Ron Miller is an attorney who focuses on serious injury and wrongful death cases involving motor vehicle collisions, medical malpractice, and products and premises liability. If you are looking for a Maryland personal injury attorney for your case, call him today at 800-553-8082.

Saying you suffered a head injury in an accident is sort of like saying your nephew is an actor. He might be Will Smith, but he also might be an understudy in a local dinner theater production.

Head injuries to automobile occupants have been shown to be a major cause of death and permanent brain injury within the U.S. and internationally. Head injuries vary from headaches that resolve quickly to brain damage that destroys a life. The data on head injury verdicts does not leave a good impression of the settlement value of head injury cases:

  • Head Lacerations and Contusions: $10,016

Years ago, we were involved in gadolinium MRI lawsuits involving nephrogenic systemic fibrosis (NSF), which is a fibrosing disorder of the skin and joints that occurs with victims with advanced renal insufficiency.

Th cases settled for millions of dollars because NSF is just an absolutely awful disease.  Now there are a new set of gadolinium MRI lawsuits alleging that the gadolinium is toxic and harming patients.

What is Gadolinium?

Women experiencing typical pregnancies are not offered the option of inducing labor at 39 weeks.  That might change.

A recent study funded by the National Institutes of Health (“NIH”) suggests that electively inducing labor 1 week before the due date decreases the risk of complications and lead to a safer delivery.  New mothers whose labor was induced in week 39 (instead of waiting for labor to begin naturally) were less likely to require a C-section and had lower rates of preeclampsia and other complications.  The research also established inducing at 39 weeks did not increase the chances of stillbirth or other severe complications compared to mothers who were not induced.  The detailed results of this pivotal NIH study were just published in the New England Journal of Medicine: Labor Induction versus Expectant Management in Low-Risk Nulliparous Women.

malpractice-7It was previously believed that early induction of labor significantly increases the likelihood of an emergency cesarean delivery in response to complications.  This made many doctors reluctant to induce any time before 40 weeks, but no comprehensive study had ever been done before.  The Pregnancy and Perinatology Branch at NIH funded the study in an effort to fill this data gap.

A neonatal stroke (also called a perinatal stroke) is defined as an interruption of blood flow to an infant’s brain that occurs between 20 weeks gestation and first 28 days after the child is born. Neonatal strokes can be ischemic or hemorrhagic.  Ischemic neonatal strokes are caused by some form of blockage in the blood vessels.  Hemorrhagic strokes occur when blood vessels rupture and bleed.

What causes a newborn to have a stroke?

Neonatal strokes are the result of some event within the body that suddenly disrupts the normal flow of blood to the baby’s brain.  In adults, the underlying causes leading to a stroke are usually high blood pressure, diabetes or some other condition.

In June 2018, a study was published in the Canadian Medical Association Journal which shows there has been an alarming increase in the rate of birth injuries resulting from forceps-assisted deliveries.  This does not surprise me because our obstetrician experts have been telling us for years that the new generation of obstetricians does not have the skill to use forceps.  If too much pressure or force is used, forceps can cause injury to both mother and baby.

What Are Forceps?

Obstetrical forceps are a surgical tool used by OB/GYNs to assist in difficult vaginal deliveries.  The forceps look like large plyers with metal spoons at the ends.  The spoons are used to basically grip the baby’s head so that the doctor can then manually maneuver the baby through the birth canal.  Sometimes, birth injury lawyers unfairly vilify forceps. But forceps are a very effective weapon with the right obstetrician.  The problem is they require a high level of skill and experience by the doctor.

babya-300x169Birth injuries can result in lifelong consequences for both the parents and the child. Serious birth injuries can result in permanent disabilities and a lifetime of expenses.  Birth injuries are often the direct result of medical negligence or preventable medical error by the doctors, nurses, and staff during the labor and delivery process.  When birth injuries are attributable to medical negligence, the civil legal system gives injured parties the ability to obtain financial compensation from doctors, hospitals, and their insurance carries.

If your child has suffered a birth injury, your question is where do I go from here?  What can I do to bring about the best possible outcome for my child?   If your child had not suffered a birth injury, money is important yet still pretty far down on the list of what you need to make a good life for your child.  For a child with significant birth injuries, money jumps higher on the “things you need” chart.  So if someone wonders why you are worried about filing a lawsuit instead of focusing on your child, I think bringing a meritorious birth injury claim is exactly what you do when you are putting your child’s future first.

Below are some common questions parents ask in birth injury cases.

Caput succedaneum and cephalohematoma are similar – but distinct – birth injuries which cause a baby’s head to swell. They are typically not serious and will heal themselves over a relatively short period of time.  For most worried parents, it is not a big deal if it is not coupled with a brain bleed or other cerebral insult.  But these conditions can lead to more severe complications in the absence of a prompt diagnosis, vigilance, and effective treatment. Furthermore, the possibility that one of these conditions is connected with or arising from a more serious birth injury also means that immediate medical attention should be given to diagnosing and providing any necessary treatment for these conditions.

The importance of prompt and effective diagnosis and treatment for these conditions, unfortunately, means that what would otherwise have been harmless can grow to become a more serious – sometimes life-long – condition on account of medical negligence. This can arise from failing to recognize the issue during or after delivery, a failure to provide proper treatment (such as a C-section, when warranted), or even failing to diagnose precipitating causes of the injuries prior to birth. If your child has suffered from one of one of these conditions as a consequence of medical neglect, you should be eligible to receive compensation.  Contact me if you are looking for answers about your child’s case.

I am going to walk you through some of the most frequently asked questions about caput succedaneum and cephalohematoma.

Hypoxic ischemia (also known as ischemic hypoxia, hypoxic-ischemic encephalopathy, and HIE) is brain damage which occurs when an infant does not receive enough oxygen and blood in their brain. All of our brains, but particularly a baby’s brain,  is extremely dependent on blood and oxygen to survive.  When the brain is deprived of blood and oxygen for a sufficient amount of time, it becomes permanently damaged from hypoxia and ischemia. Once permanently damaged by hypoxia and ischemia, the brain permanently fails to provide normal neurological function.  This can cause both mental and physical injuries.  Fatalities are not uncommon.  HIE caused by asphyxia is the leading cause of infant mortality in the United States.

Unfortunately, cases of hypoxic ischemia can often happen as a consequence of medical negligence. In particular, failing to accurately diagnose the condition (often through neglecting the fetal heart rate monitor), or inadequate treatment and care during the delivery process (often through failing to perform a c-section when needed) are the two biggest factors that cause hypoxia because of medical neglect.

Birth injury lawsuits have been successfully filed for the parents to receive their due compensation for the serious consequences which can stem from hypoxic ischemia. If you have any questions about hypoxic ischemia or believe you may be entitled to compensation due to this condition arising in your child as a consequence of medical neglect, you should reach out to me.

I look at every medical malpractice case that gets filed in Maryland.  It is incredible to me how many lawyers wait until the last minute to file a lawsuit.  In Dunham v. University of Maryland Medical Center, a bedsore case decided a few weeks ago by the Maryland Court of Special Appeals, underscores the hot water you can get in when you wait until just before the statute of limitations to bring your claim.

Facts of Dunham

Operating-room-pic-4-300x200Plaintiff originally sued his health care providers for medical malpractice based on failure to prevent and treat pressure sores. The case was initially filed in the Health Care Alternative Dispute Resolution Office (“HCADRO”) then transferred to Circuit Court. All medical malpractice actions in Maryland must be supported by an expert certificate that complies with certain conditions. Md. Code Ann., Cts. & Jud. Proc. § 3-2A-04(b) (2013 Repl. Vol.). If the expert certificate does not satisfy the requirements, the case must be dismissed unless the plaintiff obtains one of the statutory time extensions.

Our law firm has successfully handled scores of foot and ankle serious injury accident cases. If you want someone to fight for you, lawyers that knows these cases, call 800-553-8082 or get a free Internet consultation.

I think I have a pretty good handle on the settlement value of ankle fracture cases.  We have handled a lot of foot and ankle injury cases over the years.  My first foot and ankle case was 17 years ago when  I sued the New England Patriots and their team doctors that ultimately settled. Over the course of that lawsuit, I probably met with a half dozen of the best foot and ankle surgeons in the country.

Since then, Miller & Zois has handled scores of foot and ankle injury case and procured millions of dollars for our clients in these cases.  My last ankle injury verdict was in Prince George’s County was the 6th biggest verdict that year, according to Washingtonian Magazine.  We know the science of these cases and how to maximize the settlement and trial value of these claims.

Ankle Settlement Value Statistics

What kind of success are other lawyers having in fracture ankle cases?   Apparently, they are having very little success. The median settlement values for ankle fracture injuries are:

District of Columbia $66,000
Virginia $21,700
Maryland $88,000

It is amazing how low these are.  These are from a few years ago but I think the number has not changed in 2018.    Sure, some ankle fractures can be treated with conservative care if the fracture displacement is two millimeters or less or if there is no talar shift.  But it is difficult to imagine getting less than six figures in the vast majority of these cases.  I don’t know how much insurance policy limits came into play in these cases.  But, either way, these numbers are just way too low.

One of the problems, I think, is not distinguishing between a good result and a good outcome for the patient.  A good result for an orthopedic surgeon is a good looking x-ray.  The fracture is healed, mobility is good and the ankle joint is where it’s supposed to be. But you can have a good x-ray and still have a permanent injury, particularly when there is hardware is keeping the ankle together.

Two more points of interest in this data. First, don’t get an ankle fracture in Virginia. It is amazing to me how low these Virginia verdicts are. I have to think this data is screwed up in some way. Second, it is interesting that Maryland ankle fracture verdicts are 33% higher than Washington, D.C. verdicts, given that the Maryland median was much less than Washington, D.C. for both fractured shoulder and rotator cuff verdicts.

https://t1.gstatic.com/images?q=tbn:ANd9GcSXFHSoBC-IKXHH1YlS-S_ZN7nNmrR28zjLMhabnYcuBCOwRWWKThe Federal Tort Claims Act News (who knew there was such a publication?) wrote an article about how Jury Verdict Research Case Evaluation Software was predicting the values of verdicts in a particular slip and fall case with an ankle fracture. In this case, the jury predicted a probable verdict of $117,600 with only a 33% chance of success on liability (maybe a tough slip and fall case on liability).  I just struggle to see how a case with a good fracture could be valued so low.

As a point of comparison, it provided the following JVR nationwide analysis of ankle injuries:

Award Median $91,925
Probability Range $40,000 – $248,223
Award Range $1 – $5,250,804

 

One more point: median settlement values is the midpoint of the data, not the average. So included in the math are a lot of awful cases that probably never should have been filed in the first place. So why not just quote the average? Well, the high range of these ankle verdicts is $5,250,804. That also distorts the statistics. The take-home message: settlement and verdict statistics are invariably misleading.

Factors That Impact Settlement Amounts in Ankle Fracture Cases

These are 15 factors that drive the trial and settlement value of your ankle fracture case.

  1. Surgery
  2. Surgery with hardware
  3. Complex fracture
  4. Displace bone
  5. Continued ankle swelling (synovitis)
  6. Synovitis with chondral changes
  7. Signs of arthritic changes
  8. Arthrofibrosis
  9. Chondral injuries
  10. Loose bodies
  11. Nerve Damage
  12. An ankle replacement
  13. Walking with a limp
  14. Non-weight bearing ankle
  15. Amputation

All of these factors lead to the question of how is the ankle injury permanent and, if so, how severe is the permanency.

Sample Verdicts and Settlements in Ankle Cases

This will give you another way to look at value: sample verdicts and settlements.  But please remember that no two cases are alike and you cannot figure out the value of your case just by comparing your case with a similar case.  No two cases are the same and someone’s verdict is just a poor predictor of what the outcome in your case will be.  Certainly, along with other tools, it can shed light on value.  No question.  But you just cannot put too much into it.

  • 2014, Maryland: $96,789 Verdict – The plaintiff was driving on a two-lane road when another car hit him head-on. He suffered a comminuted ankle fracture as a result of the crash. The plaintiff had to have two screws permanently implanted in his leg, and developed a permanent limp as a result of his injuries. The jury awarded him $96,789.  This is one of those cases I’m talking about, right?  A permanent limp is only worth $96,000?
  • 2013, Maryland: $260,506 Verdict – When the plaintiff was inside of a Taco Bell restaurant, a fight ensued, and the plaintiff was struck in the face by an employee. He fell backward as a result of the fight which caused his ankle to become fractured. He had to receive two surgeries to fix his ankle and developed an infection. Additionally, he claimed that he had limited mobility in his ankle. The defendants contended that he provoked the fight. The jury awarded him $260,506.
  • 2014, Pennsylvania: $847,362 Verdict – As the plaintiff was exiting her apartment when she slipped and fell on icy steps. She sued the property owner, claiming that they negligently maintained the steps by failing to remove snow and freezing rain. Plaintiff alleged that the defendants failed to inspect the property over the previous night, which led to the hazardous condition. She suffered an ankle fracture, which required implementation of screws in her ankle, leading to arthritis. She also alleged that her ability to stand was compromised.
  • 2014, Pennsylvania: $225,000 Settlement – The plaintiff was crossing a street when she stepped in an uneven asphalt patch. This caused her ankle to roll, leading to a fracture. She sued the city, alleging that they failed to maintain a dangerous condition. She had to receive surgery, where two screws were implanted in her ankle. The plaintiff had to undergo physical therapy and claimed that she suffers pain and swelling during prolonged periods of standing. The defense claimed that the alleged injuries were fully healed. Still, the parties reached a pretrial settlement.
  • 2014, Virginia: $2,000,000 Verdict – The plaintiff was a 59-year-old shipyard worker who slipped and fell on a patch of black ice while taking his car in for service. He sued the dealership, alleging that they failed to maintain a lesser-used sidewalk and that they knew that it commonly ices over. He suffered an ankle fracture and claimed that the injury aggravated a pre-existing back injury. He had to receive surgery to repair his ankle and additional surgery to alleviate back pain. The defendants claimed that he had previously inquired about the back surgery prior to the fall. The jury awarded him $2,000,000.
  • 2010, North Carolina:  $10,397,291 Verdict – The plaintiff was interested in purchasing a new boat. While on a demonstration with a boat salesman, the boat hit choppy waters causing the plaintiff to be thrown up and down in the boat. He fractured both ankles, one of which required surgery. The plaintiff claimed that the defendant was operating the boat at unsafe speeds given the choppiness of the water. He sued the boat operator and the marina and received a $10,397,291 judgment. This case underscores impact on the amount of the verdict a good lost wage claim can make.  This man was a urologist and most of the damage award accounted for his past and future earnings.
  • 2010, North Carolina: $80,000 Settlement – The plaintiff was operating her vehicle when she was struck by another motorist trying to enter the street from a cross street. She suffered an ankle fracture as a result of the accident. The parties eventually settled for $80,000.  We have no more information on the severity of the claim.

Getting a Lawyer to Fight for You

If you have an ankle fracture case in Maryland or Washington, D.C., call me at 800-553-8082 or fill out this claim form online. We can help you.  If you are outside of the Baltimore-D.C. area and you have a serious ankle fracture, call me or find my bio and email me.  I can (probably) help you find the right lawyer to maximize the value of your ankle fracture claim.

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