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Personal Injury: Representative Case Experience for Causation Analyses and Utilization Review

Anesthesiology and Trauma

Pain management and assessment of reasonable and necessary epidural steroid or trigger point injections
Assessment of IDET procedures to manage symptomatic intervertebral discs
Assessment of acupuncture treatment

Biomechanics of injury and traffic reconstruction

Freightliner collisions
Automobile collisions
Pedestrian versus motor vehicle accidents
Elevator accidents
Heavy equipment injuries
Train accidents
Biodynamics of various collision scenarios: rollover, rear and front-end, under-rides, sideswipes, and angled collisions
Live instrumented testing of occupant tolerance in motor vehicle accidents
“Seat-belt defense” evaluations for either the plaintiff or defense involving fatal and serious injuries
Assessment of risk for injury given vehicle photographs, damage estimates, estimated collision velocities, and the medical records
Biodynamics of injury regarding head, spine, torso, and extremity trauma
Reconstruction of a barbecue accident, extremity trauma and fatal pulmonary embolism

Cardiology and Trauma

Myocardial infarction after MVA
Myocardial contusion after MVA
Mitral valve regurgitation and aortic insufficiency after MVA

Chiropractics and Trauma

Utilization review to assess reasonable and necessary accident related treatment
Quebec Study and guidelines for reasonable and necessary physical therapy
Mercy Care guidelines for reasonable and necessary chiropractic treatment
Workers' Compensation guidelines for reasonable and necessary chiropractic treatment
Cochrane Library of evidence-based medical databases
Agency for Healthcare Policy and Research, AHCPR guidelines
Philadelphia Panel Evidence-Based clinical practice guidelines on selected rehabilitation interventions

Forensic Pathology

Splenectomy and long-term potential complications after stabbing
Medical characteristics of defense stab wounds
Fatal inhalation injury after fire and MVA
Ecstasy abuse: blood and urine findings in routine drug screens

General Surgery and Trauma

Inguinal hernia after MVA
Umbilical hernia after MVA
Ventral hernia after MVA
Richter hernia after MVA
Appendectomy after MVA
Pancreatitis after MVA
Delayed splenic hemmorhage after MVA
Sigmoid colon diverticulitis and perforation after MVA

Neurology and Trauma

Carpal tunnel syndrome
Cubital tunnel syndrome
Post-concussion syndrome
Head trauma and Parkinson’s Syndrome
Head trauma and multiple sclerosis
Head trauma and Huntington’s chorea
Head trauma and movement disorders
Head trauma and epilepsy
Head trauma and post-traumatic headaches
Head trauma and manic-depressive syndrome
Neck injury, carotid dissection, and stroke
Neck injury and torticollis
Neck injury and brachial plexus trauma
Thoracic-outlet syndrome
Acute cervical or lumbar radiculopathy and herniated disc
Evaluation of EMG and nerve conduction studies
Utilization review regarding MRI, CT, SPECT, and QEEG

Neuropsychology and Trauma

Post-concussion syndrome and neuropsychological testing
Psychiatric overlay or psychosocial features effecting neuropsychological testing

Neuroradiology and Trauma

Radiological reviews of films: assessment of the accuracy of interpretations regarding:

Disc herniations
Disc bulges
Disc extrusions
Disc protrusions
Disc sequestrations
Spinal cord and nerve root compressions
Spondylosis or spinal degeneration
Spondylolysis or neural arch defects
Spondylolisthesis or vertebral body slippage
Congenital and developmental vertebral or brain anomalies

Neurosurgery and Trauma

Brain and spine trauma
Head trauma, headaches, and Arnold-Chiari congenital malformation of the brain
Head trauma, spinal fluid leak, and meningitis
Spinal instrumentation, loosening, and dislodgement after MVA
Head trauma and causation of brain tumor

Obstetrics and Gynecology and Trauma

Premature birth and respiratory distress syndrome after MVA
Miscarriage after MVA

Orthopaedics and Trauma

Soft tissue injury and evaluation of reasonable physical therapy
Causation of herniated discs
IDET procedures to manage symptomatic intervertebral discs
Vertebral burst and compression fractures
Vertebral and spinal deformities: spondylolisthesis, spondylolysis, scoliosis, and congenital vertebral anomalies
Spinal instrumentation and hardware failures: broken screws and wires, loosening of instrumentation
Spinal pseudoarthroses
Long bone fractures
Shoulder impingement syndrome and rotator cuff injuries
Wrist impingement syndrome
Injuries to the wrist, hand, foot, ankle complex
Failures of total hip and knee replacements
Evaluation of IDET spine procedures
Deep venous thrombosis and pulmonary emboli after orthopaedic trauma
Hip fractures associated with slips and falls in the elderly
Risk factors for falls and hip fractures in the elderly

Otolaryngology and Trauma

Head trauma, skull fracture, and anosmia or loss of sense of smell
Head trauma and loss of hearing
Head trauma and tinnitis or ringing in the ears
Disability and medical impairment rating of anosmia, hearing loss, and tinnitus
Unilateral vocal cord paralysis after prolonged intubation in a trauma patient

Physical Medicine and Rehabilitation, PM&R or Physiatry and Trauma

Assessment of reasonable and necessary physical therapy
Interpretation of EMG and nerve conduction studies in patients with suspected radiculopathy
Evaluation of disc herniations and spinal radiculopathy
Development of life care plans for serious brain and spinal cord injured patients
Structuring of an annuity based on a well-designed life care plan
Complex disability evaluations

Product liability

Silicone breast implants and reported auto-immune disorders
Fen-phen and reported heart valve problems
Experimental surgical clips to treat bowel perforation: question of unapproved use
Blood pressure cuff associated with thermal burns after autoclaving
Cuff-collar press and thermal burns to the hand
Power equipment and electrical burns
Antihelminthic, antiparasitic medicinals and birth defects
Interferential pain stimulator and electrochemical burns
Charnley hip prosthesis and fatigue failure of femoral stem component by cantilever stress
Metal plating for cervical spine fusion: dislodgment of hardware associated with pistoning of screws
Surgical frames for spine surgery: reported patient positioning problems, carotid dissection, stroke, nerve palsy, and blindness

Psychiatry and Trauma

Post-traumatic stress disorder
Tardive dyskinesia reported after Navane ingestion, a neuroleptic used for treating schizophrenia
Head trauma and manic-depressive illness
Head trauma and conversion disorder with hysterical features
Post-concussion syndrome and neuropsychological testing
Polypharmacy abuse and soft tissue injury

Pulmonary and Trauma

Pulmonary contusion after MVA
Spontaneous pneumothorax after MVA

Rheumatology and Trauma

Fibromyalgia and MVA
Rheumatoid arthritis after MVA
Systemic Lupus Erythmatosis, SLE after MVA
Silcone breast implants and reported auto-immune disorders

Toxicology of drugs, environmentals, and commercial and medicinal products

Fatal overdose and cumulative exposure to amitryptiline, an antidepressant
Transgenerational reproductive organ carcinomas and maternal diethylstilbestrol exposure
Asbestosis and mesothelioma
Eosinophilic myalgia syndrome, an auto-immune disorder and adulterated L-tryptophan ingestion
Sick building and toxic mold syndromes
Fatal hypoxia while painting in enclosed industrial spaces
Alcohol intoxication and determination of impairment based on ingestion history and estimated blood alcohol levels
Birth defects reported with medication exposure during the first trimester of pregnancy
Birth defects, mechanisms of reproductive and developmental toxicology
Birth defects, mechanisms of cellular and genetic damage and principles of cell biology
Birth defects, teratogen exposure, metabolism, and pharmacodynamics
Adverse drug events: review of the manufacturer’s adverse event and safety data
Adverse drug events: review of FDA and worldwide drug registries
Fatal liver failure and chronic Tylenol ingestion
Avascular necrosis of the hip based on the dosage and duration of corticosteroid exposure
Renal failure and gentamycin antibiotic exposure
Auto-immune disorders and silicone breast implants
Auto-immune disorders, leukemia, and coal pitch tar exposure
Withdrawal syndromes and narcotics
Fatal overdose and polypharmacy abuse

Vascular Surgery and Trauma

Ankle/knee fracture, deep venous thrombosis, and thromboprophylaxis
Below knee amputation and arterial insufficiency in a diabetic patient after an MVA
Fatal pulmonary embolism in an obese patient after a barbecue accident
Venous stasis ulcers of the lower extremity after a barbecue accident