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Every year thousands of people , many of them children, are injured by escalators in shopping malls, train stations, office buildings , and sports arenas around the country. Many escalator accidents are caused by worn, damaged or faulty equipment, and design defects. According to studies, 85% of escalator accidents could be prevented with a systematic maintenance program and quality control.

Entrapments account for approximately 20% of all accidents. Usually, entrapment occurs when a child becomes caught between two steps or between a step and a side-rail. In most entrapment cases, children are caught between the last step and the comb plate at the end of an escalator.

Thomas Kline and I were recently co-counsel in representing a young boy who was involved in a 1996 subway escalator accident in Philadelphia which resulted in the traumatic amputation of the 4-year-old boy's foot. A lawsuit was instituted against the transit authority — Septa — and the manufacter of the escalator. In December 1999, after trial, the jury concluded that the transit authority had been negligent and awarded $51 million dollars. Subsequent to the verdict, the transit authority paid the injured minor $7.4 million dollars and enacted major reforms to their inspection and repair procedures.

In 1999, the American Academy of Pediatrics (AAP) recommended that trampolines should not be used at home -- either indoors or outdoors. The policy of the AAP recommended that trampolines should not be part of routine physical education classes in schools, and that trampolines have no place in outdoor playgrounds and should never be regarded as play equipment. According to the study, "Despite all currently available measures to prevent injury, the potential for serious injury while using a trampoline remains. The need for supervision and trained personnel at all times makes home use extremely unwise."

The AAP study found that:

• Trampoline-related injuries increases 140 percent form 1990 to 1996.
  
  
• A estimated 83,400 trampoline-related injuries requiring an emergency department visit occurred in 1996 in the United States.
  
  
• 30 percent of trampoline-related injuries treated in an emergency department were fractures, often resulting in hospitalization and surgery.
  
  
• Catastrophic cervical spine injuries are rare; however head and neck injuries constitute a notable number of the more serious injuries requiring hospitalizations.
  
  
• Since 1990, the Consumer Product Safety Commision has received reports of six deaths involving trampolibnes. Victims ranged in age from 3 years through 21 years. Most deaths occurred when victims fell from the trampolines, and most involved the spinal cord.

Precautions recommended by the AAP Safety Committee are:

• Safety pads should cover all portions of the steel frame and springs.
  
  
• The surface around the trampoline should have an impact-absorbing safety surface material.
  
  
• The condition of the trampoline should be regularly checked for tears, rust, and detachments.
  
  
• Safety harnesses and spotting belts should be used where appropriate.
  
  
• Ladders may provide unattended access to the trampoline by small children and should not be used.

Many families of persons with catastrophic illnesses and injuries are not aware of their right to appeal when they are denied benefits by their managed care insurer. More than half of HMOs investigated by federal authorities did not comply with federal rules for handling appeals. The Healthcare Financing Administration (HCFA), which oversees Medicare, is expected to release new rules to clear up any confusion involving the appeals process. Most denials by HMOs and managed care insurers are based on exclusions, definitions, limitations, and experimental clauses.

• Recommendations to overcome exclusions, definitions, limitations, and experimental clauses:
  
  
• Obtain the master health insurance policy from your insurer.
  
  
• Review the specific exclusion, definition, limitation, or experimental languarge in the policy.
  
  
• Provide the health insurance policy terms and definitions to your treating healthcare providers.
  
  
• Obtain a report from the treating doctor that supports the requested care. The report from the treating doctor should state that the requested care is medically necessary.
  
  
• File an appeal if unsuccessful. Seek an external review of your health insurer's denial.
  
  
• Hire an attorney to file a bad faith or unfair insurance practice claim against the health insurer. Know your appellant rights — act timely — do not delay!

ANOXIC EXCLUSION – Health insurers are refusing to pay for rehabilitation and home care if the diagnosis is anoxia or anoxic encephalopathy. The insurer's reason for denial is that such care is custodial. These denials should be agressively challenged through the appeals process, administrative appeals, bad faith claims and litigation.

SPOLIATION - CONSUMER PRODUCT SAFETY COMMISSION – In most states, in order to prove that a product was defective and caused an injury, you must "preserve" the product involved in your accident.

As a preventative measure, accidents involving products should be reported to the CPSC (Consumer Product Safety Commission). The CPSC will issue recalls or warnings if they determine that the particular product is defective or dangerous.

"LACHES" – Injury claims need to be filed within specific periods, according to law. Failure to do so within the time limit, or atatute of limitations, is called "Laches" a legal term that means "sleeping on your rights". The statute of limitations differs for minors and adults and varies from state to state. You should discuss your potential legal claim with an attorney in a timely manner before the atatute of limitations expires.

GUARDIANSHIP AND TRAUMATIC BRAIN INJURY – Health care providers who treat the traumatically brain injured (TBI) without a properly executed release or guardianship decree are putting themselves in legal jeopardy. Often the injured person, due to his or her condition, cannot give legal authority for treatment to their physician, nurse, rehab specialists, therapists, or case manager.

Treating health care professionals should encourage families to initiate guardianship proceedings at the time of addmission, not discharge.

CEREBRAL PALSY - SPECIAL EDUCATION BENEFITS – Coordination of private health insurance, governmental insurance and special education benefits is very important to families who have children diagnosed with cerebral palsy. Exhaustion of lifetime medical benefits under a private health insurance policy occurs very quicklywhen private health insurance policy is the only resource that is utilized. As soon as possible after a diagnosis of cerebral palsy, family members should meet with their doctor, social worker, case manager, advocate, and attorney to formulate a "game plan" to inxure that the child received the maximum benefits available from all sources.

If you have questions about medical insurance, governmental or special education benefits or any other legal question, fax your questions to 1-800-854-9430. You will receive a prompt reply and there is no charge for this service.