Some of the most devastating and severe injuries consist of those that involve damage to the spinal cord. Spinal cord injuries can be caused by almost any type of impact or crushing injury to the spinal cord. The impact can be to the buttocks, head, neck or back. The injuries are often immediate and may often result in permanent paralyzation, which can range from thoracic injuries, resulting in partial loss of function, mobility and feeling in the lower body (paraplegia) to more severe cases of upper spine involvement resulting in total paralysis of nearly the entire body (quadriplegia). Spinal injuries truly are Life Changing Injuries.
A challenge attorneys face in presenting a spinal cord injury case to a jury is to paint a complete picture of the quality of life that exists after paralysis. As with any injury, jurors will have preconceived notions of the impact it might have one a person’s life, which preconceived notions are not always accurate.
There are a large number of organizations which work tirelessly to change the public perception of persons suffering paralysis, who encourage the public to see persons in wheelchairs as capable people who just “do things sitting down.” While their work has made incredible inroads for paralyzed individuals in the areas of access and employment, it has at that same time created a subliminal urge on the part of the general public to pretend like the person sitting next to them in a wheelchair, is not really sitting in a wheelchair. Nothing could be further from the truth. The challenge to the attorney presenting a paralysis case, especially paraplegia, to a jury, is to make that jury understand what this person’s whole life is like; not just how easy is was for them to carry on a conversation while “sitting down.” The attorney is presenting a tragic injury to a jury, and asking them to award the injured person millions of dollars for pain and suffering, loss of the enjoyment of life, and loss of the ability to earn a living as easily as a person not confined to a wheelchair. The attorney cannot get caught up in the illusion that if the person thinks positive thoughts, that their disability will become irrelevant to their life. If you are seeking to hold some wrongdoer responsible for your client’s spinal injury, you cannot let the injury be trivialized.
The trial lawyer has many powerful tools at his or her disposal. They should deploy all of them.
Expert Witnesses
Retaining the right expert is key to the presentation of a spinal injury claim. Caution must be used when using treating physicians. Treating physicians realize that the emotional state of the patient is crucially important to spinal injury patients, and are often reluctant to discuss in front of the patient the many severe and life-threatening complications spinal injury victims can suffer. They are often reluctant to discuss the shortened life expectancy of the their patients, and the substantial chance that a urinary tract infection or pressure sore are possibly be the biggest threats of death to a paralyzed patient. While their patient may not have yet experienced any extraordinary complications, they are subject to a wide range, including chair/pressure sores, thrombosis (blood clots) due to lack of mobility or a life-threatening disease such as pneumonia due to a weakened immune system. While treating physicians serve an important role then they act as “cheerleader” for their patients, the attorney’s job at trial is to present and seek compensation which will protect and provide for the client’s worst possible outcome; not the hoped for best.
Experts should be hired in all appropriate fields, so that all contingencies of the client’s future can be properly explained and potential treatment costed out. A Physiatrist, a medical doctor who specializes in physical medicine, rehabilitation, and pain medicine is almost always necessary. Care should be used when deciding whether to utilize a separate Rehabilitation expert. Often times these experts can be effectively turned on you by a skilled opponent, who can use them to explore the “wide array” of jobs available to those spinal injury victims lucky enough to operate at the high end of the functioning spectrum.
The Day in the Life Video
A Day in the Life video, that is a video possibly narrated by the Physiatrist, is a must in any spinal injury claim. The video should be no longer than 15 minutes, but it should be designed to give the jury a clear picture of the problems, challenges and issues that a spinal injury patient faces each and every day. Subject matter that might be awkwardly or inadequately discussed or downplayed by a brave client can be discussed and presented in a professional and complete manner in a video presentation. The video should be produced after a life care plan is prepared, and care should be taken to point out problems faced by the client that could be avoided or alleviated if the jury were to award the money provided in the life care plan for such solutions. Examples might include specialized beds, wheelchairs, transfer devices, shower equipment, and a variety of other specialized equipment and devices.
The Life Care Plan
The development of a life care plan is essential to effectively present current and long term treatment needs. A life care plan is a comprehensive care plan prepared by a certified life care planner, with the guidance of physicians, which provides a detailed plan of current and future medical treatment, anticipated costs and other miscellaneous needs, for a severely injured individual. After the plan is prepared by the life care planner and physicians, the life care planner then researches the costs of the provisions of the life care plan. The costs are then projected into the future, with allowances made for inflation and then reduction to present value.
A proper life care plan allows the attorney to present, in a organized form, a picture of the future needs of the spinal injury victim. It can be utilized for trial, or before trial for settlement discussions. When supplied to the opposition, it can serve an important purpose of quantifying the massive future costs of care for the spinal injury victim.
The contents and structure will greatly vary depending on the severity and nature of a client’s injury. The general structure and contents of a life care plan might include:
• A case summary including the client’s medical history and descriptions of any major surgeries and/or procedures;
• Current and projected medical care, including projected and anticipated emergency medical procedures and hospitalizations;
• Current and projected medical check ups, preventative examinations and evaluations;
• Current and projected therapy (i.e., speech therapy, physical therapy, occupational therapy, psychological counseling);
• Current and projected medication needs;
• Current and projected labs/diagnostic testing needs;
• Home/facility care (i.e., skilled nursing, housekeeper, handyman);
• General health maintenance and recreational activities to improve quality of life (i.e., exercise, hobbies, special recreational programs for the disabled);
• Medical supplies and equipment (i.e., wheelchair/transportation equipment, bathing equipment);
• Architectural renovations;
• Potential emergency room/hospitalization visits to address associated complications;
• Any vocational needs;
Government and Medical Studies
There is no doubt that some wheelchair bound clients can manage their health and psychological issues to the extent that they can hold gainful employment. Some have gone to law school, medical school, or become fantastic successes in their chosen fields. The attorneys defending a person or company whose wrongful conduct has caused your client to suffer paralysis will often show up at trial with several of their experts in wheelchairs. These witnesses tell the jury how a wheelchair is an impediment only to those who let it be. However, the fact that some are lucky enough to be able to achieve these lofty goals, does not mean that those who cannot are lazy or malingerers. In fact, many U.S. Government studies, which can be located and used by your experts, detail how unique it is for a paralyzed person to be able to avoid all of the problems that will derail their goals, no matter how determined they might be. Liberal use of these government studies should be made, on cross examination, especially with the defense experts.