Life Expectancy in Complex Multisystem Catastrophic Cases
By James F. Lineback MD, FCCP
Normal Life Expectancy
Determining life expectancy ordinarily starts with the normal expectancy of the individual. For example, a 56 year old male would, according to the Social Security Actuarial Publications Periodic Life Table, live an additional 24 years or a total of 80 years.
Once a baseline, – or normal life expectancy, is established, the physician expert will want to analyze the medical problems of the individual to determine:
- The serious conditions the individual had prior to the catastrophic injury.
- The impact, if any, that these medical conditions would have had on his or her life expectancy.
Medical research will need to be done to determine the impact of the pre-existing medical conditions on the life expectancy of the individual.
Impact on Life Expectancy
Once the medical conditions and their impact on life expectancy are established, the physician expert is then able to opine to a reasonable degree of medical certainty on what the actual life expectancy of the individual was.
Let me offer an example of how this type of analysis is performed:
A 56 year old male with end-stage liver disease, chronic alcoholism, hypertension, adult- onset diabetes mellitus, obesity, and coronary artery disease suffered a severe abdominal injury and died 4 years later. In this case, I was asked to opine on the 56 year old patient’s life expectancy.
Loss of Life Expectancy
My research, medical training, and experience led me to the following analysis:
|End-stage liver disease||5 year mortality – 71-90%|
|Chronic alcoholism||Years of life lost – 22.6 years|
|Diabetes||Years of life lost – 5.3 years|
|Hypertension||Years of life lost – 5.1 years|
|Obesity (severe)||Years of life lost – 5.8 years|
I concluded that it was medically probable that this individual would not have lived an additional five years, even absent the injury.
Individuals with complex multisystem comorbid conditions should be carefully evaluated for their true life expectancy.
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About the Author
James F. Lineback MD, FCCP is board certified in internal medicine and pulmonary medicine. He is an Associate Clinical Professor of Medicine at the University of California, Riverside.
© Aug. 2013. James F. Lineback, MD, FCCP. All Rights Reserved. Written for the SEAK Expert Witness Directory.