In New York accident cases, the hospital chart description of how an accident occurred is tremendously important in a successful settlement or jury verdict. What I have seen over the last several years is a carelessness, or in some cases intentional effort by emergency hospital personnel to minimize, downplay, or simply disregard the patient’s description of how she or he was injured, with a serious negative impact on the client’s case. Three examples are instructive. In a Bronx County slip and fall case, our client suffered a severely fractured right arm when she slipped and fell walking down a flight of stairs. The cause of the accident was the lack of a proper handrail, coupled with stairs which did not comply with the New York State Building Code. When the client arrived at the hospital and informed the triage nurse what had happened, the nurse wrote the following: “While walking down the stairs, she missed a step and fell to the bottom of the stairs.” Not only was this inaccurate, but it of course implied that the fault was the patient’s rather than the restaurant’s for failing to have a stairway which met building code requirements. Luckily, in this case, we prevailed, but the case was defended through trial as the defendant’s insurance company relied on the inaccurate description of the accident in the vain hope that a jury would blame our client for the accident.
Similarly, in a Brooklyn slip and fall accident, our client tripped and fell on a missing piece of concrete on an outdoor patio while at a engagement party, and suffered torn ligaments in her knee which required two surgeries to repair. The emergency department’s description of the accident: “Recreational injury.” This is an example of the damage emergency room personnel can cause to a personal injury case if they do not accurately record how the accident actually happened. Insurance claim representatives and defense attorneys rely heavily on the initial description of accidents in hospital charts, and if that description, as in this case, is both inaccurate and negates any responsibility on the defendant’s fault, this has the effect of preventing an early settlement and extending litigation. Once again, we won at trial, but this was a case which never should have reached that stage.
Most recently, in a Westchester County car accident case, (which is presently being litigated), our client suffered a torn rotator cuff when another car went through a stop sign and struck the driver’s side of our client’s car. As our client was taken from the scene by ambulance before the police arrived, the police report does not contain our client’s version of the accident. The emergency room nurse, despite being told by our client that the other driver disregarded a stop sign, wrote: “Patient injured in an intersection accident.” This vague description, without any attribution of fault, again gives the defendant’s insurance company a misplaced belief that the case may be defensible–how difficult would it have been for the nurse to accurately records what our client reported, that she was the victim of a driver who disregarded a stop sign?