Clarity in the Courtroom: The Power of DICOM Imaging in Malpractice and Personal Injury Litigation

In personal injury and medical malpractice litigation, a picture tells a thousand words but a DICOM image can include data from thousands of pictures. Whether going to trial or generating evidence to support a fast settlement, it can be important for attorneys to have a strong grasp on the underlying medical injury.  Whether it’s a judge or jury, providing a clear picture of the injury can make or break your case.

Most lawyers are not medical doctors and often require consultation with a medical expert. The attorneys we work with stress the importance of having experts involved early to help them understand nuances associated with the injury in question and the determination of its cause. 

Most experts expect to see the original DICOM imaging, understanding that this is the highest quality and most authentic information they could have to form their opinion. If you’re wondering why you shouldn’t just use a much simpler photograph or JPG image, check out the blog, “The Visual Verdict: DICOM vs. JPG Images in Legal Proceedings.” 

Due to the size of these DICOM images, sharing them with experts is slow, error-prone, and expensive.

The 90’s Called and Want Their CDs Back

Sharing medical imaging with experts starts with requesting your client’s files from the medical provider. Despite federal legislation intended to reduce the obstacles to patients getting copies of their own records, the process may take weeks or even months and can be expensive. For medical images, success typically means a CD arriving in the mail. 

Hopefully, someone in your office has a CD drive that will allow you to view the newly arrived images. Most CDs include an often rudimentary and sometimes quirky viewer, required to display a DICOM formatted image. Attorneys who use medical images frequently may want to have their own real viewer allowing them a consistent experience when reviewing images. Perhaps even better is sharing the same viewer with your expert!

No one wants to risk mailing the only copy of a piece of evidence (CD), so before sharing DICOM images the CD must be duplicated. This is a somewhat painful and time-consuming process. While CDs and their sleeves don’t cost much, the time involved in making a copy is quite wasteful and adds up. 

CDs can then be mailed or couriered to your expert or experts, across town or across the country. Either way, the mail can be slow and overnight couriers expensive. Hopefully, your package arrives in one piece and was copied correctly or you may have to repeat this process!  

Medical images like other medical records are considered private health information (PHI). Lawyers who handle PHI should be well aware of the risks of PHI falling into the wrong hands. The physical mailing of CDs is one of those processes that can easily turn into a HIPAA violation. Just mailing a disc to the wrong address or having someone other than the addressee receive the package may have severe implications for the unsuspecting law firm.

When all goes according to plan, the expert receives the CD. Many experts either view the DICOM images using the viewer included or download the contents to their own viewer.  Ultimately they have to communicate their findings and opinion back to the attorney.

The Modern Way to Share Medical Images

Increasingly, law firms are realizing that CDs are perhaps not the best media for medical images.  Besides the issues associated with sharing images as we described above, storing CDs is also problematic. We often find firms literally storing their case evidence in a shoebox. There are better ways.

Firms are now considering the cloud as a better means for capturing, storing, and sharing medical images. While you still may not be able to convince providers to send you the medical images of your client in any manner other than mailing a CD, once you receive the disc, there are now improved, faster, and cheaper methods for their handling.

Several firms, including Purview, are marketing a cloud platform that allows you to upload the CDs you receive in the mail and then store these images electronically. They provide an intuitive consistent viewing environment, that you can share with your expert(s). All of this can be done with the push of a computer button instantaneously and without the risks and tedium of copying and mailing CDs. This means no time or money wasted burning CDs, no need to rely on unreliable snail mail, and (depending on the platform) a solution to synchronous sharing so that attorneys can optimize their time consulting with their expert.  Be sure that whatever you choose, the system is HIPAA compliant and the vendor is willing to sign a Business Associates Agreement (BAA) binding them to the confidentiality requirements of HIPAA.

To learn whether your cloud solution is compliant, check out the blog, “Navigating Turbulent Legal Waters: HIPAA Responsibilities for Lawyers Handling Private Health Information in Litigation.

Cloud-based systems are a great way to store your evidentiary files before, during, and after litigation. Most enable a way to organize these images based on case or matter number. They are easily searchable and allow your expert to document their opinions and recommendations together with the images themselves.  Purview’s platform even enables synchronous viewing between you and your expert, allowing them to provide detailed analysis and ways for you to present and articulate the injuries.


The old established process for handling medical images on CDs has outlived its usefulness.  It’s time for serious medical malpractice and injury firms to adopt a better, more efficient, and modern way to handle medical images in their litigation.


Want to learn more? 

Watch the full webinar: Attorneys Leveraging Medical Imaging During Litigation
or reach out to us with your questions



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