How has the substantial evidence test been applied in medical malpractice cases?

"Substantial evidence means that a finding is supported by ' "more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." ' (Richardson v. Perales (1971) 402 U.S. 389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842). In applying the substantial evidence test we are obligated to look at the record as a whole (6) and not merely at the evidence tending to support a finding."

Footnote 6 reads: