Missouri Injury Law Blog

Currently our St Louis medical malpractice law firm, Sansone / Lauber, is handling multiple Missouri negligent gallbladder removal cases involving laparoscopic procedures known as a "lap-choli". The common theme in these cases is the negligent surgeon's failure to adequately dissect and identify the anatomy of the gallbladder, and the adjacent bile ducts and vascular system before proceeding to clip, cut, and remove.

Recently we were contacted by young Missouri woman who has spent the last several months in the hospital because the negligent lap choli surgeon left surgical clips on her common bile duct creating an "occlusion" or in lay terms, a blockage. See clips left on common bile duct in radiology image to the right. Prior to removing a gallbladder the surgeon must identify and dissect the anatomy in order to confirm the cystic duct, clip and cut it, not the common bile duct.

See Missouri Negligent Gallbladder Removal Surgery Article for Details of Surgery

As always, the negligent Missouri surgeon's operative report was flawless and according to him the original procedure went perfectly, he identified the anatomy properly, did full circumferential dissection of the gallbladder and ducts, separated the cystic artery from the cystic duct, applied two clips to the cystic duct, cut between them, and then removed the gallbladder.

However the post op evidence tells a very different story. The patient suffered symptoms of severe abdominal pain and subsequent testing showed that the surgeon left surgical clips on the common bile duct. See the ERCP test results below from 1 week post lap choli:

Continue reading "Surgical Clips Left on Common Bile Duct by Missouri Surgeon after Gallbladder Removal, Caused Duct Occlusion and Severe Complications for Patient" »

Laparoscopic gallbladder removal or "lap-choli" is the current standard of care for the removal of a gallbladder. Until about 10-15 years ago the accepted method was an open procedure which was more invasive as it required a larger wound and longer recovery. The introduction of the laparoscopic procedure is not without its problems, it requires certain degree of skill and learning and some surgeons simply do not have the proper pedigree to perform these procedures multiple times without eventually running into problems they cannot handle.

Recently, my law firm, Sansone / Lauber, filed a St Louis county lap-choli medical malpractice and wrongful death lawsuit

About 6 months ago I discussed this St Louis wrongful death case and the specifics of gallbladder procedures and some of the reasons for bad outcomes.

In the St Louis wrongful death case recently filed by my Missouri injury law firm, the primary reason for the horrific outcome and death of my client's father was the simple fact that the negligent surgeon failed to completely and circumferentially dissect the gallbladder and the relevant arteries and bile ducts, confidentially identify them ,and then... and only then... cut what the surgeon thought to be the cystic duct, but was actually the common bile duct and the right hepatic artery, which lead to the death of my client's father. Simply from the failure to take his time and properly identify the anatomy.

Continue reading "Surgeon Negligent During Lap-Choli Procedure leading to St Louis County Wrongful Death Lawsuit" »

Successful Missouri slip and fall claims require that the Plaintiff prove a dangerous condition on the property, that the property owner had a duty to protect against that danger and that the owner knew or should have known about the dangerous condition that caused the fall. These elements of Missouri premise liability cases have been discussed on this blog. Additionally I have discussed the elements of a slip and fall case in context of a Missouri slip and fall injury at gas station.

One issue that often comes up under Missouri law for premise liability cases is prior accidents or injuries and subsequent remedial measures - are they admissible at trial? The short answer, is yes, as long as they are introduced into the trial for the right reasons.

Prior accidents can be introduced to show notice if the defendant claims they were not aware of the condition or to rebut the defendant's claim that the condition was not dangerous. See Bynote v. National Super Mkts, 891 SW2d 117 (Mo banc 1995).

Subsequent remedial measures, meaning repairs or corrections, generally are not admissible as Missouri public policy is to encourage the repair of defective conditions. However, if introduced at trial for the right reasons these subsequent remedial measures can get into evidence to show control of the area or if the Defendant argues that nothing was wrong; obviously repairs disprove that assertion. Gomez v Construction Design 126 SW3d 366 (Mo Banc 2004).

Continue reading "Evidentiary Issues to Consider under Missouri Law for a Slip and Fall Personal Injury Trial" »

In speaking with other St Louis area personal injury lawyers I have come to learn that it is not only common in my practice that injury victims sometimes try to settle cases with the auto insurance company on their own. In most cases trying to settle a Missouri car accident injury case without a lawyer is a losing proposition for you and a win win for the insurance company.

Top reasons I hear from people why they try to settle their car accident injury case on their own:

1. I just want what is fair, the insurance company should give me that because the car accident was not my fault. In a perfect world this may be true, but it is the insurance adjuster's job to give you as little money as possible to get you sign away your legal rights, also known as settling. How can you trust what they tell you, your best interest are in direct conflict of their next raise and the company's bottom line.

2. The insurance adjuster promised to pay my medical bills and give me some money on top of that!

What amount of medical bills are we talking about? The gross amount the hospital and doctors charged or the reduced insurance payment amount? The insurance comply will pay the reduced amount, but under Missouri law you are entitled to the gross amount paid as the reduced amount is oftentimes irrelevant under the Missouri collateral source rule. The status of the collateral source rule in Missouri is constantly changing especially since the 2005 "tort reform" statutes. Proper application of the collateral source rule can make the difference of 10s of thousands of dollars for your case.

Case in point: Recently a Missouri car accident victim called me and she suffered some moderate to severe injuries. The insurance company promised her they would pay her medical bills plus give her 10 thousand dollars.... wow great deal right? WRONG! Her "medical bills" as she understood them were $9,000; however this was the amount adjusted for medicare payments, the total gross amount of her bills were over $30,000. So under the great offer by the insurance company she left $21,000 plus on the table. Given her injuries we will likely settle her case for policy limits of $100,000.

3. Attorney fees will take up my recovery.

See my Missouri auto accidents page and main website and the results we have gotten for our Personal injury clients. We get results based on knowledge and experience. I know what your case is worth. As in the example above, would you rather have 100% of $10,000 of 2/3rds of $100,000?

Continue reading "I Was Injured in a Missouri Car Accident, Why Do I Need to Hire a Personal Injury Lawyer?" »

Under Missouri dram shop statute, the victims of Missouri personal injury or the family of the Missouri wrongful death victim caused by an intoxicated or drunk driver may have a cause of action against the establishment that served the Missouri drunk driver that caused a car crash or hits a pedestrian.

Missouri Statute § 537.053, Sale of alcoholic beverage may be proximate cause of personal injuries or death

... a cause of action may be brought by or on behalf of any person who has suffered personal injury or death against any person licensed to sell intoxicating liquor by the drink for consumption on the premises when it is proven by clear and convincing evidence that the seller knew or should have known that intoxicating liquor was served to a person under the age of twenty-one years or knowingly served intoxicating liquor to a visibly intoxicated person.

How do you prove by "clear and convincing" evidence that the bartender knew or should have known the drunk driver was "visibly intoxicated"? See St Louis Injury Attorney Article: ... Proving the Other Driver was Intoxicated

However, in a Missouri dram shop lawsuit, proving "visible intoxication" is more difficult than simply showing the driver was legally intoxicated. For example, under the above dram shop statute, Missouri Statute § 537.503, blood alcohol content is simple relevant to proving a person was visibly intoxicated, but does not prove it. So what else, clearly a St Louis DWI personal injury lawyer would hire a toxicologist to testify, but what about testimony from someone else at the bar that served the at fault driver? the bartender? they obviously are not going to admit they served a visibly intoxicated, so you are left with tracking down other patrons at the bar, which is hard enough, much less finding one that remembers the drunk driver who caused a car accident and that they were visibly intoxicated.

So is an eye witness required? Recently a Missouri trial court ruled through summary judgment that eye witness testimony is required to prove that the Missouri drunk driver who caused a car accident was visibly intoxicated at a bar in order to be able to hold that establishment liable under Missouri's dram shop law. This issue is currently up on appeal and for an excellent analysis of the Missouri dram shop law and its application see: Amicus Brief - Missouri Dram Shop Law Appeal regarding Proof of Visible Intoxication

Continue reading "Drunk Driving Accident Lawsuits in Missouri - Making a Negligence Claim Against the Bar that Over-Served the Missouri Drunk Driver " »

Missouri injury attorneys are often retained by victims of personal injury resulting from the negligence of a landlord, whether it is a slip and fall, Missouri premise liability, or a failure to protect from 3rd party criminal conduct, assuming the duty has been established.

One such case my St Louis personal injury law firm is handling is a St Louis premise liability action against an apartment complex for negligent security. In this particular case, the common area security doors were defective and in serious disrepair allowing two men to enter the common area then quickly and easily kick through the flimsy inner door of an apartment and sexually assault the female resident. I personally inspected the door a few days after the assault and several other "security doors" in the complex and most of them were opened without using the key and with a slight push. For further information on this sexual assault and negligent security apartment lawsuit see the link above.

As in many St Louis Missouri apartment complex personal injury cases, the landlord has a contract clause in the lease stating they are not responsible for any negligent acts.

There are several personal injury court opinions from Missouri courts holding, as a matter of law, that such oftentimes these types of negligence release clauses are insufficient to bar an injury victim's claim for negligence. Generally, such clauses are disfavored and strictly construed against the party attempting to enforce it. Especially in the landlord tenant relationship because of the disparity of bargaining power, often referred to as a contract of adhesion.

The Missouri Supreme Court has held that "the exculpatory language must effectively notify a party that he or she is releasing the other party from claims arising from the other party's own negligence." Alack v. Vic Tanny International of Missouri, 923 S.W.2d 330, 337 (Mo 1996).

The Alack decision also makes it clear that such waivers of negligence also fail as a matter of law when applied to Missouri punitive damage claims. In negligence cases, punitive damages are an issue "if, at the time of the negligent act, the defendant 'knew or had reason to know that there was a high degree of probability that the action would result in injury" and the defendant showed "conscious disregard for the safety of others."

Continue reading "Missouri Waiver of Personal Injury From Future Negligence Clauses in Apartment Lease Contracts - Are they Enforceable?" »

Just about every personal injury case in Missouri, Illinois, or anywhere else, requires the use of experts. Most commonly, experts in a Missouri car accident injury claim are the treating health care providers. From the emergency room and ER doctors, to the physical therapists and the physicians and surgeons that have treated the personal injury victim. A good St Louis personal injury lawyer knows how to use these treating providers to maximize their injured client's recovery.

In many other cases not only are the treating heath care providers necessary, but also experts to prove liability are required to litigate a successful personal injury case in Missouri. They can be engineers for Missouri product liability injury lawsuits, surgeons and medical doctors for Missouri medical malpractice claims (in fact expert affidavits are required in Missouri med mal lawsuits just to file one - See Certificate of Merit to File Missouri Medical Malpractice Case) , toxicologists if you have a lawyer to sue a Missouri drunk driver and need an expert to help prove the negligent driver was drunk, assuming this was not already established by the police.

Proper use of experts in personal injury depositions or injury trials requires knowledge of how to use that expert to best benefit the injured party. For example, in a Missouri personal injury case evidence must be submitted in proper form for the jury to be able to rely on it, however, experts are allowed to rely on documents, books, or other sources in coming up with and verifying their opinion even though that document or source is not admissible as evidence.

"Evidence an expert relies on in forming his or her opinion need not be independently admissible."

"Expert can rely on hearsay information provided that those sources are not offered as independent substantive evidence, but rather serve only as a background for expert's opinion. V.A.M.S. § 490.065."

Continue reading "Use of Expert Witnesses by Missouri Injury Attorneys to successfully pursue Missouri Injury Claims and Lawsuits" »

To many victims of Missouri personal injury accidents, the cause is obvious and the medical treatment required seems obvious as well. However, at trial even these seemingly assumed things must be proven by qualified experts. Common example, a Missouri car crash resulting in severe injuries wherein the fault of one driver is clear. Beyond proving the other driver was liable, at trial, the Missouri injury lawyer for the victim must prove with competent evidence that the injured client's injuries were caused from the collision and that the medical treatment received was reasonable and necessary to treat those injuries. Moreover, and more a subject of different articles on this blog, the injured party must prove the amount of medical bills were reasonable and necessary. See Missouri Personal Injury Law - Medical Damages Amount of Bills Paid or Amount Charged

In some cases where the medical treatment necessitated was immediate, the issue of causation is presumed under the Sudden Onset Rule: Under this Missouri personal injury rule, causation may be inferred by the jury without medical testimony. Tucker v. Wibbenmeyer, 901 S.W.2d 350 (Mo. Ct. App. 1995). Sudden onset rule applies when obvious symptoms of an injury follows immediately after an accident without delay or a very short delay. Examples of where the sudden onset rule can be used in lieu of medical testimony, a person involved in a Missouri car accident immediately sustains a broken bone or open wound.

In most cases, especially where the injuries and symptoms require months and months of medical treatment, it is wise, if not legally required, to have at least one of the medical providers testify as to the necessity of the medical treatment received and that the injuries were all caused from the accident. Also, it is usually best to depose the most qualified doctor that treated the injured victim or the doctor that performed the last treatment of them. This is because a doctor can rely on the other medical records as a history and opine as the the necessity of that treatment - i.e. a surgeon and testify that the treatment an injured party received in the ER and that it was reasonable and necessary, also they can rely on those ER records as part of their diagnosis of the victim.

This will ensure that all of the Plaintiff's medical treatment is admitted into evidence and considered by a jury.

Continue reading "Trial Evidence in Missouri Personal Injury Cases: Medical Experts to Prove Personal Injury, Extent of Injury, Necessary Treatement and Causation " »