Volume 25, Issue 3                                                                                                                            Summer 2014


President’s Message

Abby Davis, BSN, RN, CLNC

I’ve learned many tools over the years as a LNC, including to dress professionally, to keep organized, and to prioritize. It’s just as important to network. Networking is an integral part of our job as a legal nurse consultant. We are constantly networking to find experts in every medical/nursing specialty, meet new attorney-clients and win possible cases. Strike up a conversation with your neighbor, in the airport, or in the grocery store line. Meet as many people as you can when you go to professional conferences. Carry business cards and exchange them. This is not the time to be shy. You need to get your name out there. That’s why I have always found it important to keep in contact with people near and far. You never know when you will need the expert you met several years ago. I have recently changed positions and I’ve met up with some former experts that I used years ago. It really is a small world and keeping up friendships and professional relationships are vital.

Several months ago, instead of the typical format of a “Lunch and Learn” during our bimonthly gatherings, we hosted a networking lunch and had record attendance! I’ve heard from many of you that you thought this was a valuable encounter and we will continue to host this on an annual basis.

If you are a new LNC or are considering a career change into this field, I encourage you to become involved in any and all groups available to you in your area and your field. Attend webinars at the National level and attend specialty meetings. The AALNC Phoenix Chapter welcomes all LNCs and anyone considering a career within this branch of nursing. Come to our meetings and participate. Meet potential experts and fellow LNCs, who have been in the business for years. If you are a seasoned veteran, it’s time you finally met on the LNC you have been emailing with for years! Having that personal connection will change your relationship for the better.

See you at our next luncheon in September!


Member’s Spotlight – Yvette Padilla, RN

Save the Dates – September 9, 2014 Chapter Luncheon

Forensic Nursing - Melissa Becker, RN, CFN

Education Luncheon s & Recognition

Daphne Press, RN - Carboxy-Tetrahydrocannabinol

Case Law - Arizona Public Records Law

Member’s Spotlight

By Carolyn Kjer, MSN, RN, LNCC

Yvette Padilla, RN  AALNC Phoenix Chapter Member & Website Chair


Yvette Padilla joined the AALNC Phoenix Chapter just over a year ago and jumped right in, joining the board of directors in 2014. “After attending several luncheons, I decided to become a board member to be more involved with AALNC Phoenix Chapter,” says Yvette. Yvette is new to legal nurse consulting and joined the AALNC Phoenix Chapter in June 2013. She graduated from Glendale Community College with an Associate Degree in Nursing in 2003 and received a Certified Legal Nurse Consultant certificate from the Vickie Milazzo Institute in 2013. Most of Yvette’s clinical career has been spent in labor and delivery, where she spent nine years.My most rewarding experience as an RN is working labor and delivery,” Yvette says. “It is wonderful to be a part of a patient's joy in welcoming their baby to the world.” She also spent a year in ambulatory care and one year as director of nursing in a nursing home. Yvette has a daughter who is a junior in high school. When not working, she is preparing to compete in a half-marathon in November. “I am excited to be a board member and hope to be able to revamp the website,” Yvette says. Information on Yvette’s practice is available at https://padillaconsultants.com/.

AALNC Phoenix Chapter 2014 Board

President: Abby Davis


President Elect: Daphne Press


Past President: Lorie Matlick


Secretary: Gerrie Springston


Membership and Director at Large: Pat Carroll


Director at Large: Joy Lawson


Treasurer: Cathy Beasley


Education Chair: Jean Cooper


Website Chair: Yvette Padilla


     Newsletter Chair: Carolyn Kjer


Save the Dates!


Tuesday, September 9, 2014 – AALNC Phoenix Chapter CEU Luncheon

                                 11:30 -12:00          Lunch and Networking                   FEE: $35.00

12:00 – 1:00           Speaker: Lois Hawkins, RN, CLCP


Topic:      Life Care Planning Navigating Medical Damages in
Personal Injury

Location: Hilton Garden Inn, 4000 N. Central Ave., Phoenix, AZ 85012

The purpose of this activity is to educate the attendee regarding the elements of a life care plan, life care plan methodology and standards of practice and when a life care plan is needed in a personal injury case.

AALNC 2014 National / Chapter Education Opportunities

Earn CE Credits through AALNC's Monthly Educational Webinars

Who: AALNC Members/Non Members

What: Educational Presentations LIVE via Webinar

Where: On your own computer

When: Monthly (schedule listed below or check http://www.aalnc.org/events/event_list.asp)

Why: To continue to be the preeminent educational resource for LNCs across the country!

Aug. 5       AALNC Webinar: HIPAA - What Every LNC Needs to Know

http://www.aalnc.org/events/event details.asp?id=463027

Oct. 18     AALNC San Diego Chapter Fall Seminar. Agenda: Report Writing for the Defense Attorney & the Plaintiff Attorney; Understanding the EMR; & Computer Research. http://aalncsandiego.org/conferences

Oct. 24     AALNC Greater Baltimore Area Chapter. Legal Nurse Consulting: The Basics and Beyond. http://www.aalnc.org/events/event details.asp?id=477729

April 2015 AALNC Legal Nurse Consulting Education & Networking Forum, Indianapolis, IN


Also available are AALNC Online Courses. Information can be found at the AALNC website: http://www.aalnc.org/default.asp?page=ConsultOnlineCourse

Additional LNC Education / Conference Opportunities

Anytime Documentation, Part 2: The Best Evidence of Care. Lippincott Nursing Center http://www.nursingcenter.com/lnc/journalarticle?Article ID=727907

Oct. 22-25 International Conference on Forensic Nursing Science and Practice, Phoenix, AZ
http://www.forensicnurses.org/events/event details.asp?id=417031


M Becker

Forensic Nursing


Melissa Becker, RN, CFN
Certified Forensic Nurse

Forensic Nursing is a specialized area of nursing that encompasses many different job descriptions depending on one’s area of practice. In its most basic format, forensic nursing is the application of nursing expertise to medical legal aspects of a case that is involved in a legal process. The American Nurses Association defines Forensic Nursing as a combination of assessment and investigative principles. Many “experts” would limit the definition of Forensic Nursing to those nurses who provide direct patient care; yet there are those of us who serve more of an investigative role than patient care provider. Emphasis on patient care can create areas of bias and conflict that do not exist in roles such as mine, which are purely fact based.

I started my Legal Nurse Consulting practice in 1997 doing the typical medical legal cases involving civil litigation such as medical malpractice, personal injury, wrongful death, and etc. In my search for the required CEU’s for my nursing licensure, I sought out more interesting courses that would fulfill my requirements while also expanding my knowledge. I attended a seminar provided by the local coroner’s office entitled “Bullets and Bandages” which discussed gunshot wounds, sharp and blunt force injuries and other exciting topics. After the seminar I approached the presenter and told her I would be interested in working with them if ever they needed additional investigators. Less than a week later I received a call to start the application process for being a Deputy Coroner with the local coroner’s office investigating all deaths that occurred outside of a healthcare facility.

As a part of my role as a Deputy Coroner, I was advised to take a course and seek certification through the American Board of Medicolegal Death Investigators. With this new certification under my belt and my expanding experience with death investigations, I added a new dimension to my usual LNC services. This resulted in my name being circulated on various “lists” as a medical legal expert, which led me to my first criminal case. I developed and crafted my “process” for reviewing criminal cases, I began providing educational seminars to the local criminal defense attorneys and their support staff and thus my criminal casework grew.

As a LNC who works behind the scenes I have the advantage of knowing, seeing and reviewing more information than most Forensic Nurses do who provide direct patient care. I will review the complaint, which lists the charges and associated statutes along with an overview of the issues in the case. In addition, I review witness, victim and defendant statements along with any police reports, medical records and photographs. I explain to attorneys that my first focus is to figure out what most likely happened and then to help them work with the evidence they have in the case. Oftentimes I am asked to evaluate if the incident and injuries fit with the level of crime charged, or, if there are any areas in which the evidence is not accurately or adequately represented.

My first criminal case involved a defendant facing multiple charges, one of which was felony assault for breaking a bone in the victim’s ankle. The victim stated that the defendant twisted her right ankle until she heard a “pop”. Within a few hours of the incident she presented to the local emergency room and an x-ray showed a fracture to a small bone in her ankle. However, the full radiology report indicated “callus formation” on the x-ray report and thus, I was able to explain to the attorney that this indicated the injury happen quite some time prior to the incident in question. While it did not change the overall case because numerous other charges were upheld; in this one charge, the medical evidence did not support a charge of Felony Assault.

Other cases I have been involved with include determining if someone was dead prior to being run over, were the injuries consistent with the history provided in an assault case, is the abrasion pattern on the neck consistent with being choked by a shirt and whether the injuries documented were actually injuries from an assault or other mechanism.    In addition, I look for consistency or inconsistencies between statements, presence or lack of injuries or patterns of injury, discuss mechanism of injuries and interpretation of medical information, statements or findings.

The role of a LNC in criminal case work is as varied as the types of criminal cases. Working on criminal defense cases provides me with great diversity and helps to ensure that the process is fair and balanced by ensuring that the medical evidence is accurately and adequately represented. I cannot change the evidence, but I can provide a neutral examination of the evidence present and relay this back to the attorney and defendant who then can make the best decision regarding a plea or going to trial. I have been involved in many difficult conversations with defendants who in an act of drunken stupidity, fueled by testosterone, punched someone once and were facing significant charges because the victim sustained a brain injury from striking their head on the concrete. At stake in these types of cases is the length of the sentence rather than if they did the act or not. I recall two such cases wherein I advised that the defendant take a plea rather than risk the victims condition worsening and the charges being upgraded. One case took the plea and the other did not, but in both cases the victim eventually died from their head injuries.    The defendant who took the plea received a significantly lighter sentence than the one that plead guilty after the victim died when the charges were amended to manslaughter.

For LNCs who wish to expand their business to include criminal case consulting I would tell you that most of the work or area of need is on the side of the defense since they have less access to the resources than the prosecution does. I would also tell you that the fees paid are nowhere near what LNCs are used to in the civil side of litigation due to the considerable budgetary constraints of the criminal justice system. I would advise nurses to take coursework in sexual assault, child abuse, and death investigation through local agencies, local colleges or even online courses as available. I would encourage LNCs to take courses in criminal or law enforcement as well such as criminal investigation, homicide investigation, interviewing techniques, etc. to broaden your body of knowledge. In addition, I am a big advocate of independent learning through associations or even books. Not all LNC’s are well suited for criminal case work but a large body of knowledge and clinical expertise can go a long way to starting the foundations necessary for this specialty area.

The best way to get ones foot in the door for criminal case consulting is to provide educational trainings for attorney’s and other support staff that can showcase you knowledge base as well as to provide real life case examples of how a LNC can be of value to their cases. These trainings are often provided to large audiences thus maximizing ones exposure to a diverse population who may need your expertise. I have developed power point presentations on numerous criminal based topics that work well to show very specifically how a LNC can help on criminal cases with real life case examples and lots of pictures. If anyone is interested they can look to my website at www.ForensicLNC.com. If you have any questions feel free to contact me at resolvemedlegal@msn.com, I enjoy talking about Forensic Nursing and empowering nurses to branch into this area.

Tuesday, May 14, 2014
Psychiatry and Legal Concerns
Benet Press, M.D.

Dr. Press provided an interesting discussion related to the challenges in evaluating and treating the psychiatric patient and avoidance of medical malpractice lawsuits.


Tuesday, July 8, 2014
Legal Issues in Dental Practice
Brian Williams, BS, DDS, FAGD

The presentation by Dr. Williams covered risk management issues in a dental practice, unique documentation related to dentistry and discussion of notable dental malpractice cases.

Dr. Williams


rosie cathy

We again salute Rosie Oldham, BS, RN, LNCC and Cathy Beasley, MS, BSN, LNCC. They are now developing an online module for the AALNC National Online LNC Course regarding one of their specialties, Toxic Tort. For more information, go to http://www.aalnc.org/?page=consultonlinecourse


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