Incident

Mr. Black was a belted backseat passenger involved in a head-on collision with roll-over. He was thrown from the vehicle and suffered significant injuries to his upper limbs.

Purpose of illustration

This exhibit was required to demonstrate his severe right upper limb crush injury with degloving, as well as his associated fractures and 3rd degree burns. The soft-tissue and bony injuries were illustrated separately to fully communicate the extent of the trauma.

Rationale for litigation visual

Voluminous hospital reports and imaging studies noted the profound nature of Mr. Bourne’s upper limb trauma – this visual served as a summary panel for the right arm pathology.

Complications

Mr. Black required numerous upper limb surgeries, including reduction of his fractures, transplantation of skin from his thigh to cover the forearm and hand degloving, and release of elbow ankylosis that resulted from the trauma.

Other visuals demonstrated

Additional panels detailed the other surgeries performed, as well as the severe trauma to his left hand, including fractures, partial amputation of several fingers and the associated surgeries.

Outcome

The case settled at the conclusion of a two-day mediation.

“The illustrations Artery Studios creates … are always of the highest quality. They are simply indispensable as demonstrative aids in graphically illustrating both the trauma mechanism and permanency of the injuries sustained by our clients… I highly recommend Artery Studios’ involvement in any serious personal injury case.”

– Michael Lamont, Lamont Law

Incident

While undergoing cholecystectomy surgery, the anterior and posterior walls of Mr. Rossi’s transverse colon were perforated, leading to fecal peritonitis, adhesion formation and incarcerated (trapped) umbilical hernia.

Purpose of illustration

This exhibit was created to demonstrate the mechanism of injury to Mr. Rossi’s colon – as per the findings upon surgical reopening, associated imaging and the case medical reports.

Rationale for litigation visual

This illustration clarifies the complex medical terminology and difficult-to-understand radiology. It provides a clear view of what occurred during the initial surgery.

Complications

Brown fluid was observed in Mr. Rossi’s abdominal drains, and intra-abdominal air was seen on CT – indicative of a perforated bowel. He required surgical repair of the perforations, removal of pus and omentum from his abdominal hernia, and a colostomy. Later, surgical reversal of his colostomy site was undertaken along with repair of the abdominal hernia. He developed a pulmonary embolism after this surgery, resulting in his death.

Other visuals demonstrated

Additional exhibits demonstrated: the anatomy of the abdomen and intestinal tract; enlargement of Mr. Rossi’s hernia (as per CT imaging); as well the numerous surgeries performed.

Outcome

The illustrations were used at a settlement conference and the case resolved close to the doctor’s policy limits.

“Working with Artery Studios was instructive because of their knowledge of anatomy and how to illustrate it … and skills and capacity to demonstrate tissues, planes, and perspective. The images helped my understanding and to feel more confident in what we could present to a jury … and that positively impacted our settlement negotiations.”

– James Coogan, Dwyer & Coogan, PC

Incident

When Ms. Smith was T-boned by the defendant running a red light, her right knee violently impacted the console, causing a depressed lateral tibial plateau fracture.

Purpose of illustration

This trauma panel was created to demonstrate the details of her significant intra-articular fracture.

Rationale for litigation visual

This exhibit visually ‘translated’ the confusing CT scans and medical reports into a crystal-clear illustration of her injury pathology, allowing all litigation participants to fully understand the extent of the damage.

Complications

Ms. Smith required reconstructive surgery, including elevation and reduction of the displaced bone fragments and bone grafting. Her knee was predicted to deteriorate with post-traumatic osteoarthritis and require pain management.

Other visuals demonstrated

Additional exhibits showed the surgery and complication issues, as well depictions of her concomitant brain injury which resulted in post-concussion symptoms and visual challenges.

Outcome

The case settled before trial, close to $1,750,000.00.

“The medical illustrations Artery Studios creates are always very helpful in formal settlement meetings, be it a mediation or a pretrial conference.The illustrations explain the injury to defense, and show details of any surgery and the long term consequences of the injury. Defense counsel and the adjuster realize how impactful the illustrations will be if the case proceeds to trial and the effect they can have on damages awards. Artery’s illustrations help impress my opponent with the seriousness of the case and assist me with resolution of it.”

– John McLeish, McLeish Orlando

Delayed appendicitis treatment causes hypoxic brain injury – $3.2M jury award

Incident

This 11-year-old boy with Down Syndrome suffered a ruptured appendix from delayed diagnosis and surgery, leading to unrecognized septic shock that triggered cardiopulmonary arrest, resulting in hypoxic brain injury.

Purpose of illustration

This illustration panel was created for use as an introductory exhibit, to demonstrate normal anatomy of the appendix and the pathology of early appendicitis versus Jason’s subsequent ruptured appendix with extensive ascites in his abdomen – as seen on CT.

Rationale for litigation visual

The exhibit allowed the jury to clearly understand the difference between early diagnosis of appendicitis and treating it initially, versus the significant abdominal pathology that resulted from rupture of the appendix due to delayed treatment.

Complications

Initially treated with antibiotics and a drain, he later underwent an appendectomy (which revealed interim abscess formation). The delay in surgery triggered cardiopulmonary arrest due to septic complications affecting his pacemaker wires, with a lengthy period of anoxia resulting in permanent brain injury.

Other visuals demonstrated

Additional exhibits included a series of comprehensive interactive timelines, as well as illustrations of the client’s anoxic brain injury issues.

Outcome

Prior to trial there was no settlement offer made by the defendants. The jury reached a $3.2 million verdict.

“Throughout the trial, the use of demonstrative exhibits prepared by Artery Studios was invaluable in educating the jury about the many complicated medical issues as well as the long timeline involved in this case. The exhibits and timelines prepared by Artery Studios aided us in telling our client’s story to the jury, and we believe these exhibits were instrumental in the positive result for our client.”

– Gena Romagnoli, Henry Phillip Gruss Ltd

Incident

This 50 year-old seat-belted driver was rear-ended at highway speeds. He suffered a lumbar spine sprain/strain injury.

Purpose of illustration

This illustration exhibit was created to demonstrate the direct anatomical link between the trauma-induced L4-5 disc herniation diagnosed post-accident, and the resultant painful sciatica symptoms of shooting burning pain into his buttock and down his leg, making it difficult to stand and walk.

Rationale for litigation exhibit

Mr. Smith had previous surgery in this area and was susceptible to further injury. The jury needed to appreciate: details of the injured disc with herniation resulting from the impact forces; associated impingement of the L4 nerve root component of the sciatic nerve; and the resultant pain that radiated through his lower back and into his left lower limb in the L4 dermatome pattern.

Complications

The L4-5 disc underwent further degenerative changes. Mr. Smith had several injections for pain, and surgery was eventually required.

Other visuals demonstrated

Additional illustrations showed: details of the mechanism of injury; an overview of how disc herniation progresses to the point of nerve root impingement; and the associated decompression surgery that was performed.

Outcome

The case settled immediately before trial was to begin.

Incident 
This 28-year-old passenger suffered multiple injuries from a rear-end collision that caused the vehicle she was into rollover and hit a pole. 

Purpose of illustration 
This exhibit was created to demonstrate Ms. Jones’s later internal chest trauma – namely, complete collapse of the middle and lower lobes of her lung, with blood filling 70% of the right chest cavity (hemithorax) and pushing against her heart. 

Rationale for litigation visual 
Although CT scans demonstrated the chest pathology to medical professionals, non-medically-trained litigation participants needed a visual ‘translation’ of the films and case reports, thereby allowing everyone to appreciate the severity of this trauma. 

Complications 
Ms. Jones underwent a thoracotomy to remove the large volume of blood from her chest. She then suffered cardiac arrest and an emergency sternotomy was performed to evacuate blood from the pleural space and to insert chest tubes. Bleeding from the innominate artery was discovered and ligated after sharp pieces of fractured clavicle and rib were removed. 

Other visuals demonstrated 
Additional illustrations depicted: multiple rib fractures causing ‘flail chest’; spinal, right clavicular and scapular fractures; and details of three chest surgeries that were performed. Complications of scapular winging and reduced shoulder mobility due to right thoracic nerve injury, as well as thoracic outlet syndrome, were also demonstrated. 

Outcome 
A significant settlement was reached just days before the trial was to commence.

This 28-year-old passenger suffered multiple injuries from a rear-end collision that caused the vehicle she was into rollover and hit a pole.

Purpose of illustration

This exhibit was created to demonstrate Ms. Jones’s later internal chest trauma – namely, complete collapse of the middle and lower lobes of her lung, with blood filling 70% of the right chest cavity (hemithorax) and pushing against her heart.

Rationale for litigation visual

Although CT scans demonstrated the chest pathology to medical professionals, non-medically-trained litigation participants needed a visual ‘translation’ of the films and case reports, thereby allowing everyone to appreciate the severity of this trauma.

Complications

Ms. Jones underwent a thoracotomy to remove the large volume of blood from her chest. She then suffered cardiac arrest and an emergency sternotomy was performed to evacuate blood from the pleural space and to insert chest tubes. Bleeding from the innominate artery was discovered and ligated after sharp pieces of fractured clavicle and rib were removed.

Other visuals demonstrated

Additional illustrations depicted: multiple rib fractures causing ‘flail chest’; spinal, right clavicular and scapular fractures; and details of three chest surgeries that were performed. Complications of scapular winging and reduced shoulder mobility due to right thoracic nerve injury, as well as thoracic outlet syndrome, were also demonstrated.

Outcome

A significant settlement was reached just days before the trial was to commence.

Incident

This 50-year-old driver sustained significant injury when his vehicle was rear-ended by a dump truck, causing trauma to his cervical spine.

Purpose of illustration

This exhibit was created to demonstrate the appearance of his spine after it was surgically fused, providing a clear translation of the imaging and medical reports, including showing the bone grafts that were inserted to replace the bulging discs that were removed – details that were difficult to appreciate on x-rays.

Rationale for litigation visual

For those untrained in medicine, this illustration provides clarity for the complex surgery performed and hard-to-understand radiologically. It provides a concise view of what took place in the OR – showing the anterior plate affixed with screws to the vertebrae, the associated bone grafts and the incision.

Other visuals demonstrated

Additional panels illustrated the post-MVA pathology of Mr. Doe’s cervical disc bulges impinging his spinal canal, and the surgery that was required to reposition his symptomatic left ulnar nerve.

Outcome

Adam Starr of Jarve Kaplan Granato Starr LLC, used the exhibits at mediation to clearly communicate the key details of his client’s spinal pathology and required surgeries performed, securing a high six-figure settlement for his client.

Incident

This 53-year-old driver was hit by a truck twice – his car first spun and was then pinned against the concrete median – subjecting him to rotational, acceleration and deceleration forces.

Purpose of illustration

Designed to show how injury to his vertebral artery caused stroke damage to areas of his brain, this panel included details of: anatomy (arterial and cranial); physiology (bloodflow and thrombus formation); and pathology (ischemic damage).

Rationale for litigation visual

This illustration exhibit was required to allow litigation participants to connect the initial physical injury to the artery in Mr. Doe’s neck, with the resultant ischemic (stroke) damage in his brain – complex factors for most non-medically trained people to understand.

Complications

Due to instability in his upper cervical spine, he was prone to recurring transient ischemia, reducing the blood supply to his brain, causing him neurological problems.

Other visuals demonstrated

Additional illustrations showed other trauma issues of: exacerbation of pre-exisiting findings; double-crush syndrome in his upper limbs; cervical radiculopathy; rotator cuff syndrome; chronic pain, including neck, back, shoulder and leg pain; and possible future spinal surgery.

Outcome

The case settled very successfully as trial was about to begin.

Incident

This left-handed 56-year-old driver was involved in a head-on collision, causing soft tissue damage to her left shoulder as well as other injuries.

Purpose of illustration

This panel was created to show the mechanism of injury to her AC joint and supraspinatus tendon, resulting from a significant seatbelt force being suddenly applied to her shoulder during impact.

Rationale for litigation visual

The transmission of forces from the shoulder belt, to the clavicle and thereby to the bones and tissues of the shoulder, were key concepts to be communicated at trial. The illustration served to ‘translate’ the opinion of the biomedical engineer into a visual format, allowing for clear understanding.

Complications

Ms. May went on to experience persistent pain in her shoulder, reflecting the effects of inflammation and scarring of tendons, ligaments and bursa, with secondary mechanical effects.

Other visuals demonstrated

Additional illustrations showed more detailed findings of the shoulder pathology, as well as left knee injury concepts.

Outcome

Plaintiff’s lawyer, Norma Mayer, opined that “…the illustration was instrumental in resolving the file at mediation.”

Incident

This 21-year-old construction worker slipped into a hole, sustaining a displaced/dislocated trimalleolar fracture that required open reduction internal fixation (ORIF). Osteoarthritis (OA) developed quickly in the joint due to the impact to, and disruption of, the articular cartilage.

Purpose of illustration

This panel was created to demonstrate the significant fracture-dislocation with associated injury to the syndesmosis (the distal tibia-fibula joint bound together by ligaments). The illustrations allowed litigation participants to fully appreciate the severity of the trauma and why OA ensued.

Rationale for litigation visual

Although x-rays demonstrated the fracture-dislocation, illustrations were required to translate the films into more readily understood images to show the full extent of trauma, including details of the syndesmosis injury.

Complications

Post-injury, this young man suffered pain on ambulation and at rest. His ankle joint demonstrated osteoarthritic degeneration within a year of the slip & fall. Some of the hardware and osteophytes required surgical removal. Further degeneration and associated surgeries were predicted for him.

Other visuals

Additional illustrations showed: the post-op appearance after ORIF surgery; hardware removal; future further osteoarthritic degeneration; and potential future ankle surgery – including debridement, fusion or replacement.

Outcome

This exhibit was created to allow the orthopedic expert to fully explain the extent of trauma this man sustained, and the significance of his intra-articular fractures. The illustrations were sent to defense and the case settled before trial.

Incident

Mr. Jones was a 45-yo male driver involved in a head-on collision and required extrication.

Purpose of Illustration

This panel was created to show details of his left wrist injury, providing a visual translation of the radiology and medical reports. It also served to demonstrate the severity of the trauma-related issue(s), to address objections of pre-existing psoriatic arthritis and two prior MVA’s with unrelated sequelae.

Rationale for litigation visual

X-rays were too difficult for a jury to comprehend understand. Other visuals showed the surgery performed and degeneration concepts resulting from the significant damage he sustained to the articular cartilage in his wrist.

Complications

He was later shown to have early arthritic changes in his left wrist joints – based on x-ray findings and a bone scan. Experts opined that his wrist would likely continue to degenerate with osteoarthritis.

Other visuals demonstrated

Concepts of: concussion; lumbar spine injury/surgery; pain treatments; sciatica complications; and right foot issues including fractures, surgeries, and degeneration. A 3D-printed model showed details of his right foot fractures.

Outcome

The demonstrative evidence was created in time for mediation. Using the visuals, the lawyer walked through the medical issues in detail, linking them directly to the biomechanical engineering opinions. A significant settlement was reached shortly thereafter with the visuals showing the clear “facts” and informing the adjuster’s decision.

Incident

This 15-year-old pedestrian was hit by a car on the left side. She flew onto the windshield, hit her head and landed on the pavement.

Purpose of illustration

This panel was intended to show findings noted by the dental expert associated with temporomandibular joint (TMJ) injury.

Rationale for litigation visual

TMJ pathology was the primary reason for the postural instability of her jaw and contributed to ongoing headaches.

Left-sided TMJ complications

She suffered pain with jaw opening and chewing, and had left-sided jaw pain at rest. Her jaw would lock closed, with instability of the joint.

Other visuals demonstrated

Additional illustrations showed issues of: mild TBI; R-sided hemianopia; sprain/strain injury to her neck and back; head/neck/back/shoulder pain; reduced range-of-motion of her C-spine; and vision problems.

Outcome

This visual was created to allow the dental expert to better explain an essential action of the mandible; it was to be used to educate litigation participants about key anatomical and functional issues of the jaw and TMJ; the case settled just prior to jury selection at the plaintiff’s pre-trial offer.