The Expert: Dr. Jonathan Eisentat, a forensic pathologist based in Georgia, testifies on the injuries suffered in the rollover and his belief that plaintiff’s paralysis was caused by striking the interior of the cabin during rollover.
During a 2020 Georgia product liability trial, Dr. Jonathan Eisentat, a Georgia forensic pathologist, testifies for the plaintiff regarding his claim that a defective seat and restraint system caused his paralysis after a big rig rollover.
Eisenstat begins by qualifying that his testimony will not be examining any body movements or biomedical mechanics. He also explains that his testimony will concern only the immediate area that the victim occupied in the cab of the truck since it was well documented that the victim was secured in by a seatbelt in his original seat when he was found and extricated.
The victim in this case had a large “V” shaped laceration in the left frontal region. The doctor points to a blood spatter in the truck interior, above the left driver’s side door and a crack in the roof panel there, to say that the laceration in this location of the head seems to correlate with this interior damage and the blood spatter. He emphasizes that his testimony does not include speculation on body movements within the vehicle, but instead deals only with the mechanism of injuries being caused by the victim striking or being struck by objects.
Having thus qualified his testimony in this way, Eisenstat launches into a discussion of the mechanism of injury for the fractures of the plaintiff’s neck. The two main forces involved here are compression of the spine from the top of the head towards the bottom of the spine and flexion of the neck with the chin pushed violently toward the chest. The bilateral “jumped facets” are bone structures within the cervical spine that have been forced out of their joints by the extreme, straight forward flexion of the head. If these flexion forces had been to one side or the other instead of straight forward, then only the opposite side facet would be dislocated, not both sides. The compression and flexion forces together caused the C6 vertebrae to fracture the C7 vertebra as it is smashed down on the lower vertebra at a bad angle. Since the thoracic vertebrae are more stable than the cervical vertebrae, it is the lower three, C5, C6, and C7 that are most commonly injured by these forces of compression and flexion, with the more stable first thoracic vertebra acting as a fulcrum in such a case. The expert concludes that the bilateral nature of this patient’s spine injury with “jumped facets” supports his contention that the injuries were caused by a blow to the top of the head.
Addressing the head laceration, the expert points out that this must have been caused by a blunt object that was a little narrow and this is consistent with the objects attached to the interior area above the left front door next to the blood spatter. Present there were a light and a coat hook that may have taken the brunt of the blow from the top of the driver’s head. These injuries are not consistent with any object coming from outside the vehicle, nor are the injuries consistent with something flying around inside the car and striking the driver. Alternatively, for an object within the vehicle to hit the top of the head hard enough to cause these injuries, the pathologist would expect to see a concurrent skull fracture and even brain injury with bleeding. He also points out that nowhere in the documentation or in those films taken at the scene, are any foreign objects noted, removed, or cleaned from the wound. This lack of evidence for other possible etiologies of the neck pathology, supports his contention that the injuries resulted from compression and flexion forces caused when the driver’s head hit the damaged area above the door.
Dr. Eisenstat’s testimony was easy to comprehend and was certainly on the attorneys’ minds when the case settled during a stay in proceedings.
Gary Gansar, MD, is residency-trained in general surgery. He served as Chief of Surgery and Staff at Elmwood Medical Center and on the Medical Executive Committee at Touro Infirmary and Mercy Hospital in New Orleans, LA. Dr. Gansar was Board Certified in general surgery while in active practice. He joined AMFS in 2015 as a Physician Medical Director.
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