EHR Audit Trails for Plaintiff’s Medical Malpractice Lawyers: The Production Is Almost Always Incomplete

Megan Shore, Founder / Trial Attorney | Shore Injury Law

Megan Shore is the founder of Shore Injury Law in Chicago, where she represents plaintiffs in medical malpractice, birth injury, and nursing home and assisted living abuse and neglect cases. Attorneys across the country retain her as a consultant on electronic medical records and audit trails in nursing home and medical malpractice litigation. She also works with special monitors of skilled nursing facilities appointed by the Attorney General, reviewing abuse and neglect and auditing facilities’ electronic medical records. Her cases have drawn coverage from CBS, NBC 5 Chicago, The Chicago Tribune, The Washington Post, and Law360.

• Education & Credentials

Ms. Shore received her J.D. from The John Marshall Law School in 2016. There she made the Dean’s List, earned a CALI Award in Civil Procedure, was a Dean Johnston Academic Scholar and a member of the Phi Delta Phi Honor Society, served as a Student Ambassador, and finished second of 124 competitors for her appellate brief in the Herzog Moot Court Competition. She studied pre-medicine and biology, along with business management, at Loyola University Chicago, where she earned her B.A. She has been licensed to practice in Illinois since 2016.

• Recognition & Leadership

Ms. Shore serves on the Executive Committee of the American Association for Justice Nursing Home Litigation Group. Crain’s Chicago Business named her one of its Notable Women in Law in 2026. The National Trial Lawyers has listed her among its Top 10 Nursing Home Lawyers and Top 40 Under 40 every year since 2021, and among its Top 100 Lawyers since 2022. She has been selected as a Super Lawyers Illinois Rising Star since 2021 and named to the National Academy of Personal Injury Attorneys Top 10 since 2023.

With the Women’s Bar Association of Illinois, she has co-chaired the Small Firms Committee, the Annual Dinner Committee, and the Top Women in Leadership Reception Committee. She mentors younger lawyers through the Illinois Supreme Court Commission on Professionalism, the Illinois State Bar Association, the Women’s Bar Association of Illinois, and the UIC Law alumni program.

• Professional Involvement

Ms. Shore teaches lawyers and legal nurse consultants how to use electronic medical records and audit trails in hospital and nursing home cases, along with preventing obstruction of justice, written and oral discovery, defeating motions to compel arbitration, and the Medical Studies Act. Recent programs include the AAJ Annual Convention (2023 and 2025), the AAJ Elder Abuse College (2023 and 2024), the Elder Abuse Trial College (2025), a Pennsylvania Association for Justice webinar and the Cleveland Academy of Trial Attorneys (2025), the Dallas Nursing Home Abuse Conference and the Georgia Trial Lawyers Association (2024), and the Legal Nurse Consultants Conference (2022). She has also taught at Chicago-Kent College of Law and served as a guest speaker in Trial Advocacy at The John Marshall Law School.

Her writing includes “Point and Click: Exposing Nursing Homes” in Trial magazine (2022), “Understanding the Leading Nursing Home EMR System” in the Illinois Trial Lawyers Journal (2020), and “Nothing Good Happens After 3 Hours…” in the AAJ Birth Trauma Litigation Group Journal (2021). Within AAJ, she belongs to the Nursing Home, Medical Malpractice, Birth Trauma, and Medical Record Retrieval CIOX Litigation Groups and the Women’s Trial Lawyers Caucus. She is also a member of the Illinois Trial Lawyers Association, the Illinois State Bar Association, the Ohio State Bar, the Ohio and Maryland Associations for Justice, the Chicago Bar Association, and the National Academy of Personal Injury Attorneys.

• Experience

Ms. Shore’s nursing home results include a $9 million jury verdict against a facility that failed to prevent a sacral bed sore from developing and worsening, a $6 million jury verdict in the choking death of a resident the facility failed to monitor, and a $5 million settlement for a resident who died after a facility failed to prevent bedsores, dehydration, malnutrition, and falls. In hospital malpractice, she obtained a $4 million settlement for a patient who died after a delay in diagnosing and treating sepsis. She brought the first federal motion to remand within the Seventh Circuit that established nursing homes were not immune from liability under the PREP Act or federal officer immunity during COVID-19.

Before founding her firm, she litigated hundreds of cases at a top-rated Chicago law firm. She has trained with and litigated alongside nationally known birth injury attorneys, on matters that produced jury verdicts from $4.5 million to $143 million, then the largest obstetrical malpractice verdict in United States history. Earlier, she served with the Illinois State’s Attorneys Appellate Prosecutor. She has also consulted for AARP.

SESSION 1 – Electronic Medical Records, Digital Evidence, and Audit Trails in Hospitals | Megan Shore | 2:30pm – 3:30pm

This session equips plaintiff’s medical malpractice attorneys to identify, challenge, and correct incomplete EHR audit trail productions. Attorneys will learn the two-component architecture of EHR audit data, the specific fields that must appear in a complete production, and the legal framework under HIPAA, the 21st Century Cures Act, and ONC certification requirements that compels defendants to produce what their systems actually capture. By the end of the session, attorneys will be able to draft targeted discovery requests, identify filtered or truncated exports, and execute a structured completeness audit to prove what is missing.

This session also teaches plaintiff’s medical malpractice attorneys how to read EHR audit trail data against the clinical chart to identify late entries, backdating, and post-event amendments. Attorneys will learn how to cross-reference system timestamps against chart narratives, use audit trail evidence for deposition preparation and trial impeachment, and seek sanctions or adverse inference instructions when audit trails are withheld or destroyed. By the end of this session, attorneys will be able to build a two-column timeline demonstrative, structure depositions around metadata contradictions, and lay the foundation for admissibility of audit trail evidence at trial.

BREAK | 3:30pm – 3:40pm

SESSION 2 – Electronic Medical Records, Digital Evidence, and Audit Trails in Nursing Homes & Assisted Living | Megan Shore | 3:40pm – 4:40pm

Not all EMR systems are alike, and nursing home software is very different from the hospital systems covered in Session 1. This session applies the same audit trail approach to nursing homes and assisted living facilities. Attorneys will learn how nursing home EMR software works on both the clinical and risk management side, how to read and interpret its audit data, and how to use those audits to expose gaps, late entries, and inconsistencies in a facility’s records.