Founded in Missouri in 1952 and now operating from 30 offices nationwide with more than 625 attorneys, Spencer Fane has become one of the fastest-growing law firms in the United States. Within its robust medical malpractice defense practice, where complex, high-stakes cases are a daily reality, the ability to truly understand and use medical evidence can make the difference between winning and losing at trial. For the attorneys handling these cases, that responsibility doesn’t fall on them alone, it is shared with their two in-house Legal Nurse Consultants, who sit at the intersection of medicine, law, and strategy.
Sarah De La Garza, one of these Legal Nurse Consultants, describes herself as the “master of the medical record” for the cases she works on. From day one, she is the person who digs into thousands of pages of records, identifies what actually matters clinically, and helps the legal team understand what the medicine does—and doesn’t—support. Just as importantly, she finds, contacts, and manages the medical experts whose opinions often determine the strength of the defense.
For years, one of the biggest friction points in that process was medical imaging. Even experienced experts struggled to access it. Files were sent on CDs or flash drives, or pushed through generic file-sharing systems that weren’t built for medical images. Studies were disorganized, hard to interpret at a glance, and difficult to share efficiently. What should have been clinical analysis instead became logistical troubleshooting.
When Spencer Fane began using Purview Image™, that dynamic fundamentally shifted. Imaging is now centralized, clearly organized by date and study type, and instantly reviewable. Sarah can quickly see what exists—and what is still missing—without opening every file individually. Experts receive a simple secure link, require no special software, and can view images on any device. During expert conferences, everyone can look at the same scans in real time, annotate, circle, and point to exactly what matters. As Sarah put it, “A task that used to take me hours now takes me minutes.”
“A task that used to take me hours now takes me minutes.”
That efficiency has real consequences for the people reading this story. For attorneys, it means less time wrestling with technology and more time building arguments. For Legal Nurse Consultants, it means spending their expertise on clinical analysis rather than file management. For experts, it means a smoother, more focused review process. And ultimately, for the firm, it means a stronger, clearer defense.
At trial, the stakes are even higher. Sarah sits just behind the defense table, ready to retrieve any piece of imaging at a moment’s notice to support, redirect, or counter an unexpected line of questioning. In complex cases involving years of imaging across multiple facilities, that level of preparedness is critical.
As Sarah explained, what was once her biggest challenge is now one of her favorite parts of the job: “It is super simple. They don’t have to download the image, they don’t have to have any special software, and while we’re on call they can be pointing, highlighting, circling, and making notes on images.”
“Experts don’t have to download the image, they don’t have to have any special software, and while we’re on call they can be pointing, highlighting, circling, and making notes on images.”
For Spencer Fane, having an experienced in-house Legal Nurse Consultant paired with the right imaging technology hasn’t just improved workflow—it has strengthened how the firm collaborates, prepares, and presents its cases when it matters most.
