Home About Contact Attorney Resources For Attorneys
Division I  ·  Attorney Services

Early Pathology Case Screening
for Attorneys

The Pathology Vulnerability Assessment helps counsel determine whether the pathology diagnostic pathway contains material process vulnerabilities, diagnostic discordance, or case-development issues before committing to broader expert review.

Who Uses the PVA

One Methodology. Different Litigation Questions.

The PVA is not a plaintiff tool or a defense tool. It applies the same structured four-domain review regardless of litigation posture. The value of the PVA depends on the litigation posture and the case decision counsel is trying to make.

Plaintiff Counsel

Does the pathology record support further case development?

  • Screen the pathology component before committing to expert spend
  • Identify process vulnerabilities that may fall outside a diagnosis-focused review
  • Direct discovery toward documented workflow and reporting issues
  • Assess whether diagnostic discordance is materially significant
  • Determine whether the pathology issues justify deeper investment
Defense Counsel

Are the pathology allegations supported by the record?

  • Test whether alleged pathology failures are documentable
  • Identify defensible workflow and documentation strengths
  • Narrow exposure by identifying which claims have process support
  • Prepare targeted rebuttal of plaintiff pathology allegations
  • Identify documentation gaps early in case evaluation
Case Evaluation

Does the pathology component justify deeper investment?

  • Early fixed-fee triage before case acceptance decision
  • Assess the pathology component before committing to the case
  • Avoid investing in cases without documentable pathology issues
  • Evaluate process vulnerability and diagnostic discordance at intake
  • Make the case decision with pathology intelligence in hand

The PVA does not replace the pathologist. A fixed-fee PVA helps counsel avoid misdirected expert spend, focus discovery, and decide whether the pathology issues warrant deeper development.

Early Case Triage

When to Request a Screening PVA

Process Vulnerability Triggers

  • → Specimen handling, labeling, or chain of custody questions
  • → Fixation, transport, or accessioning protocol concerns
  • → Gross examination adequacy, sampling, or tissue submission questions
  • → Delayed pathology report or extended turnaround time
  • → Critical value notification failure — unexpected malignancy not directly communicated
  • → CAP synoptic protocol compliance or staging documentation concerns
  • → Any question about whether the pathology process was reliable before committing to expert review

Diagnostic Discordance Triggers

  • → Original diagnosis and second opinion differ — including benign vs. malignant, grading, or staging discordance
  • → Amended report or addendum changed a clinically significant finding
  • → Outside consultation or referral review reached a different conclusion
  • → Margin, grade, or staging interpretation differs between reports
  • → Prior biopsy or specimen whose significance was not recognized at the time
  • → Counsel needs to know whether a pathology discordance is material before investing in expert review

These are common triggers — not an exhaustive list. If the pathology record is part of your case and you are uncertain whether a PVA applies, that uncertainty is itself a reason to inquire. The Screening PVA is designed precisely for that moment.

If one of these triggers is present, request a fee schedule or introductory call.

Service Tiers

Three Tiers of Engagement

Every engagement begins with a one-time master Consulting Agreement. Tier assignment is based on case complexity and your litigation objectives. All deliverables are prepared for retaining counsel and intended to support confidential attorney work-product analysis.

Tier I
Screening Pathology Vulnerability Assessment
Best for: Early case screening
$1,250 flat fee

Early-stage triage of the complete pathology diagnostic pathway across all four PVA domains — including Diagnostic Discordance Review when multiple pathology opinions are present. Delivers a written Screening PVA Report with a case-posture assessment and recommendation regarding whether deeper pathology review appears warranted. The full $1,250 Tier I fee is credited toward Tier II when the matter proceeds to Case Development PVA.

Tier II
Case Development Pathology Vulnerability Assessment
Best for: Active case development
Fee schedule available upon request

Expanded Case Development PVA Report with phase-level findings across all four PVA domains, applicable CAP and professional standards references, pathology-process deviation analysis, and a litigation-focused narrative identifying issues for counsel and appropriate next-step expert review. One post-delivery consultation call included (60 minutes, within 30 days). Follows Tier I findings — not automatic.

Tier III
PVA Expert Support & Testimony
Best for: Expert designation & testimony
Fee schedule available upon request

Expert designation and testimony grounded in PVA methodology and findings. Available selectively when the requested opinions fall within Sentinel’s pathology-process scope, PA(ASCP) qualifications, and applicable jurisdictional requirements. Testimony minimums and cancellation terms confirmed in the Matter Engagement Form.

Fee Schedule Available Upon Request. Detailed fee schedules for all three tiers are provided following initial inquiry and confirmed in the Matter Engagement Form prior to commencement of any engagement.  Request fee schedule →
Sample Deliverable

See a Screening PVA Report

A redacted sample illustrating the four-domain review methodology, phase-level findings, discordance classification, and case-posture assessment. Enter your name, firm, and email — the sample downloads immediately.

Your information is used only to fulfill this request. Sentinel does not share or sell contact information.

Four-Domain Review

The PVA Methodology

The Pathology Vulnerability Assessment evaluates the complete pathology diagnostic pathway across four structured domains. Each domain is systematically reviewed against applicable professional standards. The methodology is consistent across both tier levels — scope and deliverable depth are determined by tier assignment.

1

Pre-Analytical

Clinician order, patient identification, specimen collection, labeling and container preparation, chain of custody, accessioning, fixation protocol, transport conditions, and receipt at the laboratory. Published laboratory-quality literature has repeatedly identified the pre-analytical phase as a primary source of laboratory error — occurring before the pathologist is involved.

2

Analytical

Gross examination and tissue sampling, histologic processing and staining, microscopic examination, IHC and ancillary testing, and quality control. Gross examination is a critical analytical checkpoint — the pathologist can only diagnose what was sampled and processed correctly.

3

Post-Analytical

Report generation, diagnosis completeness and clarity, CAP synoptic protocol compliance, critical value notification, amendments and addenda handling, specimen and slide retention, and clinical consultation between the pathologist and treating physician.

4

Diagnostic Discordance Review

When multiple pathology reports, outside consultations, amended reports, or second opinions exist, Sentinel identifies whether they contain materially different diagnostic conclusions and explains the potential significance of that discordance for counsel’s case evaluation. Sentinel does not determine which diagnosis is correct — it advises counsel whether the discordance warrants pathologist review, targeted discovery, or additional record development. This is the PVA’s cost-triage function for cases involving conflicting pathology opinions.

Engagement Process

How Division I Engagements Work

1
Initial Contact

Submit an inquiry through the form below or by direct email. Sentinel will reply promptly by email to schedule an introductory call. The call is confidential and no-obligation — no privileged details are required at this stage.

2
Consulting Agreement

A one-time master Consulting Agreement is executed. This covers all future matters from your firm and does not need to be re-executed for each new case.

3
Matter Engagement & Conflict Screening

A Matter Engagement Form is completed for each new case. Conflict screening is completed before any records are accepted or work begins. Sentinel does not accept matters where a conflict of interest exists.

4
PVA Review

The Pathology Vulnerability Assessment is conducted across four domains — Pre-Analytical, Analytical, Post-Analytical, and Diagnostic Discordance Review. Each domain is reviewed against applicable CAP, ASCO, Joint Commission, and laboratory accreditation standards. Diagnostic Discordance Review identifies materially different diagnostic conclusions between available pathology opinions without independently adjudicating the correct diagnosis. Scope is consistent across tiers; depth and deliverable format are determined by tier assignment.

5
Deliverable Issued

Tier I produces a written Screening PVA Report with a case-posture assessment and recommendation regarding whether deeper pathology review appears warranted. Tier II produces a Case Development PVA Report with full four-domain analysis, phase-level findings, applicable standards references, and a litigation-focused narrative. Both are prepared for retaining counsel and intended to support confidential attorney work-product analysis. Tier upgrades are available at any point based on findings or matter needs.

Attorney Resources
PVA Methodology & Attorney Guides
In-depth articles on the PVA methodology, pre-analytical phase failures, diagnostic discordance, and how the PVA fits into your case strategy.
Attorney Resources →
Get Started

Ready to Screen a Pathology Case?

Select what you need below. No privileged case details required at this stage. Conflict screening and engagement terms are handled after initial contact.

Request Fee Schedule Schedule Introductory Call
Contact

Send an Inquiry

Sentinel will reply promptly by email. No privileged case details required at this stage.

Thank you. Sentinel will reply promptly by email to schedule an introductory call.