Carlos Mendez

Claim:Product liabilityIncident:March 12, 2025State:TX

What We Audited & What Needs Your Review

We compiled 7 clinical records across 6 providers (125 days of care, $35,300.00 in medical specials). We flagged 5 audit items below for your attention. Please confirm 3 required decisions in Step 3 to start demand letter drafting.

Step 1 Review Audit Flags (6)
Step 2 Timeline & Bills (7) →
Step 3 Decisions & Sign-Off (4) →
ALERTS

Flagged Audit Items (5)

Only 127 days remain before the filing deadline of March 12, 2027 (Tex. Civ. Prac. & Rem. Code § 16.003). Any negotiation must finish before then, or a lawsuit must be filed to protect the claim.
1 period of more than 14 days with no visit on file. 1 has record passages you may want to read.
The employer gives March 12, 2025 as the first day off work, but the medical records first take the client off work on March 27, 2025.
Helpful details not on file:
  • Where and when the product was bought
  • Expert or engineering opinion on the defect
  • Product warnings, labels or instructions
The letter will leave these out or leave a blank.
The adjuster name and claims mailing address for Travelers Property Casualty Co. of America are not on file and were not found in the insurer's letters. The demand letter will leave these blank.
CONTINUITY

Treatment Gaps (1)

Gap #1: June 25, 2025 to July 15, 2025 (20 days)

No visit is on file between June 25, 2025 (Advanced Hand & Occupational Therapy Rehabilitation) and July 15, 2025 (Houston Orthopedic & Reconstructive Surgery), a period of 20 days. Passages in the records that may bear on this period: "07/15/2025 (Final Orthopedic Discharge & MMI Evaluation): Fractures clinically united." (Medical Records Trauma and Surgical, page 2)

Covered intervals: From April 1, 2025 to June 25, 2025 there are no dated visit notes, but Advanced Hand & Occupational Therapy Rehabilitation documents care from April 1, 2025 to June 25, 2025 (16 visits), so this is not counted as a treatment gap. The individual visit dates are not listed in the records.

EVIDENCE

Liability Evidence & Suggested Next Steps

Claim Evidence ItemStatus & Source
Product identification (product, manufacturer, model or lot)On file
OSHA Investigation and Incident Report
Where and when the product was boughtNot found
Expert or engineering opinion on the defectNot found
Product warnings, labels or instructionsNot found
Photographs of the product or the sceneOn file
Failed Hydraulic Jack Arm
Suggested Next Steps (7)
Put the filing deadline of March 12, 2027 (127 days away) on the calendar and decide whether to file suit.
Make sure the product, its packaging, labels and instructions, and any purchase record are preserved in their current condition. Any testing should wait until the other parties can be notified.
A product claim usually needs an expert or engineering opinion on the defect; a design-defect claim in Texas also requires proof of a safer alternative design (Tex. Civ. Prac. & Rem. Code § 82.005).
Statute of repose: A products liability action must be started within 15 years after the date the defendant sold the product, subject to limited exceptions. The sale date is not on file; confirm it. (Tex. Civ. Prac. & Rem. Code § 16.012(b))
If any defendant is a governmental unit (for example a city, county, school district or state agency), the Texas Tort Claims Act requires notice of the claim describing the injury, the time and place of the incident and the incident itself no later than six months after the incident, unless the unit had actual notice of the injury (Tex. Civ. Prac. & Rem. Code § 101.101). Confirm whether this applies.
Add the adjuster name and claims mailing address for Travelers Property Casualty Co. of America to the case before the letter is drafted.
Houston Orthopedic is mentioned as a lienholder in Medical Billing UB04 and Itemized Ledger ($3,500.00), but no lien letter from them is on file. Ask them to confirm whether they claim a lien.
Step 1 of 3 • Audit Brief & Alerts
TIMELINE

Clinical Chronology (7 Visits)

Care-Span Map (Hover for summary • Click any dot or gap to jump)
ER/EMSSpecialistProcedureTherapyGap (>14d)
20d gap
March 12, 2025125 days care windowJuly 15, 2025
#01March 12, 2025Ambulance / EMSPasadena Volunteer Fire Department & EMS• Heavy machinery crushing injury, severe 10/10 pain, paresthesias and numbness noted i...
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Reason for visit
Heavy machinery crushing injury, severe 10/10 pain, paresthesias and numbness noted in right thumb, index, and long fingers (median nerve distribution).
Symptoms reported
Severe 10/10 pain, paresthesias and numbness noted in right thumb, index, and long fingers (median nerve distribution), exquisitely tender to palpation.
Examination findings
Severe deformity, acute swelling, active bleeding from 4cm laceration over dorsal wrist, exquisitely tender to palpation, paresthesias and numbness noted in right thumb, index, and long fingers (median nerve distribution). Status: Priority 2 Trauma.
Treatment provided
Splinted in position of presentation, sterile dressing applied. IV access established (18G left AC), 100mcg Fentanyl IV administered for severe 10/10 pain. Transported emergent to Level 2 Trauma Center.
Medications
Fentanyl 100mcg IV
Future care recommended
Transported emergent to Level 2 Trauma Center.
Billed for this visit
Pasadena Vol. Fire & EMS: $1,650.00
📄 Source: Records Trauma and Surgical, p. 1
#02March 12, 2025Emergency visitMemorial Hermann Southeast Hospital — Marcus Vance, M.D.• Comminuted intra-articular distal radius fracture (ICD-10 S52.571A)
Details ▾
Reason for visit
Severe pain exacerbated by passive finger extension, gross angular deformity of the distal forearm, decreased two-point discrimination across right median nerve distribution.
Symptoms reported
Severe pain exacerbated by passive finger extension, decreased two-point discrimination (< 8mm) across right median nerve distribution (digits 1-3).
Examination findings
Right upper extremity demonstrates gross angular deformity of the distal forearm. Tense swelling extending into thenar space. Decreased two-point discrimination (< 8mm) across right median nerve distribution (digits 1-3). Radial pulse 2+ palpable. Capillary refill < 2 seconds. Severe pain exacerbated by passive finger extension.
Imaging and tests
CT / X-Ray Right Forearm & Wrist: Severely comminuted, intra-articular fracture of the distal radius with 18 degrees dorsal tilt and 4mm radial shortening. Associated displaced fracture of the ulnar styloid base. Significant soft tissue swelling.
Diagnoses
Comminuted intra-articular distal radius fracture (ICD-10 S52.571A)
Distal ulna fracture (ICD-10 S52.611A)
Acute median nerve crush neuropraxia / acute carpal tunnel syndrome (ICD-10 G56.01)
Treatment provided
Orthopedic surgery consult requested immediately for operative intervention.
Future care recommended
Orthopedic surgery consult requested immediately for operative intervention.
Billed for this visit
Memorial Hermann ER Physicians: $1,950.00
Memorial Hermann SE (Facility UB-04): $34,800.00 (one charge for March 12, 2025 to March 14, 2025)
📄 Source: Records Trauma and Surgical, p. 1
#03March 13, 2025ProcedureHouston Orthopedic & Reconstructive Surgery — Andrew J. Vance, M.D., Board-Certified Orthopedic Hand & Microvascular Surgeon• Severely comminuted intra-articular fracture, right distal radius (ICD-10 S52.571A)
Details ▾
Examination findings
Massive dorsal and intra-articular comminution identified. Articular surface restored under direct fluoroscopy. Anatomic articular alignment confirmed. Median nerve noted to be hyperemic and flattened under severe hematoma pressure.
Diagnoses
Severely comminuted intra-articular fracture, right distal radius (ICD-10 S52.571A)
Displaced fracture of the right ulnar styloid process (ICD-10 S52.611A)
Acute post-traumatic median nerve compression / compartment syndrome (ICD-10 G56.01)
Treatment provided
Open reduction internal fixation (ORIF) right distal radius using Synthes 3.5mm Variable-Angle LCP Volar Two-Column Plate with 7 locking screws (CPT 25609); Percutaneous pinning / open repair of right distal radioulnar joint (DRUJ) (CPT 25652); Open emergency right carpal tunnel release with median neurolysis (CPT 64721); epineural release; Bulky volar sugar-tong splint applied
Billed for this visit
Greater Houston Anesthesia: $2,450.00
Houston Orthopedic (Surgical Fee): $8,400.00
📄 Source: Records Trauma and Surgical, p. 2
#04March 27, 2025Follow up visitHouston Orthopedic & Reconstructive Surgery — Andrew J. Vance, M.D., Board-Certified Orthopedic Hand & Microvascular Surgeon• 2-Week Post-Op; Mild persistent paresthesias in right index fingertip
Details ▾
Reason for visit
2-Week Post-Op; Mild persistent paresthesias in right index fingertip
Symptoms reported
Mild persistent paresthesias in right index fingertip
Resolved, improved or prior history
without erythema
Examination findings
Sutures removed. Wound healing well without erythema.
Treatment provided
Sutures removed. Transitioned to custom molded thermomold wrist orthosis. Prescribed 16 sessions of active occupational therapy.
Work & activity instructions
Off work continued.
Future care recommended
Prescribed 16 sessions of active occupational therapy.
📄 Source: Records Trauma and Surgical, p. 2
#05April 24, 2025Follow up visitHouston Orthopedic & Reconstructive Surgery — Dr. Vance• 6-Week Post-Op
Details ▾
Reason for visit
6-Week Post-Op
Examination findings
Radiographs demonstrate progressive callus formation at radius. Grip strength right hand 18 lbs vs left 95 lbs. Severe intrinsic muscle atrophy.
Imaging and tests
Radiographs demonstrate progressive callus formation at radius.
Treatment provided
continuation of therapeutic modalities
Work & activity instructions
Patient restricted from lifting > 2 lbs with right arm.
Future care recommended
Dr. Vance orders continuation of therapeutic modalities.
📄 Source: Records Trauma and Surgical, p. 2
#06June 25, 2025Summary of a course of careAdvanced Hand & Occupational Therapy Rehabilitation
Details ▾
Symptoms reported
remains unable to operate heavy impact pneumatics or automotive air-wrenches requiring sustained grip torque
Resolved, improved or prior history
Patient achieved functional recovery for activities of daily living
Examination findings
Patient achieved functional recovery for activities of daily living but remains unable to operate heavy impact pneumatics or automotive air-wrenches requiring sustained grip torque.
Treatment provided
scar desensitization, active-assisted range of motion, therapeutic ultrasound, fluidotherapy, and progressive strengthening
Course of care
April 1, 2025 to June 25, 2025, 16 visits attended
Work & activity instructions
remains unable to operate heavy impact pneumatics or automotive air-wrenches requiring sustained grip torque
Billed for this visit
Advanced Hand Therapy (16 Sessions): $4,800.00 (one charge for April 1, 2025 to June 25, 2025, 16 sessions)
📄 Source: Records Trauma and Surgical, p. 2
⚠ Treatment Gap • 20 daysJune 25, 2025 → July 15, 2025

No visit is on file between June 25, 2025 (Advanced Hand & Occupational Therapy Rehabilitation) and July 15, 2025 (Houston Orthopedic & Reconstructive Surgery), a period of 20 days. Passages in the records that may bear on this period: "07/15/2025 (Final Orthopedic Discharge & MMI Evaluation): Fractures clinically united." (Medical Records Trauma and Surgical, page 2)

"07/15/2025 (Final Orthopedic Discharge & MMI Evaluation): Fractures clinically united." (Medical Records Trauma and Surgical, p. 2)
#07July 15, 2025MMI / impairment evaluationHouston Orthopedic & Reconstructive Surgery — Andrew J. Vance, M.D., Board-Certified Orthopedic Hand & Microvascular Surgeon• Final Orthopedic Discharge & MMI Evaluation; Persistent median nerve paresthesias upo...
Details ▾
Reason for visit
Final Orthopedic Discharge & MMI Evaluation; Persistent median nerve paresthesias upon sustained grasp
Symptoms reported
Persistent median nerve paresthesias upon sustained grasp
Examination findings
Fractures clinically united. Range of motion right wrist: flexion 40° (left 70°), extension 45° (left 75°), supination 55° (left 85°).
Work & activity instructions
Permanent 25 lb lifting restriction on right dominant arm.
Maximum medical improvement
July 15, 2025
Outlook / Prognosis
Reached Maximum Medical Improvement (MMI). Permanent partial impairment rating assessed at 18% right upper extremity (11% whole person) under AMA Guides 6th Edition.
📄 Source: Records Trauma and Surgical, p. 2
BILLS

Reconciled Medical Expenses by Provider (6)

ProviderBilledPaidWritten OffStill Owed
Pasadena Vol. Fire & EMS$1,650.00$1,300.00$350.00$0.00
Memorial Hermann SE (Facility UB-04)$34,800.00$11,200.00$12,400.00$11,200.00
Memorial Hermann ER Physicians$1,950.00$1,200.00$750.00$0.00
Houston Orthopedic (Surgical Fee)$8,400.00$2,100.00$2,800.00$3,500.00
Greater Houston Anesthesia$2,450.00$1,600.00$850.00$0.00
Advanced Hand Therapy (16 Sessions)$4,800.00$1,700.00$1,600.00$1,500.00
Total Reconciled$54,050.00$19,100.00$18,750.00$16,200.00

Only amounts actually paid or still owed can be claimed, not the full amount billed (Tex. Civ. Prac. & Rem. Code § 41.0105).

WAGES

Lost Wages & Earnings Verification

Reported by the employer$23,887.50
Based on the calendar$19,760.00
LIENS

Asserted Liens & Subrogation (2)

Liens are satisfied out of recovery and are not added to medical specials.

Memorial Hermann Hospital System

Hospital lien • Amount stated: $11,200.00
Final payoff amount not yet confirmed.
📄 Source: Texas Hospital Lien and Subrogation Notice, p. 1

Blue Cross Blue Shield of Texas Employee Welfare Benefit Plan

Health plan reimbursement claim • Represented by Optum Subrogation Services • Amount stated: $19,100.00
Final payoff amount not yet confirmed.
📄 Source: Texas Hospital Lien and Subrogation Notice, p. 1

Named in records, no lien letter on file:

• Houston Orthopedic, $3,500.00 (UB04 and Itemized Ledger, p. 1)
DECISIONS

Attorney Drafting & Valuation Decisions (4)

Please confirm the 3 questions marked Required below. Your answers directly set the figures in the demand letter.

Decision 1 of 4

Liens (2 liens)

Answered ✓

Please confirm you have reviewed the liens listed above. They are shown as each holder states them, they are not added to the medical expenses, and final payoff amounts are not yet confirmed.

📄 Source: Texas Hospital Lien and Subrogation Notice, p. 1; Texas Hospital Lien and Subrogation Notice, p. 1
Decision 2 of 4

Lost wages amount

Required

Which lost wages amount should the demand letter claim?

📄 Source: Employer Wage Verification and Loss Records, p. 1
Pre-filled from cited record: $23,887.50.
Decision 3 of 4 • General Damages

Pain & suffering valuation

Answered ✓

Select the multiplier or specific dollar amount for non-economic damages based on $35,300.00 in medical specials.

Multiplier Modeler (Drag slider or click a preset)5.00× → $176,500.00
Selected Pain & Suffering Figure$176,500.00
Decision 4 of 4

Treatment gap: June 25, 2025 to July 15, 2025 (20 days)

Optional

Optional. No visit is on file between June 25, 2025 (Advanced Hand & Occupational Therapy Rehabilitation) and July 15, 2025 (Houston Orthopedic & Reconstructive Surgery), a period of 20 days. Passages in the records that may bear on this period: "07/15/2025 (Final Orthopedic Discharge & MMI Evaluation): Fractures clinically united." (Medical Records Trauma and Surgical, page 2) Should the letter address this period?

📄 Source: Medical Records Trauma and Surgical, p. 2
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Attorney Sign-Off & Demand Generation

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Step 3 of 3 • Decisions & Sign-Off
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