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Case Information
Do you believe you or loved one is victim of medical malpractice?
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Describe the incident, injury, accident, misdiagnosis, failure to diagnose or potential malpractice that has occured?
What do you believe took place or went wrong?
If at the time of incident or potential malpractice you were unaware of any wrongdoing, when did you discover potential malpractice or injury?
Where did the injury, incident, misdiagnosis, failure to diagnose or potential malpractice occur?
Who do you believe is responsible for the injury, incident, misdiagnosis, failure to diagnose or malpractice? (doctor, hospital, surgical center, etc.)
What injuries do you or loved one suffer from as a result of this incident, malpractice, or misdiagnosis, or failure to diagnose? Please describe
If death occurred, please list cause of death on death certificate
Have you or loved one seen a healthcare provider, doctor or hospital since incident, malpractice, or misdiagnosis, or failure to diagnose?
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Are you or loved one still seeing a doctor or undergoing treatment?
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Name of doctor or treating physician
Have you talked with another attorney or law firm about your potential case?
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Please list names of attorneys and/or law firms
Do you currently have a law firm or attorney representing you with this lawsuit?
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Pharmacy Malpractice Statistics
Over 1.3 million people are injured each year because of medication errors.
Medication errors cost in excess of $29 billion per year-one estimate is as high as $72 billion a year.
Nearly 100,000 people die every year as a result of medication mistakes
3% of all hospital admissions are related to problems with medications
42% of the people questioned in a recent survey said either they or someone they knew had suffered because of a medication mistake
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