Ricardo v. Leiber – DUI Accident Results in Multiple Catastrophic Injuries
DARREN O. AITKEN, ESQ. (SBN 145251)
3 MACARTHUR PLACE, SUITE 800
SANTA ANA, CA 92707-2555
(714) 434-1424 Telephone
(714) 434-3600 Facsimile
Attorneys for Plaintiffs,
FREDRICK J. RICARDO and
SUPERIOR COURT OF THE STATE OF CALIFORNIA
FOR THE COUNTY OF LOS ANGELES
FREDRICK J. RICARDO and ALICE RICARDO, Plaintiffs,
JED LEIBER and DOES 1-10, inclusive, Defendants.
CASE NO.: BC539357
JW CASE NO.: A206378-02
Assigned for all purposes to:
The Honorable Teresa Beaudet
PLAINTIFFS’ MEDIATION BRIEF
Date: June 17, 2015
Time: 9:00 a.m.
Location: 1851 East First Street, Suite 1600, Santa Ana, CA
Mediator: Troy D. Roe, Esq.
Complaint Filed: March 17, 2014
Trial Date: September 17, 2015
On December 27, 2013, at approximately 2:15 p.m., Defendant, Jed Leiber was driving a Mercedes Benz at an excessive rate of speed while intoxicated, lost control of his vehicle and began drifting to the right of the roadway where he struck Plaintiff, Fredrick Ricardo. Mr. Leiber fled the scene of the accident.
Liability is clear. Jed Leiber’s conduct is so aggravated that the imposition of punitive damages would be warranted should this matter proceed to trial.
The injuries sustained by Fredrick Ricardo were devastating. As a result of being hit by the Leiber vehicle, Mr. Ricardo (then aged 80) suffered a number of severe, life-threatening injuries. Mr. Ricardo’s initial injuries were a right “T-shaped” acetabular fracture with significant posterior column displacement, related internal bleeding and a large hematoma. (In essence, Mr. Ricardo sustained a pelvic injury involving the “cup” socket of the pelvis that forms part the hip “ball and socket” joint.) Once this condition was diagnosed, Mr. Ricardo quickly developed multiple blood clots that caused severe swelling to both of his legs and feet. The formation of these blood clots was unpredictable, and they migrated to other parts of this body. Devastatingly, these blood clots led to strokes that have created permanent cognitive impairments, including memory loss and the inability to follow a train of thought. The cognitive impairments also, at times, cause Mr. Ricardo to become paranoid and irrational, greatly complicating his physicians’ and family’s efforts to care for him and robbed Mr. Ricardo of his previously dignified demeanor. As Mr. Ricardo’s occupational therapy helped his recovery from the strokes, he has become more aware of the horrors he and his family have had to suffer.
Mr. Ricardo has been unable to walk independently or drive since December 27, 2013. He has endured months of bed confinement. While he can walk short distances with a walker, he requires a wheelchair if he is required to travel more than a couple hundred feet. Mr. Ricardo must be monitored during basic toileting and showering needs. He is at a constant risk of falling, despite extensive home modifications. The stroke-related cognitive deficits have made his care quite difficult as his judgment is impaired, and at times, Mr. Ricardo can become uncooperative.
Unfortunately, due to the blood clot risks, and the blood thinning medication Mr. Ricardo is required to take, Mr. Ricardo was not able to undergo the surgery required to fix his broken hip. Mr. Ricardo’s physicians have currently decided against the revision surgery at the present time due to the mortality risks, therefore, robbing Mr. Ricardo of any hope to restore independent mobility in the near future. Unfortunately for Mr. Ricardo, fractures of the acetabulum are harder to treat because access to this bone is more difficult, and because of the acetabulum’s proximity to the major blood vessels to the legs, the sciatic nerve, the intestines, the ureter and the bladder. Unlike a hip fracture, which can be treated relatively easily, to repair an acetabular fracture, the orthopedic surgeon, must, in essence, fix the broken bones from the inside out. Patients with acetabular fractures often require an Open Reduction with Internal Fixation (ORIF), especially those patients who also have displacement of the joint such as Mr. Ricardo. In this surgery, the physician realigns or reduces the bones as precisely as possible to prevent the development of post-injury related problems, especially arthritis. The bones are rigidly fixed with plates and screws to prevent future displacement and allow for rehabilitation to begin as quickly as possible. This intricate surgery requires a degree of health that Mr. Ricardo has not been able to achieve. Instead, Mr. Ricardo’s doctors are opting to perform a total hip replacement when one becomes necessary due to the continued degeneration of the damaged pelvis.
At the time this collision occurred, Fredrick Ricardo drove he and his wife, Dena, from their home in Huntington Beach, California, to a cousin’s home for a holiday open house. The Ricardos, turned left onto Laurel Canyon Boulevard and parked on the street in front of the apartment building located at 4200 Laurel Canyon Boulevard. They parked in front of a white colored work truck. Dena exited the vehicle from the passenger side, and waited for her husband on the sidewalk. Fredrick exited from the driver’s side and retrieved some presents from the seat behind the driver’s seat. He then began walking along his car towards the front end so he could walk across the front of his vehicle and onto the sidewalk. At that moment, and without warning, the vehicle driven by Jed Leiber came up quickly behind Mr. Ricardo, first striking the white work truck and then ramming Fredrick Ricardo’s body. The side view mirror from Mr. Leiber’s vehicle broke off, the electrical wires wrapped tightly around Fredrick Ricardo neck and the mirror smashed into Mr. Ricardo’s face, as Mr. Leiber’s vehicle pushed Mr. Ricardo into the door of his Lexus SUV. Mr. Leiber fled the scene without stopping to aid Mr. Ricardo.
With the help of witnesses to the collision identifying and chasing the Leiber vehicle, the police were able to locate and apprehend Mr. Leiber within a few miles. Upon questioning Mr. Leiber, the police detected that he was under the influence of mind altering substances and he was arrested. Mr. Leiber has since been charged with violations of a number of sections of the California Vehicle Code, including: Section 23152(a) – driving under the influence of a controlled substance; Section 22350 – driving at a speed greater than what is reasonably prudent for the conditions; and Section 21658 – failing to drive within a single lane. Defendant was also arrested for being in violation of Section 23153(a) – driving under the influence of a controlled substance and causing bodily injury to any person other than the driver.
A. Medical Course
As a result of this collision, Fredrick Ricardo suffered a number of devastating injuries that have completely destroyed his quality of life. Prior to the collision, Mr. Ricardo was an active, vibrant man, completely independent in all activities. He enjoyed the company of his friends and family and worked up until several months prior to the collision. This made a dramatic change when he was violently struck by the Defendant, Jed Leiber’s vehicle.
Paramedics were summoned to the scene, and upon arrival, Mr. Ricardo was lying on the sidewalk, with obvious head and oral trauma. He had been unconscious for approximately 6-7 minutes, and had a Glasgow Coma Scale (GCS) score of 3 out of 15. Two IVs were placed and he was placed on an oxygen rebreather mask with an improvement in his GCS to 14/15 (minus one in verbal component). He was, however, amnesic to the event, described as confused and perseverating at times. Based on the mechanism of injury, he was designated a critical trauma and taken by advanced life support to Cedars Sinai.
Upon admission to the emergency room, Mr. Ricardo was noted to have multiple contusion and abrasions to the head (nose, mouth) arms, and knees. He complained of significant pain in the right hip and low back. Within seventeen minutes of arrival, Mr. Ricardo became hypotensive with his systolic blood pressure dropping to the 50s, for which a massive blood transfusion was initiated (total of 9 units of packed red blood cells, 3 units fresh frozen plasma, and 1 unit of platelets). He was taken emergently to interventional radiology for a pelvic angiogram in order to find the location of the bleed. He was found to have a gluteal artery injury that was treated with coil embolization. Thereafter, he was taken to the intensive care unit where he again became hypotensive and unresponsive, and was intubated. A CT scan of the pelvis demonstrated continued active extravasation in the pelvis, so he was taken back to interventional radiology where he underwent a second embolization procedure involving the right hypogastric artery, the main artery to the pelvic region.
Diagnostic testing revealed complex right pelvic and acetabular fractures, as follows: right obturator ring fracture involving the inferior ischium and pubic symphysis. The fractures were deemed unsafe to be operated on given the placement of the coils near the fracture site. This injury is consistent with being struck by a vehicle as it caused by the femoral head being driven through the acetabulum as a result of a high energy blow. Unfortunately, patients with fractures of the pelvis and/or acetabulum, almost always also experience serious injury to surrounding soft tissue (skin and muscles) and neurovascular structures (nerves, arteries and veins), and this was the case with Mr. Ricardo.
A large pelvic sidewall hematoma had developed adjacent to the quadrilateral fracture, within the deep right sciatic notch, presacral space and beneath the rectus abdominis. The hemorrhage extended into the right gluteal musculature, medial thigh and right hip/proximal femur, where there was extensive soft tissue swelling. The mass effect of the hematoma caused the bladder to move forward and to the left. Mr. Ricardo had lost a tremendous amount of blood due to the internal bleeding and he had to be transfused. Mr. Ricardo’s physicians at Cedars-Sinai determined that he would need a right hip replacement after four to six weeks of physical therapy. Due to the extent of Mr. Ricardo’s vascular injuries, the hip surgery would have to be put on hold until these injuries healed. During this entire period, Mr. Ricardo was disoriented and in extreme pain.
He was also noted to have fractures of the left ribs, 5-9.
Mr. Ricardo remained in the intensive care unit where he was in severe pain, requiring Dilaudid via a pain pump. He was unable to sit up due to the pain and coughing was intolerable. An epidural catheter was eventually placed due to the intense pain, especially from the pelvis and rib fractures.
Mr. Ricardo’s right leg was noted to be shortened and externally rotated. Due to increasing right knee pain and swelling, a hinged brace was applied with 0-90 range of motion. An x-ray of the right ankle revealed possible small avulsion fractures. As movement resulted in excruciating pain, Mr. Ricardo remained essentially immobile, positioned in a flat or semi-upright configuration with a foam cushion placed on his sacrum. He required maximal assistance with overall bed mobility and transfers, and was completely unable to walk. Due to his sedentary state, he was started on medication to prevent blood clots, as well as another to improve his urinary flow.
Cognitively, Mr. Ricardo remained mildly confused with some tangential thinking and nonsensical comments. He was noted to be hyperverbal and required moderate re-direction to remain focused on task and conversation at hand. He was also highly anxious and fearful with movement. Testing revealed that he was 40-50% impaired; therefore, continued care was recommended at a skilled nursing facility.
On January 7, 2014, Mr. Ricardo was transferred to Beachside Care, a rehabilitation facility, in order to get stronger prior to repair of the complex acetabular fracture. A five person lift, using a draw sheet, was required to transfer him from the bed to the gurney on which he was transported as he was still unable to tolerate an upright position. A hip brace was eventually placed.
Mr. Ricardo continued to require narcotic analgesics for pain, including a Fentanyl patch. Physical therapy was held for several days until the pain was felt to be under control. He was felt to be physically and mentally unable to self-administer the medication. He was not alert or oriented to person, place, time and events, and had periods of confusion and forgetfulness. His rehabilitation potential was considered poor.
On January 14, 2014, after undergoing physical therapy, Mr. Ricardo became unresponsive. He turned pale and diaphoretic, and his eyes fluttered. His breathing was labored, with shallow respirations and decreased oxygen saturation to 83%. Ten liters of oxygen on a rebreather mask was initiated. His blood pressure dropped to 100/60. 9-1-1 was called and Mr. Ricardo was transferred urgently to Huntington Beach Hospital. En route, paramedics were initially unable to obtain a blood pressure. Mr. Ricardo was supposed to be taken directly to Hoag Hospital but was instead first taken to Huntington Beach Hospital because the ambulance staff deemed Mr. Ricardo’s situation to be too dire, stating that “he would not live” if he were to travel the extra eight miles to Hoag Hospital.
Upon arrival to the emergency room, Mr. Ricardo remained hypotensive with a blood pressure of 71/26 despite three liters of fluid. He was also hypothermic. Neo-synephrine was initiated to increase his blood pressure and a central venous catheter was placed in his chest. A cardiology consult was ordered due to an abnormal EKG with a rapid heart rate and conduction abnormality. A chest x-ray revealed an enlarged heart and a possible widened mediastinum. Breath sounds were absent in the right base, which was noted to be incompletely inflated, and arterial blood gases were abnormal. A CT scan of the chest demonstrated massive, bilateral pulmonary emboli, with partially occluding clots involving the peripheral branches of the right and left main pulmonary arteries, extending to the branches supplying both lower lobes. Clots were also noted in the left femoral vein. Severe right heart failure was also evident by the reflux of contrast from the right atrium to the inferior vena cava.
Given the gravity of his condition, Mr. Ricardo was transferred to Hoag Hospital for a higher level of care. There, multiple consultations were obtained from pulmonology, nephrology and neurology due to the saddle emboli and resultant heart failure, shock, acidosis, and renal failure. Immediate mechanical suction and aspiration of the pulmonary arteries was performed and a filter was placed in his inferior vena cava (IVC filter) in order to prevent further blood clots. Mr. Ricardo was noted to have become tremorous and was cool to the touch during the nearly four hour long surgery.
During the hospitalization, Mr. Ricardo was obviously short of breath, being unable to speak in complete his sentences. His speech described as garbled. He was also noted to be progressively confused and disoriented, with intermittent rambling speech and word finding difficulty. He attempted to communicate his concerns regarding pain in his right leg and foot, and difficulty with bed mobility, but was unable. He also could not remain focused on the therapeutic exercises and at times, even required assistance to eat. As a result, an MRI of the brain was ordered and revealed that Mr. Ricardo had suffered a stroke.
After consultation by neurologist, Jason Muir, M.D., a speech therapy evaluation was performed on January 27, 2014, reflecting that Mr. Ricardo was grossly disoriented. He was aware of the accident but unaware of the recent pulmonary embolism. He understood that he had had a stroke and was aware of his disorientation, stating that he was “unsure of what is going on.” He had difficulty expressing his thoughts and determining his wants or needs. His responses were delayed and he had difficulty responding to moderately complex questions. Topic maintenance was difficult and he frequently went on tangents. He was able to discuss family and personal events with occasional hesitations and revisions, and benefitted from redirection to remain on task. Further therapy was recommended.
During the interval period of time, Mr. Ricardo was returned to the Intensive Care Unit due to continuing active blood loss and hemodynamic instability for which an additional 8 units of blood were transfused. His heart rate remained rapid and he continued to pass blood tinged clots. A chest x-ray revealed a new, large mass, likely due to the enlargement of the right pulmonary artery as a result of the embolism. Pleural effusion and an area of opacity had also developed in the right mid and lower lung. Due to the development of an oxycillin resistant MRSA urinary tract infection, he was placed in isolation. He was critically ill and at risk for cardiopulmonary and neurologic decompensation. He was in a difficult situation; the doctors were trying to treat a terrible pulmonary embolism, while also trying to prevent bleeding.
On January 29, 2014, Mr. Ricardo was transferred to Crystal Cove Care Center a skilled nursing facility, for further rehabilitation. Decreased concentration was noted secondary to anxiety. He rated his pain 10/10 when the hip area was moved. He was described as deconditioned diffusely.
On February 19, 2014, Mr. Ricardo was evaluated by orthopedic hip specialist, Nader Nassif, M.D., of Newport Orthopedic Institute. He was noted to have exquisite pain with internal and external rotation of the hip such that the doctor was unable to get Mr. Ricardo up to the examination table. He remained in a wheelchair with his right knee in an immobilizer, with noted swelling. The knee exam was very limited due to severe pain. Mr. Ricardo was unable to actively extend his knee and there was pain with movement of the tibia. Mr. Ricardo was also unable to dorsi or plantar flex his right ankle. He could not tolerate some of the positioning for certain x-rays that were ordered.
Dr. Nassif diagnosed a displaced right acetabular fracture and a right knee injury, with concern for possible multi-ligamentous damage. He referred Mr. Ricardo to Dr. Eric Johnson at UCLA for open reduction and internal fixation surgery. It was felt to be a complicated case considering the chronicity of the fractures as well as the vascular complications. It was felt that addressing the acetabular fracture should be paramount to the knee, treatment for which would follow.
Mr. Ricardo returned to Crystal Cove where he continued to manifest bilateral lower extremity swelling, particularly on the left, which was rated up to 4+. On February 21, 2014, a venous ultrasound revealed a positive deep vein thrombosis.
The following week, on February 28, 2014, Mr. Ricardo was urgently returned to Hoag again due to rectal bleeding, for which another five units of blood were transfused. He had passed large, bright red clots and was again hemodynamically unstable, with his hemoglobin dropping as low as 6.9 and his blood pressure to 94/63. His heart rate was rapid and an EKG was abnormal, suggesting a posterior infarct. He was admitted to the Intensive Care Unit where aggressive IV fluid resuscitation was ordered along with gastrointestinal and cardiac evaluations. An endoscopy revealed mild gastritis while a colonoscopy showed a duodenal ulcer.
A pulmonary CT Angiogram showed that there was no additional residual pulmonary embolism, however, a doppler of the lower extremities demonstrated clots in both legs. An extensive clot, with complete occlusion, was seen in the right lower extremity, from the external iliac vein to the popliteal vein, with another occlusion in the peroneal vein. Partial occlusion was seen in the left lower leg, from the external iliac vein to the distal tibia.
Cognitively, Mr. Ricardo also remained disoriented, confused, and forgetful, with noticeable deficits in his long term memory. He could not recall why he had an immobilizer on his leg or if he had had any therapy. He was only able to follow single step instructions 50% of time and had delayed response with complex commands. His judgments regarding self and safety were significantly impaired.
Mr. Ricardo was discharged back to Crystal Cove on March 5, 2014. On April 2, 2014, he was evaluated by Eric Johnson, M.D. at UCLA who further documented the persistent displaced acetabular fracture, with significant posterior column displacement and protrusion of the femoral head. On exam, the residuals from the stroke were apparent, with decreased motor control noted in the right foot. Dr. Johnson was to consider surgery once Mr. Ricardo was medically stable.
Mr. Ricardo continued to experience pain and swelling in his legs, right worse than left. On April 11, 2014, he was returned to Hoag hospital due to swelling at a rate of 3+ on the right, from just above the knee to the foot. Swelling in the left leg was rated at a 2+. Ultrasonography continued to demonstrate the bilateral blood clots, for which blood thinners were attempted again. Mr. Ricardo’s liver enzymes were also elevated.
On April 12, 2014, Mr. Ricardo was admitted to Victoria Healthcare where he continued to undergo rehabilitation with physical and occupational therapy five days weekly. When Mr. Ricardo was discharged from Crystal Cove, he weighed 157 pounds, down from his previous weight of 180 pounds. He continued to have a fluctuating capacity to understand and make decisions. He required moderate assistance with problem solving. He perseverated on things and required redirection to participate in therapy.
Mr. Ricardo continued to be weak, requiring maximal assistance with bed mobility and transfers. He only had fair sitting balance and his standing balance was poor, preventing gait testing or therapy. His pain remained moderate to severe, particularly with therapy, rated from 6-9 on a ten scale. Mr. Ricardo’s progress was also limited secondary to decreased cognition. He required many verbal cues for safety due to forgetfulness.
Mr. Ricardo suffered a fall on April 30, 2014. Although an x-ray did not reveal any new fractures, his pain was exacerbated to the point that he resumed the need for maximal assistance for bed and functional mobility, and transfers. An MRI performed on May 2, 2014 at UCLA revealed new areas of hemorrhage in the right gluteal musculature. Surgery was further postponed until the hemorrhage cleared. Mr. Ricardo remained on anti-coagulants, requiring injections twice daily.
Mr. Ricardo was subsequently transferred to Sunflower Gardens for further skilled nursing care. He remained in a wheelchair as he was not able to bear any significant weight on his right leg, which also needed to be moved with caution due to the fractures and exquisite pain. He was extremely weak and continued assistance was required for transferring in and out of bed, dressing, bathing, personal hygiene, toileting, and generally in order to get around the facility. Special observation was also indicated due to confusion, forgetfulness, and overall wandering.
On August 13, 2014, repeat x-rays were performed at UCLA, reflecting healing of the displaced acetabular fracture. Dr. Johnson felt that Mr. Ricardo was ready to begin partial weight bearing and right hip muscle strengthening. As for surgery, Dr. Johnson opined that the pelvis/hip was unsalvageable as a reconstruction and that a total hip replacement would be required, utilizing at least two plates. Given the surgery risk, surgery was not scheduled nor has it been pursued to date. Ultimately, as the hip area continues to degenerate, a total hip replacement surgery will be performed.
Mr. Ricardo continued to experience significant pain and weakness that prevented normal activity. His legs swelled and he had significant pain in his right calf. His joints were painful and had limited mobility. His muscles ached from prolonged disuse. He remained overall deconditioned and weak, with an unsteady gait.
Emotionally, Mr. Ricardo was anxious and depressed. His sleep was disturbed. Neurologically, he continued to be forgetful and his speech was impaired. He often had episodes of disorientation.
Mr. Ricardo was evaluated by vascular surgeon, Ehab Mady, D.O. on September 15, 2014, who recommended continued anti-coagulation due to the increased risk of recurrent blood clots. He was also to continue wearing compression stockings and elevate his legs. Potassium was prescribed to offset the loss from the diuretics required to control the swelling.
On September 30, 2014, Mr. Ricardo was transferred to Huntington Valley for further rehabilitation. He began weightbearing with assistance but continued to be plagued by pain in the right hip and knee. Disuse atrophy of both of the thighs and calves persisted. He was required to use a trapeze to maneuver in bed.
Due to persistent swelling in his legs, a repeat ultrasound was performed on October 6, 2014, revealing wall thickening of the common femoral veins, likely scarring from the prior blood clots.
October 15, 2014, he began to start self-administration of Lovenox under supervision while at the skilled nursing facility. Within two weeks, he became increasingly uncomfortable with injecting himself in the stomach twice daily since the process was quite painful.
Although Mr. Ricardo was undergoing therapy, he remained in bed over 50% of the time. With increase in physical activity, his pain and anxiety escalated. He also experienced increased cramping in his legs and swelling in his joints. Due to weakness, he experienced episodes of dizziness.
Mr. Ricardo was eventually discharged home from Huntington Valley on December 31, 2014, over a year following the collision. The discharge was bittersweet. While he was home again after a year of being hospitalized, his mobility remained limited and further therapy was required. He required a cane or a walker to ambulate, and continued to have stiffness and reduced range of motion of the right hip and leg. Pain in the hip and right foot was significantly limiting. He continued to be significantly fatigued and experienced shortness of breath on exertion. Swelling persisted in his legs and feet, for which he continue to wear compression stockings. A repeat ultrasound performed on January 14, 2015 continued to reveal persistent wall thickening of the bilateral common femoral and superficial veins. Lab work revealed ongoing anemia.
Mr. Ricardo continued to experience swelling in his legs for which another ultrasound was performed in April of 2015. Chronic, non-occlusive thrombi persisted, involving the common femoral and distal femoral veins bilaterally, with abnormal deep venous reflux. As a result, it is anticipated that he will continue to require anti-coagulation because of the risk of internal bleeding. Mr. Ricardo and his family were informed that the only way to alleviate the foot and leg swelling due to water retention was for Mr. Ricardo to stand, but he was unable to do so due to his broken pelvis. Despite experiencing a great deal of pain, Mr. Ricardo was unable to take pain pills as he was bedridden and the medications adversely affected his ability to breathe and digest food.
B. Economic Damages
Since being struck by Mr. Leiber on December 27, 2013, Mr. Ricardo spent over a year in medical care centers—either hospitals due to acute medical needs, or in rehabilitation facilities recuperating from his injuries. He has since returned home, but he requires a great deal of active medical management. The total economic damages that have been incurred by Mr. Ricardo, both past and future, are conservatively estimated at no less than $1,250,000.
Over the past year, Mr. Ricardo’s health care providers have billed well over $1,500,000 for Mr. Ricardo’s care. Mr. Ricardo’s medical insurer, AARP Medicare, has paid over $160,000 on behalf of Mr. Ricardo to date to cover medical care and drug prescription costs, and Mr. Ricardo and his family have incurred over $97,000 in out of pocket expenses to cover his facility care, physical therapy expenses, co-payments, deductibles, medical equipment costs (such as a hospital bed), and many other related expenses. (See the AARP “Explanation of Benefits” documents attached hereto as Exhibit D and the AARP prescription drug “Part D” chart attached hereto as Exhibit E that outline the insurance payments and co-payments made by and on behalf of Fredrick Ricardo during the 2104 calendar year. Also see the “Trust Account Monies Log” attached hereto as Exhibit F which outlines further injury related out-of-pocket payments made by the Ricardo family directly for Mr. Ricardo’s care.) UPDATE THIS
Despite Mr. Ricardo’s return to his home, his permanent physical and cognitive deficits will require 24 hour attendant care. This care is currently being provided by his extended family on a volunteer basis. As per the preliminary life care plan by Doreen Casuto, RN, attached hereto as Exhibit___, the cost of this care will be no less than $115,000 per year. Beyond the cost of attendant care, it is likely that Mr. Ricardo will require no less than $25,000 per year in related medical care and medical equipment over the course of his expected life. Mr. Ricardo has also had extensive dental damage due to the Incident that will cost no less than $10,000 for Mr. Ricardo to endure the painful procedures for complete repair.
On the date this incident occurred, Mr. Ricardo had recently left his longtime position as a Senior Broker for Monex International, a leading bullion dealer in the United States. Mr. Ricardo intended to resume his professional activities in January 2014 after the holiday season was over. Mr. Ricardo enjoyed working, and looked forward to resuming his career and working for at least another five years. Once he resumed working, Mr. Ricardo would be expected to have earned no less than $50,000 per year. Dues to his injuries, however, Mr. Ricardo will no longer be able to resume employment, thereby incurring income losses of no less than $250,000. Beyond this monetary loss, however, is the loss of purpose and self-esteem that Mr. Ricardo will endure by being unable to be gainfully employed. Like so many of his generation, Mr. Ricardo has a strong work ethic, and he remained productive in the work force well beyond the standard “retirement age.” Providing for his family was a core value of his, and he fully intended to resume working in January 2014 before this incident robbed him of his ability to do so. The loss of his career, therefore, created both a substantial emotional, as well as economic, loss.
C. Non-Economic Damages
Obviously, this incident has completely destroyed the quality of Mr. Ricardo’s life. Before this incident, Mr. Ricardo was an active, vibrant man. He was completely independent in all activities, and enjoyed the company of his friends and family. Attached as Exhibit _______ hereto are some photographs showing Mr. Ricardo as a young serviceman, a successful bullion dealer with his co-workers, and at a recent work-related birthday celebration. As a contrast, we have also attached as Exhibit _____ a more recent photograph, showing the badly injured Mr. Ricardo on his way to a painful physical therapy session. The contrast in regard to Mr. Ricardo’s health and vitality could not be clearer.
As a result of his injuries, Fredrick Ricardo can no longer drive, work, walk independently, or use the bathroom without fear of falling and further injury. The deficits stemming from his broken pelvis continue to limit his mobility, and he has been in and out of hospitals and/or healthcare facilities since the incident. Due to the stroke caused by the blood clots he developed from the injuries he sustained in the incident, Mr. Ricardo has poor recall and pronounced short term memory deficits. He has also become emotionally labile, and is often paranoid or combative. These emotional changes obviously have taken a great emotional toll on Mr. Ricardo personally, as well has his wife and family. Mr. Ricardo needs special equipment such as a wheelchair, a special toilet, portable urinals, dressing equipment, showering equipment including a shower chair, a special mattress for sleeping, special shoes and clothing.
During his extended hospitalization period, a number of near death medical emergencies occurred due to strokes and blood clots. Furthermore, in January 2014, Mr. Ricardo’s son noticed that Mr. Ricardo’s mental status was declining. Mr. Ricardo was unable to finish his sentences or convey many of his thoughts. Mr. Ricardo’s family was informed by the health care providers at Crystal Cove that Mr. Ricardo’s stroke had caused confusion, psychosis, dementia and paranoia. Mr. Ricardo became extremely frustrated with his inability to convey thoughts. Since the initial stroke, Mr. Ricardo has had difficulty finishing thoughts or providing direction, especially if there is any external noise or talking by other people. Mr. Ricardo also became extremely depressed and lost a considerable amount of weight due to his inability to eat. His care was complicated by the fact that Mr. Ricardo could not be put on anti-coagulants because of the risk of internal bleeding. Mr. Ricardo and his family were informed that the only way to alleviate the foot and leg swelling due to water retention was for Mr. Ricardo to stand, but he was unable to do so due to his broken pelvis. Despite experiencing a great deal of pain, Mr. Ricardo was unable to take pain pills as he was bedridden and the medications adversely affected his ability to breathe and digest food.
Mr. Ricardo’s diminished mental condition continued to create issues for both Mr. Ricardo and his family. Before this incident, Mr. Ricardo had always prided himself on his appearance, and he was rarely seen not wearing a suit and tie, even after work at the dinner table. Mr. Ricardo has been known for his polished business attire style since the 1950’s, and with his stylishly feminine wife, they had built their own flavor of humor with each other. Before the incident they were enjoying a lively marriage for over a half-century and were looking forward to many more adventures and travels. After the incident their roles in each other’s lives have completely changed from an energetic married couple to patient and caregiver.
For weeks and months at Crystal Cove, Mr. Ricardo resisted all attempts to clean him or change his dirty and stained clothes based on his fear he would be “thrown out onto the streets” if he made a nice appearance. The loss of his pride in his appearance was entirely out of his previous character and very upsetting to his family. In addition, Mr. Ricardo’s inability to have a normal conversation due to not staying on point and making bizarre comments was very tough for his family to take. While Mr. Ricardo exhibits unexpected changes, Mrs. Ricardo tries to maintain her upbeat personality and appearance but the stress has taken its toll. Mrs. Ricardo is exhausted from also dealing with her body’s stress reaction of bubbling and bleeding skin on her arms and hands after each of her husband’s medical episodes.
At each hospital or medical facility, Mr. Ricardo’s extreme worries and/or stroke induce paranoia added to the already time consuming tasks medical personnel were directed by doctors to perform. Many times daily tasks like painful transfers from his bed to his wheelchair or taking his medication would not be performed at all unless his wife, a family member or close friend were on hand to talk him through completing the task. Mrs. Ricardo became extremely exhausted from the stress of her husband’s added emergency situations, knowing she could very well lose her husband any day, and from the need for her to awake every morning to prepare for her dismal travels to another healthcare facility to help her husband with his daily needs. Over a dozen family and friends have taken shifts helping Mr. Ricardo in order that Mrs. Ricardo is able to rest.
In addition, Mr. Ricardo missed the birth of his first great-grand child on February 6, 2014 and was not able to meet his great-grandson until Mother’s Day 2014, due to his poor health and his contagious MRSA infection that he contracted from the urinary catheters he had to have inserted during his bedridden emergency hospital stays. Mr. Ricardo feels that he has missed out on his great-grandson’s first months and only gets to see him a few times a month, instead of weekly which would have been the case.
Mr. Ricardo regularly endures painful physical therapy so that he can have some independence in his activities of daily living, including the ability to go to the bathroom on his own. He hopes to be able to get in and out of his bed safely and without assistance, and be able to move around his own home in a safe, comfortable manner. While these goals are far removed from the active life he led before his injuries, Mr. Ricardo endures the daily suffering that therapy entails so he may recapture as much independence, privacy and personal dignity as his severely damaged body will allow. Since hip repair surgery has been ruled out, Mr. Ricardo will never be able to regain independent mobility or true independence. He will never be able to walk more than a few yards or drive himself. In large measure, Mr. Ricardo is now a prisoner in his own home, and completely relies on others from transportation and safety assistance. He needs his food prepared for him and spends the majority of his time in front of the television propped up on a sofa.
Mr. Ricardo remains dependent on the help of others in his daily activities. This level of dependence is very hard on Mr. Ricardo who, before this incident, was a very independent man who prided himself on helping others. Some of Mr. Ricardo’s care needs include, but are not limited to, helping manage foods he is able to eat, talking him into taking his medication when the medical staff needs their assistance, feeding him, give him drinks of water or juice, picking up soiled clothes to be laundered, bringing clean clothing, get warm blankets when needed, attending doctor appointments with Mr. Ricardo to help with transportation and/or communication, attending numerous meeting with the different hospital medical personnel and doctors, setting up doctor and specialist appointments, scheduling wheelchair transportation to many doctor’s appointment, working with complex medical insurance and billing issues, attending physical therapy sessions, attending horrific and disturbing medical procedures and much more. For example, Mr. Ricardo’s wife and their son tried to comfort Mr. Ricardo as medical staff performed a procedure where a large appendage-like blood masses travel through Mr. Ricardo’s catheter while Mr. Ricardo writhed in pain.
(Alice “Dena” Ricardo)
Mr. and Mrs. Ricardo have been married since March 1957. They have three adult children together, grandchildren and, most recently, a great grandchild.
As a result of his disabling injuries, the Ricardo’s married life has been irrevocably damaged. Formerly, Mr. Ricardo was an active, healthy man who shared a full life with his spouse. The Ricardos previously enjoyed a weekly romantic date nights where they would get dressed up and go out to eat or to a play. Mr. and Mrs. Ricardo are also known for their dancing abilities. In addition, the Ricardos used to socialize regularly at their home with a number of close family members and friends. All of this stopped on December 27, 2013.
As indicated above, Mr. Ricardo can no longer drive, work, walk, or even use the bathroom without help. He needs total assistance for all activities of daily living. Sex is no longer part of their lives, and all private affection between the two of them has stopped. Mrs. Ricardo must help him eat so no further weight loss occurs. Mrs. Ricardo commuted daily from her home to the hospital and spent the majority of her waking hours there. All of the extended family have spent birthdays and other holidays in the various healthcare facilities to allow Mr. Ricardo’s participation at such events.
All household chores that were once the province of Mr. Ricardo now must be completed by Mrs. Ricardo. These tasks include watering the front and back yards; gardening and pruning of their citrus tree; filling and cleaning the pool; carrying heavy items and groceries; taking out the house trash; and taking the three large garbage cans to the curb and putting them away on a weekly basis. Many shared tasks, such as laundry, house cleaning and cooking, are now solely her responsibility. Many important “little things” have been lost. For example, Mr. Ricardo would fix Mrs. Ricardo breakfast on a daily basis and would bring it upstairs to the bedroom so that she could take her daily medications. All of this additional responsibility, in conjunction with the stress associated with caring for an injured spouse, has left Mrs. Ricardo exhausted and has disrupted her sleep patterns.
Most crucially, Mrs. Ricardo has lost the person that was her husband. Since his stroke, their conversations are now different in that Mr. Ricardo often cannot complete a thought or story without losing track of what he was going to convey. At times, he acts strangely and inappropriately. Instead of the loving spouse and life partner she once was, Mrs. Ricardo has become Mr. Ricardo’s caretaker because he is both physically and mentally dependent on her.
In addition to the loss of consortium described above, Mrs. Ricardo also has a significant claim for the negligent infliction of emotional distress (Dillon v. Legg). Mrs. Ricardo witnessed firsthand the entire terrifying string of events leading to her husband’s near death experience.
Horrified, Mrs. Ricardo saw her husband try to prop himself up on the side of the car. There was a gash across his nose, and his face was covered in blood. The electrical wires from the side view mirror of the Leiber Mercedes were wrapped around Mr. Ricardo’s neck, and the mirror itself was dangling from his chest.
Mrs. Ricardo ran into the street to the aid of her husband. She attempted to assist him in hobbling towards the front of the vehicle so he could make it to the sidewalk, but Mr. Ricardo quickly collapsed due to his injuries and the pain. Mrs. Ricardo pulled her husband out of traffic on Laurel Canyon Boulevard and into the space between the front of their vehicle and the vehicle parked ahead of them. Mrs. Ricardo held her husband’s blood covered face and head up to prevent him from being struck by the oncoming traffic.
Mrs. Ricardo watched as the emergency personnel cut Mr. Ricardo’s new suit from his body and load him onto the ambulance. Relatives arrived to drive Mrs. Ricardo to Cedars-Sinai, but it took nearly four hours for Mrs. Ricardo to locate her husband within the hospital since he had been admitted under a “trauma name.” The wait was torture on Mrs. Ricardo who did not know of her husband’s devastating condition. When she did find him, what she saw was shocking. Mr. Ricardo had visible cuts, scrapes, swelling and bruising on his face, torso, arms, and legs. She was informed that he had sustained a pelvic fracture and internal bleeding, and that they were working on getting his condition “stable.” Mr. Ricardo was disoriented and in extreme pain.
The shock of seeing her husband traumatically injured without warning, combined with the dramatic change in the nature of their relationship, has caused a significant emotional toll on Mrs. Ricardo’s mental and physical well-being. She has experienced significant mental stress and shock, and has physical symptoms such as ankle swelling and body aches on a daily basis. The stress created by this incident has created a great deal of anxiety, and has greatly worsened her pre-existing issues with hives and eczema. Mrs. Ricardo’s skin began to bubble, split and bleed daily. During the ensuing extremely demanding months, Mrs. Ricardo’s hive condition became so severe that she was required to wear one or two gloves on each hand and long sleeves to protect her skin.
Also, the greater level of physical activity that Mrs. Ricardo must undertake as a result of this incident has taken a physical toll on her health. As indicated, the volume of household chores has increased, she must regularly travel to and from her husband’s health facility, and there is a great amount of physical lifting required when caring for her husband. The cumulative effect of these efforts has caused a great deal of pain, and the extreme ankle swelling has necessitated her wearing a soft cast for periods of time. Mrs. Ricardo often finds it difficult to even walk by the end of the day. As a result of the injuries to her husband, Dena Ricardo endures daily physical and emotional exhaustion. The constant stress that she has endured since December 2013 has vastly degraded her health and robbed her of much of the enjoyment of her own life. As such, Mrs. Ricardo’s independent claim for damages is quite substantial.
The losses suffered by Fredrick Ricardo are truly massive and all-encompassing. Before this incident, Fredrick Ricardo was a vibrant 80 year old man, often mistaken for under 59 years of age, who was expecting at least another eighteen years of his active lifestyle with his wife of 57 years, Dena. All has utterly changed due to the impaired driving of Jed Leiber. Mr. Ricardo has been profoundly damaged, both physically and cognitively. Mrs. Ricardo experienced the horror of watching her husband struck by a vehicle, and then struggled on her own to keep her husband from further harm since Mr. Leiber did not stop to assist her after the collision. Mrs. Ricardo has endured the stresses of Mr. Ricardo’s slow, painful, road towards hopeful recovery, and has had to grapple with the fact that her husband is not the same person due to cognitive effects of the stroke on top of his physical injuries.
While Mr. Ricardo has endured months of life-threatening complications from the incident, Mrs. Ricardo (and her family) has had to be constantly on alert to find the right medical specialists and to locate the right medical facilities to monitor and address Mr. Ricardo’s changing medical needs, all the while dealing with the difficult insurance delays and obstacles. Mr. Ricardo must take medications with potentially dangerous side effects.
Both Mr. and Mrs. Ricardo have suffered tremendous losses as a result of Mr. Leiber’s conduct. Without question, both of their lives have been profoundly and permanently altered. Each has a substantial claim for damages against Mr. Leiber: Fredrick Ricardo for his serious hip injury that triggered the blood clotting condition that caused the stroke (as well as the painful urinary MRSA infection); Mrs. Ricardo both for the negligent infliction of emotional distress caused by being present when her husband was struck by the Leiber vehicle, witnessing months of tormented pain from the horrific mutilation of her husband’s battered body, for her own extreme bleeding-hive skin issues due to the stress and for the significant loss of her husband’s consortium caused by the both the physical and cognitive injuries sustained by Fredrick Ricardo. Their daily playful home-life as a couple has turned to that of furious patient and wearied caregiver in dismal hospital type environments filled with stress and pain where Mrs. Ricardo was often seen fleeing Mr. Ricardo’s hospital room in tears because his previous playful personality had crossed the line into frustrated, disoriented and angry personality. In addition, this incident has inflicted substantial economic losses on the Ricardo family in an amount well into the seven figures.
The Ricardo’s have taken into consideration the immense pain and suffering caused by the incident, and the fact that Mr. and Mrs. Ricardo can expect to live the long lives based on their family histories, where relatives have routinely lived well into their nineties. Unfortunately, the retirement years the Ricardo’s have been looking forward to for over a half-century will not be that of the energetic healthy couple they were before the hit-and-run incident.
In assessing the amount of an appropriate demand in this case, it is fair to say that no amount of money can ever compensate Fredrick and Dena Ricardo for what they have endured, and what they have lost. In undertaking this analysis, however, we are mindful of the extent of the losses, the looming threat of possible medical emergencies, the continued pain and physical limitations the Ricardos will endure until the end of their lives, and the constant fear that Mr. and Mrs. Ricardo carry that another medical crisis could occur any day.
At the time of the incident, Mr. Leiber was insured by policies providing total coverage of $11,000,000. Those policy limits are hereby demanded. In addition, Mr. Leiber has expressed his desires to personally make amends to Mr. and Mrs. Ricardo for the pain they have and continue to endure from the incident. Therefore, an additional request is hereby made for the sum of $5,000,000 from Mr. Leiber personally on behalf of Fredrick and Alice Ricardo. We feel that this is a fair resolution and one consistent with the compensatory award that a jury would likely render in Los Angeles Superior Court given these facts.
Dated: June 10, 2015
Darren O. Aitken
Attorneys for Plaintiffs,
FREDRICK J. RICARDO and