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      Compounding Injuries: Winning Cases with Pre-Existing Conditions

      Compounding Injuries: Winning Cases with Pre-Existing Conditions

      Pre-existing conditions complicate cases. They require proof that the defendant's negligence caused new injuries or worsened existing ones. Insurance adjusters often argue exaggeration. Calculating pain and suffering is challenging. 

      In Carol Reed vs. Life Care Centers, Morgan & Morgan attorneys Keith Mitnik and Spencer Payne secured a $13.35 million verdict for their client, who was born with spina bifida. Reed developed a stage four pressure wound due to staff negligence during her stay in a rehabilitation facility, leaving her unable to care for herself independently.

      Here are the tactics our attorneys used in the courtroom to highlight the full impact of Reed’s injury. These strategies can be applied when representing clients with severe pre-existing medical conditions, whether in medical malpractice, auto accident, or premises liability cases.

      1. Use the “As Is Justice” Framework

      In the Reed v. Life Care case, Mitnik and Payne demonstrated to the jury how Carol Reed’s pre-existing paralysis, which prevented her from feeling pain traditionally, made her more susceptible to injury and less capable of recovery, thus severely impacting her mobility and independence and showcasing a profound loss of quality of life. 

      Embracing the "As Is Justice" framework, they argued that justice must account for Reed’s condition without discounting it due to her health status, emphasizing that victims of negligence deserve full compensation regardless of pre-existing conditions, and highlighting how the defendant’s actions aggravated her condition, causing new and more severe injuries.

      Acknowledge the Condition: Be upfront about your client's pre-existing condition. Hiding it can damage credibility

      • Full Justice for All: Argue that justice should account for the client’s condition and not be discounted due to their health status.
      • Explain the Impact: By detailing how the pre-existing condition makes the client more susceptible to injury and less capable of recovery, show that the harm caused by the defendant’s negligence has exacerbated the condition. 

      2. Highlight Medical Baselines, Reserves, and Coping Capacity

      “Baselines, reserves, and coping go hand in glove with ‘As Is Justice,’” Mitnik explains. Baselines refer to pre-existing health status, and Reed’s baseline was low due to spina bifida. When someone is in good health, they have resilience, but with a lower health baseline, every challenge becomes tougher. Reserves are the capacity to cope with additional stress or injury, which were depleted for Reed due to her condition and prior health issues. Reed's low reserves were further diminished by the pressure sore she developed, worsening her overall condition and making the injury’s impact more severe compared to a healthier person. Coping is the ability to manage new health burdens, and Reed’s compromised ability to cope made the new injury's impact more severe. 

      Medical Baselines: Present evidence of your client’s health baseline before the incident, illustrating how they managed their condition.
      Reserves: Explain how their reserves (for example, ability to handle additional stress) were already low, making the new injury’s impact more significant.

      Coping Capacity: Demonstrate that your client’s capacity to cope with new injuries was compromised, resulting in greater suffering and diminished quality of life.

      3. Leverage Expert Testimony

      By using detailed medical records and evidence, Mitnik and Payne demonstrated how their client's pre-existing condition was aggravated by the incident and helped counter defense arguments that attempted to minimize the impact of the injury by pointing to her pre-existing condition. The Mitnik/Payne strategy involved proving that the defendant's actions worsened the client's condition, thereby justifying full compensation for the additional harm caused.

      • Medical Experts: Use doctors and specialists to explain the client's pre-existing condition, the aggravation caused by the incident, and the impact on their overall health.
      • Economic Experts: Present evidence of the financial impact, including increased medical expenses, lost wages, and future care costs.

      4. Use Visual Aids to Tell the Client’s Story

      Mitnik and Payne showed video footage, documentation and medical records to demonstrate not only what Reed's life was like before her admission to Life Care Centers with a broken leg and how she was unable to move herself adequately upon arrival at the facility, but also to highlight the sporadic assistance she received with regard to changing her position during her stay.

      • Humanize the Client: Share personal stories and daily struggles to reveal the person behind the case.
      • Visual Aids: Use photos, videos, and medical records to illustrate the client's journey and the incident's impact.

      5. Address the Defendant’s Arguments Proactively

      Mitnik and Payne anticipated the defense's “blame-the-patient" strategy, showing that Reed couldn’t turn herself due to her paralysis, broken leg, and deconditioning. They highlighted the facility’s negligence by proving her inability to comply with staff instructions. This dismantled the defense’s narrative and underscored her vulnerability, demonstrating that Reed deserved full justice despite her pre-existing conditions.

      Anticipate Defense Tactics: Be prepared for the defense to argue that the injuries were solely due to the pre-existing condition. Counter this by showing how the incident specifically aggravated the condition.

      Concurring Cause Doctrine: Emphasize that the defendant’s negligence need not be the sole cause of the injury but must have substantially contributed to the harm.

      6. Craft a Compelling Narrative for Damages

      Mitnik and Payne sought $35 million in damages, justifying the amount with meticulous detail. They documented daily challenges like difficult transfers and struggles with basic hygiene due to the client's inability to use straight leg braces. These indignities were tallied to show their profound impact. They argued for compensation based on per diem rates, highlighting ongoing suffering and future medical needs. This approach aimed to ensure the jury understood the severity of her situation and the necessity of the requested damages.

      • Pain and Suffering: Quantify the increased pain and suffering due to the aggravated condition.
      • Loss of Enjoyment: Argue how the incident has deprived the client of the ability to enjoy life, perform daily activities, and maintain independence. 
      • Future Damages: Highlight the need for ongoing medical treatment, therapy, and potential future surgeries, along with the associated costs.

      Leveraging Vulnerabilities for Justice

      When representing clients with severe pre-existing conditions, a strategic approach that acknowledges and leverages their vulnerabilities is crucial. At trial, the Morgan and Morgan team were able to show that the defendant put profits over people and put their client in danger of developing this wound. After eight days of trial the jury rendered a fair and just verdict for Carol Reed. “No case has gotten to me like this one where I felt the responsibility to make sure that standing up for her counted," Mitnik said after the verdict.