A Cheektowaga woman left paralyzed when a weight machine fell on top of her six years ago has been awarded a $66 million jury verdict, believed to be the single largest personal injury award in Western New York history.
The verdict for Natalie M. Barnhard, a 30-year-old former physical therapy assistant, came after a nearly eight-week trial that focused on the design and operation of the exercise machine and included three days of testimony from Barnhard.
Cybex International, the Massachusetts-based manufacturer of the machine, expressed disappointment in the verdict and vowed to “pursue all avenues” to reverse it.
Lawyers for Barnhard called the award suitable, given the extent of Barnhard’s injuries, and described as emotional the moment when the jury returned Tuesday with its verdict.
“Natalie’s mom turned to me and said ‘thank you,’ ” said Kevin English, one of two lawyers from Phillips Lytle who handled the case. “She knows Natalie can now be taken care of for the rest of her life.”
Cybex, in a statement, suggested the verdict was not supported by the facts in the case or the law.
“We will vigorously pursue all avenues to attain a reversal of this verdict,” said Chairman and CEO John Aglialoro.
The accident occurred at Amherst Orthopedic Physical Therapy, which could be liable for part of the award.
Domestic workers who work less than 40 hours a week obtained basic employment rights, including workers’ compensation and disability insurance coverage. The law took effect today (Nov. 29).
David Paterson
On Aug. 31, Gov. David Paterson signed the Domestic Workers’ Bill of Rights, which among other things forces employers to provide workers’ compensation and disability coverage to their domestic workers. It marks the first time a state has approved the benefits for domestic workers.
Those workers are defined generally as someone working in the home to care for a child, serving as a companion for a sick or elderly person, housekeeping or for any other domestic service purpose. The legislation does not apply to casual workers, one engaged in providing companionship services and employed by an employer or agency other than the family or household using the services, or who is a relative through blood, marriage or adoption of the employer.
The new law extends the state’s labor law to domestic workers, meaning that the eight-hour workday and $7.25 minimum wage apply. It also provides for one day of rest for each calendar work and three paid days off per year after one year of service to the same employer.
A new study sheds light on treatment choices for torn knee ligaments. Surgery may not be necessary.
A 30-year-old skier takes a sharp turn on the slopes and hears a dreaded “pop” in his right knee. He has ruptured the anterior cruciate ligament (ACL) a band of tissue that’s important for stabilizing the joint. After icing, compressing, and elevating his swollen knee, he visits the doctor. Now it’s time to decide on treatment.
If he’s an elite athlete or has additional knee damage, the choice is fairly clear: reconstructive surgery to replace the ACL, plus intense physical therapy. But if he’s a recreational skier who doesn’t do many knee-stressing sports, forgoing surgery in favor of rehabilitation through physical therapy may be a sensible approach.
A study by researchers in Sweden and Denmark confirms this. The investigators followed 121 young, active adults with ACL tears, half of whom were randomly assigned to have physical therapy and surgery, while the others had physical therapy with surgery as an option later. Two years after their injuries, people in both groups had “substantial improvement” in their knee condition, and there were no major differences in five knee-related categories such as pain, other symptoms like swelling, and function in daily living and sports activities.
Of the 59 people assigned to physical therapy with surgery as an option later, 23 (about 40%) decided to have surgery within the study’s two-year period while 36 (about 60%) did not.
The results suggest a wait-and-see approach may be right for some with torn ACLs and that more than half of expensive ACL reconstructions could be avoided “without adversely affecting outcomes,” the investigators wrote in the July 22, 2010, issue of The New England Journal of Medicine.
The treatments for ACL tears are well-established, but the paper will probably help patients weigh their choices and remove some sense of urgency around surgery. “This has not caused a paradigm shift in what we do,” says Dr. Laurence Higgins, chief of the Sports Medicine and Shoulder Service at Harvard-affiliated Brigham and Women’s Hospital. “But it will add evidence and may help surgeons tell their patients, Hey wait, not everyone who has an ACL tear needs surgery. Look at this great article.'” Twist of fate
The ACL has been described as the seat belt for the knee (see illustration). It runs through the middle of the knee joint and keeps the shinbone (tibia) from sliding forward past the thighbone (femur). The ACL is one of four main ligaments in the knee and one of the most commonly injured ones. The ACL can be stretched, torn, or both during a sudden or awkward twist, turn, or stop.
The anterior cruciate ligament helps keep the tibia from sliding forward in front of the femur.
An estimated 200,000 ACL tears occur in the United States each year, typically while people are playing sports that require sudden changes in direction (pivoting and cutting) or jumping. The sports on that list include basketball, football, skiing, soccer, tennis, volleyball, and some kinds of aerobics. Collisions aren’t necessary: about 70% of ACL tears occur without direct contact with another player or object.
Although ACL tears are usually a sports injury, they do occur outside the gym and playing field. People get their ACLs torn in car crashes. A simple trip or fall that twists the knee can also result in a tear.
Anyone can damage their ACL, but female gymnasts and soccer players are especially prone to ACL tears. There are several possible explanations for women being more vulnerable to ACL injuries, including differences in muscle strength, alignment, and estrogen levels that can loosen ligaments. There’s also some evidence that women are more likely than men to turn their knees inward when changing direction suddenly, placing added strain on their knees and ACLs. Tips for preventing ACL tears
For serious athletes who’ve torn their ACLs, a structured program to prevent re-injury is recommended. But for weekend warriors, here are three tips from Dr. Laurence Higgins for protecting your ACL:
Make a good landing. When you jump, land in a near-crouch position with knees bent and aligned straight up and down not “knock-kneed.” Viewing a video of your jumping style can help you fix it.
Strengthen the muscles around the knee. Keeping your quadriceps and hamstring muscles strong and flexible will make the knee more stable. (The “quads” form the front of the thigh, and hamstring muscles, the back.) One exercise that strengthens the quads and hamstrings is a walking lunge, which involves taking a large step forward and dropping the back knee down toward the floor, keeping the front knee over your ankle.
Keep your hip muscles strong. One-legged squats knee bends done while standing on one leg are an excellent way to strengthen the hips, quadriceps, and hamstrings and to improve your balance. When you do a one-legged squat, bend your knee slowly so it ends up just over your toes.
Tendon substitutes
Diagnosis of an ACL tear usually involves several hands-on tests and an MRI scan. Then it’s time to choose a treatment.
Surgical reconstruction involves replacing the injured ligament with a piece of tendon taken from the person’s own leg or from a cadaver. When the patient’s own tissue is used, it often comes from either the patellar tendon below the knee or from tendons in the thigh. Using tissue from cadavers has become increasingly common, in part because it avoids the pain caused by removing the patient’s tendon tissue. Doctors have tried repairing the ACL by sewing the torn pieces together, but that has generally proved to be ineffective.
These days, ACL surgery is usually done arthroscopically, through small incisions. That approach has shortened the recovery period, but people can still feel a fair amount of pain in the days and weeks after the operation. Months of physical therapy are needed to restore strength, coordination, and range of motion. As with all surgery, there are risks, like infection; in some cases, the operation fails to stabilize the knee.
About half of ACL tears are repaired with surgery, according to the American Academy of Orthopaedic Surgeons (AAOS). The people most likely to have the operation are elite athletes, active adults whose sports or jobs involve pivoting or hard cutting, and individuals who do heavy manual work. Replacing the torn ligament with tendon does tend to make the joint more stable than physical therapy rehab alone, which is an advantage for people who place a lot of stress on their knees. Surgery may also be the preferred route if there is additional damage to the knee for example, if a meniscus has been torn.
Many people who get reconstructive surgery resume their pre-injury activities; the AAOS reports long-term success rates of 82% to 95%. Star athletes like New England Patriots quarterback Tom Brady, who ruptured his ACL in 2008, can come back from the injury after the operation. But according to Dr. Higgins, the joint never quite works exactly the way it did before the tear, and more research is needed to understand why.
Early-onset osteoarthritis is another common complication of ACL tears, probably caused by increased wear on the leg bones and shock-absorbing cartilage in the knee over time. It’s not clear whether surgery reduces the risk of osteoarthritis. Avoiding the knife
The ACL doesn’t heal on its own, but physical therapy can strengthen the muscles around the knee enough so they compensate for the nonworking ACL. A custom-made knee brace may also be useful for tennis, soccer, or other activities that involve twisting if the person plays occasionally.
Treating an ACL tear with physical therapy alone is worth considering if it’s a partial tear or if the person isn’t very active. Adults who are active but do “in-line” sports such as cycling or running might also do well with just physical therapy because those sports don’t usually involve turning and twisting the knee.
Children and teens usually are steered toward physical therapy as the only treatment because surgery involves drilling into the growth plates of the leg bones, which may keep them from growing properly. The number of youths with torn ACLs has increased in recent years, and some blame the rising number of children playing organized, competitive sports year-round.
One big advantage of not having surgery is a faster recovery. People who don’t get surgery normally recover enough to be active again within two or three months, compared with about six months for surgery patients, says Dr. Higgins. It takes longer to recover from surgery because tendon graft used to replace the ACL needs to fully heal and be ready to withstand the stress that playing sports can put on it.
The best way to treat an ACL injury can be a judgment call that factors in extent of the injury, the person’s age, and his or her activities. Each situation is a little bit different. It’s important to get a second opinion and carefully weigh your options.
New York City’s 12,000 miles of sidewalk provides the setting for thousands of slip and fall injuries each year. New York has unique laws under which a person may recover for their resulting injuries.
November 19, 2010 /24-7PressRelease/ — With more than 12,000 miles of sidewalk, 8.4 million residents and 47 million visitors each year, it should come as no surprise that slip-and-fall accidents are as common as pigeons in New York City.
The extreme heat in the summer and cold in the winter wreak havoc on the city’s sidewalks, creating holes, uneven surfaces, cracks and other hazards that can trip up even the most seasoned New York City pedestrians.
In most American cities, the law holds municipalities responsible for maintaining the safety of public sidewalks – and this was the rule for years in New York. But in 2003, the law changed and the onus for keeping the City’s sidewalks in good repair was passed on to property owners.
Property Owners Liable for Sidewalk Upkeep
Under the City of New York’s Administrative Code ?7-210, property owners have a duty to maintain the sidewalk abutting their property in a reasonably safe condition. This includes removing ice and snow on sidewalks , as well as dirt and other debris. There is also a duty to install, construct, reconstruct, repave, repair and replace defective sidewalk.
Some examples of defective sidewalk conditions property owners must repair include:
– Missing portions of the sidewalk
– Cracked sidewalk
– Visible holes in the sidewalk
– Loose sidewalk that seesaws
– Uneven sidewalk
– Improperly sloped sidewalk that collects water
Property owners who fail to maintain the portion of sidewalk in front of their properties or who do so negligently may be legally liable for any sidewalk fall injuries or property damage that results.
The 2003 changes in the law also require property owners to carry general liability insurance policies to cover injury and property damage claims from sidewalk accidents.
Buildings containing one, two or three-family units that are wholly or partially owner occupied and used primarily as residential properties are exempt from ?7-210.
Collecting Compensation from the City
In some cases, a victim of a slip-and-fall accident still can seek compensation from the City for his or her injuries. For example, the City generally is responsible for any defects that occurred in the sidewalk prior to the 2003 changes to the law, unless the defect occurred as a result of the property owner’s acts or from the property owner’s “special use” of the sidewalk. An example of a special use is a portion of the sidewalk that is also part of a property owner’s driveway.
The City also may be responsible for any defects or dangerous conditions it creates in the sidewalk. For example, a court held the City responsible for a woman’s injuries that occurred when she stepped into a metal circular hole that was left after the City removed a damaged fire hydrant. The court found that the City and not the abutting property owner had a duty to repair the unsafe condition.
Slip-and-fall victims also may seek a disbursement from the City when the property owner fails to pay a judgment. This may occur because the property owner does not carry the required liability insurance policy or did not purchase enough coverage to fully compensate the victim for his or her losses. When this occurs, the accident victim can petition the City for payment of the judgment.
To be eligible, the following conditions must be met:
– The judgment must have been entered and payment must not have been received for at least one year
– The petitioner must provide proof that the property owner does not have sufficient liability insurance or other assets to pay the judgment
– The petitioner must provide proof of efforts used to collect the judgment
– The petition must be filed within three years of the original judgment
It is important to note that the City only will compensate the victim for his or her unpaid medical expenses up to a maximum of $50,000. Additionally, the City only allocates a total of $4 million each year for these types of claims, so not everyone with an unpaid judgment may be able to collect it from the City.
Conclusion
Many believe that slip-and-fall accidents really aren’t all that serious and only result in minor scratches and a bruised ego. But slip-and-fall accidents can be very serious and can result in broken bones, head and neck injuries, back injuries, soft tissue injuries, traumatic brain injuries (TBIs) and even death.
For more information on your legal rights following a slip-and-fall accident, contact an experienced New York personal injury attorney today.
The Workers’ Compensation Board issued a bulletin regarding the training opportunities on the new medical treatment guidelines, which go into effect for dates of service on or after Dec. 1.
The new guidelines change the manner medical care is provided to injured workers for the middle and low back, neck, shoulder, and knee. With few exceptions, all treatment in accordance with the guidelines will be pre-authorized. This is a new process that involves new procedures and new revised forms. The board is encouraging medical providers, insurers, legal professionals, and their staffs to take available training to ensure a smooth transition. Free web-based training is available on the board’s website. Those with questions may call the board’s bureau of health management at (800) 781-2362. For a copy of the bulletin, visit www.wcb.state.ny.us/content/main/SubjectNos/sn046_445.jsp.
The board also has proposed updates to the medical, podiatry, chiropractic, and psychology fee schedules to be effective Dec. 1. The changes increase the fees for evaluation and management services by 30 percent in the medical fee schedule; change the chiropractic fee schedule to allow for separate billing of treatment modalities rather treating such treatment as part of evaluation and management services; modify the ground rules to be consistent with the medical treatment guidelines that will be in effect as of Dec. 1; adjust for new, modified, and deleted current procedural terminology codes; and change minor typographical clarifications to the previous fee schedules. For information on the proposed rule, visit www.wcb.state.ny.us/content/main/wclaws/Proposed/Proposed_FeeSchedules.jsp.