Duncan v. Kansas City Southern Railway Co.10/30/2000
d a speech therapist. Further, the plan provides for a treatment program with individual counseling, family counseling, occupational therapy, physical therapy, speech therapy, weekly review by a registered nurse ("RN"), and 24-hour attendant care by either a licensed practical nurse ("LPN") or a RN. The LPN or RN would be provided by a home health agency, and their activities would be supervised by a case manager. Dr. Voogt based his plan on Rachel having the same life expectancy as persons her age without spinal cord injuries, that is 81 years.
The jury also heard testimony from Terry Arnold, defendant's expert in rehabilitation nursing and life care planning, regarding the life care plan prepared by her agency, Life Care Consultants, Inc. Ms. Arnold's plan ("Life Plan") recommends evaluations by physicians specializing in physical medicine and rehabilitation, pulmonology, urology, internal medicine, orthopedics, and psychiatry. The Life Plan further recommends educational counseling, physical therapy, and occupational therapy, as well as, 16 to 24 hour attendant care by a home health aide. Both the Voogt Plan and the Life Plan provide for medical supplies and other necessary equipment, a specialized wheelchair, van transportation, home modifications and maintenance.
Having reviewed the life care plans prepared for Rachel Duncan, it seems the variations in cost can be primarily attributed to the recommendations for attendant care. The Voogt Plan recommends 24-hour attendant care by either a LPN, a RN, or a combination of the two. According to Dr. Voogt, Rachel requires sterile and invasive procedures and Louisiana law prohibits home health aides performing such procedures. Thus, a home health agency would be required to send either a LPN or RN to care for Rachel. Dr. Voogt estimates 24-hour LPN care to be $267,686.00 annually; 24-hour RN care is estimated at $315,866.00 annually; and 12-hour LPN/12-hour RN care is estimated at $291,776.00 annually. These amounts are based on the present wages paid for LPN and RN care by two home health agencies in the Lake Charles area. The first agency pays LPNs $27.00 per hour and RNs are paid $32.00 per hour. The other agency pays LPNs $22.00 per hour and RNs are paid $28.00 per hour.
The Life Plan recommends four alternatives, 16-hour live-in home health aide; 24-hour live-in home health aide; 16-hour daily home health aide; or 24-hour daily home health aide. The estimated cost for a 16-hour live-in aide is $1,800.00 to $2,400.00 per month, and $21,600.00 to $28,800.00 annually. The estimate for a 24-hour live-in aide is $2,400.00 to $3,600.00 per month, and $28,800.00 to $43,200.00 annually. The estimate for a daily aide is $8.00 to $9.00 per hour, with an annual cost of $49,640.00 for a 16-hour aide or $74,4600.00 for a 24-hour aide. These figures are not based on estimates from specific agencies, but rather on the Duncan family hiring these persons independently.
Based on the Voogt Plan, the plaintiffs' expert economist, Bernard Pettingill, Ph.D., calculated the present values for future medical expenses with LPN care at $22.00 per hour, using a 6% discount rate, offset by 6% inflation, and based on a life expectancy of 57 years to be $10,528,722. According to Dr. Pettingill, because of increases in medical costs and inflation, these amounts would be completely exhausted at the end of Rachel's life expectancy.
Michael Kurth, Ph.D., defendant's economist, calculated the present value for future medical expenses based on the Life Plan using a 2.5% discount rate, and based on a 57-year life expectancy to be $2,165,855.00. Dr. Kurth allocated $140,160.00 for attendant care in 1998 and $36,000.00 annually for 1999 and
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