Paralysis / Spinal Cord - Demand Letter
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VI. DAMAGES
A. PHYSICAL PAIN AND SUFFERING
Brad Day will testify and his testimony will be corroborated by witnesses at the scene that he endured the most excruciating pain of his life at the accident scene when he first encountered the physical pain which will accompany him for the rest of his life.
His next recollection is waking up in the hospital, and he will recount the feelings of pain which he endured secondary to muscular spasticity prior to his rehabilitative efforts. His testimony will be that the two to three weeks prior to the beginning of rehabilitation were the least painful since the accident, primarily for the reason that he was heavily medicated and he was immobilized in a body cast. The lack of movement, combined with the loss of sensation from T-12 down resulted in a comparatively small endurance of pain during this pre-rehabilitative period of two weeks. In fact, the testimony will be that during this first two week period, Brad would have welcomed feelings of pain in lieu of the total lack of feelings which he experienced in his lower body.
1. Pain During Rehabilitation - Brad's testimony will be that from the time he began physical activity, he has experienced extreme physical pain which remains with him at this time. His first effort came when he was taken out of bed and moved into a wheelchair where he sat for a period of one hour. He will testify that he could not believe the nature and extent of the pain which he endured during this first movement after his surgery. As his feeling began to return, he endured pain in his abdominal and intestinal region due to fecal impaction.
As he moved into rehabilitation he endured extreme pain even while lying still in bed. He will describe the pain as a sharp ripping pain and relate how he's screamed himself to sleep at night after enduring rehabilitation during the day. He will further testify that he got to the point that he would not trust anyone in the hospital because they all caused pain and that as his rehabilitation increased, every movement that he made caused pain.
He will further testify that he wouldn't cooperate in the rehabilitative process because the pain which he endured during rehabilitation was so great. On the day after each rehabilitative session, which he did three times per week, Brad describes the pain when he woke up in the morning as bad, the pain in the afternoon as excruciating, and the pain in the evening as indescribable.
He will also testify to certain specific events which occurred by way of describing the nature and extent of the pain which he endured during rehabilitation. On one occasion, his therapist, after two months of progress, advised him that he was to begin a new exercise. She rolled him over on his stomach and moved his heel to a 90 degree angle towards his body. He indicates that he screamed for five to ten minutes and endured excruciating pain from the hip all the way down to his feet.
2. Pain and Distorted Sensations - All patients with significant spinal cord injuries suffer from some degree of pain. The degree of pain may vary from minor discomfort to extreme and persistent anguishing pain which dominates attention and is devastating in its effect. Brad Day falls into a middle category between minor discomfort and persistent anguishing pain which dominates attention. Brad experiences some degree of pain during every waking moment, but on any given day, the range of pain which he experiences may vary from a dull throbbing discomfort to extreme and excruciating pain.
It is difficult for a jury which has not experienced pain during every waking moment to identify with a problem of this type. Therefore, in order to understand the various mechanisms of pain perception associated with spinal cord injury, the jury will be educated as to the physiology of the sensory pathways along the spinal nerves, within the cord segment, in the ascending tracts and finally in the brain itself. Our medical evidence will show the psychological effects of a severe spinal cord lesion as it impacts on the central pain pathways.
3. Pain at the Site of Injury - At the moment of injury, Brad Day experienced excruciating pain as witnessed by James Sheridan and other witnesses at the accident scene. This arose from the bursting nature of the injury to the L1 vertebral body in conjunction with the dislocation of the T12 disc and the accompanying lesion to the spinal cord which was aggravated by the presence of bone fragments. Additionally, there was pain arising from damage to the roots of the spinal nerves which exit near the thoracolumbar junction. A high velocity wound of the type which Brad experienced customarily causes root irritation resulting in a causalgic-type, severe, persistent pain which is extremely difficult to treat. This was certainly so in Brad's case.
4. Pain Above the Site of Injury - Brad was experiencing pain sensibility above the level of the cord lesion and also experiencing severe headaches, stemming from the autonomic nervous systems signals which affect the blood vessels of the head. This was also aggravated by urinary infections which elevated his blood pressure. Finally, the major problem with the pain sensibility above the injury was precipitated by the severe constipation and impaction which Brad experienced.
5. Pain Below the Site of Injury - Although sensibility is lost below the level of the lesion, in an incomplete lesion such as Brad's, he still experiences sensations, many of which are disagreeable and seem to arise in parts of the body below the level of transection.
Afferent impulses carried by the sensory trunks within the spinal cord still rise to the brain through the traumatized (but still partially functioning) neurons just above the lesions. It is also important to realize that Brad does not have true anatomical discontinuity of all of the fiber tracts which pass through the region of injury, even though there is no capability for voluntary movement below the level of the lesion. Thus a variety of afferent sensations may still continue to stream upwards to his brain resulting in a continuous experience of disordered sensation, much of which is painful or unpleasant. The autonomic nervous system, which lies outside his spinal column is functional above the level of cord injury, and contributes to this flood of afferent impulses.
This flood of unpleasant sensations appeared after a period of delay and the pattern, location and type of discomfort varied widely. The sensations experienced include frank pain-stabbing, tearing, stretching, and unpleasant, troubling distortions of sensations.
These distortions, although not strictly "pain" as would be defined by the intact person, are bizarre and are highly unpleasant. They include burning sensations, feelings of cold, and a variety of sensations with which the normal person is unfamiliar. This latter group of sensations has been graphically described by a neurosurgeon, Dr. Henry L. Heyl, who himself suffered a serious spinal cord lesion resulting in paraplegia. Dr. Heyl writes:
"The term, paresthesia, covers a realm of discomfort about which the average neurologist who has not experienced it can only have the dimmest academic suspicions. In fact I suspect there are neurologists who don't even know the meaning of the word anesthesia as experienced by a patient. True anesthesia, meaning lack of sensation, is practically nonexistent in a paraplegic. He has so many sensations, all of them unpleasant, that, if suddenly experienced by an otherwise normal person, they would be sufficient to send such a one screaming for emergency help. I have often discussed these sensations with fellow patients. They follow the most bizarre patterns, and seem to encompass all sensory modalities. One man feels as though his naked legs were hanging out of a window on a freezing cold day. Another described sky rockets bursting in the soles of his feet; while still another feels a family of snakes squirming in his buttocks. Others constantly and deceptively experience the urgent agonies of a full bladder. These are but a sampling, for each paraplegic's sensations are very much his own."
Thus a full range of pain and unpleasant sensation are experienced by Brad. Although this topic is complex, with significant variation from patient to patient, it is accurate to state that it comprises a major portion of the unpleasant sequence of spinal cord injury, even though the loss of motor control which interferes with usual life patterns and occupations may dominate the patient's own assessment of the grievous catastrophic results of injury.
6. Treatment - The treatment of pain in patients with spinal
cord injuries is also a complex topic with great variation from patient to patient.
The kinds of pain which result from pressure and irritation of spinal roots can often be treated satisfactorily by neurosurgical operations on the bony spinal column in the region of the injury. Here the chances for relief of pain from this source are excellent.
In contrast, the kinds of pain and discomforts which result from damage and disorganization of the pathways within the spinal cord itself are much more difficult to treat. This kind of pain is rarely amenable to neurosurgical treatment and in many procedures, unsatisfactory features make it impossible to relieve pain and discomfort to a satisfactory degree.
However, early reliance on pain-relieving medication and subsequent general rehabilitation with return to attention-occupying an productive activities, often greatly reduce the pain and discomfort of the latter type. Thus treatment can take many forms and depends upon the specific type of pain and the specific personality involved.
7. Conservative Treatment - Optimizing the overall physical condition of the patient is extremely important in achieving pain control--careful, considerate care, proper diet with vitamin supplements as needed, control of infection, and proper care of bedsores and ulcerations are all important.
The next principle is appropriate concern for the patient's psychological and emotional state. Much is accomplished towards reducing pain by entrance into a treatment program he perceives as caring for him properly and an appropriate rehabilitation program. Simply keeping the patient occupied in a program of interesting activities in a direction he sees as making progress does much to relive pain. Dr. Crouch suggests such a program for Brad.
Combinations of analgesics with tranquilizers often allow satisfactory pain control. However, potentially addicting analgesic and sleep-inducing agents must be used sparingly as the addiction potential of these psychologically troubled persons trapped in a truly grievous plight is high. Fortunately, smaller than usual amounts of such agents achieve the necessary effects for a variety of reasons. Brad is very hesitant about any drug regimen, as discussed above.
B. MENTAL ANGUISH
The jury will be presented with numerous areas of mental anguish which Brad has experienced as a result of this accident, including, but not limited to, the mental anguish which obviously accompanies physical pain, frustration, anger, fear, humiliation, embarrassment, panic, hallucinations, sympathy and the various types of mental anguish which arise out of his obvious loss of mental capacity, his physical disability and his loss of enjoyment of life.
Without going into detailed discussion of the mental anguish scenario, Brad will testify in detail as to the multiple frustrations which he has endured and will endure for the remainder of his life, arising out of possessing the will and the desire but not the physical ability to perform numerous tasks ranging from the most mundane everyday activity to his inability to comprehend the complexities of the computer field which he intended to enter prior to this accident.
Brad will specifically recount the hallucinogenic episodes which he experienced in the hospital and the extreme mental anguish which accompanied those hallucinations. As a result of those episodes, he has an intense fear of the use of drugs and has a fear of drug dependency, which is a prohibitive factor to a paraplegic who will be in need of a drug regimen for the remainder of his life.
Brad recounts vividly an emotion which the paraplegic generally receives rather than gives, i.e., sympathy. He relates that upon awakening in the hospital and realizing his condition over the first two weeks, he began to feel extreme sympathy with his parents and his brothers and sisters because he realized the highly detrimental effect which his injury would have on the family and the severe depression and mental anxiety which it would cause to his parents and siblings.
He also expressed sympathy for Sara Glass over how badly she must feel from causing an injury of this type to another human being. As a result of his feelings of sympathy he attempted to contact Ms. Glass in order to relate to her that he was going to be all right and that she should not be overly concerned about him. The message which came back from Ms. Glass was that she wanted absolutely nothing to do with him and no further effort should be made to contact her. At that point his sympathy turned to anger and remains the source of additional mental anguish.
Brad has experienced considerable embarrassment and humiliation over his bowel and bladder problems, each of which will persist as a source of considerable embarrassment to him for the remainder of his life.
He will testify to various forms of frustration such as the various frustrations involved when he first attempted to perform the simplest task in rehabilitation. Brad's father will testify that he witnessed his son cry during his rehabilitation efforts because of his inability to perform very simple physical tasks. He will also testify that he experienced severe frustration and depression when he missed his first goal of not having feeling returned to his legs within three weeks after the accident.
Like most paraplegics, Brad has had a very difficult time in accepting the permanent nature of his injury, and even at this time he will argue that his condition is not permanent and that he will walk again. However, early in his hospitalization and rehabilitation, he set certain goals for himself; and when he was unable to meet those goals, his frustration replaced the enthusiasm with which he had undertaken his rehabilitative process. As he continued further through his rehabilitation attempts his frustration was replaced with anger. He recounts graphically the first time he attempted to sit up and the frustration and then the anger at the realization that he was not able to sit up by himself.
Brad will also relate to the jury various episodes in which he has experienced panic because he was in a situation in which he perceived himself to be in some type of danger and was totally unable to extricate himself from the situation because of his physical disability.
Brad will give considerable testimony as to the frustration which has turned into anger over his loss of mental function and his inability to do many of the tasks now which he was able to do before with considerable ease. He realizes that his closed-head injury has resulted in a reduction in his mental capacity, and he can give numerous examples of simple mental functions which he could perform prior to the injury which are currently outside the realm of possibility or extremely difficult for him. This is particularly relevant to the area of his interest in computers. He can still operate a computer but his closed-head injury has resulted in both a short-term and long-term memory loss. These memory losses are prohibitive in his attempts to create computer programs as he did prior to the accident because he can no longer remember the passwords and key-words for operating his programs.
C. PHYSICAL DISABILITY
Additionally, Brad will testify as to the numerous sports activities in which he used to engage including: hunting, fishing, swimming, archery, intramural sports, jogging, softball and motorcycle riding which he obviously cannot do at this time and will never do again in the future. These will provide a basis for recovery both for physical disability and for the mental anguish accompanied the physical disability due to his inability to perform these various sports activities.
Brad's favorite sports activity prior to the accident was swimming. He is able to swim under controlled circumstances and was very enthusiastic about the hydro-therapy which was extremely beneficial to his muscular maintenance program. However, he was extremely embarrassed about having to perform his hydro-therapy in a public pool and therefore his therapy was discontinued
The diet for a paraplegic usually is high in protein, vitamins, and calories. The unaffected parts of the body are built up to optimal strength to enable the patient to ambulate with braces and crutches. The muscles of Mr. Day's hands, arms, shoulders, chest, spine, abdomen, and neck must be strengthened, since he must bear full weight on these muscles. The triceps and latissimus dorsi are important muscles used in crutch-walking. The muscles of the abdomen and the back are also necessary for balance and maintenance of the upright position.
To strengthen these muscles, Mr. Day can try to do "push-ups" when he is in a prone position and "sit-ups" while he is in a sitting position. Extending the arms while he holds weights (traction weights can be used) also develops muscle strength. Squeezing rubber balls or crumpling newspaper promotes hand strength.
Through the encouragement of all the members of the rehabilitation team, Mr. Day has developed the increased exercise tolerance needed for gait training and ambulation activities.
When the spine is stable enough to allow the patient to assume an upright posture, mobilization activities are initiated. A brace or vest may be used, depending on the level of the lesion. Braces and crutches enable some patients to ambulate for short distances and even to drive manually operated automobiles. Modern technological developments, such as motorized wheelchairs and specially equipped vans, are contributing to the greater independence and ability of patients with high level spinal cord injuries.
A major goal of rehabilitative management is to help the patient overcome his sense of futility and to encourage him in the emotional adjustment that must be made before he is willing to venture into the "outside world." To achieve this goal it is important to realize that an excessively sympathetic attitude may cause the patient to develop an overdependence that defeats the purpose of the entire rehabilitation program.
To teach and help when necessary, while not taking over activities that the patient can do for himself more than repays itself in the satisfaction of seeing a completely demoralized and helpless patient begin to find meaning in his newly emerging life style.
The patient with a spinal injury is at risk the first few weeks after his return home. Urinary infections, pressure sores, and deconditioning resulting in contractures may appear and may require hospitalization. To avoid complications, Mr. Day's family was taught skin care, catheter care, range-of-motion exercises, etc. The community health nurse provides follow-up evaluations to reinforce previous teaching and to answer questions.
Mr. Day requires continuing lifelong follow-up by the physician, physical therapist, and other rehabilitation team members because the neurological deficit is permanent and new problems can erupt that require prompt attention before they take their toll in physical impairment, time, morale, and money.
D. DISFIGUREMENT
Brad has a claim for past and future disfigurement and our evaluation of this claim is that it should be based upon a per diem argument at $10.00 per day based upon a life expectancy from January 12, 1996 which represents a total of 19,339 days. Therefore, the claim which we will make to the jury as to Brad's damages arising out of disfigurement will be for $193,390.00.
The predicate for recovery of this element of damage is proof that the Plaintiff is suffering from embarrassment and humiliation as a result of unsightly changes in his physical make-up. Our evidence on this issue will be that Brad has suffered in the past and will suffer in the future various types of such unsightly alterations including: 1) surgical scars; 2) decubitus ulcer scarring; 3) muscular atrophy; 4) osteoporosis; and 5) muscle spasm.
1. Surgical Scarring
Brad has scars on his stomach from the abdominal laparotomy, on his back from the decompressive laminectomy, on his left foot from the foot surgery, and on his hip from the iliac bone graft.
2. Decubitus Ulcers
Brad has suffered from the inevitable decubitus ulcers during the two years since the accident and will continue to suffer from them for the remainder of his life. The ulcers are treated but over the years will leave additional scars on his body.
3. Muscular Atrophy
All of the affected muscles in Brad's body below the thoracolumbar joint are currently wasting away from lack of use. Although Brad is very eager and enthusiastic about rehabilitation in order to avoid muscular atrophy, he is fighting a losing battle and as the muscles continue to waste away, he will become the victim of physical deformity in that his legs will become totally disproportionate to the rest of his body. This is a physical alteration which qualifies for consideration by the jury of damages under disfigurement.
4. Osteoporosis
The major bones in the lower portion of Brad's body are currently undergoing a process of degeneration and atrophy known as osteoporosis, and as his body continues to lose calcium throughout the catabolic process, Brad will find that he is unable to stand on his legs, even with the user of a walker as he can now. This inability to stand even with the help of prosthetic devices will contribute further to the overall pathetic personal image which Brad will physically project, and the jury is entitled to take this into account in awarding disfigurement damages.
5. Muscle Spasm
Muscular spasticity in the paralytic, which Brad undergoes on a daily basis, causes the body to twist and distort into unusually contorted positions and remain in those positions in order to avoid intense pain. This muscular spasticity further contributes to the overall physical appearance of a paralytic when compared to a normal erect person. At the time of trial, the jury will have the opportunity to see the enlarged photograph of Brad as a 6'2", 240 pound sailor during his United States Navy days and have the opportunity to compare that with the considerably smaller contorted individual whom they will see in a wheelchair in court.
According to the medical testimony, Brad is physically wasting away during each day of his life, and the jury will be sufficiently impressed with the overall disfigurement which he is undergoing in order to award the rather modest claim of $193,390.00 for Brad's past and future disfigurement.
VII. STRUCTURED SETTLEMENT FRAMEWORK
As we discussed by phone, we propose to negotiate this case on the basis of a structured settlement in two component parts: (1) the initial cash outlay, and (2) the purchase of a 50-year certain and life annuity.
A. INITIAL OUTLAY
With respect to the initial cash outlay, we are taking the following factors into account which must be covered:
a. Sufficient funds for down payment on a home for Mr. Day;
b. Sufficient funds to furnish the home and completely renovate it to accommodate the needs of a paralytic;
c. A fully equipped van with the necessary hand controls and other necessities for the safe transportation of a paralytic;
d. A lump sum payment to create an emergency fund which would be in the form of a single premium deferred annuity;
e. A fund to accommodate Mr. Day through either college or technical education according to his abilities;
f. A lump sum cash payment to compensate Ed Day and Sondra Day for their individual claims for mental anguish and loss of society and companionship; and
g. Payment of attorneys' fees and reimbursement of attorneys' expenses.
At the time of our settlement conference we will provide you with a settlement brochure which will contain our verification of special damages and explain in detail the basis for our calculations of the general damages in the initial cash outlay portion of our settlement proposal.
B. STRUCTURE
As we calculate the elements of the structure we have attempted to provide sufficient periodic payments to cover the following:
a. All future medical needs;
b. Mortgage funds to purchase the home on a 30-year basis;
c. A new fully equipped van every three years;
d. An annuity income sufficient to cover unforseen non-medical needs in the future;
e. An annuity income sufficient to cover all living costs including costs of upkeep of Mr. Day's home, car and cost of living;
f. Annual increases in order to offset the effect of inflation; and
g. Sufficient funds to equip his home with the necessary rehabilitation and therapeutic equipment.
After careful analysis we have determined that the structured portion of this case would require at least a 50-year certain and life annuity with a beginning payment of $4,000.00 per month compounded annually at 5% throughout the term of the annuity. Our planning also includes the necessity of spike payments every five years to cover extraordinary circumstances that may arise which are unanticipated at this time. See the structure proposal under Sec. VIII of this demand letter for details of the spike payment plan. Any annuities utilized as part of the structured settlement herein must be purchased through an A. M. Best Rated A+ Superior VIII company. We fully intend to shop the structure exhaustively in order to achieve the best possible rate of return, the largest affordable minimum guarantee, the greatest security and the best terms available in order to meet every conceivable need which Mr. Day will experience in the future.
C. INDEPENDENT SPECIALIST
An independent structured settlement specialist, Marie Collins of Personalized Structured Settlements, will be present at the meeting, and she is currently shopping the market for the best available structure within these parameters. If you choose to use your own structured settlement specialist, all brokers involved in this claim should be apprised in advance that the annuity will be placed with the company which provides the best benefits for the money for the Plaintiff.
D. CONSTRUCTIVE RECEIPT
In order to expedite the negotiation of this settlement on a structured basis, it is probably well to advise your structured settlement specialist that we are fully aware of PLR 8333035 in which the Internal Revenue Service ruled that knowledge of the cost of the package does not constitute constructive receipt, as follows:
"PRIVATE LETTER RULING"
The following is a Private Letter Ruling from the I.R.S. on the subject of structured settlements received on May 16, 1983. LTR 8333035, May 16, 1983
***
This is in reply to a letter of April 5, 1983, submitted on your behalf by your authorized representative, requesting a supplemental ruling that disclosure by defendant of the cost of present value of annuity to be purchased to fund its monthly settlement obligation will not cause you to be in constructive receipt of the present value of the amount invested in the annuity.
***
You have asked for a clarification of the above ruling because of your concern that your knowledge of the existence of the annuity might cause you to be in constructive receipt of that annuity.
***
Based on the information submitted in the original ruling request, we conclude that disclosure by defendant of the existence, cost of present value of the annuity will not cause you to be in constructive receipt of the present value of the amount invested in the annuity.
***
Thus, we can save a lot of each other's time by eliminating all of the usual verbiage concerning constructive receipt which usually transpires in a structured settlement negotiation.
E. MINIMUM REQUIREMENTS
If you are agreeable to the following conditions, we will proceed with negotiation of a structured settlement herein:
1. Plaintiff reserves the right to approve the life insurance company from which the annuity is purchased. This must be an A+ (Superior) VIII or above A.M. Best rated company.
2. We agree to use a § 130 Qualified Assignment: however, Plaintiff reserves the right to approve the Assignee. It is our usual position not to approve a mere shell company as an Assignee. However, this may be subject to approval based upon the strength of the annuity company.
3. We will only consider a guaranteed 50-year certain and life annuity in this particular case.
4. We will alternatively consider annual inflationary increases of 3%, 4% or 5% and compare the increases in cost in order to determine the best overall utilization of funds for the Plaintiff's benefit.
5. The cost to the liability insurance carrier of the Defendant's proposed package must be disclosed to the independent structured settlement specialist utilized by the Plaintiff herein in order to provide a basis for comparative shopping of the structure so that the maximum benefits may be achieved for the Plaintiff.
If you have any questions with respect to any of these prerequisites to negotiation of the structured settlement, please feel free to call on me and we will attempt to reach a mutual understanding so that the insurance carrier's structured settlement specialist and the independent specialist utilized by the Plaintiff will be shopping for the same type of structured settlement. It has been my experience that if we can have a clear understanding in the beginning as to what the Plaintiff's minimum requirements are with respect to structure, that this will save a considerable amount of wasted effort by your structured settlement specialist shopping for the wrong type of annuity and will also expedite the resolution of this claim.
VIII. SETTLEMENT DEMAND
A. INITIAL CASH OUTLAY: $4,678,070.00
B. STRUCTURED SETTLEMENT:
1) $4,000 per month;
2) Compounded annually at 5%;
3) 50 year certain and life;
4) A+ Superior VIII of higher company;
5) Sec. 130 (c) qualified assignment; and
6) Lump sum spike payments:
1/20/93 - $70,000
1/20/98 - 100,000
1/20/2003 - 135,000
1/20/2008 - 170,000
1/20/2013 - 200,000
1/20/2018 - 240,000
1/20/2023 - 275,000
1/20/2028 - 345,000
Our settlement demand is based on jury verdict potential in the range of $6,500,000.00 - $7,000,000.00 which we feel is attainable considering the devastating nature of the injury, the youth of the client and the extensive future lifetime of pain and suffering, mental anguish, physical disability, disfigurement, damage to wage earning capacity, medical and rehabilitative needs and pre-judgment interest. We will discuss the basis for our damage evaluations in more detail in our settlement conference but I trust that this letter will suffice for your present needs.
Yours very truly,
Howard L. Nations
HLN/as
Enclosures
BRAD DAY: GENERAL DAMAGES (ANNOTATIONS)
IA1: P/S Past - 245,200
a) Body Cast - 145 days @ 16 @ 25
b) Rehab. to 1/20/88 - 585 days @ 16 @ 20
IA2: Future P/S - 893,230
16 @ 3 @ 18,609
IB1: Past M/A - 256,800
a) Body Cast - 145 days @ 16 @ 30
b) Rehab. to 1/20/88 - 585 @ 16 @ 20
IB2: Future M/A - 1,786,464
16 @ 5 @ 18,609
IC1: Past Physical Disability - 245,200
a) Body Cast - 145 days @ 16 @ 25
b) Rehab. to 1/20/88 - 585 @ 16 @ 20
IC2: Future Physical Disability - 1,488,720
16 @ 5 @ 18,609
ID1: Past Disfigurement - 7,300
10 per day @ 730
ID2: Future Disfigurement
10 per day @ 18,609
BRAD DAY - SPECIAL DAMAGES (ANNOTATIONS)
IIA1. Wage Loss: 16,640
Based on Hansen report - Appendix A.
2 years @ 8,320.00
IIA2. Future Damage Wage Earning Capacity - 487,040
Based on Hansen report - Appendix A.
IIB1. Past Medical - 81,661.00
List and documentation - Appendix B.
IIB2. Future Medical Services
a) 578.00 Annually
1) Fran Elliott report - Appendix C.
2) Present Value - 42,258.00
Based on 1.37% Factor -
P.V. per 1,000 = 73,111.00
73,111 x 5.78 = 42,258
3) Spinal Cord Clinic - 2 @ 75 = 150 Annually
IVP - renal studies - 428.00 Annually
150 + 428 = 578 X 73,111 = 42,258
b) Single Charges - 181,660.00
1) Penile Implant - 5,000
2) Psychiatric Therapy - 13,940
3) Transitional Program - 22,800
4) Cognitive Retraining - 90,000
5) Group Therapy - 7,020.00
6) Physical Therapy - 8,580.00
7) Occ. Therapy - 12,870.00
8) Vocational Retraining - 21,450.00
c) Decubiti - 73,070.00
1) 60,000.00 Based on testimony of Dr. Simmonsen
1 - 4 decubiti over his lifetime at costs of 30,000 each for hospitalization to cure.
2) 13,070.00 Based on testimony of Fran Elliott that he will need 6 weeks of nursing care at home after each hospitalization at $6,535.00 each.
IIB3. Future Medical Commodities
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