Quandary Peak is recognized as an authority on the review and production of patient Electronic Medical Records (EMR) in context of medical malpractice lawsuits.

In today’s ever expanding digital world of EMRs, we help our clients (both defendants and plaintiffs) navigate the electronic discovery process of medical records and associated electronic artifacts. Our experts are familiar with proportionality frameworks for eDiscovery as well as the state and federal rules for discovery, production, and spoilation of evidence. For cases involving medical malpractice, our team of experts provide our clients with affidavits, expert reports, declarations and are also experienced in participating in evidentiary hearings, deposition, and trial testimony.

Quandary Peak is well versed in performing detailed reviews of audit logs / audit trails, associated metadata, system generated artifacts, as well as Electronic Health Record (EHR) system settings as they pertain to medical malpractice cases. Our team of experts are experienced in reviewing these artifacts from various EHRs including Epic, Cerner, NextGen, Meditech, Medhost, and eClinicalWorks, among others. While each EHR has slight differences in the format and display of the EMR and associated system generated artifacts, our experts are capable of reviewing audit logs from any EMR system.

Medical technology concept. Electronic medical record

What We Do
  • Review of the entire Electronic Medical Record including progress notes, visit encounters, patient demographics, flowsheets, and any other related patient documentation.
  • Complete forensic discovery and analysis of EMR system generated artifacts such as EMR audit trails, access logs, EMR audit logs, system generated metadata and reports.
  • Review of relevant case depositions and opposing expert reports.
  • Data extraction along with onsite or remote inspections.
  • Provide affidavits, expert reports, declarations and participate in depositions, evidentiary hearings, and trial testimony.

What We Know
  • Regulatory standards covering EMR/EHR audits logs (e.g., 45 CFR 170.315(d))
  • HIPAA regulations, including the right of access rule – 45 CFR 164.524(a)(1)
  • 21st Century Cures Act and definition of EHI (Electronic Health Information)
  • HIPAA requirements, policies, and safeguards
  • EMR audit logs, EMR audit trails
  • Protective orders and protocols for inspections

Notable Cases


Notable Jurisdictions

Cook County Illinois, St. Louis, Missouri, West Virginia, California

Notable Clients

Rush University Medical Center, Laboratory Corporation of America Holdings (Labcorp), Aetna of California, Citizens of the State of California, Meditech

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