We evaluate standard of care, clinical decision-making, technical performance, and complication management related to interventional pain and spine procedures. This includes epidural steroid injections, facet interventions, radiofrequency ablation, sacroiliac joint procedures and fusion, peripheral nerve stimulation, spinal cord and dorsal root ganglion stimulation, intrathecal drug delivery systems, vertebral augmentation, interspinous spacers, the MILD procedure, and other minimally invasive spine interventions. Opinions may address patient selection, procedural technique and imaging guidance, patient positioning and procedural safety, peri-procedural management, complication recognition and management, and post-procedure follow-up.

We evaluate whether chronic pain conditions were assessed and managed in accordance with accepted medical standards. This includes diagnostic evaluation, appropriateness of conservative treatment, escalation to interventional or surgical care, and ongoing reassessment of treatment effectiveness. Our analysis considers clinical decision-making, documentation, treatment response, and consistency with evidence-based pain management principles.

We evaluate cases involving neurologic injury and pain syndromes, including nerve injury, spinal cord injury, cauda equina syndrome, complex regional pain syndrome (CRPS), and persistent post-surgical pain. Cases may involve complications of pain procedures, spine care, surgical intervention, or traumatic injury. Our analysis focuses on causation, diagnostic timeliness, recognition of complications, and appropriateness of management.

We evaluate care delivered following pain procedures or surgery, including recognition and management of complications, adequacy of pain control, and appropriateness of follow-up. Our analysis considers whether concerning symptoms were identified and addressed in a timely manner and whether escalation of care, additional diagnostic evaluation, or referral was appropriate. We also consider continuity and coordination of care throughout the recovery period.

We provide expert analysis regarding opioid and other pain medication prescribing, monitoring, tapering, and risk mitigation in both acute and chronic pain settings. This includes matters involving overdose, withdrawal, polypharmacy, co-prescribing of sedating medications, and monitoring for medication-related adverse effects. Our analysis considers applicable clinical guidelines, patient-specific risk factors, documentation, and the standard of care at the time treatment was provided.

We evaluate informed consent and documentation related to pain management and interventional procedures, including whether material risks, expected benefits, and reasonable alternatives were appropriately discussed. Our analysis may address consent for interventional procedures and procedural sedation, as well as the timing and adequacy of consent documentation. Particular attention is given to circumstances that may affect a patient's ability to understand and participate meaningfully in the consent process.

We provide expert opinions regarding rehabilitation planning, functional recovery, impairment, and disability following injury, surgery, or pain intervention. Our analysis may include physical therapy and rehabilitation needs, functional capacity, activity limitations, return-to-work considerations, and the relationship between medical findings and reported functional impairment. Opinions focus on functional outcomes and real-world limitations, integrating clinical findings with the overall medical record rather than relying on imaging findings alone.