Every forty-one minutes, someone in America sustains a traumatic spinal cord injury (TSCI) . Approximately eleven-thousand people in America experience a TSCI every year. Car accidents are a common cause of TSCI; however, there are a number of other causes: sports injuries, falls, and gunshot wounds. See here.

Patients treated at a Level I or II trauma center have less paralysis than those with similar injuries who are treated at a non-trauma center hospital. The most likely explanation for the better outcome is the availability of more surgeons and the greater use of spinal surgery at the trauma centers.

The designation of trauma facilities differs from state to state depending. In California, the Emergency Medical Services Authority is authorized to designate trauma centers. The American College of Surgeons (ACS) establishes guidelines for classification of hospitals and verifies whether a trauma center meets ACS’ established criteria at each level I-IV and pediatric. Key elements of a Level I trauma center include 24-hour in-house coverage by general surgeons and prompt availability of care in varying specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, which are needed to adequately respond and care for various forms of trauma that a patient may suffer. Additionally, a Level I center has a program of research, is a leader in trauma education and injury prevention, and is a referral resource for communities in nearby regions.The Level II center works closely with a Level 1 center and provides comprehensive trauma care.

ACS recommends that all TSCI patients be taken to a level I or II trauma center. Those centers are listed on its website.

Spinal cord injuries can result from a spectrum of causes: compression of the space around a disk, fractures of a vertebra (cervical, thoracic or lumbar), or a disk "blown" or crushed by a fall. The spinal cord can be injured or severed by a gunshot or by a knife wound. But the leading cause of spinal cord injuries is, by far, motor vehicle accidents (MVAs).

 Often, the MVA victim is concerned about whether a pre-existing condition will make a difference in his case. Generally, it will.

The person whose negligence causes an MVA is responsible only for the harm that results from that particular accident. That means that, if the victim had a pre-existing injury, the victim is entitled to compensation only for the extent to which the accident made the victim’s condition worse.

Sometimes the victim had no pain from his pre-existing condition, but the condition made him more susceptible to being injured. Then the "eggshell plaintiff" rule applies. The rule provides that it is no defense that a pre-existing neck or back condition made the victim more susceptible to injury. The wrongdoer who caused the MVA must fully compensate the victim. It makes no difference that another victim without the pre-existing condition might not have suffered any injury at all. The "eggshell plaintiff" is entitled to be fully compensated for the injuries he suffered in the accident, even if the careless driver had no way of knowing the victim’s condition was so fragile.

The victim’s pre-existing condition plays an important part in the evaluation of spinal cord injury cases. Sometimes, sorting out what injuries were pre-existing from those that were not can be exceedingly difficult. Because of that, the cases are best handled by attorneys experienced in analyzing medical evidence and in presenting that evidence to a jury.


A Connecticut jury recently awarded $8,000,000 to a young man injured during warm ups for a USA Track and Field Junior Olympic Championship meet in 2002. High school senior pole vaulter Brandon White fractured his back at T5 and T10 levels and remains paralyzed from the chest down. Mr. White claimed that the beginning of the runway was obstructed by a batting cage. He sued the USA Track & Field Association/Connecticut for negligent supervision and for failing to provide a sufficient runway length. His sports and safety expert testified that the the usable runway was 25 feet short of the required USATFA length.

The USATFA defendant contended that Mr. White was instructed not to warm up until an official returned. It also claimed that Mr. White did not properly prepare for his vault attempt and should not have let go of the pole when he did. Mr. White’s waiver of all liability and express assumption of risk were excluded from evidence because Connecticut law disfavors these types of waivers.

The jury, without knowledge of the waiver and assumption of risk, determined that defendants were at fault for his injuries.  However, the jury determined that Mr. White was  nonetheless 20% to blame and so his award was reduced to $6,400,000. 

California law sets the bar higher for plaintiffs to prove their case.  California courts generally enforce waivers such as the one Mr. White signed.  Unless there were exceptional circumstances, he wouldn’t have been permitted to bring his case to trial.