Court Rejects Defense Claims that Back Injury Pain and Suffering Awards Excessive

Luis Ramos was sitting in a parked car in the parking lane, on Claremont Parkway in the Bronx on September 24, 2001. He had been waiting for his son when he decided to exit the car. After opening the driver side door about six inches, his car was struck by a passing city bus.

Ramos was sitting in a 1987 Ford Thunderbird:

Ramos was thrown to the other side of the car and claimed he hurt his back.

Ultimately, Ramos sued the transit authority and on May 21, 2009, a jury found the bus driver 100% at fault for the accident and awarded plaintiff pain and suffering damages in the sum of $595,000 ($270,000 past - 8 1/2 years, $325,000 future - 9 years). Both the liability finding and the damages award were upheld on appeal last week in Ramos v. New York City Transit Authority (1st Dept. 2011).

As indicated in the decision, plaintiff was 59 years old at the time and he sustained multiple herniated discs in his lumbar spine that required a combined discectomy, laminectomy and spinal fusion four years later.

In a laminectomy, the surgeon removes the bony back wall of the affected spine, called the lamina and then in a discectomy, the surgeon removes the disc itself:

 And here's what the spine looks like after the lumbar fusion surgery with the insertion of a metal plate and screws:

In the appeal, the defense argued, unsuccessfully, that (a) the liability verdict should be reversed because plaintiff should have seen the bus before he opened his car door into traffic and (b) in the alternative, the jury should have apportioned some of the fault to plaintiff because they found he was negligent (but that his negligence was not a proximate cause of the accident).

As to damages, the defense argued that the jury award was excessive in view of plaintiff's preexisting conditions:

Plaintiff successfully countered each of the defense arguments as to damages through the testimony of his expert neurologist who stated that:

  • both the scoliosis and the syrinx were in plaintiff's cervical spine and the likelihood that either of these conditions affected plaintiff's lumbar spine was extremely remote
  • plaintiff showed no symptoms of preexisting low back pain problems and the fact that he had been diagnosed with degenerative disc disease two years before ths accident was of no consequence because there was no evidence (such as an MRI) that Ramos had a herniated disc before the accident

Inside Information:

  • Ramos refused medical treatment at the scene, reported to work that night as a doorman in an apartment building, continued to work for  a few more days and did not seek any medical attention at all until three days later when he presented to a neighborhood clinic complaining of significant lower back pain.
  • There were only three witnesses at trial - plaintiff, a police officer and plaintiff's medical expert, neurologist Ringa Krishna, M.D. The defense produced neither its bus driver nor any medical expert to rebut plaintiff's claims and proof as to causation, pain, disability and permanency.
  • Unfortunately, the surgery failed and plaintiff's condition got worse. He was diagnosed with chronic nerve damage and arthritis in his spine causing permanent low back pain and making it difficult to walk. Ramos never returned to work.
  • Plaintiff was granted a missing witness charge as to the defense physician who was engaged before trial but did not testify at the trial - the jury was told that it may infer that the defense doctor would not have supported the defendant's position with respect to the medical issues and would not contradict the plaintiff's medical evidence.

 

Verdict for $5,000,000 for Past Pain and Suffering in Trip and Fall Back Injury Case Set Aside on Appeal - Jury's Findings Irreconcilably Inconsistent as to Fault and Illogical as to Damages

What were they thinking? In a stairway trip and fall negligence case, the jury found:

  1. plaintiff was negligent but defendant building owner was completely at fault and
  2. the 35 year old plaintiff was entitled to $5,000,000 for past pain and suffering but zero for future pain and suffering


No one knows for sure what the jury was thinking but it’s certain that a brand new jury will be chosen to rule on these issues because the jurors who made these findings either were hopelessly confused, unable to understand the trial judge’s instructions or acted in inexplicable, irrational ways.

In any event, after six years of litigation, nine days of trial and countless hours of effort by lawyers for both sides, Davin Dessasore’s lawsuit against the New York City Housing Authority (the “NYCHA”) must now begin anew, according to a recent decision by an appeals court in Dessasore v. NYCHA (1st Dept. 2010).


It all began on December 11, 2003 when the then 31 year old Mr. Dessasore visited his mother at her second floor apartment located at 1085 Bruckner Boulevard in the Bronx, known as the Bronxdale Projects (an NYCHA building).

Here's one of the original 28 seven-story buildings of the Bronxdale Projects, built in 1955:

After his visit, Davin started to descend the stairs when he claims he tripped and fell to the bottom because of a detached handrail lying on the top step of the dimly lit staircase.


No one was with him or saw him fall but it was undisputed that Dessasore had been talking on his cell phone before and after he fell. The defense produced his cell phone records at trial in an effort to prove that plaintiff was careless and caused his own accident. He was cross-examined extensively on the issue of when exactly he was chatting on the phone.

Do not walk down stairs talking on your cell phone:


Plaintiff admitted he either received or made a phone call as he was leaving the apartment and was walking toward the stairs but he claimed he then put the phone away a moment before he fell. The jury found otherwise and ruled that Dessasore was negligent in speaking on his cell phone while descending the stairs but the jury ruled that his negligence was not a proximate cause of his injury and that the NYCHA was wholly at fault for the dangerous condition of the stairway. And then the jury also awarded Dessasore $5,000,000 for his injuries (details on this unusual damages verdict below). Here is a copy of the verdict sheet given to the the jurors in this case on which they recorded their findings.


The appellate court stated that the jury’s finding of 100% liability against the NYCHA without any reduction for plaintiff’s share of the fault was “irreconcilably inconsistent.” The judges noted three important pieces of evidence:

  1. plaintiff was not looking down before he started to descend the stairs,
  2. he wasn’t paying attention to his surroundings, and
  3. he was talking on his cell phone just before he fell.

Therefore, the appeals judges concluded that it was “logically impossible” to find plaintiff was negligent without also finding that his negligence was a proximate cause of the accident. So, the entire liability verdict was dismissed and a new trial ordered on all issues.


The $5,000,000 pain and suffering damages award (all for the past five years and nothing for the future) was also addressed by the appellate court. The judges found it to be irrational, given the extent of plaintiff’s injuries and evidence of their permanence. Both the trial judge and the appellate bench concluded that the jury either did not understand the trial judge’s instructions on damages or did not follow them. Therefore, the new trial on damages ordered by the trial judge was appropriate.


After he fell, Dessasore was taken by ambulance to a local hospital where he was treated and released. Within days, he was in excruciating back pain and within a month of the accident, he claimed radiating pain down the left side to his foot and an MRI showed herniated discs at L4-L5 and L5-S1.

In March 2005 Davin underwent an endoscopic diskectomy at L4-L5 and L5-S1 (a minimally invasive procedure, described here). Four months later, he underwent a second surgery – a lumbar fusion – in which a cage and six screws connected by steel bars were implanted in his back.

Here is what the spine looks like after a lumbar fusion with six screws implanted:


Unfortunately, the surgeries were unsuccessful, Dessasore’s condition worsened and by the time of trial he described nearly five years of unremitting pain, the lack of any feeling in his left arm and hand (except his thumb), the inability to talk even short distances without literally dragging his left leg to move and daily reliance on a powerful prescription pain drug (Oxycontin). His doctors diagnosed him as suffering from hemiparesis (partial paralysis affecting one side of the body).

People afflicted with hemiparesis usually have a flexed elbow, stiff knee and an inverted ankle, with the lower limb swinging forward in a semicircular fashion and often require assistive devices like this:


The defense doctors disputed the finding of hemiparesis (it's most often caused by a stroke or cerebral palsy, not trauma) testifying that there was no evidence of a spinal cord injury and no anatomical basis for many of plaintiff’s complaints. Essentially, while conceding that the MRI studies showed the presence of herniated discs, they concluded that plaintiff has preexisting degenerative disc disease because of the presence of osteophytes and that his symptoms and neurological findings were way out of proportion to the findings in his imaging studies.


The jury apparently rejected the defense doctors’ conclusions because they awarded plaintiff $5,000,000 for his past pain and suffering.

Defense counsel attacked the $5,000,000 awarded for past damages as wildly excessive to the extent it exceeded $900,000. Given recent appellate court decisions ruling on multi-million dollar past pain and suffering awards, it appears there is merit to the defense position. Awards for 5-10 years of past pain and suffering in the range of $1,000,000 to $3,000,000 tend to be upheld on appeal only for persons with catastrophic physical and brain injuries such as:

  • Smith v. Au (1st. Dept. 2005) - $1,000,000 for past pain and suffering (6 years) upheld for a 37 year old man who, due to medical malpractice, sustained  a stroke with permanent brain damage and right-sided paralysis
  • Reed v. City of New York (1st. Dept. 2003) - $2,500,000 for past pain and suffering (7 years) upheld for a 43 year old woman in a pedestrian knockdown car accident who sustained several skull fractures and significant and progressive brain damage that left her permanently demented
  • Weinstein v. New York Hospital (1st. Dept. 2001) - $2,000,000 for past pain and suffering (9 years) for a 22 year old college student who, due to medical malpractice, sustained brain damage with a permanent seizure disorder, memory deficits and loss of balance


The appellate court did not adjust the $5,000,000 award for past pain and suffering because of its rulings that the liability verdict was to be set aside and that the failure to award future damages may have been because the jury meant to include such damages in the $5,000,000 it did award (but denominated for past damages only). Since the appellate judges properly declined to speculate why or how the jury reached such an odd result, they simply ordered a new trial on all issues.


Inside Information:

  • Defense counsel attacked plaintiff’s credibility at trial and on appeal – plaintiff was a prior convicted felon who spent 4 ½ years in jail for drug dealing.
  • The jury also declined to make any award for medical expenses (past or future) despite evidence that plaintiff incurred past expenses of about $160,000 and would require lifelong medical care that his attorneys suggested would amount to about $800,000.
  • After a nine day trial and the start of deliberations at the end of the day, the jury deliberated for a mere one hour (one juror had said he had a personal problem necessitating his travel out of town and would not return to court the next day). Clearly, they rushed and wanted to be done quickly.


Shortly after trial, the defendant offered $2,000,000 to settle but it was rejected. On appeal, plaintiff’s attorney asked the court to uphold the $5,000,000 for past damages and award an additional $2,000,000 for future damages. The court declined to do either and now, plaintiff has received nothing and faces a new trial on all issues.

To recover any damages whatsoever at the new trial, plaintiff will have to prevail on liability and the defense will surely argue that Dessasore was so careless that the jury should find he completely caused his own accident and injuries and should recover nothing at all. We will follow this case and report on developments.


 

Pedestrian Hit by New York City Bus Wins $1,400,000 Pain and Suffering Jury Verdict for Back Injuries; Appeals Court Orders New Trial Because Plaintiff Failed to Allege Preexisting Condition

Defendants routinely and successfully argue in back and neck injury cases that  plaintiff’s injuries pre-existed an accident and no pain and suffering damages should be awarded (even if defendant is found to have caused the new accident). There’s merit to the argument but it’s not as simple as I’ve implied.


Under New York law, a plaintiff who’s been injured before is still entitled to recover pain and suffering damages resulting from a new injury to the same body part; however, a plaintiff is only entitled to damages to the extent to which he’s been further disabled or injured as a result of the new accident.

And, a plaintiff must make the aggravation or exacerbation of injury claim in his lawsuit pleadings before a trial judge will tell the jury that they may make an award for the increased pain and suffering. Otherwise, a plaintiff has to prove that all of his injuries were caused in the new accident and the defendant will win by convincing the jury that plaintiff’s injuries predated the current accident.


Plaintiffs usually claim that their preexisting neck and back injuries were resolved and that for years they had returned to prior levels of activity and were pain free. Now, they say, new trauma has caused new injuries, especially herniated discs, and they are in great pain and disabled as a result. The problem is, though, that magnetic resonance imaging (MRI) which illustrates the herniated discs very often is interpreted to show degenerative disc disease. When that happens, defense doctors will testify that the degeneration means plaintiff has preexisting disc disease and that it’s unclear what, if any, new spinal injuries were caused by the recent trauma.


With this background, we now turn to the case of Leslie Rodgers, a 40 year old man who was struck by a city bus at about 8 a.m. on September 23, 2003 while in the crosswalk on Gates Avenue at its intersection with Franklin Avenue in Brooklyn, New York. He was taken by ambulance to a local hospital where he was treated for minor back and other injuries and released. A month later, an MRI showed a herniated disc at L5-S1 with impingement on the S1 nerve root. Rodgers began a long course of conservative treatment including physical therapy, chiropractic treatment and two epidural steroid injections.


Finally, after three years, Rodgers underwent back surgery: a laminotomy and diskectomy at L5-S1. During the surgery, the doctor plucked out a disc fragment that had been impinging upon a nerve.

Here is what the diskectomy procedure looks like:


Post-operatively, Mr. Rodgers was much improved but his pain soon returned and at trial he testified that he was in great pain and disabled. He complained of intermittent numbness and pain up and down one leg with low back pain lasting all day and night. His surgeon opined that these conditions would be permanent. That meant Rodgers could no longer return to his job (at Fortune Society assisting HIV positive ex-convicts find housing); nor would he ever again enjoy basketball, handball or running.


The jury assessed pain and suffering at $1,400,000 ($200,000 past - 4 1/2  years; $1,200,000 future – 25 years).

The city appealed asserting:

  1. that there was evidence that Rodgers had degenerative disc disease before the accident (the MRI a month after the accident revealed an osteophyte growth at the site of plaintiff’s L5-S1 herniation as well as desiccation and degeneration of the disc),
  2. that he failed to make a claim in the lawsuit that the bus accident injuries may have been due, at least in part, to his preexisting condition and
  3. that the trial judge should not have instructed the jury that they could award damages for plaintiff’s increased susceptibility to injury

Here is a comparison of normal, healthy discs with degenerated discs with osteophytes:


Last week, in Rodgers v. New York City Transit Authority (2nd Dept. 2010), the appellate judges agreed with the city and ordered a new trial, thus vacating the entire jury verdict (Rodgers was also awarded $1,000,000 for past and future lost earnings).


The trial judge had told the jury they could award pain and suffering damages for all of the injuries suffered by Rodgers if they found that his prior physical condition left him more susceptible to greater injuries than a healthy person (i.e., one without preexisting degenerative disc disease). The defense claimed it was prejudiced by this charge (Pattern Jury Instruction 2:283) in that plaintiff had proceeded in the lawsuit for years on the sole theory that all of his injuries were caused by the bus accident and he had never once put the defense on notice that some injuries may have been exacerbated or due to his prior condition that had left him with an increased susceptibility or the possibility of asymptomatic conditions becoming symptomatic. The appellate court agreed and ruled that the jury’s verdict was improper because it may have included damages for injuries that Mr. Rodgers sustained before the bus accident.


In the new trial, the jury will consider only those injuries actually caused by the bus accident and they may award pain and suffering damages only for those new injuries. That’s a huge win for the defense in that it will be very hard for Rodgers to convince the jury that he sustained any new injuries at all in view of his preexisting condition.


Inside Information:

  • Before the accident, plaintiff had been a drug addict and served 12 years in prison for participating in a kidnapping (by the time of trial he had become a productive member of society, working and enrolled in a Ph.D. program at Hunter College).
  • Plaintiff claimed unfair surprise too – only three days before jury selection the defense notified plaintiff’s counsel that a defense radiologist would testify that plaintiff’s injuries were preexisting.
  • The jury apportioned liability 80% on the city and 20% on the plaintiff and in the new trial that apportionment will stand with the new jury considering only the issues of which injuries (and the amount of damages), if any, were caused by the bus accident.