Court ends Philip Morris appeal of $79.5M award By MARK SHERMAN, AP
WASHINGTON -The Supreme Court on Tuesday threw out a cigarette maker’s appeal of a $79.5 million award to a smoker’s widow, likely signaling the end of a 10-year legal fight over the large payout.
In a one-sentence order, the court left in place a ruling by the Oregon Supreme Court in favor of Mayola Williams. The state court has repeatedly upheld a verdict against Altria Group Inc.’s Philip Morris USA in a fraud trial in 1999.
The judgment has grown to more than $145 million with interest.
The justices heard arguments in the case in December, but said Tuesday that they are not passing judgment on the legal issues that were presented. Instead, it is as if the court had declined to hear the case at all.
Philip Morris had argued that the award should be thrown out and a new trial ordered because of flaws in the instructions given jurors before their deliberations.
Business interests had once hoped the high court would use the case to set firm limits on the award of punitive damages, intended to punish a defendant for its behavior and deter a repeat offense.
The case has bounced around appellate courts since 1999, when Williams convinced a jury that Philip Morris should be held accountable for misleading people into thinking cigarettes were not dangerous or addictive.
Williams’ husband Jesse was a janitor in Portland who started smoking during a 1950s Army hitch and died in 1997, six months after he was diagnosed with lung cancer.
His widow was awarded $800,000 in actual damages. The punitive damages are about 97 times greater. A state court previously cut the compensatory award to $521,000.
The value of the award has climbed to more than $145 million because of accrued interest, the company said. Sixty percent of it would go to an Oregon crime victims fund, although the company has said it might continue to contest the portion owed the state.
The Oregon high court made its first decision in 2002, refusing to hear an appeal from Philip Morris.
Then the U.S. Supreme Court rejected the judgment of nearly $80 million, saying in another case that damages generally should be held to no more than nine times actual economic damages. It declined, however, to make that a firm rule.
Next, the Oregon Supreme Court upheld the punitive damages, citing “extraordinarily reprehensible” conduct by Philip Morris officials.
Then came the U.S. Supreme Court’s second take on the case. In 2007, the court said in a 5-4 decision that jurors may punish a defendant only for harm done to someone who is suing, not other smokers who could make similar claims.
The state court was told to reconsider the award in the context of instructions for the trial jury that Philip Morris proposed and the trial judge rejected.
In January, the Oregon court said there were other defects in the instructions that violated Oregon law, and supported the trial judge’s decision not to give the proposed instructions to the jury.
The case is Philip Morris USA v. Williams, 07-1216.
Copyright 2009 The Associated Press.

‘Minor’ head injuries can turn serious rapidly, experts say.
People with head injuries can seem perfectly lucid

Blood can leak into brain over minutes or hours, causing swelling, pressure

Important to watch for signs of brain injury: Nausea, severe headache, glassy eyes

By Danielle Dellorto
CNN Medical Producer

(CNN) — A blow to the head that at first seems minor and does not result in immediate pain or other symptoms can in fact turn out to be a life-threatening brain injury, experts tell CNN.

Immediate treatment is essential after a brain injury because damage caused by swelling is often irreversible.

It’s very common for someone who’s had a fall or been in a car accident to appear perfectly lucid just after the impact but then to suddenly, rapidly deteriorate, Dr. Carmelo Graffagnino, director of Duke University Medical Center’s Neurosciences Critical Care Unit, told CNN.

Actress Natasha Richardson was talking and joking after she fell Monday during a beginner ski lesson, according to officials at the Canadian resort where she was staying. But soon after she returned to her room she complained of head pain and was taken to a nearby hospital, then to a larger medical center in Montreal. She was flown by private jet Tuesday to a New York hospital. She died Wednesday, according to a family statement.

“A patient can appear so deceivingly normal at first,” said Graffagnino, director of Duke University Medical Center’s Neurosciences Critical Care Unit. “But they actually have a brain bleed and as the pressure builds up, they’ll experience classic symptoms of a traumatic brain injury.”

Such injuries are known as epidural hemorrhage. Blood gets trapped between the skull and the hard layer of skin between the bone and brain, known as the dura mater. As the blood flows from the ruptured artery, the fluid builds and punctures the dura.

Patients are often unaware they’ve fractured their skull. In these cases, the fracture generally occurs just above the ear, in the temporal bone. “There is an artery that runs above the skull and can get torn and begin to bleed above the lining of the brain.” Graffagnino says.

“At that point all the pressure is pushed on the brain, causing it to swell but there is often no room for it to move inside the skull cavity. And as the pressure continues, it reduces blood flow to the brain and a patient would begin to feel the symptoms.”

The condition is commonly referred to as “talk and die” syndrome among neuroscience physicians and surgeons, because the patient can decline so rapidly.

Graffagnino says the initial fall or injury doesn’t have to be hard at all. The delay in symptoms can range from five minutes to three hours after the accident.

If an individual isn’t medically evaluated after a car accident, sports injury, or just a slip in the driveway, recognizing the signs brain injury early is critical. Nausea, severe headache, glossy eyes, sudden sleepiness, are all common symptoms. Getting to a hospital within the first few hours is critical to prevent permanent brain damage, experts say. An emergency room team can quickly determine the severity of your injury. An emergency craniotomy — opening of the skull — surgery is often needed to stop the bleeding and control brain swelling.

Immediate treatment is essential after a brain injury because the initial damage caused by swelling often is irreversible.

“One of the things we teach to trauma teams, is if a group of people are in a car crash and someone dies, we have to assume everyone else has serious injuries–even if they look good, and say they feel totally fine,” Graffagnino said.

Health Library
MayoClinic.com: Traumatic brain injury
Certain medications can increase a person’s risk for hemorrhages, especially for the elderly. Doctors say even a small bump on the head can be dangerous for patients taking blood thinners, among other prescription drugs.

“Talk and die” syndrome also can result from a subdural bleed, which develops between the brain and the dura. These bleeds can “squish the brain,” Graffagnino said, and cause injury at a slower rate. A person can often feel normal for several days before feeling any symptoms.

“You don’t have to see external injury to have injury to the brain,” said Dr Philip Stieg, chair of neurosurgery at NYP/Weill Cornell. To evaluate a person’s response after a minor trauma, Stieg recommends checking the size of their pupils and asking questions such as the patient’s name and what year it is. In the hours following, Stieg recommends monitoring the person’s cognitive skills and to “bring them in to get a CAT scan” if there is a change in behavior.

The brain also can be bruised after an accident, leaving patients with no symptoms or signs of a bleed at first glance. But the nerves surrounding the bruise can begin to stretch, causing what is known as an axonal injury. “The brain is like Jell-O. Imagine if you dropped a bowl of Jell-O on the floor and it looks intact at first but when you examine it really close, you can see it has teeny tiny cracks all in it,” Graffagnino said. “Well the brain can have these tiny cracks that don’t show up on initial CAT scan but will develop into problems down the line.”

Once surgeons stop a brain bleed, the next step is to monitor brain activity and check for permanent damage. A patient typically spends up to a month in a neuro-ICU. Patients who survive often spend the next several years in physical and cognitive therapy to regain function, according to experts.

“The most important thing to do to lower your risk is to wear a helmet when you can, and don’t brush off an injury because you feel ‘fine’ at first,” Graffagnino said. “The thing that’s going to save a life is for friends and relatives to recognize the first glimmer of a symptom. The quicker we can stop the bleed, the better.”

Bureau of Justice Statistics Study Offers Some Interesting (and Possibly Unexpected) Findings.

Although our concentration is on attorney’s fees award, we sometimes digress to report on studies relating to the general civil litigation sector. Now is the time to discuss a recent study that has some results that may be surprising in many respects.

The Bureau of Justice Statistics has issued a recent report, “Civil Bench and Jury Trials in State Courts, 2005,” based on a national study of civil litigation trends in the 75 most populous counties from 1992 to 2005 and analysis of civil tort, contract, and real property verdicts/decisions in a national sample of jurisdictions in 2005.

Here are the highlights—some of which buck conventional wisdom or lore:

· In 2005, plaintiffs won 56% of all general civil trials concluded in state courts. In tort cases, plaintiffs were most likely to prevail in lawsuits involving an animal attack (75%), followed by auto accident (64%), asbestos (55%), and intentional torts (52%). Plaintiffs had the lowest win rates in medical malpractice trials (23%), product liability trials not involving asbestos (20%), and false arrest/imprisonment trials (16%).

· Plaintiffs were significantly more likely to win in a bench trial; they won 68% of bench trials and 54% of jury trials.

· Among all plaintiff winners, the median final award was $28,000, with contract cases having higher median awards ($35,000) than tort cases ($24,000). Only about 4% of victorious plaintiffs received awards above $1 million.

· Plaintiffs winning their cases were awarded punitive damages in close to 5% of the cases, with the median punitive damages award being $64,000.

· The total number of civil trials in the nation’s 75 most populous counties declined by 52% from 1992 to 2005. Tort cases decreased the least (40%), while real property (77%) and contract (63%) cases registered the largest dips.

· Overall, median damage awards are on the decline in the most populous counties—except in products liability and medical malpractice cases. From 1992-2005, the inflation-adjusted median damages award decreased by 40%, from $72,000 in the previous large-county study to $43,000 in 2005. This drop was largely caused by a decrease in the median award for auto accidents, which dropped from $41,000 in 1992 to $17,000 in 2005. However, products liability plaintiffs in 2005 received a median award of $749,000, five times higher than in 1992, and medical malpractice plaintiffs received a median award of $682,000 in 2005, nearly 2.5 times as much as the median ($280,000) in 1992.

· Of the cases making it to trial, 61% involved tort claims, with auto accidents being the most frequent matter being tried. The median final award in auto cases was around $15,000.