Case details
Pedestrian struck by underinsured motorist claimed brain injury
SUMMARY
$965000
Amount
Settlement
Result type
Not present
Ruling
KEYWORDS
brain, brain injury, cognition, mental, psychological, traumatic brain injury
FACTS
On May 9, 2011, claimant Eileen Beall, 57, then a financial analyst for Kaiser Santa Teresa, walked approximately 11 feet into a marked cross walk when she was struck on the left side by an underinsured motorist who was traveling at the speed of 10 to 15 mph. Beall allegedly landed on the back of her head and lost conscious. She claimed she suffered a traumatic brain injury. Beall claimed that the motorist was inattentive to what was directly in front of him, in this case, a pedestrian lawfully crossing a street. She also noted that the traffic collision report stated that she flew up into the air and landed in front of the motorist’s vehicle. In addition, the California Highway Patrol found the motorist at fault for the accident, stating that “the primary collision factor of this collision was [the motorist] in violation of California Vehicle Code § 21950(a),” which states that “the driver of a vehicle shall yield the right-of-way to a pedestrian crossing the roadway within any marked crosswalk or within any unmarked crosswalk at an intersection”. The motorist admitted liability and made no claim of comparative negligence. Thus, the underinsured motorist agreed to settle the underlying case in Santa Clara Superior Court for $100,000.Beall then sought further recovery via the supplementary-underinsured-motorist provision of her own insurance policy, which was administered by Amica Mutual Insurance Co. The matter proceeded to a binding arbitration. There were no dispute over the applicable insurance coverage, but Amica did dispute the measure of such benefits, in that Beall sought the applicable policy limits and Amica contended it did not have sufficient information to makes its final claims determination., Beall claimed she suffered a traumatic brain injury in the accident. After she was struck, Beall landed on the back of her head and lost consciousness. She then regained consciousness shortly thereafter and was taken by wheelchair to the Kaiser Santa Teresa, in San Jose, since the accident occurred on the Kaiser property while Beall was on her way to work. She subsequently underwent immediate acute medical care and was diagnosed with concussive brain trauma. While in the Emergency Department, Beall complained of a sharp headache, chest discomfort while breathing and talking, shortness of breath, and dizziness. She was also unable to recall the details of the accident and complained of pain in left neck, and left arm and side. A physician reported that Beall was suffering from confusion as a result of the collision, and another physician ordered a CT scan and X-rays of Beall’s chest and right foot. Beall was also prescribed Vicodin for her pain. She was ultimately discharged that afternoon in the care of a friend since Beall was unable to drive herself home. From May 9, 2011, to May 22, 2011, Beall was on temporary total disability and unable to work. She was also referred to the Brain Injury Clinic at the University of California, San Francisco, Medical Center in December 2011, during which she was prescribed propranolol and amitriptyline. She then continued her treatment with her primary care physician, who was with Kaiser. Beall complained of, among other things, being confused, dizziness, having trouble performing calculations at work, headaches, ringing in the ear, fatigue, and olfactory hallucinations. Testing allegedly revealed that Beall was suffering from a vestibular disorder that affected her balance and vision. Her physician also diagnosed her with post-concussive syndrome. Beall subsequently consulted with two neurologists, who both confirmed the diagnosis of post-concussive syndrome. As a result, Beall underwent physical therapy, chiropractic care, and acupuncture for relief of her physical complaints. However, she claimed she developed a fear while near cars and was startled by loud noises. Thus, she was diagnosed with post-traumatic stress disorder. In April 2012, Beall was evaluated by a neuropsychologist, who claimed that testing showed several areas of deficit, some of which were common impairments “in instances of significant head injury.” The expert neuropsychologist also opined that Beall showed impairment in areas of attention and concentration and that Beall had difficulty when asked to simultaneously process multiple units. The expert further opined that Beall had difficulty whenever she was required to form and alter a cognitive set and opined that “significant levels of impairment were clearly apparent.” Beall eventually came under the care of a board certified neurologist with a specialty in memory disorders at the Sutter Pacific Medical Foundation, in San Francisco. The physician opined that Beall suffered a “closed head injury in May 2011, with subsequent headaches, exhaustion, dizziness, inability to concentrate, irritability, restlessness and cognitive dysfunction. The length of amnesia and cognitive testing all support a significant head injury.” The physician’s review of Beall’s systems was also allegedly positive for fatigue, visual changes, tinnitus, imbalance, lightheadedness, dizziness, startle response, and irritability. In December 2012, the physician’s impression of Beall included a “history of memory loss with diagnosis of cognitive disorder related to head injury” and throughout 2013, the physician noted a “history of poor concentration, memory loss and cognitive changes status post head injury.” In addition, the physician opined that, as of 2014, Beall’s condition persisted and included “headaches and imbalance” and that Beall’s vestibular dysfunction was “still problematic.” In July 2014, Beall underwent a videonystagmography (VNG) test to determine the presence or absence of an injury to the vestibular system of the brain, and the VNG revealed that Beall’s brain was abnormal and had marked caloric decrease (-14 percent) on the left related to her concussive brain trauma. At the time of the accident, Beall had been a long-time employee of Kaiser, working as a financial analyst, which concerned the detailed analysis of medical procedures to ascertain and identify areas of those procedures that had cost overruns that, if eliminated, would save Kaiser money. However, Beall claimed that she never returned to her pre-injury status as a result of her brain injury and that her physicians believe that her injury is permanent and will affect her for the rest of her life. She also noted that one physician’s testing showed that she has “difficulty with sustained concentration, mental tracking, perception and reasoning, and certain aspects of memory.” Amica’s counsel disputed the extent of Beall’s alleged . The respondent’s board-certified neurologist examined Beall and concluded that “the extent of [Beall’s] difficulties is unusual and atypical for the nature of her accident wherein loss of consciousness was brief, amnestic period was brief and no intracranial pathology was noted on testing, including MRI and EEG.” The results of Beall’s neuropsychological testing and raw test data were also reviewed by a neuropsychologist, who opined that Beall’s overall neurocognitive test results — including tests of memory, attention, processing speed, and executive function — were all at baseline and at an optimal level. The neuropsychologist’s report also noted that the one low score in Beall’s test results was “not replicated on other measures of executive function [and was] within expected normative variability in a given individual. Self-report measures indicate[d] that Beall has a propensity to somatization and [that Beall] reports significantly greater cognitive problems than [were] evidenced in her testing.” However, according to claimant’s counsel, the court granted the claimant’s motion in limine to exclude the respondent’s expert’s testimony regarding any opinion of Beall’s alleged mental condition.
COURT
Superior Court of Santa Clara County, Santa Clara, CA
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INJURIES:
- anxiety
- brain
- brain damage
- brain injury
- cognition
- depression
- epidural
- extradural hematoma
- face
- facial bone
- fracture
- head
- headaches
- hearing
- impairment
- insomnia
- loss of
- mental
- nose
- psychological
- scapula
- sensory
- shoulder
- skull
- speech
- subdural hematoma
- tinnitus
- traumatic brain injury
- vision
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