Define the scope
Identify the clinical issues, relevant dates, available records, deadlines, and any potential conflicts before substantive review begins.
Review approach
The record first.
The reasoning made clear.
A structured approach to the evidence, the clinical decisions, and the medical questions in dispute.
How a case is reviewed
From the clinical record
to an independent opinion.
Each matter is reviewed according to its specific facts. The scope, available materials, and questions to be addressed are established at the outset.
Reconstruct the care
Build a chronology from contemporaneous medical records and relevant operational documentation. Examine observations, examinations, investigations, treatment, reassessment, communications, and disposition, with attention to the sequence and timing of events.
Evaluate the decisions
Assess care in the context of the presentation, information available at the time, shipboard capabilities, and referral or evacuation circumstances. Later knowledge is distinguished from what could reasonably have been known then.
Address causation separately
Consider whether and how identified acts or omissions relate to the alleged injury. Distinguish a criticism of care from a medically supported opinion about its effect on the outcome.
Explain the opinion
Present the reasoning with supporting records and relevant medical literature. Identify uncertainty, conflicting evidence, and limitations, and reassess conclusions when additional material becomes available.
The guiding principle
An independent opinion should be traceable to the evidence and the clinical reasoning that supports it.
A disciplined assessment
What the analysis makes explicit.
Evidence & inference
The contemporaneous record is the primary evidentiary foundation. Documented actions, later accounts, reasonable inferences, and unresolved gaps are identified separately. Material actions are not assumed to have occurred merely because they might ordinarily have been performed.
Care & outcome
The standard of care and medical causation are separate questions. An adverse outcome alone does not resolve either question.
Reasoning & limitations
Opinions explain the clinical basis for the conclusion and acknowledge where the available evidence limits certainty.
Bring the medical questions into focus.
Contact Dr. Gomez to discuss the matter, relevant deadlines, and the scope of an independent medical review.