M.M. was struck by a car at the age of five and suffered a multiple injuries. M.M. suffered severe blood loss which contributed to a reduced level of consciousness at the scene of the accident. Paramedics measured her level of consciousness using the Glasgow Coma Scale (GCS) resulting in a score of 9 out of 15, indicating moderate brain injury. Shortly after receiving oxygen M.M.’s GCS score improved to a normal reading of 15.
The law states that if as a result of a motor vehicle accident a person has a GSC score of 9 arising from brain impairment, then the person will be found to have sustained a Catastrophic Impairment, which will allow the person to access enhanced medical and rehabilitation benefits.
M.M.’s insurer argued that her temporary GCS score of 9 was actually caused by hemodynamic instability and not due to brain impairment as required by law, and consequently she was not entitled to Catastrophic Impairment benefits.
M.M.’s lawyer Juan Carranza was able to demonstrate that M.M.’s bleeding caused reduced levels of oxygen flowing to the brain impairing its function such that M.M. was only able to score 9 on the GCS scale.
The arbitrator agreed with M.M.’s counsel’s argument and held that M.M. did in fact suffer a brain impairment from the accident as indicated by her GSC score of 9. The arbitrator found that M.M.’s brain suffered a loss of function for several minutes due to hypoxia (lack of oxygen) and haemorrhage pressure on the right hemisphere. This case is important as it confirms the principle that a single GCS score of 9 or less will suffice to meet the legal test for Catastrophic benefits entitlement. The decision is especially important as it clarifies previous decisions where the court had commented, in passing, that accident victims with a GCS score of 9 or less caused by blood loss, would not be considered to have sustained brain impairment and thus were not entitled to Catastrophic benefits under the GCS criteria.