Nebraska Pre-Suit Merit Framework — Hospital-Medical Liability Act Review Panel & Expert-Verified Case Workup
NEBRASKA PRE-SUIT MERIT FRAMEWORK
(Hospital-Medical Liability Act Review Panel & Expert-Verified Case Workup)
PART A — INTERNAL MERIT REVIEW WORKUP (NOT FILED WITH COURT)
A.1 Client Intake Verification
| Item | Status | Notes |
|---|---|---|
| Client identity, contact, capacity confirmed | ☐ | [______________________] |
| Conflict check completed (firm + co-counsel) | ☐ | [______________________] |
| Date of last treatment by each provider | ☐ | [__/__/____] |
| Date of injury / death / discovery | ☐ | [__/__/____] |
| Statute of limitations calendar (§ 25-222) | ☐ | SOL expires [__/__/____] |
| 10-year statute of repose (§ 25-222) | ☐ | Repose expires [__/__/____] |
| Tolling analysis — minor / mental disorder (§ 25-213) | ☐ | [______________________] |
| Engagement letter signed | ☐ | [__/__/____] |
| HIPAA / Authorization for Use and Disclosure of PHI signed | ☐ | [__/__/____] |
| Prior claims / liens identified (Medicare, Medicaid, ERISA) | ☐ | [______________________] |
A.2 Records Collection
| Records Source | Requested | Received | Reviewed |
|---|---|---|---|
| Hospital admission and discharge records | ☐ | ☐ | ☐ |
| Operative reports and anesthesia records | ☐ | ☐ | ☐ |
| Nursing notes and flowsheets | ☐ | ☐ | ☐ |
| Physician progress notes and orders | ☐ | ☐ | ☐ |
| Imaging studies (films + radiology reports) | ☐ | ☐ | ☐ |
| Pathology reports and slides | ☐ | ☐ | ☐ |
| Laboratory and microbiology | ☐ | ☐ | ☐ |
| Pharmacy / MAR | ☐ | ☐ | ☐ |
| Office records of all treating physicians | ☐ | ☐ | ☐ |
| EMS / ambulance records | ☐ | ☐ | ☐ |
| Autopsy report (wrongful death) | ☐ | ☐ | ☐ |
| Death certificate (wrongful death) | ☐ | ☐ | ☐ |
| Prior medical history (5–10 years) | ☐ | ☐ | ☐ |
| Subsequent / corrective treatment | ☐ | ☐ | ☐ |
A.3 Provider Qualification Verification (CRITICAL)
| Defendant | Qualified Under § 44-2824? | Surcharge Current? | Coverage Period | Source of Verification |
|---|---|---|---|---|
| [PHYSICIAN] | ☐ Yes ☐ No ☐ Unknown | ☐ Yes ☐ No | [__/__/____] – [__/__/____] | DOI letter dated [__/__/____] |
| [HOSPITAL] | ☐ Yes ☐ No ☐ Unknown | ☐ Yes ☐ No | [__/__/____] – [__/__/____] | DOI letter dated [__/__/____] |
| [GROUP / PA] | ☐ Yes ☐ No ☐ Unknown | ☐ Yes ☐ No | [__/__/____] – [__/__/____] | DOI letter dated [__/__/____] |
| [NURSE / CRNA] | ☐ Yes ☐ No ☐ Unknown | ☐ Yes ☐ No | [__/__/____] – [__/__/____] | DOI letter dated [__/__/____] |
A.4 Standard-of-Care Expert Vetting
Standard-of-Care Expert
- Name: [______________________________________________]
- Specialty / Sub-specialty: [______________________________________________]
- Same or similar specialty as Defendant [PHYSICIAN]? ☐ Yes ☐ No
- Currently licensed and practicing? ☐ Yes ☐ No
- Active clinical practice during the year preceding the alleged malpractice? ☐ Yes ☐ No
- Curriculum vitae received and reviewed? ☐ Yes ☐ No
- Prior testimony / disclosures (Daubert vulnerability) reviewed? ☐ Yes ☐ No
- Written preliminary opinion on file? ☐ Yes ☐ No (Date: [__/__/____])
- Retainer / engagement letter executed? ☐ Yes ☐ No
Causation Expert
- Name: [______________________________________________]
- Specialty: [______________________________________________]
- Written preliminary opinion on causation? ☐ Yes ☐ No (Date: [__/__/____])
- Opinion expressed within reasonable degree of medical certainty? ☐ Yes ☐ No
Damages / Life-Care Planner / Economist
- Name: [______________________________________________]
- Discipline: ☐ Life-Care Planner ☐ Vocational ☐ Economist ☐ Other [_____]
- Preliminary report received? ☐ Yes ☐ No (Date: [__/__/____])
A.5 Internal Merit Memorandum (Attorney Work Product)
MEMORANDUM (Attorney Work Product / Privileged)
To: File — [CASE NAME]
From: [ATTORNEY NAME]
Date: [__/__/____]
Re: Pre-Filing Merit Determination — Neb. R. Prof. Cond. § 3-503.1
-
Standard of Care. Based on review of [RECORDS] and consultation with [EXPERT NAME], the applicable standard of care required: [______________________________________________].
-
Breach. [EXPERT] is prepared to testify that Defendant [PHYSICIAN] breached that standard by: [______________________________________________].
-
Causation. [CAUSATION EXPERT] is prepared to testify, within a reasonable degree of medical certainty, that the breach was a direct and proximate cause of [INJURY/DEATH]: [______________________________________________].
-
Damages. Documented damages include: [______________________________________________].
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Defendant Qualification. Per DOI verification dated [__/__/____], the named defendants are [qualified / not qualified / mixed] under § 44-2824, which [does / does not] trigger the § 44-2825 cap and the Excess Liability Fund.
-
Limitations. SOL expires [__/__/____]; repose expires [__/__/____]. Filing window: [______________________________________________].
-
Recommendation: ☐ Proceed with Medical Review Panel under § 44-2840 / ☐ Proceed with court complaint and waive panel.
______________________________
[ATTORNEY NAME], Bar No. [_______]
PART B — INITIATING THE MEDICAL REVIEW PANEL UNDER § 44-2840
B.1 Notice of Initiation of Medical Review Panel
TO: Director, Nebraska Department of Insurance
1526 K Street, Suite 200
Lincoln, NE 68508
VIA REGISTERED / CERTIFIED MAIL — RETURN RECEIPT REQUESTED
FROM: [ATTORNEY NAME], on behalf of [CLAIMANT NAME]
[FIRM NAME], [ADDRESS], [TELEPHONE], [EMAIL]
RE: Initiation of Medical Review Panel Proceedings Pursuant to Neb. Rev. Stat. §§ 44-2840 and 44-2841
Dear Director:
Pursuant to Neb. Rev. Stat. §§ 44-2840 and 44-2841, the undersigned, on behalf of the Claimant identified below, hereby initiates Medical Review Panel proceedings against the named health care providers and serves the enclosed Proposed Complaint.
Claimant Information
- Claimant: [______________________________________________]
- Date of birth: [__/__/____]
- Address: [______________________________________________]
- Capacity: ☐ Individual ☐ Personal Representative of Estate of [_______] ☐ Parent / Next Friend of [_______], minor
Health Care Providers
| Provider | Address | Specialty | Qualified Under § 44-2824 (Y/N) |
|---|---|---|---|
| [PHYSICIAN] | [_______________] | [_______________] | ☐ |
| [HOSPITAL] | [_______________] | [_______________] | ☐ |
| [GROUP / PA] | [_______________] | [_______________] | ☐ |
Claimant's Designations Under § 44-2841
-
Physician Panelist Designated by Claimant: [PHYSICIAN NAME, M.D.], [SPECIALTY], [ADDRESS], [TELEPHONE].
-
Suggested Attorney Chair: [ATTORNEY NAME], [BAR NO.], [ADDRESS], [TELEPHONE]. (The attorney chair serves in an advisory capacity without vote and prepares the panel's opinion.)
-
Court of Intended Filing (if necessary): District Court of [____________________] County, Nebraska.
Proposed Complaint Enclosed
A true and correct copy of the Proposed Complaint, with all factual allegations, theories of liability, and prayers for relief, is enclosed herewith as Attachment 1.
Tolling of Limitations
Pursuant to Neb. Rev. Stat. § 44-2843, the running of the statute of limitations is tolled from the date this notice is served upon the Director until ninety (90) days after the panel renders its written opinion or the panel proceedings are concluded by waiver, settlement, or expiration.
Respectfully submitted,
______________________________
[ATTORNEY NAME], Bar No. [_______]
Attorney for Claimant
Date: [__/__/____]
Enclosures:
- Attachment 1: Proposed Complaint
- Attachment 2: HIPAA-compliant authorization
- Attachment 3: Medical records summary (chronology)
- Attachment 4: Curriculum vitae of designated physician panelist
cc (by registered/certified mail): Each named health care provider
B.2 Proposed Complaint (Submitted to the Panel)
[Attach the full Proposed Complaint mirroring the medical_malpractice_complaint.md template, omitting the court case number and demand for jury trial; include caption identifying the matter as a Proposed Complaint Before the Nebraska Medical Review Panel.]
B.3 Expert Support Materials Submitted to the Panel
| Document | Status | Date |
|---|---|---|
| Standard-of-care expert report | ☐ | [__/__/____] |
| Causation expert report | ☐ | [__/__/____] |
| Damages / life-care plan summary | ☐ | [__/__/____] |
| Detailed medical chronology | ☐ | [__/__/____] |
| Index of relevant records produced | ☐ | [__/__/____] |
| Expert CVs | ☐ | [__/__/____] |
B.4 Composition of the Panel Under § 44-2841
| Role | Selected By | Identity |
|---|---|---|
| Attorney Chair (advisory, no vote) | Mutual / NSBA | [______________________] |
| Physician Panelist #1 | Claimant | [______________________] |
| Physician Panelist #2 | Defendant Provider | [______________________] |
| Physician Panelist #3 | Panelists #1 and #2 | [______________________] |
| Hospital Administrator (if hospital is defendant) | Hospital | [______________________] |
B.5 Panel Discovery and Opinion Under §§ 44-2842 to 44-2844
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Discovery (§ 44-2842): The panel has authority to convene, request additional records, and consider written submissions. Panel proceedings are not adversarial trials; deposition discovery before the panel is limited and managed by the chair.
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Opinion (§ 44-2843): The panel issues a written majority opinion stating whether the evidence supports the conclusion that the health care provider failed to comply with the applicable standard of care and whether such failure was a substantial factor in producing the alleged damage. A minority report may also issue.
-
Admissibility (§ 44-2844): The panel's report (and any minority report) is admissible at the subsequent trial but is NOT conclusive. Either party may call any panel member as a witness and cross-examine on the basis for the panel's opinion.
PART C — WAIVING THE MEDICAL REVIEW PANEL
C.1 Notice of Waiver to the Director of Insurance
TO: Director, Nebraska Department of Insurance
1526 K Street, Suite 200
Lincoln, NE 68508
VIA REGISTERED / CERTIFIED MAIL — RETURN RECEIPT REQUESTED
FROM: [ATTORNEY NAME], on behalf of [CLAIMANT NAME]
RE: Notice of Waiver of Medical Review Panel and Service of Complaint Under Neb. Rev. Stat. § 44-2840
Pursuant to Neb. Rev. Stat. § 44-2840, the undersigned, on behalf of [CLAIMANT NAME], hereby provides notice that the Claimant affirmatively waives the right to medical review panel proceedings and is filing the enclosed Complaint directly in the District Court of [____________________] County, Nebraska, on this date.
A true and correct copy of the Complaint, marked filed, is enclosed.
Respectfully,
______________________________
[ATTORNEY NAME], Bar No. [_______]
Date: [__/__/____]
Enclosure: File-stamped Complaint, [CAPTION], Case No. CI [_______], District Court of [____________________] County, Nebraska.
C.2 Strategic Considerations — Panel vs. Waiver
Reasons to ELECT the Panel:
- Tolls the SOL during pendency (§ 44-2843), useful when SOL is close.
- Surfaces defense theories early.
- Free, structured peer review by Nebraska physicians.
- Favorable opinion is admissible against defense.
Reasons to WAIVE the Panel:
- Adverse panel opinion is admissible against plaintiff at trial.
- Panel can take 6–18 months and delay trial.
- Defense gets a free sworn-record discovery preview.
- Panel members may be peers / referral sources of defendant.
- Speed-to-jury matters when liability is strong.
PART D — CRITICAL DATES AND DEADLINES CALENDAR
| Trigger Event | Date | Deadline | Authority |
|---|---|---|---|
| Date of alleged malpractice | [__/__/____] | — | — |
| Date of discovery (if applicable) | [__/__/____] | — | § 25-222 |
| Standard SOL (2 years) | — | [__/__/____] | § 25-222; § 44-2828 |
| Discovery extension (1 year from discovery, never beyond standard 2-year) | — | [__/__/____] | § 25-222 |
| Statute of repose (10 years) | — | [__/__/____] | § 25-222 |
| Minor tolling expires (age 21) | — | [__/__/____] | § 25-213 |
| Date Proposed Complaint served on Director | [__/__/____] | — | § 44-2840 |
| Panel opinion issued | [__/__/____] | — | § 44-2843 |
| 90-day post-opinion filing window expires | — | [__/__/____] | § 44-2843 |
PART E — SOURCES AND REFERENCES
- Nebraska Hospital-Medical Liability Act — Neb. Rev. Stat. §§ 44-2801 to 44-2855: https://nebraskalegislature.gov/laws/browse-chapters.php?chapter=44
- Medical Review Panels — § 44-2840: https://nebraskalegislature.gov/laws/statutes.php?statute=44-2840
- Panel Composition — § 44-2841: https://nebraskalegislature.gov/laws/statutes.php?statute=44-2841
- Tolling — § 44-2843: https://nebraskalegislature.gov/laws/statutes.php?statute=44-2843
- Cap — § 44-2825: https://nebraskalegislature.gov/laws/statutes.php?statute=44-2825
- Excess Liability Fund — § 44-2829: https://nebraskalegislature.gov/laws/statutes.php?statute=44-2829
- Statute of Limitations / Repose — § 25-222: https://nebraskalegislature.gov/laws/statutes.php?statute=25-222
- Tolling for minors / mental disorder — § 25-213: https://nebraskalegislature.gov/laws/statutes.php?statute=25-213
- Nebraska Department of Insurance: https://doi.nebraska.gov/
- Gourley v. Nebraska Methodist Health System, 265 Neb. 918, 663 N.W.2d 43 (2003) (cap upheld): https://law.justia.com/cases/nebraska/supreme-court/2003/679-1.html
- Schafersman v. Agland Coop, 262 Neb. 215 (2001) (Daubert adopted)
- Schmidt v. Ramsey, 860 F.3d 1038 (8th Cir. 2017) (Act upheld under federal challenge)
- Nebraska Rules of Professional Conduct — § 3-503.1: https://nebraskajudicial.gov/supreme-court-rules/
About This Template
Medical malpractice cases involve claims that a doctor, nurse, hospital, or other provider fell below the standard of care and caused an injury. Most states require a pre-suit notice, a certificate or affidavit of merit from another qualified professional, and strict compliance with shortened statutes of limitations. Getting these preliminary documents right is what lets a case actually proceed, because courts dismiss malpractice suits over procedural defects every day.
Important Notice
This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Last updated: May 2026