Spinal Cord Injury Leads to $3,500,000 Pain and Suffering Award by Appellate Court

Ray Hammond was 42 years old on February 4, 2004 when he was walking his six year old daughter home from school at about 2:45 p.m. As they crossed a street in in Queens, he was holding her hand when he was struck by a left turning car.

Mr. Hammond was thrown in the air, landed on the hood of the car, smashed against the windshield and ended up at Jamaica Hospital Medical Center where he was admitted and confined for three and a half months.

In an ensuing lawsuit, the driver was found fully at fault for the accident and the jury then awarded Hammond pain and suffering damages in the sum of $4,000,000 ($2,000,000 past - 4 years, $2,000,000 future - 40 years).

On appeal, the defendant argued that the pain and suffering award was excessive. The appellate court agreed, in part. In Hammond v. Diaz (2d Dept. 2011), the $2,000,000 verdict for 40 years of future pain and suffering has been ruled excessive and therefore reduced by $500,000 (the $2,000,000 for past damages was affirmed). The total pain and suffering award thus now stands at $3,500,000.

The jury made a loss of consortium award to plaintiff's wife in the sum of $1,000,000; however, the appellate court found this excessive too and ordered a reduction to $200,000 ($100,000 past, $100,000 future).

Unfortunately, the court's decision reveals nothing at all about Mr. Hammond's physical injuries in this case (except to state that Mr. Hammond was hospitalized for 3 1/2 months and then treated as an inpatient at a rehabilitation hospital for an additional month).

Essentially, Mr. Hammond sustained spinal cord contusions near C-4 that left him with permanent hemiplegia (paralysis of muscles on one side of the body).

Here are the consequences of plaintiff's hemiplegia:

  • foot drop with permanent limp and need to use a foot brace
  • dominant right hand and arm weakness, with muscle atrophy and and the inability to clench

Typical drop foot brace:

While in the hospital, Mr. Hammond's left lung became infected from septic shock and he was required to undergo a lobectomy, in which the lower lobe of one lung was removed.

Previously a self-employed optician, Hammond was unable to work at all for two years. He then found a job in a friend's practice for two days a week but testified at trial that he remains unable to grip anything with his right hand, suffers from muscle spasms several times every day and fatigues quickly while in constant pain all over his right side.

Mr. Hammond's other activities remain severely limited in that he can no longer:

  • swim (he'd been an expert)
  • run
  • walk long distances or
  • play with his daughter, except in very minimal ways

The defense argued for a reduction in damages because plaintiff's condition had significantly improved from the time of his initial hospitalization (when he was unable to move any of his limbs) to the time of trial (when he could walk,  perform many activities of daily living and took yoga classes three days a week).

Inside Information:

  • Two doctors testified: Ahmed Elfiky, M.D., a neurologist for the plaintiff (transcript here) and Edward Toriello, M.D., an orthopedic surgeon for the defense (transcript here). The defense has plaintiff examined by its own neurologist before trial but that doctor did not testify and plaintiff was granted a so-called missing witness charge.
  • In closing arguments, plaintiff's attorney asked the jury to award pain and suffering damages in the sum of $5,000,000 ($2,000,000 past, $3,000,000 future) while defense counsel refrained from suggesting a figure.

 

 

Improper Conduct of Trial Judge in Medical Malpractice Case Leads to Appellate Court Reversal of Defense Verdict for Orthopedic Surgeon; New Trial Ordered

Joan Sutton, a 68 year old retiree, suffered from chronic left hip pain, was diagnosed with degenerative arthritis and underwent total hip replacement surgery on June 12, 2003 with orthopedic surgeon Elias Kassapides, M.D. at St. Luke’s - Roosevelt Hospital in New York City. The doctor removed and exchanged the femoral head (the ball) and the acetabulum (the cup) which together comprise the hip joint and replaced them with artificial components.

Here is what a degenerative hip joint looks like:


Unfortunately, Ms. Sutton’s hip pain continued after surgery and she eventually treated with new surgeons, one of whom, on August 18, 2004, performed revision surgery on her left hip. He took out the prosthetic devices and put in new ones.

And here is what the hip replacement components look like after the surgery:

Contending that surgical mal-positioning of the hardware implants caused the need for new surgery, Sutton sued Dr. Kassapides but on May 2, 2008, a jury in Queens County rendered a defense verdict finding that there was no malpractice.

Now, though, in Sutton v. Kassapides, an appellate court has upheld plaintiff’s appeal and reversed that finding, set it aside and ordered that a new trial be held. The appellate court ruled that plaintiff was deprived of a fair trial as a result of the cumulative effect of the improper conduct of the trial judge, both during his cross-examination of witnesses and in his charge to the jury.

No details about the judge’s inappropriateness were set forth in the appellate court’s decision so we’ve dug up the information and here it is. The judge, Duane A. Hart, was charged by plaintiff’s counsel with stepping beyond his role as a disinterested umpire, evincing a clear bias in favor of the defendant and excessively intervening into the trial proceedings by:

  • Pre-judging the case before trial began and concluding that plaintiff’s claims required dismissal
  • Taking over the cross-examination of witnesses by his tone and the nature of his questions demonstrating partiality to the defense
  • Falling asleep while on the bench during court proceedings

For examples of some of the judge’s improprieties during the trial, here is the plaintiff’s brief on appeal which includes portions of the trial transcript, at pages 11-18, demonstrating several instances of the judge’s unusual and improper actions in this case.

On retrial, the issue to be determined will be whether the defendant’s positioning of the hardware components "deviated from medically accepted practices." That’s precisely the phrase judges routinely use in their instructions to jurors at the end of medical malpractice cases in New York and it’s set out in full at Pattern Jury Instructions 2:150.

Plaintiff claimed that Dr. Kassapides was negligent (and caused the need for revision surgery) because he left about 25% of the hip socket uncovered due to his placement of the acetabular cup at corresponding angle of 30 degrees instead of 45 degrees. Defendant’s expert testified, though, that the cup was properly placed and that, as plaintiff’s expert conceded, an acetabular cup may be safely placed between 30 and 50 degrees.

As to damages (not reached at trial due to the defense verdict on liability), plaintiff will have to convince the new jury that she would not have been required to undergo left hip revision surgery but for the defendant’s negligence. The defendant will point out that plaintiff had, before her initial left hip surgery, undergone an unrelated right hip replacement that needed to be revised because the cup was placed too vertically. That may well undercut her claim that it was only the defendant’s negligence (assuming she can prove negligence) that caused the need for her left hip revision surgery.

In any event, whatever a new jury might award, it's unlikely damages would be sustained above $500,000 in view of last month's appeals court decision in Dublis v. Bosco (2010). There, a 74 year old woman underwent surgical revision of an artificial hip in which the femoral head and the acetabular cup were replaced. Unfortunately, plaintiff was left with a foot drop caused by intra-operative nerve damage. While her attorneys requested $800,000 for plaintiff’s pain and suffering, the jury awarded pain and suffering damages in the sum of $500,000 ($200,000 past, $300,000 future) and that amount was, over defendant’s objections, upheld as reasonable. While not perfectly analogous to the facts in Sutton v. Kassapides, it’s likely that this decision, as a practical matter, has set the ceiling for damages in Ms. Sutton’s retrial.

Inside Information:

  • Plaintiff’s attorneys made the unusual request, granted on appeal, that the retrial should be held before a different judge. That request has been made and granted several times regarding this particular trial judge, for example, in Williams v. Naylor (2009), Pickering v. Lehrer (2006) and Allstate Insurance Co. v. Albino (2005).
  • Judge Hart has been censured by the state Commission on Judicial Conduct for his improper conduct in other cases and matters.
  • It is often very difficult for plaintiffs in medical malpractice cases to find top notch local experts to testify for then (and against their colleagues) so resort is made to out of state experts. Here, though, plaintiff’s expert, Ronald Krasnick, M.D., a Burlington, New Jersey orthopedist, appears to have been overmatched by defendant’s expert, William Macaulay, M.D., a world-renowned orthopedic surgeon. Jurors are often greatly influenced by such matters, especially considering that these types of cases are often battles of experts and are decided in large part based on which competing expert’s opinion is more credible.
  • One of the mistakes by Judge Hart was his charge to the jury that if they concluded that defendant merely made an error in judgment (i.e., he chose among several accepted methods of treatment) as opposed to a deviation from accepted medical practices in how he perfumed the surgery, then they could find for the defense. The plaintiff argued successfully on appeal that this charge should not have been given because her claim was not whether the initial left hip surgery should have been performed or not; rather, she claimed that it was how the doctor performed the surgery (the ball and cup placement mal-positioning) that constituted negligence. In charging the error in judgment rule, Judge Hart ignored clear and binding precedent from New York’s highest court in the case of Nestorowich v. Ricotta (2002).

 

26 Bones in the Foot - Recent Foot Fracture Verdicts Range from $75,000 to $2,200,000

There are 26 bones in the foot. So the variety of foot injuries is huge - from crush and calacaneous fractures to a 5th metatarsal (little toe) fracture. And thus the range for verdicts and settlements for pain and suffering in foot injury cases is quite wide.

In a recent case, Lentini v. NYC Transit Authority (Supreme Court, Bronx County; Index # 18020/06; 11/3/08), $2,200,000 was awarded recently by a jury for a 76 year old woman who sustained a complex crush injury to several bones in her foot requiring four orthopedic and reconstructive surgeries to salvage her foot.

By contrast, in Crooms v. Sauer Bros. Inc. (1st Dept. 2008), the appellate court ruled on 2/28/08 that $75,000 for a fractured metatarsal and thrombosis (the formation of a blood clot - in this case, from the cast) does not deviate from reasonable compensation where an unemployed former transit worker on disability made a full recovery.

Let's take a look at those 26 bones in the foot.

One of the highest ever foot injury verdicts for pain and suffering upheld by the courts in New York (other than in amputation cases) was $3,000,000 in De La Cruz v. New York City Transit Authority (2d Dept., 2008) in which, while nominally involving fractures, the main injury to the 29 year old plaintiff was deep peroneal nerve entrapment  resulting in permanent unbearable pain, numbness and parasthesia in her foot. The nerve damage was caused when Ms. De La Cruz was struck by a bus and knocked to the ground upon which her foot was run over and crushed by the front wheel of the bus. The Queens County trial jury awarded her $15,000,000 for her pain and suffering. Upon a motion by the defendants, the trial judge reduced the award to $3,000,000 ($1,000,000 past and $2,000,000 future) and the appellate court upheld that determination.

Other significant cases for foot fracture pain and suffering include:

  • Lujwangana v. Ilchert (Supreme Court, Westchester County; Index # 16983/03; 4/6/06) - $1,150,000 pain and suffering ($600,000 past; $550,000 future) for a 23 year old college student in a car accident who sustained a traumatic dislocation of her foot that required three surgeries including a subtalar fusion.
  • Avens v. New York City Transit Authority (Supreme Court, New York County; Index # 402772/07; 6/4/08) - $950,000 pain and suffering verdict ($300,000 past; $650,000 future) for a 78 year old retiree who sustained a Lisfranc's fracture of her foot in a bus accident, underwent open reduction internal fixation surgery.
  • Perez v. New York City Transit Authority (1st Dept., 2002) - $750,000 pain and suffering verdict upheld for a 42 year old unemployed man who fell over a defective subway vent and sustained a transverse fracture of the cuneiform of his foot and underwent six podiatric surgeries.
  • Roca v. Plaza Realty Management (Supreme Court, Westchester County; Index # 21756/06; 12/5/08) - $450,000 pain and suffering verdict for a 41 year old unemployed woman who fell in a parking lot and sustained a toe fracture with a neuropathy of her peroneal nerve that caused a foot drop that was resolved by the time of the trial 3 1/2 years after the accident.