A bad outcome does not necessarily mean malpractice occurred. A mistake or error alone is not enough to establish a malpractice claim. The error must involve a failure to meet the applicable standard of care and must have caused injury or harm.

Alan J. Belsky personally conducts the preliminary review. His extensive medical knowledge and experience reflect a lifelong interest in medicine and anatomy, together with decades of medical malpractice work.

The review combines meticulous examination of the medical records with a thorough, one-on-one conversation. Alan considers the circumstances leading to the medical event, preexisting conditions and other health problems, prior treatments, and how those factors may relate to the injury.

He also identifies the providers involved in the care and examines their roles, their relationships with the practice or hospital, and whether those relationships may provide a basis for holding an organization responsible for a provider’s conduct.

The main medical reports seldom tell the whole story. For a surgical event, nursing and anesthesia records may reveal details that are absent from the operative report. When complications develop during a hospital admission, nursing notes, progress notes, and other records can help reconstruct changes in the patient’s condition, what the care team knew, and how they responded. A meticulous review looks beyond the principal reports to understand the full course of care.

This preliminary assessment helps identify the issues requiring further investigation and review by qualified medical experts.

Maryland medical malpractice claims face substantial preliminary requirements that ordinary accident claims generally do not. For claims subject to Maryland’s statutory process, a claimant must first file with the Health Care Alternative Dispute Resolution Office (HCADRO), rather than simply beginning with a lawsuit in circuit court. Generally, a qualified expert’s certificate and supporting report must address the departure from the standard of care and its connection to the injury.

The expert must meet specific professional qualifications. When the care involves providers from different specialties, multiple experts—and corresponding certificates and reports—may be needed. These requirements can make the initial investigation expensive before the case reaches court.

Alan refers to some matters as falling into a “black hole”: cases with medical merit, but damages too limited to justify the expense of proving and pursuing them. The question is whether the potential recovery can reasonably support the investment required.

In Alan’s experience, these claims seldom resolve through a straightforward conversation with an insurance adjuster. Providers may strongly contest allegations of wrongdoing, and insurance arrangements can further complicate settlement. A potential claim therefore requires a realistic assessment of both its medical merits and its financial viability.

Maryland law: Claim filing and expert certificate requirements · Expert qualifications.

A few details is all we need to get started. Tell us what happened, approximately when and where it occurred, and what injury or harm followed. Mention any ongoing treatment, prior review by another attorney, or approaching deadline.

Electronic medical records and patient portals such as MyChart often make it easier and faster to access medical information that once took weeks or longer to obtain. If you already have portal access, those records can help us begin the review. However, the portal may not contain the complete chart, so additional records may still be needed.

You do not need to obtain or organize every medical record before contacting us. The office will explain which records are needed and how to provide them securely.

A thorough review requires understanding your health before the medical event, including conditions and treatments that may have contributed to the problem or affected your recovery. Our purpose is to understand what happened and distinguish the harm caused by the event from other health concerns.

It is also our job to identify and anticipate likely defense arguments. Learning about potentially relevant conditions early allows us to evaluate those arguments and prepare an informed response.

Claims for pain, suffering, and emotional distress may also make aspects of your prior mental health history relevant. That does not mean every prior condition is relevant or that having one defeats your claim. We will discuss sensitive information with you carefully and explain why it may matter.

It is not unusual for a medical malpractice review to take four to six months or longer. The time depends on the complexity of the care, the availability of complete records, and the need for review by qualified medical specialists.

When treatment is ongoing and the patient has not reached maximum medical improvement—the point at which the condition has substantially stabilized—our assessment may continue as the diagnosis, prognosis, and lasting effects become clearer. Filing deadlines must still be evaluated promptly; ongoing treatment does not mean a claim can safely wait.

Our role is to evaluate a potential legal claim. We do not diagnose medical conditions or direct treatment. If your symptoms have not yet been explained or a diagnosis remains uncertain, that medical evaluation must come from your treating providers.

We can review the care you received and investigate a possible failure or delay in diagnosis, but we cannot substitute for the clinicians responsible for determining your condition and treatment needs.

An initial inquiry or preliminary review does not mean the office has agreed to represent you. Representation begins only after we expressly agree to accept the matter and enter into a written engagement agreement. Until then, you should not assume the office is filing a claim or protecting a deadline on your behalf.

We handle all cases we accept on a contingency fee basis. The attorney’s fee is one-third of the gross recovery if the case resolves without mediation, arbitration, or litigation. If any of those proceedings occur, the fee is 40% of the gross recovery.

The fee is calculated before deducting case expenses. Expenses advanced by the firm are then deducted from the remaining recovery.

If the case cannot be pursued or is lost, you owe no attorney’s fee and are not required to repay expenses advanced by the firm. These terms are explained in the written engagement agreement.

Different fee limits apply to certain federal and military medical malpractice claims. When applicable law imposes a lower limit, that limit governs instead of our standard contingency percentages.

For Federal Tort Claims Act claims, the caps are generally 20% for administrative resolutions and 25% for judgments or settlements after suit is filed.

Federal law: 28 U.S.C. § 2678.

Some medical malpractice cases resolve through settlement, including mediation. Others require trial. The course depends on the evidence, the disputed issues, and whether the parties can reach an acceptable resolution.

We prepare each accepted case with the possibility of trial in mind. Any settlement offer is discussed with you, and the decision whether to accept it is yours.

Alan J. Belsky personally conducts the preliminary medical review and works directly with clients to understand their care and injuries. Throughout an accepted case, the office explains significant developments, what information is needed, and the decisions that require your involvement.