Articles Posted in Quadriplegia

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An eighteen-year old resident of an apartment building was walking along the grounds of the apartment building in Florida when he met an accident. He lay on the concrete pavement, unable to move because of a spinal injury. A few minutes later, an employee of the apartment owner was making his rounds of the apartment. He saw the eighteen- year old sprawled on the pavement and thought that he was unconscious due to a drug overdose or because he was drunk. He shook the eighteen-year old and found him to be conscious. The Long Island employee told him that he will move him to a more lighted area so that he can help him. The eighteen-year old protested, asking the employee not to touch him or to move him as his spine may be broken. The eighteen-year old protested continuously but the employee did not heed his protests, he dragged the eighteen-year old near the entrance of the building. He then called emergency services who rushed the eighteen-year old to the hospital. When the police and emergency services arrived, the employee told the police that he moved the eighteen year old because he thought that he was just passed out because he was drunk or overdosed from drugs. He had no idea he was injured. The incident resulted in the eighteen-year old being disabled due to quadriplegia or paralyzed from the neck down.

The eighteen-year old then sued the apartment owner and his insurer. He did not include in the suit the employee of the apartment owner. He wanted to call him as an adverse witness because the employee made inconsistent statements before the police (at the time of the incident) and then when he was deposed (before the trial) which testimonies and statements totally contradicted his testimony at trial. The trial court refused the eighteen year old’s request to call the employee as an adverse witness. The trial court held that there was a question as to whether the employee was really employed by the apartment owner; the trial court also held that the employee could not be called as an adverse witness because he was not a party to the case or listed as a party defendant in the damage suit.

The apartment owner and the insurer based their defense on the Good Samaritan Act. They claim that the employee was immune from a suit in damages because he was only trying to help. Under Florida Law, bystanders who help those who were injured cannot be sued for damages if the person they aided suffered injury in the course of being rescued or aided. They also claimed that even if they were found to be liable the amount of lost earning capacity of the eighteen year old cannot be determined because the eighteen-year old was a career criminal who had no real job or job prospects as he dealt in drugs and petit larceny,

The trial court also refused to allow the testimony of the expert witness for the eighteen year old. The proposed expert testimony was from a doctor who had experience in rehabilitation medicine specializing in those with spinal injuries. He treated and examined the eighteen-year old and supervised his physical therapy. His testimony was proffered but it was not admitted as evidence for the eighteen year old who tried to prove that it was not the injury that caused the quadriplegia but it was the dragging of his injured body down the pavement from where he was injured to the entrance of the building that resulted in his disability.

The jury found for the defendant apartment owner and insurer, claiming that they had no liability to pay damages to the eighteen year old as their agent merely tried to help him. The eighteen-year old appealed the jury verdict for the apartment owner.

The only question is whether or not the jury verdict for the apartment owner and the insurer are errors which can be cured by a re-trial.

The Court held that the trial court erred in not allowing the employee to be examined by the eighteen year old as an adverse witness. The employee, if he were truly an employee of the apartment owner instead of merely a bystander has interests that were adverse to that of the eighteen-year old. To protect his job, he would have to testify favorably to his employer. The employee, if he is not really an employee, may also be examined as an adverse witness because he made prior inconsistent statements to the police and then on deposition. The eighteen-year old had the right to examine the credibility of the employee and to sift through his varying pronouncements which were true and which were not.

The trial court erred in not allowing the Manhattan doctor to testify as an expert witness. He is board-certified as a physician specializing in rehabilitation of patients with spinal injury. He may have examined and treated the eighteen-year old and can thus give testimony of the injuries he diagnosed and the treatments he prescribed. But he is also an expert in his field and his testimony as an expert should have been admitted for the benefit of the jury who were laymen and unable to know from their common everyday experience what spinal injury are all about.
The evidence regarding the drug use and drug dealing of the eighteen-year old are relevant not to prove his credibility as a witness about his injures (the medical evidence proves his injuries). They are relevant to prove his earning capacity or lack thereof. At the re-trial, the jury should be instructed to regard the evidence of former drug dealing and petit larceny when the eighteen year old was only fourteen as evidence of his earning capacity and not evidence of his injuries or of his credibility to testify as to his injury.

As for the apartment owner and his insurer, they can surely hide behind the provisions of the Good Samaritan Act but only if they can prove that the help they gave to the injured eighteen year old was requested by him and was not objected to by him. There is evidence that the eighteen year old continuously objected and protested his being dragged and moved from one place to another. His protests and objections went unheeded. For this alone, the Good Samaritan defense cannot be availed of. There is also the issue (which was not taken up) regarding the liability of the apartment owner and his insurer for injuries to third persons while on their property. Their liability in this regard cannot be ignored as it was.
The Court granted the eighteen-year old a re-trial.
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A independent building and construction contractor was working for a construction corporation in a project in Panama City on September 3, 1985. He was at the office working on some paper work. While he was seated at his desk, he reached out to his left to a cubby hole near his desk for some more blueprints. As he reached for the blueprints he turned in his seat. He twisted his trunk and he could not move: hand outstretched, trunk twisted to the left in his seat. He remained there until his wife found him forty-five minutes later. An ambulance was called to rush the independent contractor to the hospital.

His wife took him to the emergency room where he was diagnosed to be suffering from paralysis from the neck down. CT scans were performed on him in Panama City and he was diagnosed with sudden quadriparesis (weakness in the muscles of the four limbs) of unknown origin. The doctor in Panama City opined that his injury was vascular in origin and it must have been a pre-existing vascular anomaly.

The Panamanian construction company, his employer, paid for his medical bills and paid for temporary partial disability benefits. When the man returned for further diagnoses and treatment in the United States, he consulted his general physician, the one he had been seeing for most of his adult life. His general physician referred him to a neurosurgeon who conducted more tests on him. His American doctor found that what happened to the independent contractor was spinal contusion. As the man turned and reached for the blueprints while he was seated, his spine was twisted out of shape and there was a momentary loss of blood supply to his spine. The momentary loss of blood supply to the spine resulted in lack of oxygen and thus, paralysis. The vascular disability resulted from the blood supply loss and the oxygen deprivation of the spine.

Physical therapy and medication were advised. A year after the incident, the independent contractor was still suffering from muscular weakness in all his four limbs but he was able to walk around with the aid of a cane. He was able to do very light work for a short time. The American neurosurgeon opined that spinal injuries heal very slowly and it may take two years before the true extent and nature of the independent contractor’s injuries and disabilities are.
Further MRI scans revealed that the acute quadriparesis occurred spontaneously and that the spinal cord in the neck, the upper and lower back was within normal limits. With the help of these medical findings, the American neurosurgeon ruled out pre-existing muscular anomalies. The damage to the membranes covering the spinal cord, the myelin, looked to be healing. The general physician of the independent contractor testified that the independent contractor did not have any history of back pain although he had a history of migraine headaches.

The deputy commissioner for compensation claims found that although the medical evidence regarding the independent contractor’s condition was largely conflicting, the evidence that the sudden loss of blood circulation in his spine was not due to a pre-existing medical condition. There was no known cause. The onset was sudden. The injury occurred while the independent contractor was at work and it was occurred as he was discharging his functions at work. Had he not been at work, seated at his desk and doing paperwork, he would not have reached out to get blueprints from a nearby cabinet and he would not have twisted his spine so as to cut-off the blood supply to his spine. It was the turning and bending motions while seated at his desk which caused the internal spinal injury to the independent contractor.
The commissioner’s order for the employer to pay temporary total and temporary partial disability benefits, medical bills and to furnish medical care and treatment to the independent contractor is upheld.

Doctors in The Bronx and Brooklyn are taking note.
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A NYC eighteen-year old resident of an apartment building was walking along the grounds of the apartment building in Florida when he met an accident. He lay on the concrete pavement, unable to move because of a spinal injury. A few minutes later, an employee of the apartment owner was making his rounds of the apartment. He saw the eighteen- year old sprawled on the pavement and thought that he was unconscious due to a drug overdose or because he was drunk. He shook the eighteen-year old and found him to be conscious. The employee told him that he will move him to a more lighted area so that he can help him. The eighteen-year old protested, asking the employee not to touch him or to move him as his spine may be broken. The eighteen-year old protested continuously but the employee did not heed his protests, he dragged the eighteen-year old near the entrance of the building. He then called emergency services who rushed the eighteen-year old to the hospital. When the police and emergency services arrived, the employee told the police that he moved the eighteen year old because he thought that he was just passed out because he was drunk or overdosed from drugs. He had no idea he was injured. The incident resulted in the eighteen-year old being disabled due to quadriplegia or paralyzed from the neck down.

The eighteen-year old then sued the Westchester apartment owner and his insurer. He did not include in the suit the employee of the apartment owner. He wanted to call him as an adverse witness because the employee made inconsistent statements before the police (at the time of the incident) and then when he was deposed (before the trial) which testimonies and statements totally contradicted his testimony at trial. The trial court refused the eighteen year old’s request to call the employee as an adverse witness. The trial court held that there was a question as to whether the employee was really employed by the apartment owner; the trial court also held that the employee could not be called as an adverse witness because he was not a party to the case or listed as a party defendant in the damage suit.

The apartment owner and the insurer based their defense on the Good Samaritan Act. They claim that the employee was immune from a suit in damages because he was only trying to help. Under Florida Law, bystanders who help those who were injured cannot be sued for damages if the person they aided suffered injury in the course of being rescued or aided. They also claimed that even if they were found to be liable the amount of lost earning capacity of the eighteen year old cannot be determined because the eighteen-year old was a career criminal who had no real job or job prospects as he dealt in drugs and petit larceny.

The trial court also refused to allow the testimony of the expert witness for the eighteen year old. The proposed expert testimony was from a doctor who had experience in rehabilitation medicine specializing in those with spinal injuries. He treated and examined the eighteen-year old and supervised his physical therapy. His testimony was proffered but it was not admitted as evidence for the eighteen year old who tried to prove that it was not the injury that caused the quadriplegia but it was the dragging of his injured body down the pavement from where he was injured to the entrance of the building that resulted in his disability.

The jury found for the defendant apartment owner and insurer, claiming that they had no liability to pay damages to the eighteen year old as their agent merely tried to help him. The eighteen-year old appealed the jury verdict for the apartment owner.

The only question is whether or not the jury verdict for the apartment owner and the insurer are errors which can be cured by a re-trial.

The Court held that the trial court erred in not allowing the employee to be examined by the eighteen year old as an adverse witness. The employee, if he were truly an employee of the apartment owner instead of merely a bystander has interests that were adverse to that of the eighteen-year old. To protect his job, he would have to testify favorably to his employer. The employee, if he is not really an employee, may also be examined as an adverse witness because he made prior inconsistent statements to the police and then on deposition. The eighteen-year old had the right to examine the credibility of the employee and to sift through his varying pronouncements which were true and which were not.

The trial court erred in not allowing the doctor to testify as an expert witness. He is board-certified as a physician specializing in rehabilitation of patients with spinal injury. He may have examined and treated the eighteen-year old and can thus give testimony of the injuries he diagnosed and the treatments he prescribed. But he is also an expert in his field and his testimony as an expert should have been admitted for the benefit of the jury who were laymen and unable to know from their common everyday experience what spinal injury are all about.
The evidence regarding the drug use and drug dealing of the eighteen-year old are relevant not to prove his credibility as a witness about his injures (the medical evidence proves his injuries). They are relevant to prove his earning capacity or lack thereof. At the re-trial, the jury should be instructed to regard the evidence of former drug dealing and petit larceny when the eighteen year old was only fourteen as evidence of his earning capacity and not evidence of his injuries or of his credibility to testify as to his injury.

As for the apartment owner and his insurer, they can surely hide behind the provisions of the Good Samaritan Act but only if they can prove that the help they gave to the injured eighteen year old was requested by him and was not objected to by him. There is evidence that the eighteen year old continuously objected and protested his being dragged and moved from one place to another. His protests and objections went unheeded. For this alone, the Good Samaritan defense cannot be availed of. There is also the issue (which was not taken up) regarding the liability of the apartment owner and his insurer for injuries to third persons while on their property. Their liability in this regard cannot be ignored as it was.
The Court granted the eighteen-year old a re-trial.
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In a hybrid proceeding pursuant to Civil Procedure Laws and Rules, to review a determination of the State Health Department Commissioner and the Bureau of Financial Management and Information Support Director, which reduced a component of the petitioner’s Medicaid reimbursement rate following an audit, and an action for a judgment declaring that the guideline of the State Health Department for designating a diagnosis of quadriplegia (spinal injury that paralyze the four limbs) on a patient review instrument is invalid, the nursing home appeals from so much of a judgment of the Supreme Court, as failed to annul that portion of the determination which found that the petitioner had misclassified two of its residents in the special care group, failed to direct that the State Health Department permit the nursing home to submit the revised patient review instruments for certain of its residents, and declared that the challenged guideline does not constitute a rule or regulation subject to the provisions of the State Administrative Procedure Act, and the Commissioner and the Director cross-appeal from so much of the same judgment as annulled that portion of the determination which reclassified the two residents in the reduced physical functioning group and remitted the matter to the State Health Department to reclassify the two residents in the clinically complex group and to calculate the petitioner’s Medicaid reimbursement rate for the period covered by its patient review instruments accordingly.

The petitioner is a not-for-profit corporation owned by the United Cerebral Palsy Association which operates a 185-bed nursing home in Nassau County.

As part of the Medicaid reimbursement rate calculation, Patient Review Instruments are completed semiannually for each patient in the nursing home. Patient Review Instruments require detailed information assessing patients’ conditions, treatment, and dependencies and required care, needs, and services. These Patient Review Instruments place patients into 16 patient classification categories or resource utilization groups, corresponding roughly to the severity of the patients’ medical conditions and the intensity of the required care. The categories are further divided into five hierarchical groups which, in descending order of resource utilization, are heavy rehabilitation, special care, clinically complex, severe behavioral, and reduced physical functioning. Each category is assigned a numerical value, which reflects the relative resource utilization of patients in that group. The patient’s Case Mix Index of a nursing home is the weighted average of its patients in each category. Thus, the greater the resource utilization is the greater the associated Case Mix Index, and therefore the greater the reimbursement.

The New York City Department of Health publishes a clarification sheet to assist nursing homes in completing the Patient Review Instruments. One of the questions of the Patient Review Instruments requires nursing homes to designate a diagnosis code reflecting the resident’s primary medical condition requiring the largest amount of nursing time in the preceding four weeks. In 1999, the Department of Health issued a revised clarification sheet in which it explained that a diagnosis code of quadriplegia should not be used in instances where a resident has not incurred a spinal injury or spinal cord disease.

In August 2000 the petitioner nursing home submitted its Patient Review Instrument data to the Department of Health. In a subsequent audit, the Department of Health concluded that the petitioner had improperly designated a diagnosis code of quadriplegia on the Patient Review Instruments for two residents, who suffer from cerebral palsy with spastic quadriplegia, because their quadriplegia was not caused by spinal injury or disease. As a result of the audit, Department of Health downgraded the two residents from the special care group to the reduced physical functioning group and reduced the nursing home’s reimbursement rate accordingly.

The audit was in conformity with a clarification sheet issued by the Department of Health which advised that the Medicaid International Classification of Disease Code for quadriplegia could not be utilized in completing a PRI unless a resident’s quadriplegia was attributable to spinal injury.

The Westchester nursing home contends that in issuing the spinal cord etiology standard, the Department of Health changed its long-standing policy of reimbursing nursing homes at the same rate for all quadriplegic residents regardless of the etiology of their conditions and established a new rule without complying with the rule-making procedures outlined in the State Administrative Procedure Act. State Administrative Procedure Act, however, specifically excludes from the definition of a rule forms and instructions, interpretive statements and statements of general policy which in themselves have no legal effect but are merely explanatory. The spinal cord etiology standard sets forth the interpretation by the Department of Health of the particular medical condition that qualifies a resident for a quadriplegia diagnosis in response to question 30 of the PRI and, correspondingly, for classification in the special care group. As such, it is an explanatory statement and a technical instruction for meeting the regulatory requirement which has no legal effect standing alone. Moreover, even if it reflects a change in how the Department of Health interprets the prerequisites for a quadriplegia diagnosis it does not render it an unpromulgated rule.

The petitioner nursing home further contends that the spinal cord etiology standard is arbitrary and capricious, irrational, and contravenes the design and purpose of the Medicaid reimbursement system requiring that reimbursement rates be reasonable and adequate to meet the costs which must be incurred by efficiently and economically operated facilities. Generally, rate-setting actions of the Commissioner, being quasi-legislative in nature, may not be annulled except upon a compelling showing that the calculations from which they derived were unreasonable. Thus, a petitioner attempting to challenge the reasonableness of agency rate-setting action bears the burden of demonstrating that the adopted methodology is without a rational basis. The petitioner failed to meet its burden.

The nursing home maintains that there is no rational basis for excluding residents whose quadriplegia is not caused by a spinal cord etiology from the special care group because all quadriplegics, regardless of the etiology of their condition, require a high level of skilled nursing care. While not disputing that all quadriplegics require a high level of care, the Commissioner submitted an expert medical affidavit establishing that there are discrete medical and psychiatric conditions experienced by quadriplegics with spinal cord injury or disease requiring an associated increase in the level and intensity of care, treatment, and medications, as compared with quadriplegics with other etiologies. Reimbursing nursing homes at a lower rate for patients whose conditions, care needs, and resource utilization are less demanding is neither irrational nor inconsistent with the Medicaid reimbursement scheme, and the petitioner failed to demonstrate that the reduced reimbursement rate is unreasonable or inadequate to meet its costs. Contrary to the nursing homes’ contention, the doctrine of judicial estoppel does not bar the Commissioner from relying on the affidavit of their medical expert since the Department of Health did not secure a judgment in its favor in the unrelated proceeding brought in the Supreme Court, Albany County, nor is the Commissioner’s position in this proceeding inconsistent with the position the Department of Health took in that proceeding.

Finally, the State Health Department Commissioner’s determination to reclassify the two residents in the reduced physical functioning group based on the auditors’ findings was arbitrary and capricious. Accordingly, the Supreme Court properly directed the State Health Department Commissioner to reclassify the two residents in the appropriate category and to correct the petitioner’s Case Mix Index accordingly.
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A teenager’s spinal cordwas destroyed in 1978 after she received a lethal dose of radiation at a hospital she was receiving cancer treatment from. She was awarded $7.6 million by a jury.

Some believed at the time that it was the single, largest payment awarded in a malpractice suit in the U.S.

After the trial, the 18-year-old said that the jury was full of “wonderful people and now I have a chance for my life.”

The girl’s lawyers said that most of the money was going to have to go toward medical payments.

The representatives for the hospital said the case “was built on circumstantial evidence.” He also called the verdict excessive and said that they most certainly were going to appeal.
The girl, confined to a wheelchair, was paralyzed in 1972 when she was receiving radiation therapy for a slow-growing cancer. The thyroid cancer was thought to be treatable; she was to go through a six-week cycle of treatment. The young woman was not suffering from cancer at the trial, but it was unknown how she had been cured of it.

According to a doctor, witnesses prominent and knowledgeable in the field of medicine testified that the paralysis was caused by a double dose of radiation which destroyed the spinal cord.

An overlap of the radiation fields was blamed, even though no one took responsibility for it. The jury was told that the young woman now needs 24-hour care and has a minimum of $55,000 in yearly medical expenses.

The hospital’s defense attorney said that the paralysis was due to an unusual reaction and nothing else. He adamantly refused to acknowledge an overdose. Again, he planned on appealing the “excessive” verdict. Hospitals in Nassau and Suffolk are watching.

Despite 10 surgeries, the young woman will most likely spend the rest of her life as a quadriplegic. She does have slight use of her right arm, but that is all. In most cases, no improvement is made after a certain amount of time has elapsed.
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Investigators have learned of a man who dived under a wave while bodysurfing at Mooloolaba Beach in 2005, with full control of his limbs. When he came up again, he was a quadriplegic.

The victim had a weakened neck from years of playing rugby union. In fact, his doctors had already given him warnings only weeks before his accident that he had to stop playing rugby or risk permanent spinal injury. His accidental head-first collision with a sandbar hidden under the waves was the final blow that injured his spinal cord.

The 35-year-old can now only move his face and shoulders. To get around, he has a wheelchair he can control with his chin. Firms have discovered that even now, he is doing something important with the injuries he has suffered. Now, he is a member of the Spinal Education Awareness Team, or SEAT, speaking for the Spinal Injuries Association with offices in Manhattan as well as Long Island.

SEAT is composed of 14 men and women from all over the state of Queensland, Australia, where the victim resides, all of them with paraplegia or quadriplegia. They travel to different schools, telling the students about spinal injuries, their own lives, and most importantly, how children can avoid the risks that lead to spinal injuries that could affect them for the rest of their lives.

“The last thing I want to see a young person have a spinal injury,” the former rugby player said. “It not only affects you, it affects your whole family and everyone around you.”

He continued to say that it was the love and support of his wife, his 11-year-old son, and his 1-year-old daughter that helped see him through the tough times after his accident. He and other members of SEAT are very involved in fundraising through the Spinal Injuries Association to spread the word on how to avoid such catastrophic injuries, and support those who have already suffered them. Their efforts have already brought a great deal of hope to the injured and may well have given young people who may have been in dangerous situations a reason to think twice.
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In an accident at Disney World in 183, a college student was paralyzed from the neck down. The young man (at the time) was set up to receive up to $42 million over the next 51 years in accordance with an out-of-court settlement reached with the family entertainment institution.
The 21-year-old senior music major from Mississippi Valley State College was reported as saying, “It came out more than I expected.”
The trombone player and other students from around the country were rehearsing for the opening ceremonies performance when a platform fell on him. The impact broke his neck and spinal cord, leaving him a quadriplegic.
The settlement was announced by the victim’s attorney and was confirmed by a Disney spokesman. He declined to comment further. A spokesman for Disney’s insurer, Granite State Insurance Company of New York, did not comment, either. Hospitals and doctors in Brooklyn and The Bronx are expert in treating spinal injuries.
According to the settlement documents, a NYC Spinal Injury Lawyer said, the boy was set to receive 5 annual payments from the park’s insurers. Certain details were not available, but the trombonist said he had already been paid $1 million to pay for medical expenses, a specially equipped van, and a new house to be built right next to his parents’ in Mississippi.
The “awfully impressive” settlement did not include a provision that restricted both sides from speaking of the ordeal. “That is standard for settlements like these, especially when dealing with family-friendly attractions that don’t want negative press,” a New York Spinal Injury Attorney said.
The payments break down into at least 2 different types of payments annually. The first is $90,000 which is to increase by 7% each year for the rest of his life. This could add up to be a substantial amount of money. The second type is a flat fee, one such payment is set at 123,000 a year for 20 years. Those payments are not set to increase or be elongated.
The boy was at Disney World because he was chosen to be a member of the All American Marching Band – a 450-piece band of college students. The students were selected from around the country to play for the Epcot Center’s opening.
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On the day the jury made the decision to convict a Dallas father for child abuse, the two-year-old boy was brought in. The jury was asked to meet the victim, who had been so badly abused that he was blind, deaf, and paralyzed. Jurors wept and the father accused of the crime could not even look at the boy.
The 26-year-old father did not watch while the nurse showed the jurors how the boy lived since his father severed the boy’s spinal cord in December 2008. It took the jury only 30 minutes before they sentenced the father to life in prison.
“I looked at him a lot – no remorse,” one juror told an NY City Spinal Injury Lawyer. “The evidence showed it was all about him.”
The father of the boy will not be eligible for parole in 30 years. The child has been adopted, but is not expected to live into adulthood.
The child slept as his nurse stood with him in front of the jury box. The way she can tell when he is awake is when his heartbeat speeds up. Jurors cried and shook their heads as they observed the little boy in his wheelchair. The nurse reported that he was having a “good day”, which means the child did not suffer a seizure and spent most of the day sleeping. It means he has a normal heart rate and didn’t need any oxygen. He is unable to hold his head up and his spine is curved – doctors had to create a new one from his ribs to prevent further damage. In Queens and Staten Island it’s been reported that injuries like these can lead to quadriplegia.
No one is sure how the child was hurt. He was only five months old when he was either shaken or hit with or against something, NYC Spinal Injury Lawyers have learned. His parents took him to the hospital when he stopped breathing and doctors were able to revive him.
The child had 42 broken bones – each of his fingers and toes were broken. He also displayed bite marks, bruises, and at least one of his fingernails was torn off. Many of the breaks were previously inflicted and had never been treated. He is also severely brain damaged.
The boy’s mother, 24, faces trial later.
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