Medical Legal Consulting News, February 2014
IN THIS ISSUE:
- MLCS “Believe It or Not”
- Narcotic seeking “Believe It or Not”
- Vocabulary Quiz: Narcotics
We hope your new year is progressing well. Like many of you, we here at MLCS have been enduring a brutal Midwest winter; spring can’t get here soon enough! But while we wait on warmer weather, MLCS is also hard at work adapting and updating our services. In the near future, expect to see a newly revised website, introductions to our expanded staff, and alterations to our feedback protocol.
If you haven’t had a chance to check out our new referral form, please email us for a copy. If you have used the new form, we are eager to know what you think—especially if there are any components you would like us to add to it.
As always, we appreciate your continued business. Please feel free to contact us with any concerns or questions.
Linda Luedtke, RN, MSN
President and Director of Consulting Services
MLCS “Believe It or Not”
Can we just say that sometimes our record reviews get a little weird?
After 20+ years of reviewing medical records, MLCS has seen some cases that just might qualify for Ripley’s Believe It Or Not.
Sometimes it’s an odd injury or ailment, sometimes it’s a new or seemingly unusual treatment, sometimes it’s like a circus of different accidents and diagnoses—and sometimes it’s all of the above!
Part of that, to be fair, is the nature of the beast. With medical science always advancing and adapting, today’s unusual may be tomorrow’s standard practice—and sometimes unusual instances really do require unusual or alternative remedies. But, sometimes situations fly right past alternative and land squarely in the “Can you believe this?” category.
This year, MLCS combs our case files for the wild and weird, showing how our nurses use training, experience and knowledge of current medical literature to sift out the medical novelty from the medical absurdity, providing insight into standard or non-standard medical procedures as well as a reliable opinion on related vs. unjustified charges. The result is an essential educational and/or negotiating tool for a personal injury claim.
Narcotic seeking “Believe It or Not”
Many of our recent “Believe it or not” cases include medical record reviews that have suggested a component of narcotic seeking, either prior to the injury or associated with treatment of accident-related complaints. We have encountered record reviews in which thousands of narcotic pills are dispensed within a month’s time and/or in which the claimant reports taking more than 50 narcotic or psychotropic pills in a single day. It is not uncommon for MLCS nurses to see dosages of narcotics prescribed in amounts that would be lethal to the non-opiate-dependent individual.
We stay on the lookout for drug seeking and opiate dependence in many ways. During the course of the review process, the MLCS nurse tracks medications and the dosages of narcotics or psychotropics in the medical and pharmacy records, and notes when pain medications are requested by name or when non-narcotic or less potent narcotics are reported to be ineffective.
In analyzing the records, the MLCS nurse looks for signs, symptoms and side effects of drug use and drug withdrawal. When large quantities are being dispensed, the lack of typical biological effects from the medication can point to diversion. These findings and well-established behaviors of narcotic seeking documented within the medical records are cited in the analysis of the records.
Can you pass this drug test?