Evidence Record

US State, New York Appellate Division  ·  2012  ·  Evidence challenged

Karam v. Adirondack Neurosurgical Specialists

93 A.D.3d 1260 (N.Y. App. Div. 2012)

EMR audit trail

What happened

In a medical malpractice action, the plaintiff challenged the integrity of a clinical note that was critical to the hospital's defence. Metadata and audit trail analysis of the hospital's EMR system revealed that the note's actual creation and modification time conflicted with the timestamp that the system displayed to clinicians and administrators. The discrepancy existed within the hospital's own centralised system: the audit trail contradicted the displayed record. The court admitted this evidence and used it to impeach the credibility of the medical record on the key timing questions in the case. The case is a foundational US authority for the discoverability of EMR audit trails, and illustrates that the timestamps displayed by centralised clinical systems can differ from the actual system-level audit logs, creating an internal inconsistency that opens the entire record to challenge.

Outcome

Medical record credibility impeached on critical timing. Audit-trail conflict admitted in evidence.

Sources

Authority source confirmed

Public proof. Private work.

immut records a cryptographic hash of your file on the public XRP Ledger at the moment of creation. The timestamp is independently verifiable by anyone.

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