Illustrated Medicine: Case Study

Rollover Causes Chest Trauma with Cardiac Arrest

This 28-year-old passenger suffered multiple injuries from a rear-end collision that caused the vehicle she was into rollover and hit a pole. 

Purpose of illustration 
This exhibit was created to demonstrate Ms. Jones’s later internal chest trauma – namely, complete collapse of the middle and lower lobes of her lung, with blood filling 70% of the right chest cavity (hemithorax) and pushing against her heart. 

Rationale for litigation visual 
Although CT scans demonstrated the chest pathology to medical professionals, non-medically-trained litigation participants needed a visual ‘translation’ of the films and case reports, thereby allowing everyone to appreciate the severity of this trauma. 

Ms. Jones underwent a thoracotomy to remove the large volume of blood from her chest. She then suffered cardiac arrest and an emergency sternotomy was performed to evacuate blood from the pleural space and to insert chest tubes. Bleeding from the innominate artery was discovered and ligated after sharp pieces of fractured clavicle and rib were removed. 

Other visuals demonstrated 
Additional illustrations depicted: multiple rib fractures causing ‘flail chest’; spinal, right clavicular and scapular fractures; and details of three chest surgeries that were performed. Complications of scapular winging and reduced shoulder mobility due to right thoracic nerve injury, as well as thoracic outlet syndrome, were also demonstrated. 

A significant settlement was reached just days before the trial was to commence.