Academy of Chiropractic’s Doctors PI Program

Narratives 65

From the Desk of :
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

“Accident History”

One of the most common problems in narrative reports is the accident description. According to the last 10,000+ lawyers I have lectured to, one of the most significant problems they are having is the accident history. 


Here is a typical scenario in today’s law offices. Their client gets into an accident and the police are the first on the scene. The ambulance is next on the scene, followed by the emergency room nurse, emergency room physician and then the family doctor or orthopedist. The problem is THEIR CLIENT as they typically tell different renditions of the same story and it is usually not consistent. 


This is a significant problem for the legal community. Therefore, when you have an expansive accident history, it often lends itself to yet another rendition that is not consistent with the all those prior to you. AS a result, lawyers want you to keep it very generic and leave the details to the police or accident reconstructionist. 


In addition, IF… you do not have credential in accident reconstruction, your recounting of the accident will typically not be admissible at best and if not 100% accurate will be used against your patient at worst. Therefore, keep it very narrow focusing only on what will change your diagnosis, prognosis and treatment plan and that is usually just the point of impact and little more, but not too much. Seatbelt disposition and awareness of impending impact help lend themselves to your prognosis, so those are acceptable. 


March 14, 2017

RE: Final Narrative Report-William Patient


Date of Loss: 06/07/2016 

Date of First Office Visit: 06/08/2016


The above issues were discussed in Quickie Consult “Narratives 56 N” as this is the wrong format for a narrative.


ACCIDENT HISTORY 

The patient reported that he was the driver of a Jeep Wrangler 4 door pulling a trailer with lawn equipment. It was early in the morning. He noticed a car proceeding along in the opposite direction in front of him was drifting into his lane. The driver was hummed over with their head hanging down as if they were passed out or asleep. Once he realized the vehicle was going to hit him he attempted to swerve out of the way and the vehicle hit the trailer head-on. He was traveling at about 30 mph and the other car appeared to be traveling at a considerably higher speed and did not hit the brakes at impact.


Mr. Patient also reported that, at the time of the accident, the road conditions were clean and dry and visibility was good.  Damage to the other vehicle was significant.  He also stated that he did see the accident coming but he was not braced for the impact.  Also, he was wearing his seat belt and had his shoulder harness on.  No front or side air bags deployed at the moment of impact.  On impact the patient's body did not strike the inside of his vehicle.  He stated that he did not lose consciousness during the accident.  According to the patient, the police showed up at the scene.  An accident report was filled out at that time.  


First, look at line 3 in the first paragraph, there is a typo in the word “hummed.” That is unacceptable and totally changes the context of the accounting of the accident although you shouldn’t even have it in there. Grammar and typos matter. I ALWAYS have my reports proof read prior to sending them to a lawyer. If you need a proofreader, I can provide you one. Just ask (they will charge you as they do not work for me). Ideally, I would suggest that you have at least one staff member who excels in grammar and make that part of your interview process. 


ACCIDENT HISTORY 

The patient reported that he was the driver of a Jeep Wrangler 4 door pulling a trailer with lawn equipment. It was early in the morning. He noticed a car proceeding along in the opposite direction in front of him was drifting into his lane. The driver was hummed over with their head hanging down as if they were passed out or asleep. Once he realized the vehicle was going to hit him he attempted to swerve out of the way and the vehicle hit the trailer head-on. He was traveling at about 30 mph and the other car appeared to be traveling at a considerably higher speed and did not hit the brakes at impact.



Mr. Patient also reported that, at the time of the accident, the road conditions were clean and dry and visibility was good.  Damage to the other vehicle was significant.  He also stated that he did see the accident coming but he was not braced for the impact.  Also, he was wearing his seat belt and had his shoulder harness on.  No front or side air bags deployed at the moment of impact.  On impact the patient's body did not strike the inside of his vehicle.  He stated that he did not lose consciousness during the accident.  According to the patient, the police showed up at the scene.  An accident report was filled out at that time.  



This entire shaded section has nothing to do with the diagnosis, prognosis or treatment plan and is purely the territory of the police and accident reconstructionist (if you want to do this, take the accident engineering course). The fact that the vehicle hit the attached trailer is significant, but the doctor did a poor job in describing that due to all the previous description on the accident and not connected well. 


A better way to describe the vector of force would be “Mr. Patient reported that he was involved in a motor vehicle accident where a trailer that was attached to his car was struck by an oncoming vehicle. As a result, he explained that his car was spun around violently.”  



The shaded area is conjecture. How does he know that other driver never hit the brakes? He doesn’t and then destroys the credibility of the report. 


The shaded area has nothing to do with the diagnosis, prognosis or treatment plan and is left to the police and accident reconstructionist. Leave it out!


The shaded area is pertinent, but does not make sense. How can a driver see an impending accident coming at him at high speed and NOT react by not bracing? A reasonable person would dismiss this as fiction. Again, this is an area where there would be 4 renditions of the same story, therefore I would leave out anything that I felt not consistent. 


The shaded area is not clear. The airbags did not deploy at the “moment of impact.” Does that mean they deployed AFTER that moment? Clarity matters and this passage is anything but clear.


The balance of the report is acceptable, however in the first sentence, the doctor omitted to include “the patient stated” that his body did not strike the inside of the vehicle. He included that in the balance of the statements, but in the passage cited above, it appears as if the doctor was the witness and not the report from the patient. 

Although these seem like minor issues to many, they are often the arbiter between having long-term relationship with lawyers or NOT because in the legal community, these are MAJOR issues!!!