The Expert: Dr. Maryanne Gaffney-Kraft, a medical examiner, on her autopsy of the toddler, Remington Walden, and her conclusion that he died from burns in the fire.
Testifying during a 2015 Georgia product liability trial, Dr. Maryanne Gaffney-Kraft, a clinical and forensic pathologist who performed the autopsy of a child killed in a motor vehicle accident, details her opinion that the child died from burns in the fire that occurred.
The plaintiffs claimed a faulty gasoline tank placement led to the explosion that ultimately killed the toddler. Notably, the doctor lays out her version of events and organizes the evidence to support this into four areas: findings at autopsy, toxicology reports, eyewitness reports, and positioning of the victim at the scene. She concludes that the child was alive after the impact of the accident and subsequently incurred incredible suffering as he was burned. “If it had not been for the fire, he would be alive right now,” she determines.
The autopsy revealed that the four year old had no hidden pathology that would have threatened his life, but he did have two major injuries. The first was a 100% body surface area burn with charring, and the second was a blunt force injury, breaking his right leg. The latter was survivable. The fact that there was significant hemorrhage around the broken femur implies that the child’s heart was beating and pushing blood to that area after the accident’s impact, so he was alive “for a few minutes” during the fire. There were no other blunt force injuries, including any forceful injury to his head.
The toxicology testing found that the carboxyhemoglobin blood level in this child was significantly elevated. This is a measure of how much poisonous carbon monoxide is in the bloodstream. The expert gives examples: a smoker might normally have a level of 5% and a person consistently inhaling carbon monoxide in a highly polluted city may have a level of 3 or 4%. Gaffney-Kraft explains that this toxicology report could be misleading because it reflects levels of 6.8% and 7.1%, which do not reach the lethal level of 8%. Yet, the doctor explains that these elevated carboxyhemoglobin levels are indeed significant because they indicate that the victim was breathing, and that he was breathing in carbon monoxide from the smoke from the fire. The expert testifies that she would expect a child living in a fairly rural area, as in this case, to have a carboxyhemoglobin level of less than 1%. The elevated but nonlethal levels imply that, although his death was not from carbon monoxide poisoning, it was in fact from the thermal injury to the child, which occurred while he was still breathing carbon monoxide from the fire.
The witnesses from the accident scene stated the child was screaming and trying to exit the vehicle. These reports were supported by pictures taken at the scene which clearly portrayed the purposeful movements of a body trying to escape a burning car. Taken together, the evidence explained by the pathologist clearly supported her view that the victim would not have died but for the explosion of the car.
The jury concurred, awarding $150 million, including $30 million for pain and suffering.
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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