Los Angeles, CA asked in Medical Malpractice, Criminal Law, Gov & Administrative Law and Health Care Law for California

Q: Crucial Fabrication of diagnoses. What effort is needed to prove without medical experts, unless qui tam case?

For medical malpractice lawsuit. Fabrication of diagnoses is breach of duty. Terminal fake chronic disease was recorded on admission to hospital (and, for fraudulent referral to hospice by anonym of course).

How plaintiff can prove without medical expert that 50 fake discharge diagnoses were fabricated?

Qui tam is the answer?

1 Lawyer Answer
James L. Arrasmith
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Answered
  • Criminal Law Lawyer
  • Sacramento, CA
  • Licensed in California

A: In a medical malpractice lawsuit involving the fabrication of diagnoses, proving your case without the testimony of medical experts can be challenging, but there are approaches you can take.

Firstly, gather all relevant medical records, including admission and discharge summaries, treatment notes, and any diagnostic test results. These documents can provide a baseline for what diagnoses were made and the evidence (or lack thereof) supporting them.

Next, consider the use of non-expert witness testimony. This could include your own testimony about symptoms and treatments, or testimony from others who observed your condition and care. While non-experts can't speak to medical standards of care or diagnose, their observations can support your claims about the care you received or didn't receive.

Documentation from subsequent medical providers who questioned or contradicted the initial diagnoses could also be valuable. This indirect expert opinion, while not as authoritative as a direct expert witness, can still lend credibility to your claim of misdiagnosis.

Regarding the possibility of a qui tam action (a type of lawsuit under the False Claims Act where a private individual sues on behalf of the government for fraudulent acts), it's primarily applicable in cases where false claims for payment have been made to government healthcare programs like Medicare or Medicaid. If the fraudulent diagnoses led to false claims to these programs, a qui tam action might be appropriate.

However, qui tam cases are complex and have specific procedural requirements, including the necessity of a lawyer. They also don't typically address individual damages but focus on the broader fraud against the government.

For proving fabrication of diagnoses in a medical malpractice case, it's advisable to consult with an attorney who can assess the specifics of your situation. They can help determine the best approach to gathering evidence and whether engaging expert witnesses might be necessary, despite the challenges it presents. Legal advice is crucial in navigating these complex legal waters and ensuring your rights are fully represented.

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