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INTRODUCTION
The most recent 2001 articles are listed first, dating back to
1994. Many are raising awareness of RSD/CRPS and hopefully Canadian
RSD organizations will get more public support for education and
research.
Championship Victoria
curler awarded 1.1 million
VICTORIA -- A champion Victoria curler, whose passion for her
sport and career as a teacher was ruined by a freak, seemingly
minor accident, was awarded $1.1 million Friday by a judge in
B.C. Supreme Court.
Melissa Soligo was a member of the Julie Sutton rink that finished
second at the 1991 world curling championships and won a bronze
medal at the Winter Olympics in Albertville, France, in 1992 when
curling was a demonstration sport.
While on an evening stroll in suburban Saanich on May 9, 1996,
the side mirror of a passing pickup truck struck her left shoulder.
Soligo, then 27 years old and starting her career as a physical-education
teacher, initially thought the accident was trivial and refused
to call an ambulance.
But the accident left her unable to continue as a physical-education
teacher, in constant pain and now coaching in a sport in which
she once starred.
She has difficulty using her left arm and has constant pain in
her
left shoulder.
Court was told Soligo has ``complex regional pain syndrome''
and has been diagnosed as having post-traumatic adhesive capsulitus
of her left shoulder.
Her physiotherapist has designed a hand splint because the third
and fourth fingers of her left hand are becoming clawed.
Soligo successfully sued the driver of the pickup truck, who
is covered by the Crown-owned Insurance Corp. of B.C.
``Ms. Soligo lives in constant pain,'' wrote Justice Robert Hutchison,
a former Olympian who ran for the Canadian track team in the 1952
Olympics.
She has endured seven surgical procedures as well as multiple
non-surgical treatments, he said.
As well, Soligo testified that she needs at least two or three
physiotherapy sessions a week to remain functional at all.
``She has lost the ability to follow her chosen career path,''
Hutchison wrote in his judgment. ``She has also lost her ability
to compete in her sport at the highest international levels.
``She has lost her own enjoyment from being an elite curler,
and can only coach with the assistance of Tylenol 3 painkillers.
She is also unable to do more than the most limited amount of
house and yard work.''
Hutchison noted that Soligo had to watch on television as the
rink for which she used to curl won $50,000 in a game in Saskatchewan.
Soligo's job prospects are much changed as well, the judge said.
Experts testified it would be difficult for Soligo to be a teacher,
let alone a physical-education teacher, with her disability.
Hutchison said Soligo will likely be capable of only part-time
work because of her injury and chronic pain, and will have to
work shorter hours at lower wages than she would as a teacher.
Since the accident, Soligo worked in a clerical position at Camosun
College until the onset of complex regional pain syndrome.
additional excerpt: Victoria Times Colonist
Almost half of the award is to compensate for the loss of future
income earning capacity.
ICBC can appeal the award within 30 days.
Soligo couldn't be immediately reached for comment. Copyright
Victoria Times Colonist 2001 All Rights Reserved. Copyright The
Province (Vancouver) 2001 All Rights Reserved.
Malpractice nightmare:
'Burg man wins appeal but his life is no better
even with a settlement
Byline Kate McCrindle
Citation The Chatham Daily News, April 6, 2000, Final Edition,
p.1 Photo: Kirk Robinson shows deformed hand
WALLACEBURG -- Kirk Robinson won the battle but
lost the war when, after seven years, he successfully sued an
orthopedic surgeon for malpractice and won a court of appeal decision
last month.
Justice J.A. Charron of the Ontario Court of Appeal
upheld a 1998 ruling that found Dr. John Halpenny, formerly of
Sydenham District Hospital and now practicing in New York, failed
to provide the required standard of care when he set a slightly
broken finger in a hand cast improperly, destroying Robinson's
dominant hand.
Despite a court-ordered settlement estimated at
$250,000 and scheduled to arrive in the next few weeks, the 45-year-old
Wallaceburg former labourer will receive roughly half of that
because the Ontario government is making him repay seven years
of disability benefits. After legal fees, he estimates about $80,000
will be returned to the government.
However, Robinson will never be able to work as
a labourer again, won't be eligible for medical or further disability
benefits, nor was he eligible for disability retraining because
he was ``too old'' and his hand ``too useless.''
``That's the government. That's the way the system
works,'' said Robinson.
``I'd take my hand back any day. They might as well
have cut it off,'' Robinson said.
His life-altering health care nightmare began innocently
enough on June 12, 1993 when he was carrying a box down to the
basement and tripped, slightly fracturing his left middle finger.
He went to Sydenham District Hospital, where Halpenny
put his entire hand in a cast, fingers in a curled position. When
the cast was removed July 9, all four fingers were stiffened into
the cast position. He was told it should return to normal in a
few weeks.
A week later, his fingers atrophied further, closing
into a fist. His family doctor referred him back to Halpenny,
who didn't see him until Aug. 19, by which time the fingers were
frozen one half inch from his palm.
He was sent for physiotherapy, where therapists
made several attempts to pry his fingers open after dipping his
hand in hot wax. All attempts were unsuccessful. Robinson was
eventually sent, by his family doctor, to a specialist in London.
Three surgeries later, there was little improvement.
The specialist testified during the trial that the cast applied
by Halpenny had not been set in the proper ``safety'' position
to avoid seizure of the digits, that a syndrome called Reflex
Sympathetic Dystrophy had set in and not been identified or treated
by Halpenny, and that the therapy prescribed may have exacerbated
the condition.
Under cross-examination by Robinson's lawyer, Jerry
O'Brien, Halpenny testified that he had destroyed Robinson's records,
along with about 50 other patient's records, when he moved to
New York in 1994.
``It was truly a rare event but it became obvious
at the trial there had been a breach (in the standard of care),''
O'Brien said.
The long and difficult trial echoed Robinson's own
struggles and pain.
After the surgeries, he used a device called a force
therapy machine that pumped his hand open and shut in a further
attempt at rehabilitation.
``Torture chamber, I called it,'' he said, recalling
the excruciating pain.
He was told to `live with it,' that his hand would
never recover, and that he now suffered a severe, permanent disability.
With five children to feed -- the eldest with cerebral
palsy -- and no income, he was refused disability. He'd been unemployed
prior to the accident due to an economic downturn.
He fought that in court, and it took two years to
win.
``What was I supposed to do to feed my kids?''
Trips to therapy three times a week, visits to doctors
in London, and chronic pain filled his days. His mother, Audry,
remembers many times bringing groceries to the family so they
could eat.
Robinson sought work regardless, and said employers
would take one look at his ``crumpled claw'' and say, `We don't
want you here with that hand.'''
He can't work outdoors because the hand is exceptionally
sensitive to cold, and aches constantly when it rains. Arthritis
is now setting in, and the RDS causes painful nerve reactions.
``If I hit it, it feels like an electric shock.''
His dreams of taking over a small engine business
were shattered, and his first marriage dissolved.
He feels the Canadian Medical Protection Association,
which defends doctors across the province, would have been better
off to settle early, when an award would have been considerably
less. Instead, they went to the Court of Appeal, extending the
ordeal another two years.
``They try to drag it out so you'll give up,'' Robinson
said.
Embittered by provincial bureaucracy and wet winters,
Robinson plans to leave Ontario when his settlement comes in,
and strike westward in hopes of finding work and a new beginning.
``I'm glad it's over.''
PNE accident
victim gets $1-million-plus court award
Byline Neal Hall; Sun Court Reporter
Vancouver Sun, May 4, 2000, Final Edition, p.B4
A Coquitlam woman who was struck on the head by
a wooden room divider at the Pacific National Exhibition in 1996
has won a court award of more than $1 million for the chronic
pain she has suffered ever since.
The accident rendered Nadia Delli Santi unable to
work and resulted in major depression, a B.C. Supreme Court judge
found in a decision released Wednesday.
Delli Santi said Wednesday she was happy with the
court award, but she added: "It ruined my life."
The 41-year-old woman was at the PNE with her two
children Aug. 17, 1997, when someone stole her cell phone.
She was sitting in a chair, reporting her loss at
the lost and found, when an unstable room divider fell on her,
striking her head.
Delli Santi immediately felt something was ``funny''
with her arm. She was taken to hospital by ambulance. The PNE
later admitted liability for the accident.
``Since that day, her condition has worsened and
she currently suffers from chronic, disabling pain that is probably
permanent,'' Justice Marion Allan concluded in a 40-page written
judgment.
``While the plaintiff's condition is likely to improve
if she follows all medical advice, I conclude that it is extremely
unlikely
that she will ever be able to resume her previous life either
at home or in business,'' the judge said.
The judge awarded Delli Santi non-pecuniary damages
of $150,000, past income loss of $80,000, $650,000 for loss of
future income, $11,088 in special damages and $120,000 for the
cost of future care. With interest and court costs, the total
is almost $1.1 million.
``It's one of the highest awards of its kind for
pain and suffering involving complex regional pain syndrome,''
Delli Santi's lawyer, Michael Pohorecky said.
``We were seeking in excess of $2 million because
now she can't take over her father's business in Los Angeles,
which grossed $2 million last year,'' he said.
Married with a son and daughter aged 7 and 12, Delli
Santi was described by the judge as an extremely intelligent woman
who, despite little formal schooling, ran a growing business that
imported and installed decorative casts of residential fireplaces,
columns and other architectural ornaments made by her father.
Delli Santi tried to continue her business until
July 1998, when she took the advice of her doctors and stopped
working because she had become nervous, frustrated and depressed,
which led her to making mistakes, the judge noted.
Copyright Vancouver Sun 2000 All Rights Reserved.
What Happened to Heidi?:
The untold story of her tragic death (excerpt)
Byline Rick Ousston
Vancouver Sun Nov. 11, 2000 Final Edition p. A1
In 1993, a 48-year-old bank worker named Sandra Hay Bryan was
awarded $374,362 for pain, suffering, wage loss and special damages
after Hicks was found negligent in caring for her.
He had not given his patient sufficient information to allow
her to consent to a surgical procedure.
Bryan, a loans officer at the Bank of Montreal's Burrard Street
location, experienced some pain and swelling in her right wrist
in
1989. It wasn't debilitating, just bothersome, and her family
doctor referred her to Hicks. According to court testimony, Hicks
diagnosed a growth called a ganglion, and recommended surgical
removal.
According to Justice Marion Allan, what Hicks didn't do was tell
his patient that the chances are about equal that ganglions will
go
away on their own without surgery, or stay the same, or grow worse.
And he didn't warn his patient about the risk of infection inherent
in any surgical procedure, the judge said.
Bryan suffered an infection called reflex sympathetic dystrophy
(RSD) after her 1989 operation.
``Ms. Bryan's hand is now totally dysfunctional,'' Allan concluded.
``It burns and sometimes becomes freezing cold; it is painful
and
swollen.... She is unable to work, exercise, prepare meals, or
do housework. She is unable to hold a fork or open a can.
''Lawyers for both sides agreed the surgery performed by Hicks
did not fall outside the norms of appropriate care. Bryan's lawyer
argued the issue was that his client had not given informed consent
to a procedure that resulted in the crippling of her hand.
The judge agreed, saying: ``Dr. Hicks breached his duty of disclosure.''
That breach, the judge said, was negligence.
Ex-PR head wants to publicize
painful facts of nerve disease
Byline Marg Langton
The Spectator (Hamilton), January 30, 1999, Final Edition, p.N6
Suzanne McPetrie was never shy about getting publicity during
her long and colourful reign as public relations chief at Burlington
Public Library.
And I never hesitated to promote the people and events she was
flogging. They were sure to be intriguing. Often -- like McPetrie
-- they were ahead of their time in areas as eclectic as health,finance
and feminism.
McPetrie retired from the library at age 70. The intervening
five years have offered more time for an abiding fascination with
graphology (handwriting analysis). The last 18 months have also
tossed another challenge her way, a disease that's largely-unknown
and often-misdiagnosed.
It's a mouthful -- reflex sympathetic dystrophy syndrome or RSDS.
Surprisingly, it was diagnosed back in '91 when McPetrie had a
mild fracture in her right wrist which called for a cast.
``While I was in the cast, my fingers turned blue and I had intense
finger pain. When the cast was removed, my hand was like a claw
and the pain got worse.''
That's when a sharp physician hit on RSDS as the cause and recommended
physiotherapy. McPetrie praises the skill of Waterdown Therapy
owner Marian Johnson, who got the hand functioning again after
months of work. The hand was still weak, though, and thesporty
Mustang with stick shift had to go.
It would be almost two years before the pain subsided.
The simple definition of RSDS is nerves getting stuck in the
`on' position. They react to an injury, surgery or even something
as innocuous as a stubbed toe. But they never return to the normal
resting state after responding to the danger signal in some part
of the body.
The sympathetic nervous system is part of the autonomic system
of motor nerve cells that functions automatically. It connects
the brain with internal organs, circulatory system and mucous
membranes.
The autonomic system has two subsystems: the sympathetic and
parasympathetic. The sympathetic is more pervasive. It can tense
and constrict involuntary muscles and blood vessels and step up
gland activity. Thus, as the Life Science Library book The Mind
points out, ``It profoundly influences all body functions.''
One insidious characteristic of RSDS is its ability to spread
to other parts of the body.
McPetrie confronted that reality in '97 when pain flared up in
her left knee. Four months after the intense burning pain attacked
the site of an old ski injury, she was unable to walk. Bone scans,
ultrasound, anti-inflammatory drugs and cortisone were not doing
the trick.
Magnetic resonance imaging last February revealed some osteoarthritis,
common for a woman of 75. Most doctors saw nothing else. ``They
just said it was osteoarthritis and stuck needles in my knee.''
Meanwhile, the pain was becoming unbearable. A relative with
access to Toronto's power circles got Toronto Western Hospital
knee surgeon K. Wayne Marshall to examine the problem joint last
March. He operated a week later after warning his patient about
the huge risk.
She was willing to accept the odds. Since she was already in
a wheelchair, the chance of spending the rest of her life there
made McPetrie feel she had nothing to lose.
The surgery got rid of the pain. The next step was physiotherapy
to restore muscle tone in the legs.
The poster woman for positive thinking says this is a success
story because she is a lot better. Physiotherapy continues, she
can walk short distances with a cane, but any overexertion sets
her back for weeks.
The toes on her left foot are curled in and stiffened. Despite
an hour of stretching exercises each morning, she has poor circulation
and little energy.
``The thing that bothers you more than anything else is fatigue.
I get tired of saying I'm tired. And people get tired of hearing
me say it.''
Acupuncture helped McPetrie regain use of her hand. But this
time round, she's had no relief from other forms of alternative
medicine.
Through it all, the woman, who will never really retire, has
kept up her end of a business partnership.
She and Edda Manley run a school for handwriting analysis. McPetrie
has missed only one session.
Her lively mind can't help marvelling over the unexpected learning
curve which has been a side effect of the illness. She's learned
a new appreciation for the usual cliches about material things
not mattering without health, the need to appreciate every kindness
and
value friendships more.
McPetrie believes doctors don't give people her age the same
attention as younger generations.
And she's formed her own theory on public response to those with<
disabilities. ``Little kids and teenagers are marvellous. But
women in their 30s will knock you down before they help you.''
The former PR dynamo is not going public with her affliction
for ego massage. She wants to educate people who may think they
have arthritis, but have an inexplicable, ongoing pain.
Experience has taught her the need to be proactive when it comes
to personal health. ``Very few doctors know about RSDS and how
to treat it.''
RSDS SUPPORT
- The Reflex Sympathetic Dystrophy Syndrome Association of
America has 41 Canadians in its membership of more than 3,000.
- Executive director James Broatch believes RSDS is often misdiagnosed
because it may begin while the patient has a cast on an injury.
He says doctors either miss sympathetic nervous system changes
or expect them to go away. He says RSDS spreads in 70 percent
of cases if it's not caught within three to six months.
- Telltale signs are: discoloured skin, swelling, pain out
of proportion to the event and skin temperature changes.
- Treatments cover a broad menu, from drug therapy, nerve blocks
and physical therapy to transcutaneous electrical nerve stimulation,
surgery and implantable devices.
- The association was formed 14 years ago. Non-U.S. membership
costs $25 or whatever the individual can afford. Funds go for
research and a newsletter that includes a section on pen pals
for support. For information, call the association in Haddonfield,
N.J. at (856) 795-8845.
Pain Syndrome Needs a Quick
Diagnosis
Byline Marilyn Dunlop
The Toronto Star, April 5, 1997, Final Edition, p.L12
A pain syndrome that can begin two to five weeks following a minor
injury needs to be recognized quickly by family doctors, an Ohio
pain specialist says. ``If the diagnosis is delayed, the condition
quickly gets out of hand,'' warns Dr. Vikram Patel of the Pain
Medicine Centre at the Medical College of Ohio in Toledo.``The
treatment becomes difficult and the patient doesn't recover completely.
In the worst-case scenario, they might even become a pain invalid.''
Patel told the Medical Post that the syndrome begins after an
injury so slight the patient might not be aware of it.``It may
be a trivial trauma, such as bumping one's knee or elbow against
a table.'' This sets up an abnormal circuit in the nervous system,
Patel explains. After several days, the person notices a burning
sensation, often in the tips of the fingers or toes of the bumped
arm or leg.
``The pain may become so intense the person cannot even tolerate
clothes touching the skin near the area,'' he says, adding that,typically,
the amount of pain seems far more severe than would be expected
from such a slight injury.Such patients require the help of professionals
at a pain clinic, Patel says. Their treatment must be tailored
to them and would include a combination of nerve blocks, drugs
and physical therapy. He said the syndrome, once called causalgia,
is now named complex regional pain syndrome.
Copyright The Toronto Star 1997 All Rights Reserved.
Pain of Nerve Injury Hard
to Control
Byline Allan Bruckheim
The Gazette (Montreal), March 28, 1996, Final Edition, p.D4
Column FAMILY DOCTOR (The-Montreal-Gazette)
A persistent burning, tingling pain in my right thigh was diagnosed
by my doctor as reflex sympathetic dystrophy. It is the result
of a large boulder falling across my leg and crushing it. I can't
understand everything my doctor has tried to tell me. Can you
offer more information that perhaps I can understand?
Normally, pain impulses are carried by sensory nerves in the
body, and the sympathetic system controls such things as sweating,
blood circulation and temperature regulation. However, when this
system begins to malfunction after an accident, it can affect
the area of injury in a variety of unusual ways.It can change
the perception of pain, the way skin senses cold and touch, the
temperature and color of the skin and its sweating function. When
these symptoms can be related to the injury rather than to other
nerve problems (such as those that result from diabetes, nerve
tumors or carpal tunnel syndrome), the diagnosis might be reflex
sympathetic dystrophy. A burning pain, sometimes described as
throbbing in nature, can affect an entire arm or leg in the region
of the injury. As the condition progresses, there are changes
in the consistency of the skin, loss of body hair in the area,
muscle wasting, swelling and edema. The nails become brittle and
the joints can atrophy. Corticosteroids can be used in the early
stages of the condition, but if the symptoms last more than six
months, the chance of recovery is remote. Ordinary short-acting
painkillers do little to relieve the constant pain, and the physician
might resort to injecting a local anesthetic or nerve-blocking
agent to stop the pain. Repeated blocks can be used, but if the
relief lasts for only a short time, surgical procedures might
be necessary, using a permanent sympathectomy or complete block
of the affected nerves. Once the condition becomes chronic, many
patients require antidepressants, anticonvulsants and narcotic
pain medications to control their symptoms.
Write to Dr. Bruckheim, c/o The Gazette, Living Section, 250
St. Antoine St. W., Montreal H2Y 3R7. Dr. Bruckheim cannot give
personal replies but will answer as many questions as possible
in his column. Copyright The Gazette (Montreal) 1996 All Rights
Reserved.=20
Kurt's
Biggest Fan Gets Thrill of a Lifetime
Byline Steve Milton
The Spectator (Hamilton), April 18, 1994, Final
Edition, p.D1
KIM EDWARDS will trade a few hours shuteye, anytime,
for a chance to meet Kurt Browning.
``I didn't sleep for four days,'' the 22-year-old
Hamilton resident said at Copps Coliseum yesterday afternoon on
her way to watch Browning and the rest of the Stars on Ice practice
before last night's sold-out performance.
Kim has Reflex Sympathetic Dystrophy, which affects
the nervous system, spreads slowly and is very painful. Since
last summer she has been confined to a wheelchair, but that has
in no way diminished her affection for Browning, the four-time
world champion.
After the show, which he headlines and in which
he performs several demanding numbers, Browning gave Kim the thrill
of a lifetime when he stopped to talk to her for a few minutes.
Earlier in the day he had received a letter Kim had written him
and International Management Group which runs Stars on Ice, provided
her with a backstage pass.
``She knows everything about him, you can ask her
anything,'' Kim's proud mother, Carol Edwards, said and a few
test questions proved her point. Kim had the Kid from Caroline
nailed down perfectly.
As for Browning, he was only too happy to meet one
of his biggest fans. ``It was great,'' he smiled. ``I'm glad it
all worked out and we're able to get together.''
Copyright The Spectator (Hamilton) 1994 All Rights
Reserved.
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