Case Screening, Merit Review, and Case Analysis
Screening versus merit review
Screening is rapid triage: jurisdiction, statute of limitations, parties and insurance, the nature of the injury, a plausible liability theory, causation, damages, and whether qualified experts exist. Merit review is deeper: a full chronology, standard-of-care analysis, identification of deviations, causation reasoning, damages assessment, and a written strengths-and-weaknesses memorandum. Many states require an affidavit or certificate of merit with the complaint, so screening should confirm that requirement early.
The analytical spine
For each alleged breach, articulate four things: the applicable standard of care, the specific deviation, the resulting harm, and the causal link. Address pre-existing conditions, comparative or contributory fault, and alternative causes. Consider all potential defendants - physician, nurse, hospital, pharmacy, device manufacturer - and theories such as corporate negligence, failure to rescue, inadequate staffing, or failure to escalate. Review the record for both supporting and contradicting evidence; a one-sided memo is a liability.
Deliverables and traps
Deliverables include chronologies, timelines, provider summaries, damages summaries, deposition questions, and exhibit lists. Traps: equating a poor outcome with negligence; ignoring a plaintiff's own contribution; missing a limitation deadline; ignoring the defense perspective; overstating conclusions beyond what the record supports.
Worked example: a post-operative patient deteriorates overnight and is found unresponsive. The screening question is not whether the outcome was tragic, but what monitoring was ordered, what was documented, who was notified, and when escalation should have occurred - then compare each answer to the standard.
Rule of thumb: for every case, write the one-paragraph theory of liability and the one-paragraph theory of defense; if either is missing, the review is incomplete.