Catastrophic Injury

Catastrophic injury is a term of art used within the legal practice and the insurance industry. It refers to a permanent injury that is so horrific that the victim will require ongoing care and treatment for the rest of their life. These are typically high value cases that require expert witnesses in life care planning and economics. The insurance industry considers these “high risk” cases that have the potential for a “nuclear” verdict. The stakes are always high in a catastrophic injury case.

We represented a courageous woman who was struck by a commercial truck while exiting a pharmacy. The woman was hit from behind which pushed her into a snowbank and one of her legs was run over. Our client’s leg was shattered. She had an open fracture, which means part of her tibia bone was sticking out of her leg. The woman was raced to a local emergency room. However, the injury was so catastrophic that she needed to be med flighted to a tertiary car facility in Boston. Her trauma surgeons feared she would lose her leg.

Generally speaking, there are three types of fractures: A non-displaced fracture is oftentimes referred to as a “hairline fracture.” In these fractures the bone remains in place and the affected body part is put in a cast, so the bone is able to naturally heal itself. A displaced fracture refers to the bone shifting out of place. To treat this type of fracture, the bone has to be manually reset back to its anatomical position. Then, surgical implants such as screws and/or plates are required to hold the bone in place. This is known as an open reduction with internal fixation (ORIF). Frequently, the hardware can cause residual pain approximately one year later and may have to be removed. An open fracture is the most severe type of fracture. Not only must the surgeon reset the bone, but there is an added element of risk of infection because the leg is exposed to bacteria.

In our client’s case, the open fracture was so severe that she sustained a horrible infection. Her trauma surgeon was unable to perform an ORIF because the patient’s leg was so compromised that the surgical team did not want to make an open incision. So, to reset the bone, they had to place an external fixator which looks like a metal cage that surrounded her shin. The sight was ghastly.

Our client was admitted to the hospital and later an inpatient rehabilitation facility for nearly a year. She developed subsequent infections in her leg which required debridement of the necrotic tissue that went almost down to the bone. After the external fixator was removed, it was finally safe for her surgeon to perform an ORIF which consisted of several screws implanted in her ankle. Our client bravely endured months of physical therapy to teach her how to walk again. Thankfully, she was not relegated to a wheel chain.

However, the displacement of the bone was so great that the screws could not handle the pressure of the torque. The surgical screws snapped in half and our client was left with a “nonunion.” The injury was back to square one. She was barely able to walk again. The road ahead of her was so arduous that our client was close to getting an amputation.

After more physical therapy, our client was able to just barely walk again even with the non-union. However, the most basic life activities that we take for granted were nearly insurmountable for her. The prospect of going back to work was an impossibility. Not only that, our client required expensive medical care for the rest of her life. This is an example of a catastrophic injury.

To make the case “come to life” we hired a professional videographer to create a “day in the life video.” When spent an entire day filming our client going about her daily routine and interviewing her support network. To say the production value was high quality would be an understatement. The insurance adjuster negotiating the claim was able to see, firsthand, how heart breaking our client’s life had become.

Additionally, we needed to ensure that our client was going to be provided with all the financial compensation she needed to take care of her for the rest of her life – approximately 30 years of life expectancy according to government actuarial life tables. Actuarial Life Table (ssa.gov) We retained an accomplished life care planner to map out the cost of our client’s future medical care. The number was an astronomical amount in the millions of dollars. If we hadn’t provided the insurance company with non-speculative proof of our client’s future damages, she would’ve left millions of dollars on the table.