Secondary Complications After Spinal Cord Injury: Legal Compensation in California

Secondary complications are medical conditions that arise as a direct consequence of spinal cord injury, rather than from the initial trauma itself. These complications occur because spinal cord damage disrupts the body's normal regulatory systems, affecting everything from circulation and sensation to immune function and organ control. The severity and type of secondary complications depend on the level and completeness of the spinal cord injury, with higher-level injuries (cervical and upper thoracic) generally creating more severe complications.

Unlike the primary injury, which occurs at the moment of trauma, secondary complications can develop days, weeks, months, or even years after the initial accident. This delayed onset makes them particularly challenging in personal injury litigation, as insurance companies often try to argue that these conditions are unrelated to the original accident. However, medical literature clearly establishes the causal connection between spinal cord injuries and their secondary complications. When pursuing a catastrophic injury claim in California, it's essential to work with attorneys who understand these medical complexities and can effectively demonstrate how secondary complications are a foreseeable and compensable consequence of the defendant's negligence.

The financial impact of secondary complications is staggering. A study published in the Journal of Spinal Cord Medicine found that treating pressure ulcers alone can cost between $20,000 and $150,000 per occurrence, with severe cases requiring surgical intervention costing significantly more. When you multiply this by the multiple complications that many SCI patients experience over their lifetime, the total cost can easily reach into the millions of dollars. This is why comprehensive life care planning and expert medical testimony are critical components of any serious spinal cord injury case in California.

Pressure sores, also called pressure ulcers, decubitus ulcers, or bedsores, are areas of damaged skin and tissue that develop when prolonged pressure cuts off blood supply to vulnerable areas of the body. For individuals with spinal cord injuries who have limited or no mobility and reduced sensation, pressure sores are an ever-present threat. These wounds typically develop over bony prominences such as the tailbone, hips, heels, and shoulder blades. What begins as a red, irritated patch of skin can rapidly progress through four stages, ultimately reaching bone and causing life-threatening infections.

The National Pressure Ulcer Advisory Panel estimates that severe pressure ulcers (Stage III and IV) have a mortality rate of up to 60% within one year of diagnosis, making them more deadly than many forms of cancer. Despite this, insurance companies routinely try to minimize the significance of pressure sores in settlement negotiations. In California personal injury cases, pressure sore treatment costs must be included in your damage calculation, including preventive measures required for life such as specialized mattresses, wheelchair cushions, and regular repositioning assistance.

Respiratory complications are the leading cause of death among individuals with spinal cord injuries, particularly those with cervical and high thoracic injuries. When the spinal cord is damaged at these levels, the muscles responsible for breathing may be partially or completely paralyzed. This results in reduced lung capacity, weakened cough reflex, and difficulty clearing secretions from the airways. The combination of these factors creates a perfect environment for pneumonia and other serious respiratory infections.

According to research published in the Archives of Physical Medicine and Rehabilitation, individuals with cervical spinal cord injuries are 20 times more likely to die from pneumonia than the general population. Respiratory complications often require mechanical ventilation, tracheostomy, aggressive pulmonary therapy, and frequent hospitalizations. Your personal injury attorney should work with pulmonologists and life care planners who can provide detailed testimony about the respiratory challenges your specific injury level creates. Whether your injury occurred in a pedestrian accident or workplace incident, these respiratory costs are fully compensable under California law.

Spinal cord injuries disrupt normal bladder function, leading to urinary retention, incontinence, or the need for catheterization. Urinary tract infections (UTIs) are among the most common complications following spinal cord injury, with studies showing that up to 80% of individuals with SCI experience recurrent UTIs. Left untreated or inadequately managed, these infections can ascend to the kidneys, causing pyelonephritis, kidney stones, renal failure, and life-threatening sepsis.

The management of neurogenic bladder requires a comprehensive, lifelong approach that may include intermittent catheterization, indwelling catheters, suprapubic catheters, or surgical interventions. In California personal injury litigation, urinary complications and their management must be included in your damage calculation, encompassing direct medical costs and the cost of supplies, medications, urological monitoring, and treatment of complications. Expert testimony from urologists is essential to demonstrate the full scope and cost of these complications.

Deep vein thrombosis (DVT)—the formation of blood clots in the deep veins of the legs—is a serious and potentially fatal complication of spinal cord injury. Studies show that without prophylactic treatment, up to 100% of acute spinal cord injury patients will develop DVT. These clots can break loose and travel to the lungs, causing pulmonary embolism (PE), which is fatal in approximately 10-20% of cases and is one of the leading causes of death in the first year following spinal cord injury.

Prevention and treatment of DVT in spinal cord injury patients require aggressive intervention, including anticoagulation medications, compression stockings, pneumatic compression devices, and in some cases, surgical placement of inferior vena cava filters. California law is clear that defendants are liable for all foreseeable complications of the injuries they cause. Your personal injury claim should include the full cost of DVT prevention and treatment. If you suffered your injury in a bicycle accident or rideshare collision, the at-fault party's insurance must cover these critical preventive measures and treatments.

Autonomic dysreflexia (AD) is a potentially life-threatening condition that can occur in individuals with spinal cord injuries at T6 or above. The body's autonomic nervous system responds with a massive, uncontrolled spike in blood pressure that can reach dangerous levels, potentially causing stroke, seizures, heart attack, or death. The symptoms include severe headache, profuse sweating above the level of injury, flushed skin, nasal congestion, and anxiety.

In California spinal cord injury litigation, the risk and management of autonomic dysreflexia must be factored into life care plans and damage calculations. This includes the cost of patient and caregiver education, blood pressure monitoring equipment, emergency medications, and the potential need for emergency medical care. For individuals with cervical or high thoracic injuries, AD is not a rare complication—it's an expected part of their medical reality that requires ongoing vigilance and management.

Spasticity—involuntary muscle contractions and stiffness—affects up to 70% of individuals with spinal cord injuries. Severe spasticity can be painful, interfere with function, disrupt sleep, and lead to contractures. Management requires a multi-faceted approach including physical therapy, stretching programs, oral medications, botulinum toxin injections, intrathecal baclofen pumps, and in severe cases, surgical procedures such as tendon releases or nerve blocks.

The lifetime cost of managing spasticity and preventing contractures can be substantial, including daily physical therapy, medications, medical devices, and surgical interventions. In California personal injury cases, these costs must be thoroughly documented and included in your claim. Whether your injury resulted from a distracted driving accident or other negligence, you're entitled to full compensation for spasticity management.

Chronic pain is one of the most challenging complications of spinal cord injury, affecting up to 80% of individuals with SCI. Neuropathic pain is particularly difficult to treat and is often described as burning, shooting, stabbing, or electric-shock sensations that can be constant or intermittent. The impact of chronic pain on quality of life cannot be overstated—it interferes with sleep, rehabilitation, social activities, and mental health.

In California personal injury litigation, chronic pain must be addressed both as a component of pain and suffering damages and as a source of ongoing medical expenses. The cost of pain management over a lifetime can be substantial, including medications, pain management specialists, interventional procedures, psychological counseling, and assistive devices. Your personal injury lawyer should work with pain management specialists who can provide detailed testimony. California law recognizes that pain and suffering is a legitimate and significant component of damages in catastrophic injury cases.

The psychological impact of spinal cord injury is profound and long-lasting. Studies show that up to 40% of individuals with SCI experience clinical depression, and anxiety disorders are similarly common. Depression and anxiety are medical complications that require professional treatment and significantly impact recovery and rehabilitation participation. Untreated depression is associated with poorer medical outcomes, including increased risk of pressure sores, infections, and rehospitalization.

California law recognizes psychological injuries as compensable damages in personal injury cases. Your claim should include the cost of psychological and psychiatric treatment, including therapy sessions, medications, and any necessary inpatient mental health treatment. Expert testimony from psychologists or psychiatrists who specialize in spinal cord injury can help demonstrate the causal connection between the accident and the resulting psychological complications.

Properly valuing a spinal cord injury claim in California requires a comprehensive understanding of both the immediate injury and all foreseeable secondary complications. A thorough damage calculation must include past and future medical expenses, preventive care costs, assistive devices, home modifications, attendant care, lost wages, and pain and suffering. Many personal injury claims fall short because attorneys focus primarily on initial medical treatment and fail to account for the lifetime of complications that lie ahead.

The foundation of any serious spinal cord injury claim is a comprehensive life care plan prepared by a certified life care planner with expertise in spinal cord injuries. California follows the collateral source rule, which means that compensation you receive from other sources doesn't reduce the amount the defendant must pay. While California caps non-economic damages at $250,000 in medical malpractice cases, there is no cap in other types of personal injury cases, including car accidents, truck accidents, and motorcycle crashes.

Not all personal injury attorneys are equipped to handle spinal cord injury cases. These cases are among the most complex and high-stakes in personal injury law, requiring specialized medical knowledge, access to top experts, substantial financial resources to fund litigation, and trial experience in catastrophic injury cases. An attorney who primarily handles minor car accident cases or slip-and-falls may not have the expertise or resources necessary to maximize the value of a spinal cord injury claim.

At Hurt Advice, our attorneys have extensive experience representing spinal cord injury victims throughout California. We understand the medical complexities of these cases, including the full range of secondary complications and their impact on our clients' lives. We work with the nation's leading experts to build comprehensive cases that account for every aspect of our clients' current and future needs. Contact us today for a free consultation. Visit our about page to learn more about our firm, or check out our client testimonials and case results.