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Foreign object cases may result in a number of different circumstances. Most commonly, they arise when a patient discovers at some point after surgery that a surgical instrument or other object has been left inside their body. The patient may discover this through performance of another medical procedure or through the occurrence of pain and injury due to the presence of the foreign object.

If you or someone you know has been injured due to a foreign object, you may be entitled to monetary compensation. Please fill out the form below for a free evaluation of your claim by an experienced attorney. There is no cost or obligation for this service.

Free Foreign Objects Left in Body Consultation

Title:
First Name:	*
Middle Name:
Last Name:	*
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City:	*
State, Zip:	* *
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Injured Person Information:

Date of Birth / Age: (ex. mm/dd/yyyy or 54)
Were you injured?	Yes No
If not, who are you inquiring on behalf of?

If you are NOT inquiring on your own behalf,
what is your relationship to the injured person?

Is the person deceased?

Yes No

If deceased, what is the cause of death
as stated on the death certificate:

Date of Death: (ex. mm/dd/yyyy)
Was an autopsy performed?	Yes No
If not deceased, does the injury prevent you or the victim from working?	Yes No

If yes, when did you/victim stop working?
What is the approximate lost wages due to the injury?

Accident / Injury Information:

Name of Doctor:
Date of malpractice:	*
City where malpractice occured:	*
State where malpractice occured:	*

What type of procedure, surgery or treatment was performed?
Why do you believe malpractice occurred?
Describe injury resulting from malpractice:
Name and address of Doctor, Hospital, Nursing Home or Healthcare facility:

Case Description*
Please explain exactly what happened, trying to state
as thoroughly as possible who you believe was responsible
and why you believe that person was negligent:

Please explain the full extent of the victims injuries:

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