Don’t Forget Mechanism of Injury

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Mistakes are going to happen in the field.  But just because one of your crews might have made a mistake or been involved in an accident does not mean that you have no defense if a patient later claims that he or she was injured in that accident.  Even if liability appears likely, don’t forget to analyze whether the mechanism of injury fits the injury the plaintiff is claiming.

Let’s consider a hypothetical to illustrate.  During a significant snowstorm, your ambulance responds to a motor vehicle accident, say a frontal collision.  Because of the weather, other ambulances are busy responding to various accidents in the area.  In this accident, Driver A has multiple leg lacerations and is put on the unit’s stretcher and placed in the back of the ambulance.  Driver B is complaining of neck and back pain, so he is placed in a c-collar and removed from his vehicle, put on a spine board with a CID in place as well, then put on the “bench seat” in the back of the ambulance and secured on the bench seat with multiple straps, so both patients can be taken to the hospital for evaluation and treatment.

As the ambulance is beginning to leave the scene, it hits a patch of ice and the front of the ambulance goes into a ditch nose-first.  The ambulance is quickly wenched out of the ditch and proceeds to the hospital without further incident. 

Driver B later files suit, alleging that his body and the spine board he was on slid forward during the ambulance’s accident and the top of his head struck the side of a metal cabinet, injuring him.  Eventually, Driver B is diagnosed with Brown-Sequard Syndrome, an injury to one side of the spinal cord that causes loss of motor function on the same side of the body as the lesion and loss of sensation on the opposite side.

First of all, your ambulance crew might not be guilty of any negligence for the ambulance going into the ditch.  Negligence is determined based upon the circumstances that existed at the time, and the severe weather conditions might form a basis for arguing that there was no negligence.  But even assuming the crew is found to be negligent in the operation of the vehicle, you still have a defense to liability because the mechanism of possible injury in the accident does not fit the injury the plaintiff is claiming.

Remember, Driver B/the plaintiff was involved in an MVA before your crew responded.  Did his Brown-Sequard injury result from the flexion/whiplash type forces his body experienced in the frontal MVA, or from the compression type forces his head and neck might have sustained when the ambulance went into the ditch and his spine board slid forward slightly on the bench seat?

A neurologist, neurosurgeon or biomechanical engineer should be retained to provide analysis and possible testimony.  In this hypothetical, the answer would be that the Brown-Sequard injury most likely resulted from the original MVA.  According to the medical literature, Brown-Sequard can be caused by penetrating injuries to the spinal cord or by whiplash or flexion-extension type forces.  There is no medical literature to support the claim that Brown-Sequard can be caused by compression forces. If the patient’s head and neck sustained any force when when the ambulance went into the ditch, it would have been compression.

This is simply one example.  Mechanism of injury can become an important factor in any number of situations–patient drops, claims of “rough handling,” stretcher mishaps, etc.  Don’t assume you owe a patient damages just because an accident happened.  Make sure the mechanism of injury fits the injury for which recovery is sought.

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3 Responses to Don’t Forget Mechanism of Injury

  1. Jimmy Carter says:

    Interesting hypothetical.

  2. Hi there everyone, it’s my first pay a visit at this web site, and piece of writing is in fact fruitful designed for me, keep up posting these content.

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