Burnett & Williams - Experienced Winchester Medical Malpractice Lawyers

Specialization and Experience work for you
Burnett & Williams was founded as the result of personal injury law becoming increasingly complex and in a time when general practitioners were finding it increasingly difficult to provide quality representation to personal injury clients. To overcome these challenges, Peter Burnett limited his general law practice of 10 years to personal injury cases and started Burnett & Williams in 1988.

Medical Malpractice
Medical malpractice cases are especially challenging. To prevail in a malpractice action, a plaintiff is required to prove that a doctor, hospital, or other health care provider was negligent and that the negligence caused injury. Proof of each element, negligence and causation, generally requires expert testimony. We work with doctors throughout the country to determine whether malpractice has occurred and then to determine what the result would have been if the health care provider had complied with the standard of care required by law. Of course, the defendants will have their own experts and that is what makes most of these cases such a challenge. Countering the defendants’ experts requires comprehensive knowledge of the client’s case and an understanding of the medical issues involved. We are proud of our ability to overcome these challenges and to help make a difference for our clients who have been injured by malpractice. Because these cases can be so difficult to prove, we are selective about the cases we take, but once we take a case we are dogged in our pursuit of it. It is a difficult process and we are good at it.

If You've Been Injured
Choosing a lawyer can be time consuming, stressful, and confusing. If you've been injured, you need compassionate, experienced legal asistance. The attorneys at Burnett & Williams have extensive experience in all types of personal injury law. Contact us for more information and a free consultation. Having difficulty traveling? We will be happy to visit you at home or meet with you in a location that is convenient for you.

Serving : Winchester, Stephen's City, Berryville and Paris VA

Many individuals who are involved in a personal injury matter have questions and concerns about taking legal action.  For many people simple questions are the most important, like do I need a lawyer, how much will it cost and how long do I have to take action?  For answers to these essential questions and more about our firm, visit our “frequently asked questions” page. 

What puts a psychiatrist at risk for a malpractice lawsuit?

[No authors listed]

This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS, Inc. (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation, education and onsite risk management audits, and other resources to healthcare providers to help improve patient outcomes and reduce professional liability risk. The answers published in this column represent those of only one risk management consulting company. Other risk management consulting companies or insurance carriers may provide different advice, and readers should take this into consideration. The information in this column does not constitute legal advice. For legal advice, contact your personal attorney.

PMID: 19763207 [PubMed - in process]
source

Medical malpractice and new devices: defining an elusive standard of care.

Greenberg MD.

RAND Center for Corporate Ethics and Governance, Pittsburgh, PA 15212, USA. michaelg@rand.org

Early adoption of a new medical device by a physician carries with it some degree of malpractice liability risk. The legal standard for malpractice varies from place to place, but generally requires an evaluation of the physician's conduct either against that of a hypothetical "reasonable physician," or else against professional custom. Where the use of a new device involves a significant departure from traditional modalities of care, and a bad clinical result follows, questions may arise about whether the legal standard for malpractice has been violated. We suggest that a liberal interpretation of the malpractice standard of care is appropriate, and even necessary to avoid the potential for perverse disincentives to technical innovation in medicine.

PMID: 19715141 [PubMed - indexed for MEDLINE]
source

Below is a glossary of terms commonly used in personal injury cases, including automobile accidents, medical malpractice, wrongful death or other matters.

Pain Clinic: A multidisciplinary team approach for treating patients with chronic pain. Education is emphasized, as well as physical conditioning, self-management techniques, decreasing narcotic dependence, and addressing psychological barriers to recovery.

Paraplegia: Paralysis of the legs (from the waist down).

Paraspinal Musculature: The muscles that can be readily palpated on either side of the spinous processes during an examination.

Paraspinal Tenderness: Tenderness in the muscles on one or both sides of the spinous processes.

Paresthesia: An abnormal sensation of numbness usually involving tingling or pins and needles, which is typically not painful. It may also include a burning feeling.

Parietal Lobe, Right: Damage of this area can cause visuo-spatial deficits (e.g., the person may have difficulty finding their way around new or familiar places).

Parietal Lobe, Left: Damage to this area may disrupt a person’s ability to understand spoken and/or written language.

Pars Interarticularis: It literally means “the part between the articulations.” This is the portion of the vertebra which lies between the upper facet process and the lower facet process. If this section of bone is fractured or not fully fused, it may result in a spondylolysis or spondylolisthesis.

Pars Interarticularis Defect: A fracture or congenital defect in the bony portion connecting facet joints and the pars interarticularis. This is also called a spondylolysis and may lead to spondylolisthesis.

Passive Range of Motion: In the spine or extremities, passive range of motion (ROM) is measured in flexion, extension, lateral flexion, and rotation, abduction, adduction, inversion, and aversion. This differs from active range of motion in that the patient uses no voluntary muscle contraction and must be taken through the ROM by the examiner.

Patella Tendon Reflex: The reflex contraction of the quadriceps muscle with tapping of the tendon of the patella. Used to discern indirectly the functioning of the L4 and, to a lesser extent, the L3 spinal nerve functions. Also known as the Knee Jerk Reflex.

Pedicle: That portion of a vertebra which separates the larger, vertebral body in the front from the smaller bony structures toward the back.

Peripheral Neuropathy: A generalized “slowing” of the peripheral nervous system which is often characterized by decreased sensation in a stocking and glove distribution in the feet and hands. This condition can sometimes be diagnosed with a nerve conduction study.

Physical Therapy: Treatment for musculoskeletal and neurological disorders provided by a licensed physical therapist. Usually involving exercise, electrical modalities, and myofascial techniques.

Piriformis Syndrome: Various symptoms involving posterior hip pain localized in the piriformis muscle that may include radiating numbness or tingling down one leg. A small portion of the population has a sciatic nerve which goes through the piriformis muscle, which may be irritated when inflammation occurs within the muscle.

Plaintiff: The party who requests damages and initiates a civil lawsuit.

Pleadings: The formal, written documents filed by the parties with the court which set forth, or elaborate on, their respective claims and defenses.

Plexopathy: Dysfunction of the brachial plexus or lumbar plexus.

Post-Concussive Syndrome: Any alteration in cerebral function caused by direct or indirect forces transmitted to the head resulting in brief loss of consciousness, light-headedness, vertigo, cognitive and memory dysfunction, tinnitus, difficulty concentrating, amnesia, headaches, balance disorder, nausea and/or vomiting.

Post Traumatic Amnesia (PTA): A period of hours, weeks, days or months after the injury, when the person exhibits a loss of day-to-day memory. The person is unable to store new information and therefore has a decreased ability to learn. Memory of the PTA period is never stored, therefore things that happened during that period cannot be recalled. May also be called Anterograde Amnesia.

Post-Traumatic Stress Disorder: This is a psychologicalcondition involving emotional and behavioral distress after exposure to a traumatic event or events. Physiologic change such as increased sympathetic nervous system activity, alterations in stress hormones secretion, memory processing and limbic system abnormalities in brain imaging studies of traumatized patients have been shown in significant, longer term cases. The formal diagnosis is contained in the DSM-IV (Diagnostic and Statistical Manual) published by the American Psychological Association. Symptoms may include insomnia, irritability, difficulty concentrating, extreme psychological or physical distress when exposed to cues that remind the person of the incident, nightmares, anxiety, exaggerated startle response, numbing of the senses, avoidance of activities or places that bring back memories of the event, among others.

Power of Attorney: A letter or document authorizing one person to act as an agent or attorney for another.

Prejudice Outweighs Probative Value: Rule of evidence which provides that relevant evidence may be excluded if its probative value is substantially outweighed by the danger that it may confuse or mislead the jury, or unfairly prejudice the opposing party.

Preponderance of the Evidence: Degree of evidence necessary for a plaintiff to win in a civil case. Evidence which is of greater weight or more convincing than the evidence which is offered in opposition. On a scale of 1 to 100, fifty-one percent (51%) or better.

Pro Se: When a party does not retain an attorney and appears for and represents himself/herself in court.

Prolapsed Disc: A term often used synonymously with herniated disc the annulus fibrosis becomes disrupted and the inside of the disc material, the nucleus pulposus, extends outward.

Prolotherapy: The injections intended to cause scarring of tissue around joints to reduce ligament hypermobility at a joint area.

Pronated Foot: A foot that is extra lax, resulting in excessive roll of the foot and flattening of the arch.

Protruded Disc: A contained disc herniation, sometimes called a bulging disc.

Provocative Maneuver: A physical exam test which attempts to reproduce pain through movement, mobilization, pressure over a structure, or other means.

Proximate Cause: Refers to a cause which leads directly, or in an unbroken sequence, to a particular result. An element of negligence.

Ptosis: Drooping of a body part, such as the upper eyelid, from paralysis, or drooping of the visceral organs from weakness of the abdominal muscles.

Quadriparesis: Weakness of all four limbs.

Radicular: Of or pertaining to a nerve root exiting the spinal cord.

Radicular Pain: Pain caused by a radiculopathy or radiculitis.

Radicular Symptoms: Sensations such as pain radiating down arms or legs. Symptoms may involve motor or sensory dysfunction.

Radiculitis: Inflammation of a nerve root causing symptoms of pain in the distribution of that root.

Radiculopathy: Dysfunction of a nerve root that can cause (1) numbness or tingling in a specific pattern corresponding to that nerve root or (2) muscle weakness in the muscles supplied by that nerve, or (3) loss of reflex associated with that nerve.

Range of Motion: (ROM) The range of movement of a joint or a spinal area that is measured and compared to normal. Restrictions in the range of motion of a joint or spinal area indicates some type of dysfunction.

Reasonable Medical Certainty: Standard for admission into evidence of opinions of a health care provider concerning his/her patient’s condition, diagnosis, or prognosis. A doctor’s opinion cannot be based on possibilities, but rather must be founded on probabilities. Reasonable medical certainty means “more probably than not.”

Referred Pain: Pain that originates in one part of the body, but is felt in another part of the body.

Reflex Sympathetic Dystrophy: A clinically determined syndrome characterized by burning, atrophy, hypersensitivity, temperature changes in the affected area, and decreased range of motion. The cause is usually trauma. This has recently been renamed Complex Regional Pain Syndrome.

Release: Waiver, relinquishment, or giving up a right, claim, or demand.

Relevant Evidnece: Evidence having a tendency to make the existence of any fact that is of consequence to the determination of the action more or less probable than it would be without the evidence. Generally, only relevant evidence is admissible.

Retrograde Amnesia: Inability to recall events prior to the accident; it may be a specific span of time or type of information.

Retrolisthesis: A term which refers to a vertebral body which has moved backwards relative to the vertebral body below.

Reversal: A radiographic term which describes a spinal curve which has been reversed to the opposite direction, e.g., the reversal of the normal lordotic curve of the cervical or lumbar spine.

Rheumatoid Arthritis: A common type of inflammatory arthritis believed to be a result of an autoimmune process which primarily affects the joints of the hands and feet as well as the cervical spine.It can also affect all other joints in the body. It is characterized by pain, stiffness and swelling in the joints.

Rhizotomy: The cutting or burning of a nerve root. See also Neurotomy.

Roos Test: A test for thoracic outlet syndrome in which the shoulder is abducted to 90 and the shoulder joint is externally rotated. The fingers are then rapidly flexed and extended. If this test elicits arm pain, vascular thoracic outlet syndrome may be implicated. The pulse is also monitored.

Rotator Cuff Impingement: Compression of any of the rotator cuff or tendonous fibers at the shoulder joint underneath the supraspinatus tendon.

Rules of Evidence: Rules of law which determine which testimony, documents, etc. should be submitted for consideration by a judge or a jury, and the weight such evidence is to be given in determining a question of fact.

Sacroiliac Joint: Referring to the area where the sacrum and ilium bones form a joint.

Sacroiliac Joint Dysfunction: Dysfunction of the sacroiliac joint due to trauma or degenerative changes.

Sacrum: The base of the bone support for the spine. It is made up of the S1 through S5 vertebrae, which fuse to form a triangular shaped bone.

Scalene: Three anterior neck muscles which attach between the back of the first six cervical vertebrae and the first and second ribs. This muscle group allows for bending and rotating the neck.

Schmorl’s Node: A bone defect in the upper or lower margin of the body of the vertebra. It may be traumatic, developmental, or degenerative in nature.

Sciatica: A description of pain and/or numbness associated with inflammation of the sciatic nerve, usually due to compression of the spinal nerve between fifth lumbar (L5) and first sacral vertebrae(S1). It is often the result of a herniatednucleus pulposus at the L4-5 or L5-S1 levels.

Sciatic Nerve: The major nerve supplying motor and sensory functions to the legs. This is the largest peripheral nerve in the body. This nerve later divides to form the tibial and peroneal nerve. It arises from the L4, L5, and S1-S3 spinal nerves. It emerges from the lumbar spine and sacrum into the gluteal region through the sciatic notch. It is the largest diameter nerve in the body.

Sciatic Notch: A notch between the sacrum and the ilium. The sciatic nerve travels through this region.

Scoliosis: An abnormal lateral curvature and/or rotation of the spine. May be idiopathic, anatomic (as with a short leg) or functional (as with muscle spasm) in etiology.

Segmental Dysfunction: Refers to vertebral segments which are not moving normally in relation to one another.

Segmental Instability: Motion of a spinal motion segment which significantly exceeds normal range of motion for that segment so that further over-stretching of the supporting soft tissue may occur.

Seizure: An uncontrolled discharge of nerve cells which may spread to other cells nearby or throughout the entire brain. It usually lasts only a few minutes. It may be associated with loss of consciousness, loss of bowel and bladder control and tremors. May also cause aggressive or other behavioral change.

Selective Nerve Root Block: Injection of an anti-inflammatory and local anesthetic onto the sleeve surrounding a spinal nerve. This can be done for both therapeutic and diagnostic purposes to determine if a spinal nerve is causing pain. Also known as a Spinal NerveBlock.

Service of Process: Refers to the rules of law prescribing the manner, and upon whom, a summons and complaint giving a defendant notice of a lawsuit must be served. The person giving notice must be someone other than a party to the lawsuit, who is eighteen (18) years or older, and competent to be a witness.

Settlement: A final resolution of a claim by agreement between the parties.

Short Leg Syndrome: Pain symptoms arising from a difference in length between the lower extremities. Short leg syndrome may cause musculoskeletal-type symptoms which can be corrected with a shoe lift.

Shunt: A procedure to draw off excessive fluid in the brain. A surgically placed tube running from the ventricles which deposits fluid into the abdominal cavity, heart or large veins of the neck.

SI Dysfunction: A mechanical abnormality of the sacroiliac joint which alters normal movement.

Skull Fracture: The breaking of bones surrounding the brain. A depressed skull fracture is one in which the broken bone exerts pressure on the brain.

Small Claims Court: Court of limited jurisdiction, available for resolution of disputes by the parties without attorneys. Original purpose was to “bring justice home to every man’s door.” Limited to claims not in excess of $2,500.00. Parties represent themselves at the hearing. Attorneys are restricted from participating.

Somatosensory Evoked Potentials: An electrical test used to determine the integrity of the sensory pathways in the spinal cord. Also termed SSEP.

Spasm: A painful involuntary, sustained contraction of a muscle, due to irritation.

Spasticity: An involuntary increase in muscle tone (tension) that occurs following injury to the brain or spinal cord, causing the muscles to resist being moved. Characteristics may include increase in deep tendon reflexes, resistance to passive stretch, clasp knife phenomenon and clonus.

Special Damages: Fixed costs or expenses attributable to any injury or loss, including past, present, and future income loss, treatment costs, and other out-of-pocket expenses.

SPECT: An acronym for Single Photon Emission Computed Tomography, a nuclear-radiographic technique. Often used to detect presence of fractures or other bone abnormalities.

Spinal Cord: The extension of the central nervous system which extends from the brain stem to the cauda equina and is surrounded by the spinal canal. This acts as a conduit for information to and from the brain as it relates to the rest of the body.

Spinal Fusion: A surgical procedure to form a bony bridge between two or more spinal vertebrae to eliminate movement over painful or unstable spinal segments. Spinal fusion can also occur at birth or as a result of the aging process.

Spinal Instability: Abnormal or excessive motion in a vertebral segment with respect to the vertebrae above and/or below it.

Spinal Nerve Block: Injection of an anti-inflammatory and local anesthetic on to the sleeve surrounding a spinal nerve. This can be done for both therapeutic and diagnostic purposes to determine if a spinal nerve is causing pain. Also known as Selective Nerve Root Block.

Spinal Stenosis: Narrowing of the central spinal canal that contains the spinal cord and/or cauda equina. This can be caused by congenital conditions, abnormal development or degenerative changes of the disc and/or facet joints or ligaments.

Spinal Subluxation: A term used in chiropractic to describe the alteration of the normal dynamics between adjacent vertebrae, which may result in motion, muscular or neurological dysfunction.

Spinous Process: A projection of bone which extends from the junction of the two laminae projecting off the back of the vertebra.

Spondylitis: An inflammatory condition of the spine.

Spondyloarthritis: An arthritic condition of the spine. It is related to spondylosis.

Spondyloarthropathy: A form of inflammatory arthritis which typically involves the spine, especially the sacroiliac joints.

Spondyloarthrosis: Arthrosis of the synovial joints of the spine.This usually refers to degenerative joint disease.

Spondylolisthesis: Forward or backward displacement of one vertebra in the relation to the adjacent vertebra below. Depending on the amount of the displacement, spondylolisthesis may require surgical intervention to fuse the spine.

Spondylolysis: A defect or fracture of the pars interarticularis, on one or both sides. This condition is often associated with spondylolisthesis.

Sprain: Trauma to the joint capsule or ligaments, causing pain and impairment of joint movement, depending upon the degree of severity of injury to the ligaments.

Spurling’s Sign: A physical examination procedure test in which the patient’s head is rotated sideways and extended backwards, while gentle compression is applied to the top of the head. The test is used to determine if neural foraminal narrowing is compressing the exiting spinal nerve. A positive test involves pain, numbness, or paresthesia extending into the arm below the elbow. Also called ForaminalCompression Test.

SSEP: Somatosensory Evoked Potentials. This is a neurodiagnostic test to evaluate sensory nerves.

Static Intersegmental Subluxation: A chiropractic describing term a malposition of vertebrae detected on static palpation testing.

Statute: Written law enacted by the legislature.

Statute of Limitations: Laws enacted by every state which govern the time frame when a lawsuit must be filed, and beyond which the claim can no longer be made. Statutes of limitation differ from state to state and according to the nature of the claim. In Washington, the limitation period applicable to most claims for personal injuries and damages caused by negligence, including motor vehicle accidents, is three years.

Stenosis: In the spine, this can refer to a narrowing of the vertebral canal (central spinal stenosis), the bony foramen through which a spinal nerve passes (foraminal stenosis), or the lateral passage where a nerve descends to prepare to exit the spine (lateral recess or sub-articular stenosis).

Step Defect: A spinal fracture noted at the front side of the vertebral body.

Sternal Compression Test: A physical examination maneuver which attempts to identify rib fractures by applying front to back pressure over the sternum with inhaling. May also identify injury to the costal cartilage.

Sternocleidomastoid Muscle: An anterior neck muscle which attaches at the sternum and collarbone and then at the mastoid process of the skull. It is often injured in whiplash injuries.

Straight-Leg Raise: A physical examination maneuver typically used to determine if a low back spinal nerve is under tension. The patient is lying on his/her back or in a sitting position, and the leg is raised.

Strain: Trauma to the muscle or tendons as a result of violent contraction or excessive stretching.

Subacute: Between acute and chronic. Further defined by some to mean the time period six to twelve weeks into the healing process. Defined by others by the level of inflammation and symptoms.

Subarachnoid Space: The space below the arachnoid membrane which is filled with spinal fluid. The arachnoid membrane is a layer enclosing the brain and spinal cord, just below the dura.

Subdural: Beneath the dura (tough membrane) covering the brain and spinal cord.

Subluxation: In chiropractic terms, subluxation refers to an abnormal joint movement beyond normal range of motion, producing neurological effects. In medical terms, an incomplete or partial dislocation of a joint.

Subluxation Complex: A chiropractic term relating to the various components of a spinal subluxation. These components include spinal kinesiopathology (abnormal spinal position or movement), myopathology (abnormal muscle function), neuropathology (abnormal nerve function), histopathology (abnormal soft tissue function), and pathophysiology (resultant degenerative processes.

Subpoena: A written command requiring a person to appear at a certain time and place to give testimony at a deposition or other proceeding. A subpoena need only give the person five (5) court days notice to be valid.

Subpoena Duces Tecum: A written command requiring a witness to produce documentary or other tangible evidence he/she possesses or controls and which is relevant to matters at issue in the case.

Subrogation: When an insurance company pays the claim of a policy holder, the policy holder then gives the insurance company the right to seek money back from the person or manufacturer who caused the accident or damage. This is called subrogating the claim.

Summary Judgment: A procedure by which one party seeks to persuade the court that there is no genuine issue or controversy regarding material facts, and accordingly, that the party filing the motion is entitled to prevail as a matter of law.

Summons: Notice to all defendants that a lawsuit has been commenced, that they have been named as a defendant, and that they must answer the complaint within twenty (20) days or a default judgment may be taken against them.

Supraspinatus Tendinitis: Inflammation of the supraspinatus tendon, found at the top of shoulder blade/lower neck region.

Supraspinatus Tendon: The tendon attaching the supraspinatus muscle to the anatomy of the shoulder joint.

Surface EMG: A graphic record of micro-voltage present in muscles in static or active contraction as measured by sensors placed upon the skin.

Synovial Fluid: The lubricating fluid within the joints.

Synovial Membrane: The normal lining of a joint, which becomes inflamed when traumatized or arthritic.

Synovitis: Inflammation of the synovial membrane.

T1 Weighted Image: An MRI technology for imaging of fat tissue as a bright signal and water as a dark signal. This is particularly helpful in the lumbar spine, as many of the structures are outlined by fatty tissue and show up dark against the bright fat signal.

T2 Weighted Image:MRI technology for the imaging of fluid, water, or fat as a bright signal.

Temporal Lobes: There are two temporal lobes, one on each side of the brain, at about the level of the ears. These lobes allow a person to tell one smell from another and one sound from another. They also help in sorting out new information and are believed to be responsible for short-term memory.

Temporomandibular Dysfunction (TMD): Dysfunction of the temporomandibular joint.May result in headaches, jaw pain and contribute to neck pain.

Temporomandibular Joint (TMJ): The jaw joint between the mandible and the articular surface of the temporal bone. This joint allows opening and closing of the jaw, as well as numerous other movements. The joint contains a disc.

Tender Point: A specific area of tenderness within a muscle which does not refer pain to other body parts. It is commonly seen in fibromyalgia. Sometimes considered a latent trigger point.

Tendinitis: Inflammation of a tendon.

Tendon Reflex: A physical exam technique which evaluates the integrity of the neurologic function of the muscle being tested.

TENS: Transcutaneous Electrical Nerve Stimulation. A form of electrical treatment used to block pain perception.

Tension Headache:A headache caused by excessive contraction of cervical muscles.

Testimony: A formal statement, by a party or witness in a case under oath. Statement may be verbal or written.

Thoracic: Pertaining to the chest or thorax.

Thoracic Outlet Syndrome: TOS. Compression of the neurovascular bundle in the shoulder, collarbone and neck (usually irritation of nerves within the bundle). The compression may cause decreased or abnormal blood flow into the arms, often associated with certain overhead positions of the arms. Symptoms include paresthesia, numbness, pain in the arm and hand, and weakness in the hand.

Thoracolumbar Junction: The region of the twelfth thoracic vertebra and the first lumbarvertebra. This is the region where the relatively less flexible mid-back spine (due to the rib cage) joins with the more mobile low back.

Thoracic Vertebrae: The twelve vertebrae which connect the ribs and form the back wall of the thorax.

Tinnitus: Ringing in the ears or in the head due to nerve damage, over dosage of certain drugs, or excessive contraction of the small intricate muscle of the inner ear. Tinnitus can result from trauma.

Tissue Texture Abnormality: An osteopathic term describing a palpable change in the tissues that is associated with somatic dysfunction.

Tort: French word meaning “wrong”. Body of law which determines rights and liabilities when property is damaged or a person is injured, through negligent or intentional conduct.

Trapezius: A large, flat, triangular muscle on each side of the upper back that serves chiefly to rotate the scapula and assist in turning one’s head.

Traumatic Brain Injury (TBI): An injury caused by a blow or jolt to the head, penetrating head injury, or by being violently shaken, that disrupts the function of the brain. A TBI can change how a person acts, moves, communicates, and thinks. The term TBI is not used for brain injuries that happen during birth; those are called developmental disabilities.

Trial: Judicial examination and determination of legal and factual issues between the parties to an action. May be civil or criminal. In a trial by jury the jury decides questions of fact with the judge determining the law to be applied. In a trial by judge, he/she decides both the facts and the law to be applied.

Trial De Novo: Means “new trial.” In mandatory arbitration, after the parties receive the award or decision, a party not satisfied with the award may appeal by filing a request for a trial with the Superior Court. The request must be made within twenty (20) days of the award being filed with the court. No information related to the previous arbitration hearing or award from it can be made at the trial.

Trigger Point (TP): A taut, palpable spot in muscle that is painful to touch and refers pain to another body area.

Trochanteric Bursitis:Inflammation of the trochanteric bursa surrounding the hip joint.

Ulnar Nerve: The ulnar nerve provides sensory function to the pinky and ring finger. It takes its name from the ulna, one of the bones of the forearm, in close proximity and along which the nerve is located.

Ulnar Neuropathy: A lesion of the ulnar nerve which can cause numbness in the fourth and fifth fingers. This can be confused with a radiculopathy from the eighth cervical (C8) nerve root.

Ultrasound: High-frequency sound that is applied as a therapeutic heat treatment in physical therapy rehabilitation.

Uncovertebral Joint: The joints in the lower cervical spine from the second to the seventh cervical vertebrae (C2-C7). These are formed by the side projections on the rim of the vertebral bodies. They are independent of the disc and facet joints. Also known as the Joints of Luschka.

Upper Cervical Dysfunction: A restriction or abnormal movement of the top two vertebral joints in the neck following a neck injury. A common cause of headaches.

Vascular Headache: A headache caused by excessive dilation of the arteries in the brain and its dural coverings. See Migraine Headaches.

Ventricles, Brain: Four natural cavities in the brain which are filled with cerebrospinal fluid (CSF). The outline of one or more of these cavities may change when a space-occupying lesion (hemorrhage, tumor) has developed in a lobe of the brain.

Verdict: The definitive answer given by the jury concerning the issues the judge asked them to resolve.

Vertebra: One of the twenty-four (24) bones that make up the spine. There are three types: cervical (seven in number), thoracic (twelve), and lumbar (five), with each section possessing unique characteristics. The sacralvertebrae are fused in one bone.

Vertigo: Dizziness with a sensation of spinning.

Voir Dire: Part of the jury selection process. A number of prospective jurors are selected and seated in the jury box. The judge and/or lawyers ask a series of questions to disclose any predisposition or biases that may impact their judgment. Generally, each party is entitled to three preemptory challenges by which prospective jurors can be removed without cause. If the judge so finds, jurors may also be removed for cause due to obvious bias or other reasons demonstrating an inability to serve.

V Sign: A radiographic sign seen on a lateral x-ray view which may represent a torn or stretched transverse ligament.

Waiver: A knowing, intelligent, and voluntary surrender of a known right or claim.

Whiplash Injury: A sprain or strain syndrome of the cervical spine caused by a hyperextension-hyperflexion or acceleration - deceleration injury. This most commonly occurs in car collisions.

Witness: Someone with knowledge pertaining to the facts of the case. Each party identifies his/her witnesses prior to trial or arbitration.