Brooklyn, New York. When 51 year old school teacher Carol Brown sustained injury to her right hand from a negligently maintained heavy metal door in a New York City owned building she had little idea the injury would cause her excruciating pain for the rest of her life.
Five years later a New York City jury awarded Ms. Brown $ 200,000 for past pain and suffering and $ 1,000,000 for future pain and suffering.
Brown’s doctors testified that Brown’s hand injury had caused her reflex sympathetic dystrophy (RSD) a from of complex regional pain syndrome (CRPS).
COMPLEX REGIONAL PAIN SYNDROME (CRPS)
CRPS comes in two forms: 1) complex regional pain syndrome type 1 (RSD), that suffered by Brown, and 2) complex regional pain syndrom type 2, also known as “causalgia.”
Both forms are described by the Merck Manual of Medical Information as “persistent burning pain accompanied by certain abnormalities that occur in the same area as the pain.”
The abnormalities that accompany the burning pain may include:
1) increased sensitivity
3) changes in skin color
4) abnormally cold skin temperature
5) abnormally hot skin temperature
6) excessive sweating
7) a lack of sweating in a particular area
8) muscle spasm
9) limited movement (decreased range of motion)
EARLY DIAGNOSIS IS CRITICAL
According to Stephen J. Parillo, Associate Professor of Emergency Medicine at Jefferson Medical College, “CRPS…is treatable if recognized early; however, the syndrome may become disabling if unrecognized.”
According to Parillo, “A single, reliable, sensitive, and specific diagnostic test for RSDS is not available.”
Nonetheless doctors use a variety of tools to complete the diagnosis including: bone scans, MRI, and nerve blocks.
According to the Merck Manual of Medical Information complex regional pain syndrome type 1 (RSDS) results from “injury to tissues other than nerve tissue” and complex regional pain syndrome Type 2 results from “injury to nerve tissue.”
RJ Schwartzman in Current Opinions of Neurology and Neurosurgery states that “CRPS usually occurs secondary to fractures, sprains and trivial soft tissue injury.”
The incidence after fractures and contusions ranges from 10-30%.
While there is no known cure, CRPS is managed using a multi-disciplinary, non surgical approach with the proper combination of medications, nerve blocks, massage and physical and occupational therapy.
According to VerdictSearch.com juries have been very sympathetic to plaintiffs with CRPS.
“A simple search of the VerdictSearch database would provide 49 such instances of that injury from cases disposed in 2008 alone. Do the math, and you’ll find that cases involving that injury produce an average jury verdict of $ 8,174,911. Of course, you’d have to view the cases in your jurisdiction and weed out those that include other more significant injuries, but the point should be clear…”
Victory is never certain in any trial, even those involving a serious injury like CRPS. In October, 2007 a New York County, New York jury refused to award damages to a plaintiff who claimed her hand surgeon’s surgical and post operative care were improper and therefore caused the patient to suffer from complex regional pain syndrome type 1.
Emergency room personnel and other doctors need to know the symptoms of this disease so they can refer out for prompt and appropriate treatment. If you have been injured in an accident, especially one involving fracture or severe bruising, be on the lookout for CRPS.
If you feel a persistent burning pain and one or more of the symptoms listed above, report it to your doctor immediately. Make sure he is familiar with the literature for this disease.
Image by charliekjo
Aaron Goldhammer, 25, a Cal State Northridge alumnus, at his home in Woodland Hills. Serving in the Israeli army was a promise he had made to himself following his recovery from complex regional pain syndrome, a rare pain condition, he said. He is currently undergoing weapons and combat training before he departs in April.