The Cascade Effect

Frequently I represent older adults who have a traumatic injury from a fall or automobile collision. The initial injury to my client is a broken hip, arm, torn rotator cuff, or perhaps something equally disabling, without a fracture or tear. Many times I have watched those clients suffer through what I have termed the “cascade effect.” A broken hip leads to a nursing home, which leads to pneumonia/staph infection/other “unrelated condition”, and not infrequently death within a year or two. Was the broken hip because the fall related to the other conditions and/or death? I have repeatedly taken the position that Illinois Pattern Jury Instruction 15.01 should be used for the jury’s consideration. It reads as follows:

When I use the expression “proximate cause,” I mean any cause which, in natural or probable sequence, produced the injury complained of. It need not be the only cause, nor the last or nearest cause. It is sufficient if it concurs with some other cause acting at the same time, which in combination with it, causes the injury.

Occasionally, my client’s treating physician will agree with my “cascade effect” theory. Frequently, however, the doctor believes it but because he or she does not have sufficient medical support for the theory, will say it is only speculation, or agree with the defense attorney in that regard. Recently published medical research provides significant support for the cascade theory. The Journal of the American Medical Association published an article, “Long-Term Survival of Adult Trauma Patients” which concludes:

Among adults admitted for trauma in Washington State, three year cumulative mortality was 16% despite a decline in in-hospital deaths. Discharged to a skilled nursing facility at any age following trauma admission was associated with a higher risk of subsequent mortality.

In other words, people who are hospitalized for trauma die less frequently then in the past while in the hospital, but at a greater rate once they are out of the hospital. Moreover, they have significant “side effects” or as a doctor would say, “morbidity”, then they otherwise would have.

 Read the article for yourself. It can be found by following this link. http://jama.ama-assn.org/content/305/10/1001.abstract

So if you or a loved one have suffered a fall, auto accident, collision or other traumatic event you should be aware of this statistic and do what you can to guard yourself against it coming to fruition.

Tom Paris, Chicago Attorney 
312/759-1600
312/201-1436(fax)

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