The elderly patient sustained a knee injury, as well as a fracture of her left arm. The woman’s treating orthopedic surgeon instructed her to avoid work and any strenuous activity; as a result, the woman became sedentary at home. While she was in otherwise good health, the woman had been taking medication to control her blood pressure and cholesterol. Two weeks later, the woman called an ambulance after collapsing at home and was taken to the hospital, where she was diagnosed with a pulmonary embolism as well as atrial fibrillation. She was treated using Xarelto but the course of the patient’s recovery has since proven to be complicated, with multiple hospital stays. It was alleged that the patient’s change to a sedentary lifestyle following the accident was a direct cause of her deteriorating health.

In my clinical practice I have treated patients with deep vein thrombosis and atrial fibrillation. There are studies that show that immobilization after trauma increases the chance of venous clotting and pulmonary embolism. In a large study, 45% of patients with venous thromboembolism had more than 48 hours of immobility in the preceding month. Minor injuries may increase the rate for developing venous clotting and subsequent embolism. Another study revealed that 11.7 of nearly 2500 patients had a minor injury in the three months preceding the venous thrombosis compared to 4.4% of controls. It may have been the case that this patient's shift to a more sedentary lifestyle contributed to her eventual illness.

Do you have experience treating patients who have sustained similar injuries due to accidents of this nature? How common is it for patients to develop these sequelae after an accident?

Location: NJ BA, Rutgers University MD, Rutgers Medical School, University of Pennsylvania School of Medicine Residency, Hospital of the University of Pennsylvania Fellowship, Hospital of the University of Pennsylvania Boards: Internal Medicine, Cardiovascular Medicine, Interventional Cardiology Member, Alpha Omega Alpha (honor Former A******** P******** o* C******* M******* U**** Former C******* A******** P******** o* M******* U********* o* P*********** S***** o* M******* Former D******* C****** C************** L********* S** J******** H******* Former D******* C******* C*** U*** C***** H******** U********* M****** C***** C***** Former C********** C********** A******** C***** H****************** M****** C***** C***** Former C********* C*********** I************* C********* P*** P*********** M****** C***** Former C********* C*********** I************* C********* A******* C*** M****** C***** Former C********* C*********** I************* C********* S**** M******* H******* Former C********* C*********** I************* C********* C*** R******* M****** C***** Former C********* C*********** I************* C********* N******* H******* Former C********* C*********** I************* C********* M**** F********* H******* Former C********* S**** C*********** I************* C********* V***** M****** C***** Current

This case involves an elderly female patient in otherwise good health who was still working, driving, and living independently when she suffered a trip and fall accident in the parking lot of a major big box retailer.

Cardiology Experts Discuss Pulmonary Embolism Following Trip and Fall Accident

This case involves an elderly man in Minnesota who was injured while disembarking from a bus. The man was more than 90 years old; he fell and broke his hip when exiting a tour bus type vehicle at the end of the tour. He had a walker with him, and had been receiving assistance getting on and off the bus the entire day. At the end of the tour, the driver was standing by the door of the vehicle when he exited but did not grab his arm or otherwise assist him out of the bus.

With my past three decades working with a city transit authority in capacities that exposed me to the above topic, bus operators were only instructed to manually assist a disabled passenger when it was related to a mobility device in boarding, alighting, and securing the device. This was especially true if the passenger was not in the company of their own personal attendant. Operators are permitted to assist anyone who requires assistance to secure either a shoulder or lap belt. If the passenger was simply elderly but not disabled and did not request assistance from the operator, many operators do not physically touch the person as some passengers reject this sometimes rather loudly. Finally, operators are required to follow their agency's SOP (Standing Operating Procedure) on the possible different policies requiring the boarding and/or alighting from the bus of disabled and visibly non disabled customers.

1. Please briefly describe your experience with bus operations, specifically as it relates to training/supervision of drivers in relation to assisting elderly patrons. 2. Do you have experience with tour buses or other small bus type vehicles in which a driver should assist an elderly patron from the vehicle?

Location: NY Member, National Transit Institute Former B** O******* N** Y*** C*** T****** A******** Former D******* o* T************* T******* B** S***** a** T******* D******* N** Y*** C*** T****** A******** Former L*** B** a** S******** I********* N** Y*** C*** T****** A******** Former L*** B** S******** I********* F*** I*********** Current S***** C********* o* T****** T******* a** S********* A D****** S******** D******** Current I********** C********* S****** T****** S******** F***

Midwest

Minnesota

This qualified expert of Bus Operations has over 40 years of experience in the Bus Industry including 33 Years with the NYC Transit Authority. He is a member of the National Transit Institute and is currently a senior consultant of transit training and simulation for a driving simulator developer and an independent consultant for a surface transit solutions firm.

Transportation Expert Opines on Trip and Fall Accident During Bus Tour

This case involves a trip-and-fall at a convenience store in Washington. On the date of the incident in question, the plaintiff was shopping in the defendant store using a small shopping cart. The plaintiff rounded a corner around an open refrigerator case when she suddenly tripped over a piece of the case that had been protruding into the aisle, causing her to lose her balance and fall. As a result of the fall the woman suffered a number of serious head injuries, as well as brain damage that has prevented her from returning to work.

I am very qualified and never disqualified in one 65 retail cases in four years. I have served as an expert retail witness in Supermarket cases for the plaintiff involving Slip and Fall, Display design malfunctions and product display presentation. With two degrees in Architecture, and over 35 years of practical Store Design including supermarket venues, I am able to comment and evaluate the very items you suggest could not be per Industry Standard and manufacturing best practice. In addition, I currently serve as one of twelve store planners serving the American Display Industry Organization on the Creative Design Committee. It sounds like an afterthought as most reputable refrigerated case manufacturers have a proven safe way to protect the lower end corner of a case. I do not understand why the guard would "stand-off" from the unit, unless there was some glass that could be hit by a shopping cart. Otherwise, there is no reason to have what sounds like a makeshift hazardous to be utilized. Lastly, it is a common practice to "break" all metal edges to eliminate metal spurs, or razor sharp edges to interact with a customer. I have designed over 50 million dollars of displays and oversaw the installation and manufacturing stages and can speak to my experience to address similar conditions which I have encountered over my career of hands-on design, supervision of installations and manufacturing.

1. Please briefly describe your experience with grocery store safety. 2. Can you speak specifically to any standards or best practices as it relates to refrigeration displays?

Location: NY BS, Architectural Technology, New York Institute of Technology BA, Architecture, City College of New York Fellow, Institute of Store Planners Former D******* o* S**** P******* F******* S***** Former V*** P******** S**** D***** a** D****** R*** K*** I*** Former V*** P******** S**** D***** a** D****** K** J****** Former E******** V*** P******** E********* L** Current P******** a r***** s**** p******* c**********

West Coast

Washington

This highly qualified expert has been in the retail and retail planning industry for over 40 years. He received his BS in architectural technology from the New York Institute of Technology and his BA in architecture from the City College of New York. This expert has received numerous prestigious awards in his industry including the Best Specialty Store Design and the Best Store Fixture Design. His articles on store design have been featured in magazines such as Display Design Ideas and New York Magazine. This expert has held executive and management positions as a store planner at multiple retail companies, and he is currently the principal of his own retail store planning consulting firm. He specializes in store layout, design, and safety with a client base that includes Macy's, Walmart, Kmart, Sears, Stop and Shop, and many more.

Customer Suffers Serious Trip and Fall Due to Unsafe Display

This case involves a full-time nanny who was rendered paralyzed after a slip and fall accident in a mall. The floor near a flight of stairs had recently been mopped by the janitorial staff but no wet floor signs or other warning had been placed in the vicinity to indicate danger. As the nanny was approaching the stairs, she slipped and fell down the flight of stairs, injuring her head and spinal chord. She was rushed to the hospital and eventually pronounced paraplegic. The nanny was previously responsible for the full-time care of 3 children ranging in ages from 6 months to 7 years old. Due to her injuries, she is no longer able to perform her job and cannot find work. A vocational rehabilitation expert was sought to complete both a rehabilitation assessment and assessment of her loss of earnings.

I have performed hundreds of vocational assessments for injured individuals and evaluated their abilities to perform their past occupation(s) and other occupations. I have provided reports on the financial impact of such individuals who cannot perform their jobs in the same capacity as they used to. I have also provided reports on individuals who have had to transition careers and how that transition eroded their earnings potential. I can evaluate how an injury will impact an individual's work-life expectancy and I use a methodology to calculate total earnings lost. Depending on the occupation and the level of skill the work requires, there are formulas I use to determine losses based on the age the individual is, their ability to return to work and how long they are able to work for. I also incorporate other costs such as the lost benefits associated with their former position.

1. Please briefly describe your experience completing both rehabilitation assessments and calculating the loss of earnings.

Vocational Rehabilitation Expert Assesses Damages For Paralyzed Nanny

This case involves a handicapped man that was injured by a newly installed automatic door at a hospital. The door in question was in the hospital lobby. One of the lobby desk staff members came over to assist the man with the door. She pushed the button for the automatic door to open and the man wheeled himself through. As the man was going through the door, it closed on him, knocking him to the ground. The man sustained serious head injuries and was unable to fully recover from his injuries. An expert in medical facility management was sought to discuss the policies necessary to ensure the safety of vulnerable patients while visiting a medical center.

I have 7 years experience as a clinical regulatory registered nurse and I have worked in various medical settings for 22 years. I have been involved in creating and directing policies which specifically pertain to patient safety at medical centers many times throughout my career. I have specifically been involved in the workplace regarding patient falls, what to do and not do, how to prevent, and developing a fall risk assessment. Facility policies should revolve around safety monitoring regarding the automatic door, including time-lapse for closing, testing, calibration, as well as documents supporting that this is monitored. There should also be staff reporting on door use and monitoring patients as they enter and exit.

1. Please explain why you're qualified to serve as an expert reviewer of this matter. 2. What policies must exist to ensure the safety of patients at medical centers? 3. Have you ever been involved with creating and/or directing policies which specifically pertain to patient safety at a medical center?

Automatic Hospital Door Injures Handicapped Man

This case involves a child who suffered a traumatic brain injury after a slip and fall incident in a department store. The child was running in the kitchen and bath section of the store which had combination flooring. From the base of the main aisle inwards approximately 2 feet was ceramic tile. The floor then transitioned to laminate wood and covering the transition gap was a slightly rounded, rubber molding. The rubber molding was only securely glued to the laminate side of the transition point and not the ceramic flooring. As the child was running, their shoe caught the rubber molding causing them to fall forward. The impact of the fall caused the child severe concussion and long-term neurological impairment.

I have worked for 40+ years in the flooring arena with both ceramic and wood surfaces. In flooring, it is important to make a safe and visual transition and from one product to another whether or not it is the same or different material. If the molding is not properly installed to have a smooth transition from one product to the next to cover a gap and is too high it defeats the purpose of what it was intended for - safety. If your client tripped on the transition and the height was unreasonable it could constitute negligence. Given what you've described, I think you have a case, but I would like to see a photo and a measured height of the transition piece on both sides.

1. Does a flooring transition at such a high-traffic point constitute an unsafe condition? 2. If the molding deflected up when caught by individuals shoe, does this constitute an unsafe condition?

Child Slips On Mixed Surface Flooring In Department Store

Kristin Casler

Case: Doris M. May v. Ruby Tuesday, Inc., No. 5:13–CV–170 (FJS/ATB), U.S. District Court, Northern District of New York; Oct. 2, 2014 Background: Plaintiff Doris M. May alleges that she was injured when she tripped on a concrete wheel stop in a handicap parking spot in front of the doors of a Ruby Tuesday restaurant


Doris M. May v. Ruby Tuesday, Inc., No. 5:13–CV–170 (FJS/ATB), U.S. District Court, Northern District of New York; Oct. 2, 2014

Plaintiff Doris M. May alleges that she was injured when she tripped on a concrete wheel stop in a handicap parking spot in front of the doors of a Ruby Tuesday restaurant in 2011. She alleges she suffered serious personal injuries and that the defendant restaurant’s negligence in placing the handicapped parking place in direct alignment with the center of the entrance/exit doors caused her injuries. She also alleges that the restaurant created an obstruction to unencumbered travel by the placement of the concrete curb and metal sign and failed to properly mark the obstruction and to design and place railings or other visible barriers.

Plaintiff’s architecture expert, Daniel J. Manning, opined that the center of the handicap parking spot’s access alley should have been aligned with the center of the restaurant doors, instead of the spot and the wheel stop being centered on the doors.

Thus the defendant challenged Manning’s qualifications and the reliability of his opinions under Daubert v. Merrell Dow Pharms., Inc. (509 U.S. 579 [1993])

In an Oct. 2 memorandum opinion, Judge Frederick J. Scullin found Manning qualified to testify. He has designed commercial buildings and has worked with civil engineers to design parking lots, the judge said. However, the court found his opinion unreliable because he failed to provide any basis for his conclusion that good architectural practice and preventive design would have aligned the centerline of the access aisle to the center line of the exit/entrance doors to the restaurant. Correspondingly, he did not indicate what the source of this good architectural practice and preventive design was, the judge said. Nor did he state what methodology he used to reach his conclusion.

As a result, Manning acknowledged that the restaurant and parking lot comply with all applicable codes and regulations.

“For the above-cited reasons, the Court finds that there is too great an analytical gap between the data on which Mr. Manning relies and the opinion he proposes,” the judge also said. “Thus, the Court concludes that his proposed expert testimony is unreliable.”

The judge then granted the restaurant defendant summary judgment.

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