Loss Joseph Citron, MD JD Citron will present ophthalmic injuries in the context of structural, neurological and visual components, along with a method to determine the value for the losses.   Concurrent Session #401 Integrating Healthcare Reimbursement with LNC Work Including LCPs, Damage Determinations and Fraud Examination Rebecca Busch, RN MBA CCM CFE FIHFMA FIALCP, Medical Business Associates Busch will provide an overview of how money can solve a medical malpractice mystery or fraudulent false claim, determine appropriate damages and be used to predict the actual cost of a future service. Attend this session to learn what you need to do to expand your expertise on integrating money concepts into your practice.   Concurrent Session #402 The Making of an Expert Witness: Benner's Novice to Expert Model Frances W. "Billie" Sills, MSN RN ARNP LNC, East Tennessee State University Benner's model provides an essential understanding of how knowledge and skills are acquired and how we can directly apply it to nursing practice, education, research and administration. Her initial research attempted to uncover and describe knowledge embedded in nursing practice. The use of the Dreyfus model of five levels of competency provides the concepts needed to differentiate between what can be taught by precept and what must be learned from experience. Benner believes that skilled pattern recognition can be taught and will lead to advancement through stages. Both experience and mastery are necessary for a skill to be transformed to a more advanced one. During this presentation, Sills will use clinical examples to demonstrate each step, as well as the learning needs and styles at different levels of skill acquisition. 9:30 a.m. - 10:45 a.m. Concurrent Session #410 Epidural Hematoma: Issues from an LNC's Perspective Cheryl Gatti, RN BSN LNCC, Lark & Gatti Medical Legal Consultants Jude Lark, RN BSN CCRN An epidural hematoma is a complication associated with poor patient outcomes if not immediately diagnosed. More surgeries and procedures, including pain management with epidural catheters, are being performed and have the potential for the development of epidural hematomas. As LNCs, we are seeing an increase in the number of cases associated with a failure to diagnose or a delay in diagnosis of the hematoma. For the LNC reviewing cases involving epidural hematomas, it is imperative that he/she understand the pathophysiology, co-morbidities that increase the risk and the types of patients who are at risk. It also is important that the LNC be knowledgeable regarding the standards of medical and nursing care related to spinal procedures and epidural catheters.   Concurrent Session #411 Negligence in Home Healthcare Holly Bedgio, RN-BC BSN CRNI CWS CLNC, Matrix Homecare With the onset of managed care and Medicare cuts, patients are being discharged quicker and sicker than ever before. Consequently, the home healthcare industry is growing by leaps and bounds as more patients are choosing to be cared for at home. This means the responsibility for care is passed to family caregivers who may not always be able to provide care in a safe and effective manner. Home healthcare is a provision of intermittent skilled nursing care, as well as other skilled care services such as physical, speech and occupational therapy and medical social services ordered by the physician. Home healthcare agencies are certified to make certain they meet certain federal and safety guidelines. Bedgio will cover some of those guidelines and discuss how, in some cases, the patient also is eligible for other services, such as medical social worker and home health aides. Knowledge of the basic rules of home care is essential for the LNC to determine if deviations in care have occurred; therefore discussion also will focus on what the law requires to provide safe, competent care at home, and what the responsibilities of the home health agency are regarding provision of care, supervision and patient education. Many complications can be prevented with early detection, thorough monitoring and communication with the physician. As deviations in any of these areas can lead to negligence, Bedgio will focus on litigation with respect to appropriate care rendered in the appropriate setting.   Concurrent Session #412 An Introduction to Marketing for the LNC Chris Rokosh, RN LNC, CanLNC Education Megan Rokosh, BCOM, Hot Sauce Communications Discover some of the basic principles and practices of marketing specific to the LNC. Basic marketing framework will be shown as well as specific "marketing commandments" for LNCs. The discussion will cover market research, with definitions and examples, and client contact, with specific tips for LNCs to use. A portion of the presentation will be dedicated to empowering LNCs to use personal development as a marketing tool as well, and to continue to refine their skills to increase their chances of success in legal nurse consulting. Back to top       Back to index page