My Most Memorable CLNC® Case: How I Helped the Plaintiff Attorney Overcome Pre-Existing Medical Conditions in Motor Vehicle Collision (MVC) Case

My most Memorable CLNC® Case comes from my current role as a full-time in-house Certified Legal Nurse Consultant for a plaintiff law firm. The case involved a 60-year-old woman who was involved in a motor vehicle collision (MVC). A truck rear-ended her car, causing her to suffer severe whiplash. We had to prove that the patient’s brain injury was directly caused by the impact of the MVA. This case changed my thought process regarding the impact of remote pre-existing medical conditions on causation and the outcome of a case. This patient’s medical history from over twenty years ago suggested previous signs and symptoms similar to a tegmen defect, but she was never definitively diagnosed with one.

Our client was driving a medium-sized SUV when a Ford super duty truck slammed into the back of her vehicle. The impact was severe and left our client with a brain injury. She sustained a concussion and developed a tegmen defect as a result of the impact. A craniotomy was required to repair the tegmen defect. During the craniotomy, she suffered a bleeding complication (an expected complication) that increased pressure on her brain and worsened her cognitive impairment. She continues to suffer from lingering cognitive difficulties and has undergone cognitive neuro- and psych therapy. Her total medical bills exceeded $175,000.

A major defense argument was that the plaintiff’s remote pre-existing conditions caused the current alleged injuries. We were able to disprove this argument through expert testimony (neurosurgeon and neuropsychologist consult) and 2D visual demonstrative evidence of the brain to illustrate the anatomy and physiology of the brain injury and the craniotomy. It was challenging to find a reputable neuropsychologist consultant in the same geographical location as the plaintiff, but once I found one, the plaintiff was able to get the assessment, diagnosis and care she needed.

This case settled for $500,000 because we were able to prove to the insurance company that the MVC was the direct cause of this woman’s brain injury, unrelated to any prior medical conditions. She now suffers from altered cognitive function and emotional distress, which have significantly impacted the quality of her interpersonal relationships, her marriage, her work and her overall quality of life.

I provided the following CLNC services:

1. Reviewed multiple sets of medical records from multiple providers and document care summaries for each set of records.
2. Documented a medical narrative from the date of incident to the most recent date of medical service prior to the settlement. This made it easy for the attorney to copy and paste the medical narrative into the demand.
3. Researched medical terms, including the main issue and tegmen defect, to ensure the attorney understood key points and the impact of the defect on the patient’s current medical condition.
4. Collaborated and coordinated with a third-party vendor for the 2D visuals and proofread their written descriptions of the visuals.
5. Produced medical records to the same third-party vendor to enhance their understanding of the medical condition and improve the effectiveness of the 2D visuals.
6. Searched for a neuropsychologist consultant.
7. Coordinated a neuropsychological consultation and follow-up appointments to determine the degree of the patient’s cognitive disability and future treatment needed. This was essential for determining damages and future cost projections for extended care.
8. Maintained ongoing communication with the plaintiff at least every two weeks to inform her of case progress, next steps and to answer questions. Frequent communication built a solid foundation of trust with our firm and calmed her anxiety, which seemed to be more pronounced after the MVA and subsequent craniotomy and bleeding complication. She was very grateful to us for the neuropsychological consult, treatment and the favorable settlement outcome.
9. Maintained ongoing communication with the in-house team (paralegal, legal assistant, attorney) regarding experts and progress on record review. The attorney and I had several conversations about this case regarding causation and pre-existing conditions. Open communication with the attorney and plaintiff was essential and helped the case move forward to a favorable outcome.

The positive client interactions in this memorable case are the type that enhance my reputation and that of the firm. These positive client interactions are essential for building and sustaining a firm’s reputation, particularly when we demonstrate genuine care about our client’s justice and well-being, beyond just the financial aspects. This, in turn, leads to more referrals and a stronger standing in the community.

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Lori Sprenger, PhD, RN, CLNC is an in-house Certified Legal Nurse Consultant for a plaintiff law firm in Atlanta. Lori specializes in personal injury and medical malpractice cases.

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