Medical Malpractice Claims - From Investigation to Litigation

By Catherine Bertram, partner

Medical malpractice cases are often some of the most complex civil claims that trial attorneys handle.  In almost all states, and certainly in Maryland, D.C. and Virginia, there are special statutes and regulations that apply to these types of cases.  Attorneys who practice in this area must be familiar with these rules in order to represent their clients and the families of their clients.  Experienced attorneys know how to efficiently review and investigate these cases.  At our firm, we have established working relationships with medical experts on a national basis in almost all specialties so we can obtain independent reviews of the events and obtain answers for our clients to determine if the care rendered met the applicable standards or not.  

Step One

In most cases after we conduct an initial interview we ask the patient, or the family member with legal power to sign for the patient, to sign a medical authorization that allows us to obtain the key medical records and images.   Our staff is very experienced in this part of the case and they know how to process these requests and get us the records and images we need in a timely fashion.  

Step Two

Once the records are obtained they are reviewed and organized in a coherent manner for the reviewing expert or experts.  In some cases the records need to be reviewed by several types of experts in order to determine if there is a case of medical malpractice.  In some cases have records reviewed by both physician and nursing experts, depending on the circumstances.

Step Three    

We will then speak with the reviewing expert in order to determine if the case has merit in their opinion and whether it is a case that can be pursued.   We also try to answer any questions the patient or family may have about the outcome.  During those calls we have to ask certain questions to determine whether the elements of a medical malpractice claim exist.  The first issue is generally whether the doctor or nurse’s care fell below the standard expected of that individual in the same or similar circumstances.  The second question, which is equally important and must be proven by the patient in a civil malpractice case, is whether the doctor or nurse’s failure was a proximate cause of the patient’s injuries and harms.  In other words, is there a direct link between the doctor or nurse’s wrongful act,  or failure to act, and the injury the patient sustained.  This is commonly referred to by attorneys and judges as “proximate cause”.   If the case has failures by the doctor or nurse but those failures are not a cause of the patient’s injury then there is no case.     Sometimes the questions the patient has can be answered and sometimes the expert has more question and needs additional records or images or other information before they can reach a conclusion.   We continue to work with the expert to obtain that information.  Sometimes, a final conclusion cannot be reached because the records are not clear, the information is missing or there is contradictory information in the records. These issues are all then discussed with the patient and/or the family.  Sometimes,  final answers to certain questions are not obtained until you take the sworn testimony of various doctors and nurses in the lawsuit.  

Step Four

The attorneys from our firm then have a conversation with the patient and/or the family about what the expert’s conclusions were and what the next steps will be. There is no cost associated with this meeting or phone call.   Sometimes this conversation is done by phone, especially in circumstances where the patient is too hurt to travel or lives out of town.   In other cases,  the meeting is held in person at the law firm.  If circumstances are such that the patient cannot travel, and we need to meet, then our attorneys travel to the patient’s home, rehabilitation center or the hospital.

Step Five

If the family and the law firm decide the case has merit, and we want to pursue it together,  then a legal document called a retainer is signed. This document explains how the fee will be paid and how expenses from the case will be handled.

Step Six

Depending on whether the case is in DC, Maryland or Virginia, we work with our experts to develop the case.  We have working relationships with many local hospitals and insurance companies who insure the local doctors and hospitals.  We can often contact those claims directors or the risk managers for the hospital or nursing home and talk to them directly about the claim before the lawsuit is filed.  They know we mean business and they know we have qualified experts who have thoroughly reviewed the case so they are often willing to explore early resolution of cases through private mediation with a retired local judge.  This works quite well for our clients.   

If early resolution is not possible, we have the resources and the experience to file the necessary paperwork and provide the required statutory notices in DC, Maryland and Virginia to pursue the claims.  

If you have any questions about a potential case, feel free to call. 

About the author:

Catherine Bertram is board certified in civil trials and was recently nominated as a Top Lawyer for Washingtonian Magazine. Ms. Bertram has over 20 years of trial experience and is unique in that she was formerly the Director of Risk Management for Georgetown University Hospital so she brings a wealth of knowledge to her practice including how hospitals should be run and what doctors and nurses can do to protect patients.   She is a partner with the firm and devotes a majority of her practice to the representation of patients and families who have been injured or lost due to medical errors.  Ms. Bertram lives in DC and lectures regularly to lawyers and health care providers, nationally and locally,  regarding patient safety, medical negligence and other related issues. She has also published a chapter in a medical textbook.   She can be reached by email at or by phone 202-822-1875 in her office in Washington, D.C.


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Practice Areas

The experienced trial attorneys at Regan Zambri & Long, PLLC concentrate their practice on representing clients who have been seriously injured and the families of those who have died as a result of medical malpractice, automobile collision, defective products, unsafe premises, tractor trailer collision, workplace injuries and other serious personal injury and wrongful death matters. For your convenience, we have listed some of the types of cases that our law firm regularly handles.

If you have questions about a particular case or would like to talk to an attorney at Regan Zambri & Long, PLLC, please contact us by email or by telephone.

  • Medical Malpractice
  • Defective Products
  • Birth Injury/Cerebral Palsy
  • Premises Liability
  • Automobile Accidents
  • Truck Accidents
  • Wrongful Death
  • Burn Injury
  • Workers' Compensation
  • Police Misconduct
  • Legal Malpractice
  • Insurance