The Importance of Accurate Medical Records in Personal Injury Cases

The Importance of Accurate Medical Records in Personal Injury Cases

by / Wednesday, 19 October 2022 / Published in Medical Malpractice, Personal Injury
A doctor and a nurse look at a file.

In any type of personal injury case, medical records are a critical type of evidence. This is true whether a case involves medical malpractice, a work-related injury, injuries caused by a slip-and-fall, birth trauma, or a car accident. It’s not at all uncommon for a party accused of causing an injury to try and deny that any injury ever occurred at all or accuse someone of exaggerating their injuries. But with your medical records, you’ll be able to prove exactly what your injuries were, how extensive they were, and how they were treated. 

But what if your medical records don’t seem to be an accurate reflection of your injuries and the care you received? Sometimes, mistakes can happen and medical records need to be corrected. But what if it seems like your records have been intentionally altered to downplay your injuries? After all, in medical malpractice cases in particular, wouldn’t the doctor have a vested interest in trying to cover up their actions? 

Falsified medical records are something that does come up every now and then. However, not only is it illegal to falsify records, it can be easy to prove where falsifications were made. A patient’s medical record isn’t only viewed by the patient’s doctor, it’s also accessed by nurses, insurance providers, and testing facilities. This means that multiple copies of a record can exist. Medical bills will also reflect the care a patient received to treat their injuries. In the case of digital records, changes can be tracked. 

When a medical record is changed for legitimate reasons, changes should be noted with terms like “addendum” or “correction” and include an explanation of the reason for the change and where the new information came from. If information is being corrected, the incorrect information should be crossed out, but you should be able to still read the original content. 

Can You Request Corrections to Medical Records?

If you’ve requested a copy of your medical records and found a mistake, the first thing you should do is contact your care provider and ask about their process for requesting corrections. In some cases, they might provide you with a form to fill out. In other cases, you may need to write a letter explaining what needs to be corrected. In any case, expect to provide information like:

  • Your contact information
  • The care provider’s name and contact information
  • When the mistake was made
  • An explanation of the mistake that needs to be fixed
  • A copy of the page that needs to be corrected or a note explaining where the error is
  • Information that proves why the correction needs to be made

Can Inaccurate Medical Records be Medical Malpractice?

Incorrect information in a medical record isn’t necessarily grounds for a medical malpractice lawsuit by itself. However, if that incorrect information causes patient harm in some way, it’s important to contact a medical malpractice lawyer to learn more about your legal options. For example, if information about a severe allergy is left out of a patient’s record, a care provider might provide medication that causes an adverse reaction. Or if a test result for a patient gets put in the wrong patient’s file by mistake, unnecessary treatment might be given.

Contact a Michigan Personal Injury Lawyer

Goodwin & Scieszka is experienced in helping the victims of a wide range of accidents in the state of Michigan, including motor vehicle crashes, dog bites, medical malpractice, and more. If you or a loved one has been injured and you have questions about your situation, one of our personal injury lawyers can help answer your questions and work with you to figure out if you have a case. Contact us today to get started.

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