Mr. and Mrs. Edward McGlynn and their children were driving in New Jersey. Mr. McGlynn was driving; Pam was in the front passenger seat and the children were in the rear seat of the car. Mr. McGlynn recalls seeing a flash. An eighty foot tall tree on the right side of the road struck the Jeep, took down power lines, and came to rest across the width of the highway. The initial impact area with the tree was on the roof right above where Pam was sitting. The roof of the vehicle was crushed and the windows were shattered Mr. McGlynn’s car stopped 20 feet away from the impact.
Mrs. McGlynn was removed from the car; she was pronounced dead. Mr. McGlynn was found by the police lying on the wet pavement. The Belvidere Squad described Mr. McGlynn as lying on his back on the road. He was alert and oriented. He knew who he was, where he was, and the date. The patient had pain in his neck, between his shoulder blades and in the middle of his back. He rated the pain as 10 (out of possible 10 with 10 being the worst possible pain.) Additionally, Mr. McGlynn had a weak grip and decreased feeling in his arms. The pain in his back got worse when his back was touched. He had intermittent feeling in his legs when he was first seen by the Belvidere Squad. Enroute to the hospital the patient lost all feeling in his legs and from his nipple level down.
At the hospital, diagnostic testing performed to determine the extent of his injuries showed soft tissue swelling in the patient’s neck. There was a burst fracture of the C7 vertebral body. The fracture likely included the left C6 pedicle of the spine. Fragments of bone were pushed into the spinal cord narrowing the cord by at least 50%.
Mr. McGlynn’s attorney asked us at Med League to summarize the medical records that filled more than a dozen 3 inch binders. Forty-one year-old Mr. McGlynn’s life was completely changed by the death of his wife and his permanent paralysis. Over the next several years, Mr. McGlynn suffered from pain, anxiety, depression, repeated urinary tract infections, bladder stones, and pressure ulcers, to name a few of his problems. We created a detailed narrative report and exhibits identifying his problems, dimensions of pressures sores, and need for medications. Pat Iyer was prepared to testify about Mr. McGlynn’s treatment and symptoms had the case gone to court.
Suit filed against the New Jersey Department of Transportation was resolved in 2011. The State agreed to pay $4.75 million. As soon as the McGlynn case was settled, the Supreme Court of New Jersey held in a death case based on the same negligent maintenance theory that the State was not liable for a failure to inspect or for a negligent inspection. Sometimes timing is everything, his attorneys Stuart Kurtzer and John Dodig said.
Use of pain and suffering summaries
The pain and suffering report is usually prepared by legal nurse consultants functioning as expert witnesses on behalf of the patient and is particularly helpful in malpractice and personal injury cases. They are effective in the situations shown below:
1. There are extensive medical records covering a long admission to the hospital or several admissions over a number of months or years.
2. The plaintiff is unable to describe his or her own pain and suffering due to death,
disability, or lack of communication skill or memory.
3. The plaintiff experienced marked pain, has required extensive narcotic or analgesic medication, multiple medical and nursing interventions, surgical procedures, complications, noxious sensations, or emotional suffering.
4. The attorney wants the nurse to educate the jury about the plaintiff’s unpleasant experiences.
5. The attorney wants to build maximum impact by having a nurse testify to the patient’s pain and suffering rather than putting the patient on the stand and risk having the plaintiff being perceived as whining.
The report provides the attorney with a comprehensive overview of the contents of the medical record, with a specific focus on the problems the patient experienced. The summary is useful for the liability witnesses in the case, who may use it to refresh their recollection about the medical events when preparing for deposition or trial. The summary may reduce the need and cost of the liability experts to perform a complete review of all of the medical records. The pain and suffering report is allowed under the Federal Rules of Evidence 1006, often echoed in state rules, when there are voluminous or difficult to understand records.
When prepared for the defense attorney, the summary of the medical record reviews the plaintiff’s claims in the complaint, deposition, expert witness reports, or pain and suffering summary. The expert witness evaluates the medical documentation and refutes the plaintiff’s exaggerations.
Patricia Iyer MSN RN LNCC and Jane Heron MBA RN at Med League prepare these reports. Contact us at www.medleague.com or at 908-788-8227 for details of how we may be able to assist you with your next case.