Personal Injury Claim against Negligent Driver/Owner for rear ending our client resulting in a rotator cuff surgery.

We are making a bodily injury claim against a company insured by First Commercial Claims Services. Ms. CLIENT*, is a 44 -year-old female, was the restrained driver of a car when she was rear ended by a vehicle that was cited for careless driving. Osceola County Emergency Services examined Ms. CLIENT and noted that her chief complaint was back pain. Fire rescue came to the scene and transported her to a hospital in Orlando. She complained to the paramedics at the accident scene that she had shoulder pain. She also advised the doctors at the hospital in Orlando that she had shoulder pain. Florida Hospital Emergency Physician Record MVA lists the location of pain/injuries as her left shoulder and lower back, and lists a neck sprain/strain and lumbar sprain/strain.

On May 21, 2007 Donald A. Daugherty, MD Internal Medicine DCIM prescribed her hydrocodone and flexeril for muscle spasm. His diagnosis was 1. Neck Pain 2. Muscle Contraction headaches. She treated with Donald Daugherty, MD and reported to him "that she recently was in Florida and her car was rear ended as she was driving. She had her seatbelt on." The Florida Hospital Emergency Department trauma Flowsheet states that Ms. CLIENT has a 6 level of pain in her lower back. The pain history was an ache that radiates to the left arm.

On May 22, 2007, Michael Kicera, P.T. diagnosed Ms. CLIENT with cervical pain secondary to an MVA in Florida on 5/14/2007. He stated that Ms. CLIENT reports that she was rear-ended and did have her seatbelt on but has had cervical and left shoulder pain since the accident. He noted her primary complaint was that she had no previous neck problems and is concerned because her pain has been very high all week. She stated that it has gone from a 10/10 to a 6/10 and has improved slightly. She requested a neck collar because it was helpful to her. Ms. CLIENT stated that she has a constant pain mostly at the base of her skull which does disrupt her sleep and limits her range of motion on all planes. Ms. CLIENT lives with elderly women that she cares for and has had some difficulty doing this because of her cervical pain.

Michael Kicera, P.T.'s objective findings were that Ms. CLIENT has significant range of motion limitations at the cervical spine through rotation, side bending, flexion, and extension, all limited by approximately 75%. She does improve with passive range of motion and is able to achieve approximately 50% on all these planes passively in a seated position. She reports pain with palpitation of the bilateral cervical paraspinal musculature and the upper cervical; vertebrae as well as over the left upper and middle trapezius. Strength is within normal limits when tested isometrically and does reproduce some discomfort especially with resisted left side bending. Vertebral artery tests are done but may not be conclusive secondary to the significant limited range of motion.

She has some mild tightness in the left cervical paraspinal musculature. Does not appear to be any asymmetries at the cervical spine or upper thoracic spine. She does carry her shoulders very high and anteriorly. She is advised on appropriate postural alignment in a seated position and instructed in chin-tucks, which the patient tolerated well today. Additionally instructed in gentle rotational range of motion exercises in the supine position and advised on icing on a regular basis to decrease inflammation. Used supine cervical manual traction, which the patient felt did alleviate her symptoms. Also gentle prolonged manual stretches to the left SCM (Sternocleidomastoid (SCM)) and trapezius musculature. Used soft tissue mobilizations and myofascial release over this are to decrease tightness and pain.

Michael Kicera's assessment was a 44 year-old-female involved in an MVA 1 week ago with soft tissue strain to the cervical paraspinal musculature, ligaments, left SCM and trapezius. The short term goal (3-4 weeks) - The patient will report a decrease in cervical pain to be 3/10, increasing cervical range of motion in all planes by 50% to enable her to turn her head to look for traffic safely. Long term goals (by discharge) The patient will have functional range of motion and report 0-1/10 pain in the cervical spine when turning her head to look for traffic or during the normal course of her day.

On May 31, 2007, Michael Kicera, P.T.'s diagnoses was cervical pain due to MVA in Florida on 5/14/2007. He states that she is still complaining of pain over the left shoulder area.

On June 4, 2007 Dr. Daugherty noted that she still had pain in the trapezius muscles particularly on the left. On June 12, 2007 Kay Olson, P.T.A Physical therapy diagnosed Ms. client with cervical pain and stated that she is experiencing some left upper trap pain and collarbone hurts as well on the left side. She could not tolerate any type of soft tissue work. On June 19, 2007 Michael Kicera diagnosed her with cervical pain and his subjective findings state that lifting has been giving her problems. On July 11, 2007 Kay Olson's subjective complaint was some collarbone pain on the left side. On July 17, 2007 Dr. Daugherty noted that she still has pain over the left infraclavicular area due to contusion and strain from the seatbelt.

On July 27, 2007, Lisa C. Friedman, MD stated the Ms. client is being seen with continued pain in her shoulder since the car accident in May. Dr. Friedman stated that she continues to have discomfort in the area of the upper left anterior chest wall towards the left shoulder, exactly where the shoulder strap of her seatbelt went. She has muscle spam in this area. She had cyclobenzaprine but ran out. On July 30, 2007 Dr. Friedman scheduled Ms. client for an MRI scan after Ms. client stated that she was dissatisfied with the cuyclobenzaprine which was given for the muscle spasm of the left anterior shoulder girdle area.

On 8/2/07 a MRI upper extremity joint, left shoulder without contrast was performed. Conclusion:

1) Full-thickness tear in the supraspinatus tendon of the rotator cuff near the insertion of the greater tuberosity. Superimposed on this some general tendinopathy and partial tearing.

2) Bulky hypertrophic degenerative spurring in the AC joint with associated subacromial/subdeltoid bursitis.

3) Tendinopathy in the subscapularis tendon. Additionally there may be some tendinopathy in the long head of biceps tendon but no complete tear or subluxation.

4) Mild glenohumeral degenerative change.

5) There is no muscle retraction or atrophy in the supraspinatus muscle or tendon.

The Interpreting Radiologist was Daniel Hoefter, M.D.

On August 7, 2007, Dr. Daugherty noted that her MRI of the left shoulder showed a rotator cuff tear and that she continues to have pain. She was referred her to Orthopedics for further assessment. On August 17, 2007, Jeffrey J. Welch, MD stated that he was seeing Ms. client at the request of Dr. Daugherty for evaluation of a left shoulder injury which occurred in Florida on 5/14/2007 when she was in a car and was rear ended. He stated that her shoulder can be sore at times, especially when she is sleeping. Reaching overhead bothers her. He also stated that she had an MRI scan which shows a full thickness rotator cuff tear. One examination, she has pain when she gets overhead. She has positive impingement sign. She has pain with abduction against resistance with the arm at 90. There is anterior posterior apprehension. She has tenderness over the AC joint. His impression is full thickness rotator cuff tear. He thinks that she would benefit from a rotator cuff repair. He told her that if he left it there would be a very good chance that it would get worse with time.

III. MEDICAL EXPENSES

PROVIDER DATE(S) BILLED

Osceola County EMS 5/14/2007 $ 428.00

Florida Hospital Med Center 5/14/2007 $ 1019.00

Florida Radiology Associates 5/14/2007 $ 80.00

Dean Health System 5/21/2007-10/19/2007 $ 9382.5 + 411.40

Turville Bay MRI Centers 8/2/07 $ 1,220.00

Total: $12,540.90

Although we did not recommend her orthopedic surgeon to her, Attorney Justin Ziegler confirmed (via one of his many contacts throughout the United States) that the orthopedic surgeon is highly credentialed. We are also seeking the thus far undisclosed bodily injury insurance limits of the driver and/or owner of the car that hit her. This claim is another example of the importance of carrying uninsured/underinsured motorist insurance. We wish our client a successful surgery. Although our client lives over 1,500 miles away, Lawyer Justin Ziegler has provided her with his email which he continuously checks and his cell phone number so that she can always access him.