A medical malpractice consists of negligent conduct, which causes damage. From a theoretical point of view, "malpractice" may occur, yet if this does not cause damage or is not a cause of injury, there are no legal grounds to pursue the case. This is also true, where there is true 'malpractice', yet no evidence of residual damage. Thus, a malpractice, in particular medical malpractice may be legally pursued where there evidence of permanent injury, irrespective of any past history of damage.

Case Study
As an example one may take the case of one Dr. Jeffery MacDonald, who at the time of the incident was serving as a Captain in the United States Special Forces. Dr. MacDonald case is a prime example where medical malpractice was deliberately covered up in the first set of findings. The doctor was however later convicted of multiple murder in proceedings carried out at the request of the murdered victim's parents. The murdered victims were none other than the doctor's wife and his two young daughters.
According to the first set of briefs of the case, police broke into the house of Dr. MacDonald upon receiving a telephone call from a neighbor. The police found the doctor’s wife already dead with multiple stab wounds, as well as the young daughters of the doctor. The doctor too was barely alive, leading the police to deduce that there was a break-in, and an outsider had tried to murder the entire family.

Initial investigations led the police to believe the story of the doctor that there were ‘hippies’ involved and they had tried to murder the entire family. As evidence to this report of the doctor, the house was searched and investigations team comprising of a doctor and police found tables overturned and magazines scattered.
Though the military court charged the doctor with murder of his family. The purported cover up of medical evidence, such as the nature of self-inflicted injuries of the defendant somewhat forced the court to free the doctor, citing insufficient evidence and mishandling of evidence respectively as the reasons for letting the doctor go free.

The first case was filed in 1970 and decided within a short period. However, upon the request of the wife's parents, the case was re-opened and permission sought to re-examine the case. Though the doctor's lawyers contended that there were no grounds to re-examine and re-open the case, citing double jeopardy and absence of any new evidence. Yet, the Supreme Court accepted the plea to re-open the case for respective prosecution.
Detailed investigations on the request of the parents of the murdered wife revealed that the self-inflicted injuries, though healed after a period of some 7 years, when the case was reopened, were convincingly covered up. The primary and perhaps the strongest set of evidence brought up by the prosecution were the angle of the self-inflicted injuries upon the body of the defendant. Here, one may note that considerable time has lapsed since the brutal incident, and the re-opening of the case (some 7 years), the experience of the prosecuting doctor, one that revealed that the self-inflicted injuries were caused in downward direction, assisted the court in deciding the case against the defendant.

Opinion on the Case
One can clearly note the nature of cover up apparently carried out by the doctor's personal physician, as well as the irresponsible attitude of then police officials regarding evidence. One may also observe the particular negligence regarding the medical reports which were 'botched up' to protect the defendant, leading us to deduce a severe case of medical malpractice. Had the medical reports of the doctor been studied immediately after the brutal incidence, one would have found sufficient evidence to indict the defendant, such as the nature, the angle of the self-inflicted injuries and motive of the murders. The fact that medical evidence had been destroyed, records were not maintained, and nor were physical evidence taken into account, all too clearly leads one to deduce that there were gross anomalies committed in the investigation of the subject case.
Furthermore, the then cover up of the brutal incident also did not take into account the abusive language written on the walls above the bed, as well as any concrete evidence which would support the defendants story that there was or were 'hippies' involved. The investigation team should have taken into account these aspects, as well as the fact that there was nothing stolen, robbed, nor were there any signs of a break-in, either of which would provide evidence that there was an outsider involved. Hence the ruling of the honorable court was correct, and though late, justice had prevailed in the subject case.