Nukevets thought my review of the new Grisham book was interesting, and I agree with him when he posits that readers flock to Grisham, believing that they are getting a realistic portrayal of lawyers. That was one of the reasons I reviewed the book. As I said in the review, the book is just a big ole lawyer joke. Unfortunately, people seem to believe lawyer jokes are true reflections of their subjects.

He also says:

I would not doubt that you can find some mistake in just about any medical record you choose to audit. The question is – did that mistake do anything to result in a bad outcome? If the answer to that question is yes, and deadly mistakes are probably made every day – then there should be some recourse open to the person/family. If the answer is no, then it needs to be recognized that MD’s are human, and subject to the same frailties as the rest of us. It seems that the default has become to audit a medical record, find a mistake and, no matter how trivial the error, immediately jump to the conclusion that ”we found an mistake in the medical record, and the patient died – therefore………..” .

Nukevets has correctly stated the standard: did the mistake cause the bad outcome. I fear he has bought into propaganda when he believes that trivial recording errors result in big malpractice cases. Believe me, that's not enough. Now, I have had cases where there was negligence, and there were also fabricated or destroyed medical records, that by implication supported our claims of negligence. But, without expert testimony -- that will resonate with a jury -- that there has been a deviation from the medical standard of care, you just don't have a case.