Explaining pressure sores to a jury in spinal cord injury cases

As a trial lawyer in Atlanta, Georgia, often representing survivors of  spinal cord injuries,  both paraplegia and quadriplegia, I have dealth  with effects of such injuries about which most people know nothing. Among those are pressure sores, muscle spasticity and autonomic dysreflexia. Of course, this brief post is not medical advice, just an expression of awareness of the types of things that must be conveyed to a judge and jury  to help them understand.

Spinal cord injury survivors are extremely vulnerable to the development of pressure sores — also known as bed sores or decubitus ulcers — even with the very best of care. Even Christopher Reeve ("Superman"), who had the very best care money could buy, had a pressure sore that became severely infected, leading to systemic infection, a heart attack, coma and death. We have had a quadriplegic client who died from a pulmonary embolus while in one of the very best hospitals for treatment of a pressure sore.

A paraplegic or quadriplegic may not feel a pressure sore developing, so it is extremely important to change position on regular intervals to allow the blood circulation through pressured areas. A healthy person will feel discomfort in a position that could affected circulation, and shift position.  With a spinal cord injury,  such messages are blocked at the level of injury so that the person not even be aware of the area where potential skin damage could occur.

Damage from a pressure sore may range from slight discoloration of the skin (stage 1) to open sores that go all the way to the bone (severe). The affected area may feel warmer than the surrounding tissue. In light-skinned people, the discoloration may appear as dark purple or red. In darker-skinned people, the discoloration will appear darker than the surrounding tissue.

A "day in the life" video can be extremely effective in explaining the care routine for pressure sores.  Medical illustrations can aid a physician in explaining how and why pressure sores develop.  Simple common sense analogies — which I will not put on a web site where opposing counsel could read them — can also aid jury comprehension.

There are many online information resources about spinal cord injury. One of the best sources is Apparelyzed.com.  It is extremely important that anyone with a spinal cord injury go to a specialized rehabilitation center such as the Shepherd Center in Atlanta, which is just down the street from us.

Of course a trial lawyer cannot give medical advice. But if you are going to court to recover damages sufficient to fund a life care plan for a spinal cord injury, it is important to have a lawyer to understands this stuff well enough to communicate it effectively to a judge and jurors who may have no knowledge of the complexity of spinal cord injuries.

The Shigley Law Firm  represents plaintiffs in wrongful death and catastrophic injury (including spinal cord and brain injuries) in cases statewide in Georgia, and in other states subject to the multijurisdictional practice and pro hac vice rules in each state.  Ken Shigley was designated as a "SuperLawyer" in Atlanta Magazine and one of the "Legal Elite" in Georgia Trend Magazine. He is a Certified Civil Trial Advocate of the National Board of Trial Advocacy, and has been chair of both the Southeastern Motor Carrier Liability Institute and the Georgia Insurance Law Institute. He particularly focuses on cases arising from truck and bus accidents and defectively manufactured products. Click here for a free consultation with no obligation.

 

  • rasha ahmed

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  • http://legalnurseconsultanttom.com Thomas Sharon, R.N., M.P.H

    Who is at Risk of Bed Sores?
    In making the assessment, the admitting nurse must determine whether anyone or more of the following risk factors exist:
    age over 60
    spinal cord paralysis
    stroke
    nervous system disease
    poor circulation
    diabetes
    confined to bed
    altered level of consciousness
    confusion
    bladder incontinence
    bowel incontinence
    diarrhea
    anemia
    dehydration
    malnutrition
    obesity
    emaciation
    reduced mobility (traction or body cast)
    The usual procedure is to assign a value of 1 to each risk factor and add up those that exist. The totals then translate to one of the three levels of risk as follows: 0 to 6 indicates low risk, 7 to 13 indicates moderate risk, 14 to 18 indicates high risk. The parts of the body that are susceptible to pressure ulcers are the heels, ankles, knees, buttocks, tailbone, lower spine, shoulder blades, ears, and back of the head.

  • http://www.catastrophicinjury.com Brain Injury

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