Severity of Carol's injuries went way beyond broken bones, raising issues of shock, blood loss, nerve damage, kidney damage, elevated pressures, and more

Comminuted fracture of Carol
Shuler's left arm

How severe were Carol's injuries from our September 2015 eviction, when Missouri deputies body slammed her butt-first to the ground and yanked so viciously on her limbs that her left arm was broken just above the elbow, requiring trauma surgery? What kind of issues can crop up from a comminuted fracture -- a bone broken into three or more fragments -- of the sort Carol had? Did this put Carol's overall health at risk? Did it even put her life in danger?

We recently received Carol's medical records from Cox Medical Center in Springfield, Missouri, where her fracture was diagnosed and treated, and she underwent 4-5 months of physical and occupational therapy. (Portions of the records are embedded at the end of this post.) Let's see what those records tell us:


A "shattered" bone

I've used the term "shattered" to describe Carol's injuries here, based on a layman's examination of X-rays. I had no idea if that term actually fit, from a medical sense. It turns out that it does. This is from Carol's Outpatient Rehabilitation Intake Form, dated 10/28/15, roughly seven weeks after the injury and six weeks after surgery:

Purpose of Therapy: Recovery from ortho trauma surgery on shattered left elbow/arm and dislocation on 9/16. Need better ROM (range of motion) and function of arm to normal.

Using the term "shattered" to describe Carol's injuries was not an exaggeration. Members of her medical team used the same term.


A need for oxygen

Carol has reported receiving oxygen twice during the evening on the day she was injured -- once at Cox North and once at Cox South. Notes on the rehab intake form show that she was given oxygen twice on 9/9/15.

Why was Carol given oxygen, twice? We don't know for sure, but the most likely reason is that medical personnel saw signs that she was in danger of going into shock -- and shock, often triggered by blood loss, can kill people if not treated in a timely fashion.

Carol was not bleeding in an external way, one that could be seen. But when I saw her in the hospital, the morning after her injury, her right arm was purple from bruising, from shoulder to finger tip. And that was the unbroken arm. I can only imagine how bad bruising was on the broken arm, which was in a fiberglass splint.

Bruising occurs when blood gets trapped beneath the surface of the skin. This probably is what triggered the need for oxygen in Carol's case -- and concerns about shock.


More about blood loss

As a layman, I had not thought much about blood loss in Carol's case -- either due to the injury or surgery. An Operative Report from her medical records shows she had 150 ml of blood loss. That might be a normal amount due to surgery, but blood loss can be an issue with fractures themselves.

From a Web site about a lawyer who specializes in personal-injury cases that often involve fractures:

Bone is living tissue with its own blood supply. The soft inside center of bone (bone marrow) is where the body makes its blood cells. Between 10-15 million red blood cells are made every second in the bone marrow.

A lot of blood is found inside our bones, especially the long bones in our arms and legs. There are many arteries inside our bones which deliver blood to our bones from the arterial circulation originating from the heart. . . .

Since our bones, especially the long bones in our arms and legs, have a rich blood supply, a broken bone injury can result in excessive bleeding. For example, a bone fracture of the thigh bone (femur) can result in 1-2 liters of blood loss. Substantial bleeding from a bone fracture often causes the victim of a bone fracture injury to go into shock. (Again, this points to the need for oxygen in Carol's case).

The high energy forces from car, truck and motorcycle accidents often cause broken bone injuries where the bone is shattered into many pieces. This type of bone fracture is called a “comminuted fracture.” Shattered bone fragments often have sharp and pointed edges which can tear nearby blood vessels. The most frequent areas where blood vessels are damaged from shattered bone fragments are in the arms and legs.

A comminuted fracture, the kind Carol had, often tears nearby blood vessels? No wonder her medical team was concerned about oxygen, shock, and issues related to blood loss.


A matter of nerve

Carol's Operative Report indicates surgeon Brian Buck performed an "in situ ulnar nerve release" as part of the repair. This indicates Carol's ulnar nerve was damaged, or compressed, near the elbow. From a medical-journal article on the subject:

Ulnar nerve entrapment at the elbow is the second most common compression neuropathy in the upper extremity following carpal tunnel syndrome . . .  with an estimated prevalence of 1% in the US population. . . .

Trauma and arthritis have both been implicated as causes for ulnar neuropathy. Nevertheless, the most frequent cause of cubital tunnel syndrome remains idiopathic. Multiple potential sites of compression exist along the path of the ulnar nerve.

Concerns about kidney damage

A Consultative Report by Dr. Brian Rekus indicates Carol had a number of elevated pressures -- blood pressure, thyroid, creatinine -- after surgery.  Rekus, an internist, was brought in to help manage those.

Elevated creatinine levels signify kidney disease or impaired kidney function. Carol's level was elevated at 1.53, and when checked a few days later, had decreased to 1.3.


The bottom line: Injuries that Missouri deputies inflicted upon Carol went way beyond the broken bones that look downright scary on an X-ray. It's really scary when you review her medical records and see that the severity of her injuries caused issues that, if not treated promptly and properly, could have put her overall health -- even her life -- at risk.

And yet, these same cops treat the matter so blithely that they created written narratives -- hinting that Carol broke her own arm by flailing about in the back seat of a patrol car -- that would have to improve to be absurd. This reflects the utter disregard and contempt too many cops have for the general public -- especially when everyday citizens become the victims of police brutality.

On top of that, cops generally have access to lawyers, who are more than happy to dump on abuse victims, trying to sell bogus law-enforcement stories that have little, or no, resemblance to the truth.

This post, along with the supporting documents below, shows just how badly Carol was injured -- and how easily her condition could have taken a turn in a dark direction. That cops would create written statements that they know are false shows how little they care about those they supposedly "serve and protect."