Jean Marie McKinney

As I conclude my final blog entry for the LNC mentorship I find it interesting that this blog is actually about the mentorship where I accumulated most of my hours. I had the privilege of working in The Law Offices of Martin J. Siegel. This firm is a full service firm with experienced attorneys who specialize in a variety of areas. Mr. Siegel was formerly a partner with the Law Offices of Doroshow, Pasaquale, Krawitz, Siegel and Bhaya in Wilmington. He was the managing associate and then managing partner of the firm’s New Jersey office. Presently Mr. Siegel is the principal owner of The Law Offices of Martin J. Siegel located in New Jersey and Delaware. Mr. Siegel’s practice focuses on plaintiffs’ tort litigation and defense of criminal matters. He has extensive training as a civil mediator and arbitrator. He is also an Adjunct Professor in Alternate Dispute Resolution at Widener School of Law.

     I was fortunate that Mr. Siegel afforded me the opportunity to develop a chronology for a medical malpractice case. This was definitely a challenging assignment. Even though I have experience in medical record review it is a very different process when you are presenting the information to someone outside the medical profession. Mr. Siegel does, however, have an impressive body of medical knowledge. Hopefully the information that I prepared will be helpful in the progression of this legal case. I am grateful to Mr. Siegel and to his staff for allowing me to participate in this exercise in his private practice.  

     In order to complete the requirements for the Legal Nurse Consulting Program the student is required to spend time with three different mentors. As part of this requirement I spent time with Lynda Kopishke. Lynda certainly has a diverse, varied and interesting legal practice. She manages to balance her legal practice along with her managerial position at Interim Healthcare.

     Interim Healthcare is a temporary healthcare agency where Lynda has established a litigation support division. Through the litigation support division Lynda and her staff of other LNCs provide services in the areas of forensic analysis, expert witness and consultation, medical literature searches for attorneys and life care planning services.  

     During the time I spent with Lynda I had the privilege of observing, discussing and participating in researching the standards of care, product liability, and preparing a case for testimony by the expert witness. I found it most helpful to observe this talented mentor take a case from the very beginning and progress through the analysis phase and gather the appropriate research and supporting documentation for the requesting lawyer.  

     I am grateful to Lynda and the staff of Interim for taking the time from their busy schedule to assist me in my educational pursuits. 

     At the conclusion of my LNC educational experience I had the privilege of observing a mentor who is personable, talented, and gives multitasking a new meaning. The mentor that I am referencing to is Kara DiCecco. Kara is employed full time at the law firm of Doroshow, Pasquale, Krawitz & Bhaya. She is a woman of many talents. Kara is a registered nurse with a Master’s Degree in Nursing, and is a Legal Nurse Consultant Certified. Doroshow, Pasquale, Krawitz & Bhaya advertises Kara’s position on their web site. Specifically the firm states under the medical malpractice section”… Our firm offers free initial consultation to discuss your case. Once you call, our staff, which includes experienced trial attorneys and a paralegal that is also a Registered Nurse, will fully investigate your claim…” Kara is involved in reviewing medical records, screening cases for merit, assisting with the development of medical exhibits for trial and securing expert witnesses.

     In addition to working at the law firm Kara works part time at a medical aid unit and teaches at two institutions of higher learning. On one Saturday when Kara took two LNC students she showed us how she combines these multiple positions. In the midst of teaching the LNC students about worker’s compensation, she squeezed in a teaching session to undergraduate nursing students about basic cardio pulmonary resuscitation. This was not only a valuable lesson for the nursing students but also an excellent refresher for this LNC student. 

     Kara is also involved in the national association of LNCs. Presently she is the president of the Delaware chapter of the AALNC. She is on the editorial board for the Journal of Legal Nurse Consulting and edits articles for this peer reviewed journal.   

     I have only included some of the multiple tasks that Kara completes in a day. However Kara completes all of them with ease, proficiency and a never ending desire to teach and assist students, consumers and clients. How lucky I was to spend some time with her.

Workers Compensation

     As part of a mentorship with a legal nurse consultant practicing in a law firm, we reviewed (in part) the Worker’s Compensation Act and Rules for Delaware. These laws can vary from state to state.

    Employers must provide Workers Compensation coverage to their employees. In Delaware the Workers Compensation Law is administered by the Office of Workers Compensation within the Department of Labor. This law provides for income replacement and compensation for reasonable and necessary medical treatment without the burden of having to establish fault.

    Additionally, the State of Delaware currently allows for the determination of permanency for those workers who are evaluated to determine if they have suffered a permanent loss of function, as well as criteria for those who are disfigured from the injury or subsequent surgery related to the work injury.

    Governor Minner included in her economic development plan reform of the current system of workers compensation. It would certainly be a challenge to provide adequate coverage to injured workers since the proposed changes are drastic. Ensuring fair and objective medical treatment without imposing undue burdens on employer would be the ideal compromise.

    As recently as June 29, 2006 business and labor leaders met in Dover  to work toward reform in the workers compensation system. At one point the Governor mandated that the legislative houses would not be allowed to adjourn until the bill was passed. However this demand was unsuccessful. Hopefully efforts toward a more reasonable reform will resume when the legislative sessions resume.    

        As a student in the legal nurse consulting program I had the opportunity to observe a portion of a trial. This trial dealt with a mother who was charged with felony assault by abuse or neglect for recklessly causing serious physical injury to her child, and first degree reckless endangering. Interestingly this 30 year old mother is a nurse. 

     The State presented two expert witnesses who testified that the accused was diagnosed with Pediatric Condition Falsification (PCF). PCF is a medically accepted condition whereby the caretaker engages in lying or creating symptoms of an underlying illness. Specifically in this case the State accused the mother of injecting human feces into the child’s bloodstream.

     The State also presented the child’s medical history which included multiple hospitalizations under the age of two years. It was also reported that the mother kept numerous records pertaining to the child’s episodes of vomiting and diarrhea. She sought prescriptions from the pediatrician for multiple laxatives. Additionally the state presented a time line that showed when the mother researched medical symptoms in her computer that corresponded with the child’s hospital admissions.

     A local newspaper followed the trial and published the trial’s events each day. This trial resulted in a hung jury. The status of an appeal (if any) is unknown at this writing. 

      This truly is a sad outcome because if the child is actually at risk he is returning to a home where he is still in danger. Hopefully the State is re-evaluating how they can gather evidence with a greater direct link to the accused.

     If the accused was truly innocent this cloud of suspicion still follows her. She has lost her job and spent thousands of dollars to defend herself against the medical and legal system. Tragically her son has spent months in foster care with unknown psychological consequences.