Assessing Liability in Auto Injury Cases Involving Medical Malpractice
What happens when a personal-injury case involved both medical malpractice and an auto collision? Who is liable: the doctor or the driver?
Answering these questions are crucial in determining appropriate compensation, since medical malpractice claims will need be litigated separately from auto-injury cases. A recent case study highlighted how forensic investigators handled such a case for a woman injured in a motor vehicle collision in China.
A 48-year old woman was sent to a county hospital after injuring her right knee and thorax in an auto collision. Doctors could not identify any fracture with X-ray imaging, and diagnosed her with a soft-tissue contusion. She wore a plaster slab for 21 days, after which she resumed functional exercise. Although her thorax symptoms improved, she continued to experience knee pain. When she visited the hospital again three months later, X-ray and MRI imaging showed that she did have a fracture of the right tibia outer place, right meniscus, and effusion of the right tibia outer plate. Doctors recommended that she receive an open reduction and internal fixation for the fractures, but she declined treatment due to loss of trust.
She then went to a different hospital, where she was diagnosed with traumatic arthritis and treated with knee-replacement surgery. A month after surgery, she prosecuted the driver and the insurance company for personal-injury compensation.
However both the driver and the insurance company argued that the woman's knee pain and dysfunction resulted from medical malpractice rather than the collision. Misdiagnosis led to a delay in treatment, and the knee-replacement surgery was inappropriate for her symptoms, resulting in unnecessarily high medical costs.
The court requested judicial expertise to determine liability. Forensic investigators carefully examined the woman's medical records and concluded that the knee fracture was primarily caused by the auto collision. Based on the WHO International Classification of Disability and Health, they estimated that the crash accounted for 60% of the responsibility, the misdiagnosis for 30%, and the premature surgery for 10%.
This case study suggests a potential strategy for assessing liability in complex personal-injury cases. "Comprehensive and careful analysis would be helpful to determine the responsibility and resolve the compensational debate judicially," the researchers concluded.
Chen J and Xio W. Assessment of the responsibility between a road traffic accident and medical defects after the traffic accident injury of knee joint. Journal of Forensic and Legal Medicine 2012; 19: 168-170.