Mastering the Complexities of Complex Regional Pain Syndrome

April 25, 2018

Complex Regional Pain Syndrome (“CRPS”) is a controversial and nebulous pain condition that is being increasingly seen in personal injury cases. The condition often results in severe permanent neuropathic pain and functional limitations. Extreme cases can result in total dis­ability requiring extensive skilled nursing care. Over the past decade and half, improvements in the diagnostic criteria (known as the Budapest Diagnostic Criteria) for CRPS have led to its increased acceptance as a compensable medical condition.

Lead trial attorney John W. Patton, Jr. and associate Ryan J. Reguly recently parachuted in to defend a leading national event management and marketing firm in a damages only federal trial in the Northern District of Illinois involving an alleged severe case of CRPS. Prior to Patton & Ryan taking over the defense, its client had already been found 100% at fault in a previous liability trial. Patton & Ryan was undeterred by this challenge and eagerly undertook an aggressive defense.

This case began as a relatively straight forward trip and fall injury involving an attendee of a medical conference at a convention center in suburban Dallas, Texas. While hurrying to a meeting, the Plaintiff tripped over an overturned folding table left unattended by the event staff cleaning up the area, and injured her left arm and hand. The Plaintiff refused to seek medical treatment in Texas and flew home to Chicago that same day. Initially, adjusters assessed the claim as minor injury targeted for a nominal settlement.

Eventually, Plaintiff found her way into the care of a leading Chica­go-based expert on the diagnosis and treatment of CRPS. At the first visit, this expert diagnosed Plaintiff with CRPS and immediately began an aggressive course of treatment culminating in the implantation of a permanent spinal cord stimulator. Following the implantation of a spinal cord stimulator, Plaintiff claimed her CRPS was greatly improved, but immediately began reporting neck pain from the surgery. She then underwent another series of painful injection to treat this newly developed neck pain. What had begun as a soft tissue injury to Plaintiff’s left wrist, had slowly developed into a debilitating permanent pain condition limiting the use of her entire left arm and chronic neck pain.

After being called to the defense, Patton & Ryan quickly jumped in and began building a three-pronged defense challenging the CRPS diagnosis, causation, and the degree of the Plaintiff’s subjective pain. Relying on its vast knowledge and experience in defending against CRPS claims, Patton & Ryan disclosed prior deposition testimony from Plaintiff’s Chicago-based CRPS expert in which he admitted he could not tie CRPS to a fall from years prior. Patton & Ryan also obtained surveillance showing that the Plaintiff had full and normal use of her left arm. Patton & Ryan provided this information to its pain management expert who testified at trial that the Plaintiff did not have CRPS due to her lack of physical symptoms and attributed Plaintiff’s subjective pain to symptom magnification.

At trial, Patton & Ryan proved, through the effective use of video surveillance, expert testimony, and impeachment, that Plaintiff was vastly overstating her subjective pain complaints. The physician diagnosing Plaintiff with CRPS also conceded on cross-examination that he could not causally relate the CRPS to her fall. Sensing that Patton & Ryan had scored serious points during trial, the Plaintiff reduced her request for damages at trial to $6.5 million, down from her $8.2 million pre-trial demand. Ultimately, Plaintiff was awarded only $2.6 million in damages, which was approximately 30% of the pre-trial demand. In this case involving catastrophic damages resulting from a rare and complex pain condition, Patton & Ryan’s unique knowledge and experience tempered the Plaintiff’s expectations and saved its clients millions of dollars.