Burns - Demand Letter - Page 3
Industrial Accident
Demand Letter
E. SURGICAL PROCEDURES - PAST
1) DATE: 03/03/1999
DIAGNOSIS: Seventy-eight (78%) percent total body surface area burns to anterior posterior trunk, bilateral arms and hands, face and bilateral legs.
PROCEDURE NO. 1: Split-thickness skin harvest from lateral right thigh and buttocks.
PROCEDURE NO. 2: Excision of burn wounds over anterior and posterior trunk, bilateral arms and hands, bilateral legs.
PROCEDURE NO. 3: Application of 2000 sq cm of 4:1 autograft to the left lateral flank.
PROCEDURE NO. 4: 1000 sq cm of 2:1 autograft over the dorsum of bilateral hands.
PROCEDURE NO. 5: Application of 2:1 cadaveric skin to approximately 14,000 sq cm of excised burn wound with overlay of cadaveric skin on autografted areas.
DOCTORS: Ronald M. Herndon, M.D.;
John S. Adams, M.D.
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2) DATE: 03/03/1999
DIAGNOSIS: Presumed inhalational injury
PROCEDURE NO. 6: Fiberoptic bronchoscopy
DOCTORS: Kevin J. Smith, M.D.
John S. Adams, M.D.
Rita C. McDonald, M.D.
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3) DATE: 03/03/1999
DIAGNOSIS: Inability to eat
PROCEDURE NO. 7: Endoscopic placement of duodenal feeding tube.
DOCTORS: Kevin J. Smith, M.D.
John S. Adams, M.D.
Vic Murry, M.D.
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4) DATE: 03/10/1999
DIAGNOSIS: Inhalation injury.
PROCEDURE NO. 8: Fiberoptic bronchoscopy.
DOCTORS: Kevin J. Smith, M.D.
John S. Adams, M.D.
Vic Murry, M.D.
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5) DATE: 03/11/1999
DIAGNOSIS: Seventy-eight (78%) percent total body surface area burn with inhalation injury.
PROCEDURE NO. 9: Excision of 5500 sq cm of burn over the left leg, left arm, left flank, chest, and bilateral hands.
PROCEDURE NO. 10: Split-thickness skin harvest of approximately 2000 sq cm of autograft from the anterior abdomen, medial left thigh, scalp and scrotum.
PROCEDURE NO. 11: Application of 1700 sq cm of 2:1 autograft to the left arm and axilla.
PROCEDURE NO. 12: Autograft, 150 sq cm, 2:1 patch grafting to the dorsum of both hands.
PROCEDURE NO. 13: Autograft, 3150 sq cm, 4:1, to the left flank and chest and the left leg.
PROCEDURE NO. 14: Homograft, 500 sq cm, 2:1, over the left lower leg.
PROCEDURE NO. 15: Homograft, 5000 sq cm, 2:1, overlay of all autografted areas.
DOCTORS: Kevin J. Smith, M.D.
John S. Adams, M.D.
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6) DATE: 03/13/1999
DIAGNOSIS: Ventilator dependence.
PROCEDURE NO. 16: Tracheostomy.
DOCTORS: Kevin J. Smith, M.D.
John S. Adams, M.D.
Vic Murry, M.D.
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7) DATE: 03/21/1999
DIAGNOSIS: Burns and tracheostomy.
PROCEDURE NO. 17: Replacement of tracheostomy tube, wound debridement.
DOCTORS: Ronald P. Wallace, M.D.
Dr. T. Mabry
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8) DATE: 03/26/1999
DIAGNOSIS: Thermal burns to trunk, arms, legs and face.
PROCEDURE NO. 18: Debridement and split-thickness skin grafting of burn wounds to left forearm, left upper arm, left axilla, left anterior shoulder, left lateral trunk and left medial thigh.
DOCTORS: F. C. Turner, M.D., M.Sc., F.R.C.S.C.
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F. HEALTH CARE PROVIDERS
MALY-Flight, Inc.
315 Frison Drive
Greendale, Texas 55555
(512) 555-5555
Robert Fernandeen, M.D.
Cortez-Sparks Hospital
Greendale, Texas
Steven E. Wolf, M.D.
James Thomas Dane, M.D.
David N. Herndon, M.D.
D. Hart, M.D.
Mamta Somaiya, M.D.
Dr. J. Haigh
Dr. Desai
Dr. Reiter
Dr. Champion
Don Lefiber, L.M.S.W.
A. Carpenter, R.N.
T. Stanfield, R.N.
S. Bruce, R.N.
J. Pimentel, R.N.
R. Hogland, R.N.
R. Rozzaro, R.N.
K. Branch
Dr. Joan Richardson
Dr. Klaus
Dr. Walden
Dr. Daniel Lenihan
Dr. Woodson
Dr. Hunsicker
Art Sanford, M.D.
Dr. Perez
L. Thomas, R.N.
Dr. Catton
Dr. Bajaj
S. Hays, R.C.P.
B. Walton
Sanford A. Rubin, M.D.
Suzanne W. Blackwell, M.D.
Mahendra N. Gohil, M.D.
Masood Ahmad
The Grace Medical Branch Hospital
Cornelius, Texas 55555
R. L. Lindsay, M.D.
J. S. Dools, M.D.
Dr. Harrop
C. S. Kemp, R.N.
D. J. Shaw, R.N.
J. Knight, R.N.
A. Stevens
K. C. Sluggett, R.N.
M. Bhanji
Soodeen, R.N.
J. S. Lewis, R.N.
J. Bleendolchi
Anna Cruz, R.N.
N. Fellger
L. Pettis, R.N.
K. Hamilton
G. Whaler
M. Peppinck, R.N
T. . Mooers, R.N.
S.M. Wilson Wipond, R.N.
C. P. Moser, R.N.
J. R. Stroud, R.N.
Bugo Kidnopp, R. N.
J. S. Sleith, R. N.
Foothills Hospital
Dr. John A. McWhae
Calgary, Alberta, Canada
Kit Harrison, Ph.D.
600 Dodger Road, Suite 1400
Cornelius, TX 55555
(555) 555-5555
G. LIFE EXPECTANCY
According to the 1997 United States Life Tables, National Vital Statistics Report, Vol. 47, No. 28, December 13, 1999, Harry Hunter has a life expectancy of 23.5 years. A copy of the 1997 United States Life Tables is attached as Exhibit C.
H. LIFE CARE PLAN
In considering a life care plan for Harry, it is necessary to undertake evaluation of his future needs from both the brain injury and the burns viewpoints. With respect to his future needs for neuropsychological interventions, Dr. Pat Lewisson has determined the needed therapies as follows:
1. The patient is now a candidate for neuropsychological interventions and supportive therapies. Psychopharmacological support of the injuries is indicated as well and he may need to begin a course of serotoninergic therapies for management of cognitive and affective manifestations of the injuries. Anxiolytic therapies would be of benefit also.
2. Current therapies for physical and occupational rehabilitation should continue. Patient remains totally disabled at this time. Alternative pain control techniques should be implemented as an adjunct to the present regimen.
I. PER DIEM EVALUATION
One of the accepted methods under Texas law for arguing damages in cases of this type is the per diem argument. For purposes of our present evaluation, we will employ a per diem approach to the damages. We will take the segmental approach to damages in evaluating Harry's damages because we feel that various elements of damages were greater immediately following the incident and changed thereafter. Harry has a life expectancy of 8,583 days. For purposes of a per diem argument, Harry's life expectancy includes 154,494 conscious hours predicated on eighteen waking hours per day.
Our evidence will establish through the testimony of both Harry and Charlott that Harry seldom sleeps more than one hour at a time because he is awakened by the constant itching over the burned areas of his body. He averages four hours of sleep per night, in fitful one hour segments. However, in order to appear fair to the jury, we will use this eighteen waking hour figure for the calculation of his conscious pain and suffering, mental anguish, physical disability, and physical disfigurement rather than the actual twenty waking hours per day.
