[Video] The Importance of Case Clinics: Reviewing Orthopedic Cases with Dr. Jason Strachan

Wondering if your medical malpractice case has merit? Ensure you take on the most valuable cases and get a competitive edge in the courtroom with Case Clinics from Expert Institute. Our team of 55+ physicians covering 30 different specialties can screen your cases for merit, review tedious medical files, identify strengths and weaknesses in the facts, and help you develop winning trial strategies—all without formally retaining an expert for your case. We discuss with Dr. Jason Strachan, M.B.B.S., about his extensive orthopedic surgery experience, the cases he works on, the importance of Case Clinics, and more.

Video Chapters

00:00 Introduction

00:55 What do you do at Expert Institute?

01:56 How do you evaluate a case?

03:46 What do attorneys find most valuable in the Case Clinic Process?

05:21 What kinds of cases do you work on?

06:58 What is a memorable case you’ve worked on?

09:04 Why are Case Clinics important?

Find the full transcript of his interview below:

Introduction

My name is Jason Strachan. I’m a doctor. I trained in Jamaica. I grew up [and] I was born in Jamaica, in Kingston. [I] went to high school there [and] started university in 2005. I finished med school in 2010. Since that time, I’ve been practicing medicine in different places, doing different specialties—primarily orthopedics. Because of the nature of medicine in Jamaica, I was actually able to rotate through many different specialties. So, on top of doing orthopedics, I was able to do some cardiothoracic surgery, [spent] a long time in the emergency department, [and did] some pediatric sports medicine. But orthopedics is primarily what I did. And it’s what I’m doing [at Expert Institute] since I’ve been here for the past two years.

What do you do at Expert Institute?

At Expert Institute, I’m a Senior Medical Research Associate. We are the physicians who do the Case Clinics, evaluate the records that attorneys send in, [and] tell them whether there is any standard of care departures [and] if there is causation, liability, and leading to damages. My role is to help attorneys figure out whether they have [a case] or not. A lot of the time, it’s about vetting—helping them vet the cases so that they know whether there is any merit to [the case]. Other times, it’s more about helping them figure out the particular strategy that they want to use. So, in this role, there are so many different things that are necessary. It requires a lot of medical knowledge, as well as being able to learn [about the] law [which] you pick up from the client and learning how to kind of bridge the two disciplines.

How do you evaluate a case?

With the Case Clinic process, it involves getting the records, [then] going through all the records. We want to know what the attorney would like out of the Case Clinic beforehand. Most of the time, it’s a merit review. They want to know if there’s a standard of care departure or not. Based [on] what we know, we’ll go through the records—at times thousands of pages of records—to be able to figure out a chronology of what happened and then figure out why [it happened]. Once you get the why, you want to know “did this why lead to something else?”

It’s a very holistic review, but it’s not just the medicine alone. There’s a great portion of it that’s about the customer service. It involves knowing the clients. You have to know if this attorney is one who is extremely risk-averse, or does this person want to go to all lengths to figure out whether there is a case or not. So, it requires you to know the demographics of who you’re working with and their pain points. You have to know what they want, what really makes them tick.

Not every attorney is going to want cases that are difficult to litigate because that’s a lot of money going into it. And a lot of the times it’s kind of 50/50. There are attorneys who just want slam dunk cases. How will you know that? The only way to know is [by] spending a lot of time with the different attorneys, talking to them, [and] having an idea of their background. So [you need to know] the cities they’re from and what they want out of [the Case Clinic]. There’s a lot that goes into the entire process that we’re able to simplify and condense into a very digestible form for the attorneys.

What do attorneys find most valuable in the Case Clinic process?

What attorneys find most valuable is to be able to use us as a screening tool for the cases. On my first day here at Expert Institute, I remember an attorney saying that ‘I don’t make my year by my $1 million settlement that I managed to win. But I can lose my year if I dump $300,000 into a case, and it gets thrown out.’ So with that mindset, I realized that the value that we give is in being able to screen this case to figure out whether it’s worth the hours, the manpower, and the money that you’re going to put into it to take it all the way. That’s one way that I think [we help], and it’s a major thing. But there are other things as well.

Another thing I’ll bring up is they use [the Case Clinic] to help to develop their strategy and know the causation links. They want to be able to say [that] they know that there is a standard of care breach, but how do we link that to what happened to the patient? That’s what we help them figure out because we know the medicine, they know the law. They’ve been doing law longer than most of us have been doing medicine, so they know quite a bit, but they don’t know the intricacies and the fine details. Our job is to help them figure out what’s the best, what works, how these two things link, and then help them to move forward.

What kinds of cases do you work on?

I routinely work on orthopedic spine surgery and sports medicine cases. I would say what I see the most are spine surgery cases, so your lumbar discectomies, your lumbar fusions, your ACDF (Anterior Cervical Discectomy and Fusion) surgeries, and the complications from [these surgeries] are what attorneys bring, the post-operative infections, [the] people who have worse outcomes. They get the surgery, and [there’s] absolutely no relief. Of course, everyone’s going to think that the surgeon did something wrong. But that’s not necessarily negligence. It’s really being able to kind of go between the two and understand that there is a fine line between negligence and a bad outcome.

I see a lot of spine surgery cases because anyone with a bad back usually needs to get evaluated at some point. I see a lot of hip replacements and knee replacements as well. I’ll put those as second and third [most common] on the list. And for hip replacements, it’s a lot of foot drop [cases] after hip replacements. That’s something that attorneys and I routinely go back and forth about as I try to explain to them why this is or is not a standard of care breach. Knee replacements and infections affect both of those. I do a lot of arthroscopies, so knee surgery for athletes, ankle surgery, shoulder, but I think those three—the spine, knees, the hip replacements—are the top ones that I see.

What is a memorable case you’ve worked on?

I had a case with an attorney a few weeks ago where he was exploring both the product liability and the medical malpractice angle. There was a recall on the exact device that was being used for the knee replacement. This was the Exactech recall, which came in February of 2022. The attorney brought the case because this [product] was recalled at the time, and he wanted to know if there was any link in terms of the complications that the client had. And the recall device, no. The recall device was because of oxidation. So [the recall was due to] packaging issues, and this led to the breakdown of the arthroplasty device, and that could cause instability with the knee. That in itself led to a bad outcome.

With that note, the surgery for the revision, which was necessary, [had] many complications. I was able to discuss with the attorney that we can’t go after the medical malpractice because there is no standard of care departure. The surgeon did everything by the book, and the complication is known and recognized. However, we do have a strong product liability angle here because the issue that led to the recall is why she needs the revision [and] why she got complications. It can be said that the device is responsible for the complications.

That attorney was extremely pleased with [the result] to the point that he wanted to—or I think he’s already started to—advertise in his local newspaper so that he’s able to get enough clients together who’ve had poor outcomes from the knee replacements and turn it into a class action suit. Now the hope is that [with] the class action, we get to vet the different patients so that we’re able to say ‘this is a known and recognized thing so this should be a part [of the lawsuit].’ We’re also able to help with that. That’s another angle and thing that we [can] do.

Why are Case Clinics important?

With the Case Clinic model, it has to be understood that it’s not what it was about four or five years ago. What it is now is such a holistic process. It takes into account so many different things. It’s not just going through records and regurgitating the things that you yourself as a client are already able to pick up.

Now, you’re understanding the why and the how. When you understand those, you’re able to do multiple things. You can decide ‘I want to move forward with this—here is how I do it.’ Or, if you want to decline it, you have all the reasons to know why you need to decline this case [and] why it’s not a good case to go through with.

If you think there is one aspect of it that you’d like to harp on and you think you can win this, we can help you to develop the [strategy] around it and help you spot the landmines ahead of time because we know what [the defense] may come with and which parts of [the case] will be defensible. We try to guide you to evade those landmines.

It’s a very holistic process, and there’s so much to be done. The team itself is so specialized now with so many physicians. It’s a very good use of resources to invest in the product because you’re always going to get good value from [Case Clinics].