We face this situation all too often. An attorney reaches out to our firm with a medical matter that requires some form of visual translation to educate their intended audience. After a preliminary discussion regarding the case facts, the following question usually throws a monkey wrench in the whole process: “What is your timeframe?”. The response is generally along the lines of: “Our DED (discovery end date) is in a week. How fast can you get the medical illustrations done?”. We look at our production calendar, dishearteningly attempting to play Tetris with a schedule that is already riddled with deadlines.
So how late is too late to ask for a medical illustration? It’s an understandable question if you’ve never created one before. Our job as Certified Medical Illustrators is to clarify complex medical issues and make them easily understandable. This can lead to the belief that the process of creating the product is as easy as the clarification. This could not be further from the truth.
All cases (except animations) are placed on our production calendar roughly 6-8 weeks in advance, with adjustments made for production time and current projects on our docket. Before our Certified Medical Illustrators can begin creating any type of exhibit, several steps need to be tackled first:
Initial Contact: The medical illustration process always begins with a series of questions designed to assess the scope of your project. If you are new to our firm (or unsure how to proceed), our illustrators will help you determine the best and most cost-effective way to convey your case facts visually. We will then tentatively schedule the case on our production calendar.
Receiving Case Materials: For us to begin, we will request your client’s radiological studies, radiology reports, operative reports, admission/discharge summaries, history and physicals, as well as your testifying experts’ narratives. Of course, some cases are more voluminous than others, but these items generally supply us with all the necessary information to begin creating the medical illustration. Most attorneys choose to send these materials via UPS or FedEx, but they can also be delivered electronically through a platform such as Dropbox. Physical delivery methods add a few days to the process. Once our team has received the material and logged it into our system, then the research process begins.
Preparing the Proposal: Turnaround time for our illustrators to receive, research, and create the medical illustration proposal is roughly two weeks, depending on the breadth of the research. First, an in-depth outline of all the information found in the reports is compiled. If the info denotes something unique, perhaps a new type of surgical procedure, further studies are conducted to ensure accuracy. Once completed, the proposal is sent electronically to you and your paralegal (if provided).
Acceptance of Proposal & Remittance of Retainer: Once you have received the proposal, you will have the opportunity to request alterations to it, if necessary. Our illustrators will add, omit, or revise the proposed illustrations until you feel confident the quoted visuals will benefit your case. When you’re satisfied with the medical illustration proposal, sign the last two pages and return it to us with the retainer. The signed proposal and retainer must be received before we can begin our production process.
Production: Despite how commonplace a case may appear at first glance, each one contains unique elements that are specific to your case alone! These unique elements lead to variant production times, based on several factors: the type of courtroom visual, the complexity of the injuries, and the number of illustrations required.
The term ‘courtroom visual’ refers to several types of products. The easiest to curate are film exhibits and film colorizations. For film exhibits, we simply find the best image from the radiological studies and arrange it on an exhibit with labels denoting the pathological elements. Colorizations are similar, but the different components of the film are enhanced with color (as if with a highlighter) to distinguish the injury with greater visual clarity.
Custom medical illustrations are the most commonly requested service we provide. These illustrations are anatomically precise 2D images of your client’s injuries or surgical procedures. Unlike a film or film colorization, custom medical illustrations are fully rendered graphics, utilizing highly specialized visual techniques to simplify complex medical data so that anyone, regardless of their education, can understand the concepts put forth.
Stock medical exhibits are also 2D illustrations, but they are not customized to your client. This can limit the scope of their usage. Stock can be useful in smaller matters where cost is paramount, and your client’s injuries are very common. They are also helpful in explaining basic anatomy. Stock illustrations can be delivered as soon as the signed proposal and retainer have been received. They can also be purchased with ease on our website!
Animations are the most complex and time-consuming product to create. However, they can be instrumental in detailing cases in which movement is a deciding factor.
Unfortunately, not all parts of the body are rendered as easily as others—the more unique the injury or surgery, the more production time required. A broken finger, for example, is going to need less time to create than a subdural brain hematoma. This is because the brain has so many intricate folds that must be painstakingly illustrated! Most custom medical exhibits take between one to three days of production time to generate, depending on difficulty. On the other hand, radiological enlargements and colorizations can take between half a day to one day to design. Animations (the most difficult) can take months to create.
Exhibit Receipt/Revisions: When the illustrations are complete, you and your medical expert have the opportunity to review preliminary drafts via email and propose revisions. If revisions are in order, we will create one (1) revised set of drawings, as per your final instructions, at no additional cost. Subsequent changes will be billed based on our standard rates. Once the preliminary visuals are approved, three letter-sized color copies are mailed to you. You also have the option to purchase poster-sized versions of your exhibits, if you wish to utilize such a format.
Our team of illustrators aren’t strangers to late nights in the office or coming in on the odd weekend to accommodate a last-minute request. Sometimes though, the timeframe is just too tight, and we have to reduce the scope of a project to something more manageable, such as converting a custom medical illustration to a film-colorization or stock exhibit. Other times the case is simply too complicated and time-consuming to be produced within the allotted deadline, and we have to let you know that, unfortunately, we cannot take the case. When this happens, we are just as disappointed as you! We HATE to say “no.” After all, medical art is our passion! But, as with everything, there are exceptions. Canceled projects and extended DEDs can leave openings in the production calendar, so it never hurts to ask!
Our illustrators are committed to helping you find the best option for your needs. With adequate production time, your medical illustrations will be an indispensable tool to aid in understanding your client’s injuries with the utmost accuracy, certainty, and simplicity. It also never fails to put a smile on our faces when you reach out 6-8 weeks in advance!
About the Author:
Ronald Mathias, CMI, is the Founder and Managing Member of Anatomical Justice, LLC. He has been immersed in medical media production and visual translation for the past twenty-five years. During that time, he has created thousands of innovative demonstrative aids for personal injury, medical malpractice and product liability cases for plaintiff and defendant attorneys across the US. His work has also included artwork for medical textbooks, journals, medical device advertising, comic books, and storyboarding for film.