In 2014 almost a quarter of a million Canadian received treatment in an Intensive care Unit (ICU) and, even before Covid, that number was increasing yearly.
Among adults, common reasons for admission included post-surgical care, heart attacks, and respiratory issues. Recent cost figures are unavailable but a decade ago at a teaching hospital the cost of ICU care per day was almost $4200.
Canadians can rightly feel secure knowing that such sophisticated and expensive care is available to them under the public health care system. But what they might not appreciate is that a there is a growing awareness on the part of critical care clinicians that, essential though access to ICU care is, it is also the cause of emotional and cognitive illness. This awareness, in turn, may have implications for both personal injury lawyers and their clients.
In general, the fact that a client spent time in an ICU is used by lawyers to emphasize the seriousness of their injury, thereby lending weight to the damages they claim. But a growing body of medical research shows that spending even a small amount of time in an IUC can add additional and entirely new disability to whatever injury created the initial need for critical care. Consider the following two examples.
In 2019 medical researchers culled over 13,000 published studies to identify the most robust papers. When they pooled and reanalyzed the data they found compelling evidence that PTSD symptoms may affect 1 in every 5 adult critical care survivors, with a high expected prevalence 12 months after discharge. Importantly, these conclusions precisely echoed the findings of a somewhat smaller review published in 2015. It should also be noted that family members of ICU patients have been found to have a high incidence of adverse psychological outcomes, including PTSD.
Though PTSD is likely the most thoroughly studied mental consequence of ICU admission, there is increasing awareness of negative cognitive outcomes. Impaired cognition is distressingly common, with prevalence ranging from 35% to 81% at 3 months following discharge, depending on the population studied and method of diagnosis. The degree of cognitive impairment ranges from mild to severe, and may interfere with the patient’s ability to complete day-to-day tasks. Symptoms of disordered thoughts may include difficulties remembering to take medications or attend follow up appointments, preparing meals following new dietary restrictions, or learning how to properly manage new chronic conditions such as diabetes.
If an individual is pursuing legal action for a serious injury and has spent time in an ICU it is worthwhile documenting any evidence of adverse emotional and cognitive changes, including for family members. The information should be shared with the legal team who may wish to build into the claim for damages compensation for this potentially devastating event.