For the injury lawyer handling a knee case, a working knowledge of the anatomy, terminology and basic pathology is essential.
The AAOS reports in 2010 there were about 10.4 million patient visits to doctor’s offices because of common knee injuries such as fractures, dislocations, sprains and ligament tears. “Knee injury is one of the most common reasons people see their doctors”.
It’s the largest joint in the body – if you are going to represent a client with a knee injury, learn the anatomy – what the component parts are and how they work.
The simple and most cost effective way to learn about your client’s knee injury is to start with the first responder’s records. Pay careful attention to the history, complaints and physical examination findings. Was swelling or effusion documented? Was there a description of redness, bruising or contusion? Look for the term “hematoma”. Was decreased range of motion or “ROM” documented? Did your client require assistance ambulating or were they placed on a stretcher.
The next source of information is the emergency room records. Patient complaints, history and physical findings must be carefully reviewed. X-rays reports, doctor’s notes and discharge instructions are also important points of information.
The initial treatment records with the PCP, family doctor or internist should be carefully examined for knee complaints and findings. Your knowledge of all of these materials in a thorough, comprehensive and chronological order will truly benefit your case presentation to the treating orthopaedic surgeon, claims adjuster and defense counsel.
All doctors, especially orthopaedic surgeons are busy people. When you meet with your client’s treating orthopaedic surgeon, physiatrist or neurologist, knowledge of the minute details contained in the medical records is essential. They will not know as much about these facts as you do! This is how you get their attention and how you get the most out of the brief conference they will give you. Use this time wisely – go in with a goal oriented plan.
I like to have my client’s doctors, especially in knee cases, give me answers to these topics:
1. What is the injury?
2. Is it traumatic, and if so, how can we prove that?
3. What was pre-existing and what was new?
4. What is the treatment plan: cost, length of time, rate of success?
5. What effects or limitations will be permanent and can that be proven? (we live in a Daubert world- remember to get your doctor to think in terms of that level of proof).
Remember, timing of the conference with the treating doctor is important. Too soon and many of the inquiries will go unanswered: too late and all the documentation will have already been created.
If the case warrants it, hire a medical illustrator or visual presentation company. It pays to have your AV person meet with the treating doctor to prepare and later review your exhibits, especially if they are to be used in trial.
Have your client take the time to explain how their knee injury has affected their lives. These details are important to your jury. While the average juror may not appreciate the significance of anterior cruciate ligament instability, they will understand the difficulty associated with knee pain that prevents your client from getting out of their car.
To do the best possible job for your client in a knee injury case, know more about your clients’ knee injury than everyone else involved in the case. Know all the complaints, the documented findings, the dates of treatment, complaints on those dates, doctor’s opinions, treatment and results. Know the knee inside and out. You will be surprised how this body of knowledge will enhance the valve of the case and improve the result for your client.