Electrolyte Imbalance Brain Injury: When Hospital Negligence Causes Permanent Harm
In 2022, a Florida jury awarded Miranda Crohan $68.6 million after four doctors were found responsible for brain damage caused by a severe electrolyte imbalance. Ms. Crohan collapsed due to hyponatremia (low blood sodium) in 2017, and errors in managing her sodium levels at a Tampa hospital led to catastrophic, permanent brain injury requiring lifelong care.
Her case is not isolated. As of 2025, electrolyte imbalances remain one of the most common yet preventable causes of brain injury in hospitalized patients across the United States. When healthcare providers fail to properly monitor and correct these imbalances, the consequences can be devastating—ranging from permanent cognitive impairment to paralysis, coma, or death.
If you or a loved one suffered brain damage from improper electrolyte management in a New York hospital, understanding your legal rights is critical. This page explains how electrolyte imbalances cause brain injury, what constitutes hospital negligence, and how to pursue compensation for preventable harm.
Key Takeaways
- Electrolyte imbalances are common: According to research published in PMC, 82% of traumatic brain injury patients develop hyponatremia, and improper management can cause additional brain damage.
- Hospital errors occur in three ways: Administering sodium too rapidly, failing to monitor levels adequately, or not using protective medications to prevent overcorrection.
- The standard of care is clear: Medical protocols require sodium correction of no more than 6-8 mEq/L per 24 hours to prevent osmotic demyelination syndrome.
- Compensation is available: Recent verdicts and settlements for electrolyte-related brain injuries range from $14.9 million to $68.6 million when negligence is proven.
- Time limits apply: New York’s medical malpractice statute of limitations requires action within 2.5 years of the injury or discovery of negligence.
What Are Electrolytes and Why Do They Matter for Brain Function?
Electrolytes are electrically charged minerals in your blood and body fluids that regulate critical functions throughout the body. The primary electrolytes include sodium, potassium, calcium, magnesium, chloride, and phosphate.
For brain function, electrolytes are essential because they:
- Control nerve signal transmission: Electrical signals between brain cells depend on sodium and potassium moving across cell membranes.
- Regulate brain cell volume: Sodium concentration determines how much water enters or leaves brain cells.
- Maintain blood-brain barrier integrity: Calcium and magnesium help protect the brain from harmful substances.
- Support neurotransmitter function: Calcium triggers the release of chemical messengers between neurons.
When electrolyte levels fall outside normal ranges, brain cells can swell or shrink. Because the brain is encased in the rigid skull, even small amounts of swelling can cause catastrophic damage by cutting off blood flow and oxygen delivery to brain tissue.
Types of Electrolyte Imbalances That Cause Brain Injury
Several electrolyte disorders can lead to brain damage when improperly managed in hospital settings. Understanding these conditions helps identify when medical care falls below accepted standards.
Hyponatremia (Low Sodium)
Hyponatremia, defined as serum sodium below 136 mEq/L, represents the most common electrolyte abnormality in hospitalized patients. It affects up to 50% of neurosurgical patients and 38% of neurocritical care patients.
Low sodium causes water to enter brain cells through osmosis, leading to cerebral edema (brain swelling). In patients who already have brain injuries or limited skull space, this additional swelling can be life-threatening. According to medical research, acute hyponatremic encephalopathy carries a 34% mortality rate.
Hyponatremia commonly develops in hospitalized patients due to:
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- Cerebral salt-wasting syndrome (CSWS)
- Excessive IV fluid administration
- Diuretic medications
- Post-surgical hormonal changes
Hypernatremia (High Sodium)
Hypernatremia occurs when sodium levels exceed 145 mEq/L. This condition causes water to leave brain cells, leading to cell shrinkage and potential tearing of blood vessels in the brain.
Research published in PMC shows that hypernatremia in traumatic brain injury patients is associated with increased mortality. Causes in hospital settings include:
- Diabetes insipidus following head trauma (affects 15-20% of TBI cases)
- Inadequate fluid replacement
- High-sodium IV solutions administered too rapidly
- Dehydration from diarrhea, vomiting, or fever
Other Critical Electrolyte Imbalances
Additional electrolyte disorders that contribute to poor neurological outcomes include:
- Hypokalaemia (low potassium): Found in 78% of brain injury patients, affecting nerve signal transmission
- Hypocalcaemia (low calcium): Present in 72% of TBI cases, impairing neurotransmitter release
- Hypomagnesemia (low magnesium): Affects 66% of brain injury patients, increasing seizure risk
- Hypophosphatemia (low phosphate): Occurs in 44% of cases, reducing cellular energy production
How Hospital Negligence Causes Electrolyte-Related Brain Damage
Not every electrolyte imbalance constitutes medical malpractice. However, when healthcare providers fail to meet established standards of care, resulting brain damage may form the basis of a negligence claim.
Failure to Monitor Sodium Levels Adequately
High-risk patients require serial sodium measurements throughout hospitalization. A $14.9 million settlement was reached in the case of Jennifer Lee, who presented to Palos Community Hospital in 2009 with severe dehydration. The hospital failed to properly monitor her electrolyte levels during IV fluid treatment, resulting in permanent brain damage.
Monitoring failures include:
- Not checking sodium levels in patients receiving IV fluids, a form of monitoring failure
- Using standard lab alarm thresholds (often 121 mg/dL) instead of the critical threshold for head trauma patients (130 mg/dL)
- Failing to order tests when patients show behavioral changes or altered consciousness
- Not continuing electrolyte monitoring during post-discharge rehabilitation
- Inadequate handoff communication between shifts about trending electrolyte abnormalities
Correcting Sodium Too Rapidly
The most dangerous form of electrolyte-related negligence involves overly rapid correction of low sodium levels. Medical protocols taught in medical schools establish that sodium should not be corrected by more than 6-8 mEq/L in 24 hours.
When sodium rises too quickly, it creates an osmotic shift that pulls water out of brain cells faster than they can adapt. This causes cells to shrink and die, leading to central pontine myelinolysis or osmotic demyelination syndrome—devastating conditions that can cause permanent paralysis, difficulty speaking and swallowing, and locked-in syndrome.
Rapid overcorrection typically occurs when providers:
- Administer hypertonic saline (3% NaCl) too aggressively
- Fail to account for the patient’s baseline sodium level
- Do not distinguish between acute and chronic hyponatremia (which require different correction rates)
- Continue IV saline infusions without rechecking sodium levels
- Ignore warning signs of neurological deterioration during correction
Critical Distinction: Acute hyponatremia (developing in less than 48 hours) can be corrected somewhat faster initially (1-2 mmol/L per hour to reach 4-6 mmol/L total increase). Chronic hyponatremia (present for more than 48 hours) requires slower correction of 4-8 mmol/L per day, with high-risk patients limited to 4-6 mmol/L per day maximum. Treating chronic hyponatremia as if it were acute is a common error with catastrophic consequences.
Failing to Use Protective Measures
When sodium levels begin rising too quickly during correction, medical providers should implement protective strategies:
- Administer desmopressin to prevent further increases
- Use 5% dextrose in water to therapeutically re-lower sodium
- Discontinue hypertonic saline immediately
- Perform more frequent monitoring (every 2-4 hours during active correction)
- Consult endocrinology or nephrology specialists for complex cases
Failure to employ these protective measures when overcorrection is detected falls below the standard of care.
Misdiagnosing the Underlying Cause
Proper treatment depends on correctly identifying why the electrolyte imbalance occurred. Healthcare providers must distinguish between conditions that appear similar but require different treatments:
| Condition | Sodium Level | Fluid Status | Treatment |
|---|---|---|---|
| SIADH | Low | Euvolemic (normal) | Fluid restriction, vaptans |
| Cerebral Salt-Wasting | Low | Hypovolemic (depleted) | Fluid resuscitation, sodium supplementation |
| Diabetes Insipidus | High | Hypovolemic | Desmopressin, fluid replacement |
Treating SIADH with fluid restriction in a patient who actually has cerebral salt-wasting (and needs fluids) can worsen their condition. Similarly, aggressive fluid administration to someone with SIADH can dangerously lower sodium further.
Central Pontine Myelinolysis and Osmotic Demyelination Syndrome
Central pontine myelinolysis (CPM) and osmotic demyelination syndrome (ODS) are the most feared complications of improper electrolyte management. These conditions result specifically from overly rapid correction of chronic hyponatremia.
What Happens in CPM and ODS
According to medical research, when sodium levels rise too quickly, the sudden osmotic shift causes astrocyte apoptosis (death of supporting brain cells) followed by loss of communication between astrocytes and oligodendrocytes, which are crucial for myelination processes.
Myelin is the protective coating around nerve fibers that allows rapid signal transmission. When this coating is damaged or destroyed, nerve signals slow down or stop entirely, causing:
- Quadriparesis or paralysis (inability to move arms and legs)
- Dysarthria (difficulty speaking)
- Dysphagia (difficulty swallowing)
- Behavioral changes and memory impairment
- Locked-in syndrome (aware but unable to move or communicate except through eye movements)
CPM specifically affects the pons, a critical brainstem structure that controls breathing, sleep, and consciousness. ODS is a broader term encompassing demyelination in multiple brain regions including the basal ganglia, cerebellum, and thalamus.
Risk Factors for CPM/ODS
Certain patients face higher risk of developing osmotic demyelination syndrome:
- Chronic hyponatremia with serum sodium below 120 mmol/L
- Alcoholism or liver disease
- Malnutrition
- Hypokalemia (low potassium)
- Concurrent burns or other severe illness
Healthcare providers should identify these risk factors and correct sodium even more cautiously in vulnerable patients.
Diagnosis and Prognosis
CPM and ODS are typically diagnosed through MRI imaging, which reveals characteristic changes in affected brain regions. Symptoms may not appear immediately after overcorrection—there is often a delay of 2-6 days before neurological deterioration becomes apparent.
Prognosis varies widely. Some patients experience partial recovery over months to years, while others face permanent disability requiring lifelong care including assisted feeding, mobility support, and management of complications like aspiration pneumonia.
Signs and Symptoms of Electrolyte Imbalance
Recognizing the warning signs of electrolyte disorders can be lifesaving. Family members should watch for these symptoms in hospitalized loved ones and immediately alert nursing staff if they develop.
Early Warning Signs of Hyponatremia
- Nausea and vomiting
- Headache
- Muscle cramps or weakness
- Lethargy or unusual fatigue
- Confusion or disorientation
- Behavioral changes or personality shifts
- Restlessness or irritability
Severe Hyponatremia Symptoms
As sodium levels continue to drop, symptoms become more serious:
- Seizures
- Decreased level of consciousness
- Difficulty staying awake
- Slurred speech
- Inability to recognize family members
- Respiratory difficulties
- Coma
Symptoms of Rapid Correction (CPM/ODS)
If sodium was corrected too rapidly, symptoms may appear 2-6 days later:
- Progressive weakness in arms and legs
- Difficulty speaking clearly
- Trouble swallowing
- Changes in behavior or personality
- Tremors or abnormal movements
- Loss of balance or coordination
- Inability to move despite being conscious
Family Advocacy Matters: Medical staff may be managing multiple patients and can miss subtle changes. Family presence and reporting of behavioral changes can prompt testing that reveals dangerous electrolyte levels. One young man’s life was saved when family members noticed behavioral changes and requested sodium testing, which revealed a critically low level of 113 mg/dL, leading to immediate ICU transfer.
High-Risk Situations and Vulnerable Patient Populations
Certain medical situations and patient characteristics increase the risk of electrolyte-related brain injury. Healthcare providers should exercise heightened vigilance when treating these populations.
Traumatic Brain Injury Patients
According to research, the vast majority of TBI patients develop electrolyte imbalances:
- 82% develop hyponatremia
- 78% experience hypokalaemia
- 72% have hypocalcaemia
- 100% showed hypoalbuminemia in one study
Head trauma patients face particular vulnerability because their brains are already swollen from the initial injury, sometimes causing dangerous intracranial pressure. Standard sodium thresholds used for the general population may be dangerously low for this group. The critical threshold should be 130 mg/dL, not the typical lab alarm setting of 121 mg/dL.
Post-Surgical Patients
Surgery triggers hormonal responses that can affect electrolyte balance. Post-operative patients, particularly those undergoing neurosurgery, have a 1% prevalence of severe hyponatremia. IV fluid administration during and after surgery compounds this risk.
Women of Childbearing Age
Medical research shows that menstruating women face higher risk of brain damage from hyponatremia because estrogen impairs the Na⁺-K⁺ ATPase pump that helps brain cells adapt to changing sodium levels. Women in this demographic who develop acute hyponatremia require especially careful monitoring.
Children
Prepubescent children have reduced adaptive capacity for handling electrolyte shifts. Their brains are less able to regulate cell volume in response to changing sodium concentrations, making them more vulnerable to cerebral edema.
Elderly Patients
Chronic hyponatremia affects 10-20% of elderly patients. Even when compensated, low sodium in this population contributes to:
- Increased fall risk (21.3% vs. 5.3% in controls)
- Gait impairment and attention deficits
- Memory problems
- Osteoporosis and fracture risk
- Accelerated cellular aging through oxidative stress
Patients Receiving Certain Medications
Several medication classes increase electrolyte imbalance risk:
- Diuretics (especially thiazides)
- Antidepressants (SSRIs)
- Antipsychotics
- Anticonvulsants
- NSAIDs
- Chemotherapy agents
What Families Should Watch For During Hospitalization
Family members can play a crucial role in preventing electrolyte-related brain injury by advocating for proper care. If your loved one is in any high-risk category, take these steps:
Report Changes
Immediately alert nursing staff if you notice unusual confusion, personality changes, increasing sleepiness, restlessness, or slurred speech. These may indicate dangerous electrolyte shifts.
Request Testing
Ask when sodium levels were last checked and what the results were. For head injury patients, insist on physician consultation if sodium falls below 130 mg/dL.
Document Everything
Keep notes of dates and times of symptom changes, names of healthcare providers you spoke with, what you reported, and their responses. This documentation can be invaluable if negligence later becomes apparent.
If a nurse or resident is not responsive to your concerns, escalate through the chain of command by requesting the attending physician, contacting the nursing supervisor, or reaching out to patient relations services.
Notable Cases and Legal Outcomes
Understanding how courts have evaluated electrolyte-related malpractice claims provides insight into what constitutes negligence and the potential value of these cases.
Miranda Crohan Case
Location: Tampa, Florida
Year: 2022 (injury occurred 2017)
Verdict: $68.6 million
Facts: Ms. Crohan collapsed due to severe hyponatremia. Four doctors at a Tampa hospital were found responsible for errors in managing her sodium levels, leading to catastrophic brain injury.
Outcome: Despite defense claims that her brain damage resulted from an autoimmune condition, the jury found that improper treatment of her sodium imbalance caused lifelong injuries requiring permanent care.
Source: CVN Blog
Jennifer Lee Case
Location: Illinois
Year: 2009
Settlement: $14.9 million
Facts: Ms. Lee presented to Palos Community Hospital with severe dehydration from vomiting and diarrhea. The typical treatment for dehydration involves IV fluids with careful electrolyte monitoring.
Negligence: Hospital staff failed to properly monitor her electrolyte levels during fluid replacement, resulting in permanent brain damage.
Source: Robert Kreisman Blog
These substantial verdicts and settlements reflect several factors:
- Preventability: Proper monitoring and adherence to correction protocols could have prevented the injuries
- Severity: Brain damage from electrolyte mismanagement often requires lifelong care
- Clear standards: The 6-8 mEq/L per 24-hour correction rate is well-established and taught in medical schools
- Lifetime costs: Permanent brain injury involves decades of medical care, therapy, assistive devices, and lost earning capacity
Standards of Care: What Hospitals Should Do
Medical standards for electrolyte management are well-defined in 2025-2026 clinical guidelines. When healthcare providers deviate from these protocols without medical justification, resulting harm may constitute negligence.
Monitoring Requirements
High-risk patients require:
- Baseline electrolyte panel upon admission
- Serial measurements throughout hospitalization (frequency depending on risk factors)
- Every 2-4 hour checks during active sodium correction
- Assessment of volume status (euvolemic vs. hypovolemic)
- Continued monitoring during rehabilitation and post-discharge follow-up
Sodium Correction Protocols
The established standards include:
| Condition | Maximum Correction Rate | Special Considerations |
|---|---|---|
| Chronic hyponatremia (standard risk) | 4-8 mEq/L per 24 hours | Maximum 8-12 mEq/L per day |
| Chronic hyponatremia (high risk) | 4-6 mEq/L per 24 hours | Alcoholism, malnutrition, liver disease |
| Acute symptomatic hyponatremia | 1-2 mmol/L per hour initially | Goal: 4-6 mmol/L total increase, then slow |
| SIADH | 8-12 mEq/L per 24 hours maximum | Fluid restriction primary treatment |
Treatment Options
Proper management may include:
- Fluid restriction: First-line for euvolemic hyponatremia (SIADH)
- Hypertonic saline (3% NaCl): For severe symptomatic cases, with careful monitoring
- Isotonic saline: For hypovolemic patients (CSWS)
- Vaptans: Vasopressin receptor antagonists for SIADH
- Fludrocortisone: Mineralocorticoid for cerebral salt-wasting
- Desmopressin: For diabetes insipidus or to prevent overcorrection
Protective Measures if Overcorrection Occurs
If sodium rises too quickly, providers should immediately:
- Stop hypertonic saline administration
- Administer desmopressin to prevent further sodium increase
- Consider 5% dextrose in water for therapeutic re-lowering
- Increase monitoring frequency
- Document the overcorrection and response in medical records
- Obtain neurology or endocrinology consultation
When Hospital Errors Constitute Medical Malpractice
Not every bad outcome represents malpractice. To establish a medical negligence claim in New York, you must prove four elements:
1. Duty of Care
The healthcare provider had a professional relationship with the patient requiring them to meet medical standards. This is typically established by admission to the hospital or accepting the patient for treatment.
2. Breach of Duty
The provider failed to meet the standard of care that a reasonably competent healthcare professional would have provided under similar circumstances, which may constitute doctor negligence. Examples include:
- Correcting sodium faster than the 6-8 mEq/L per 24-hour standard
- Failing to monitor sodium levels in high-risk patients
- Not recognizing symptoms of hyponatremia despite documented behavioral changes
- Misdiagnosing SIADH as cerebral salt-wasting (or vice versa) and providing incorrect treatment
- Ignoring lab results showing dangerous electrolyte levels
- Continuing treatment despite warning signs of overcorrection
3. Causation
The breach of duty directly caused the brain injury. Medical records, expert testimony, and MRI findings showing osmotic demyelination syndrome help establish this connection. In electrolyte cases, the timeline is often clear: improperly rapid sodium correction followed by development of CPM/ODS.
4. Damages
The patient suffered measurable harm, including:
- Medical expenses (past and future)
- Lost wages and earning capacity
- Pain and suffering
- Loss of enjoyment of life
- Permanent disability
- Need for long-term care
- Assistive devices and home modifications
Expert Testimony Requirement
New York law requires expert medical testimony to establish the standard of care, how it was breached, and that the breach caused the injury. Your attorney will retain qualified medical experts—typically neurologists, nephrologists, or intensivists—to review records and provide opinions about the care received.
Your Legal Rights in New York
New York medical malpractice law provides specific protections and requirements for pursuing compensation after hospital negligence causes brain injury.
Statute of Limitations
Under New York law as of 2026, you generally have 2.5 years from the date of the negligent act to file a medical malpractice lawsuit. However, several exceptions may extend this deadline:
- Continuous treatment doctrine: If you continued receiving treatment from the same provider for the same condition, the deadline may not start until treatment ends
- Discovery rule: In some cases, the deadline begins when you reasonably should have discovered the malpractice
- Foreign object exception: Different rules apply if a foreign object was left in the body
Do not wait to consult an attorney. Medical record requests, expert reviews, and case preparation take time. Acting promptly preserves evidence and ensures you meet all deadlines.
Certificate of Merit Requirement
Before filing a malpractice lawsuit in New York, your attorney must obtain a certificate from a qualified medical expert stating that the case has merit based on review of the medical records. This requirement ensures frivolous claims are not pursued.
Damage Caps
Unlike some states, New York does not cap economic damages (medical expenses, lost wages) or non-economic damages (pain and suffering) in medical malpractice cases. The Miranda Crohan case’s $68.6 million verdict demonstrates that juries can award substantial compensation when justified by the severity of injuries and lifetime care needs.
Comparative Negligence
If the patient bears some responsibility for the injury, New York’s comparative negligence law reduces the recovery proportionally. For example, if a patient was non-compliant with medical instructions and that contributed to the injury, damages would be reduced by their percentage of fault. However, in most electrolyte-related brain injury cases, the patient had no control over monitoring or correction rates.
Steps to Take if You Suspect Negligence
If you believe hospital errors in electrolyte management caused your or a loved one’s brain injury, taking prompt action protects your legal rights.
Step 1: Request Complete Medical Records
You are entitled to copies of all medical records. Request:
- Admission and discharge summaries
- All laboratory results, especially sodium levels
- Medication administration records (MARs)
- IV fluid orders and rates
- Nursing notes documenting patient condition
- Physician progress notes
- Imaging reports (especially brain MRIs)
- Incident reports (if any were filed)
Under HIPAA, hospitals must provide records within 30 days. New York law allows you to request records in electronic format.
Step 2: Preserve Evidence
Document everything related to the injury and its impact:
- Photographs or videos showing the patient’s condition
- Timeline of symptom development
- Communications with healthcare providers
- Financial records of medical expenses
- Employment records showing lost wages
- Journal entries about daily challenges and pain
Step 3: Do Not Sign Settlement Releases
Hospital risk management or insurance representatives may contact you offering settlements or requesting you sign releases. Do not sign anything without consulting an attorney. These early offers are typically far below the true value of your claim.
Step 4: Consult a Medical Malpractice Attorney
Contact a lawyer experienced in brain injury and hospital negligence cases. Look for:
- Specific experience with medical malpractice
- Track record of substantial verdicts and settlements
- Resources to retain qualified medical experts
- Willingness to take cases to trial if necessary
- Clear communication about the process and your options
Most medical malpractice attorneys work on contingency, meaning they only collect fees if you recover compensation. Initial consultations are typically free.
Step 5: Follow Current Medical Advice
Continue receiving appropriate medical care for your brain injury. This serves two purposes:
- Maximizing your recovery and quality of life
- Creating documentation of the ongoing nature and extent of your injuries
Gaps in treatment can be used by defense attorneys to argue injuries were not as severe as claimed.
Time Is Critical: The 2.5-year statute of limitations in New York may seem like a long time, but medical malpractice cases are complex. Record review, expert consultation, and case development take many months. Contacting an attorney within weeks or months of discovering the negligence—not years—ensures the strongest possible case.
How a Brain Injury Lawyer Can Help
Electrolyte-related brain injury cases require specialized legal and medical knowledge. An experienced attorney provides critical services throughout the process.
Comprehensive Record Review
Medical records in hospital cases often span hundreds or thousands of pages. Your attorney will systematically review all documentation to identify:
- Exact sodium levels and correction rates
- Whether monitoring met standards for your risk level
- Warning signs documented by nurses that were not addressed
- Deviations from hospital protocols
- Communication failures between providers
Retention of Medical Experts
Your case requires experts who can:
- Explain the standard of care for electrolyte management
- Identify specific breaches in your treatment
- Establish causation between the breach and your brain injury
- Project future medical needs and associated costs
- Testify at trial if settlement cannot be reached
Qualified experts typically include neurologists, nephrologists, intensivists, and life care planners. Top attorneys have relationships with respected experts across these specialties.
Calculation of Full Damages
Brain injuries from electrolyte mismanagement often cause permanent disabilities. Your attorney will work with medical and economic experts to calculate:
- Past medical expenses: Hospital bills, rehabilitation, medications, assistive devices
- Future medical costs: Lifetime care needs, therapy, medications, equipment replacement
- Lost wages: Income lost during hospitalization and recovery
- Lost earning capacity: Reduced ability to work in the future
- Pain and suffering: Physical pain, emotional distress, loss of enjoyment of life
- Loss of consortium: Impact on relationship with spouse (claimed by spouse separately)
Permanent brain injury cases can involve millions of dollars in lifetime costs. Accepting early settlement offers without proper calculation of these expenses can leave you drastically undercompensated.
Negotiation and Trial Experience
Most medical malpractice cases settle before trial, but achieving fair settlement requires credible trial preparation. Hospitals and insurers take cases more seriously when your attorney has a track record of trying cases and winning substantial verdicts.
Your lawyer will:
- File the lawsuit and certificate of merit
- Conduct discovery (depositions, interrogatories, document requests)
- Depose healthcare providers about their care decisions
- Prepare expert reports and disclosures
- Engage in settlement negotiations
- Take the case to trial if settlement offers are inadequate
Contingency Fee Structure
New York medical malpractice attorneys typically work on contingency, with fees structured as a percentage of recovery:
- Generally 30-40% of the total recovery
- Higher percentages may apply if the case goes to trial
- No fees owed if there is no recovery
- Case expenses (expert fees, filing costs, deposition transcripts) are typically advanced by the firm and reimbursed from settlement or verdict
This structure allows access to quality legal representation regardless of your financial situation.
Frequently Asked Questions
How do I know if my brain injury was caused by hospital negligence rather than my underlying medical condition?
This determination requires expert medical review of your records. Key indicators include: documented rapid sodium correction exceeding 6-8 mEq/L in 24 hours, gaps in electrolyte monitoring despite high-risk status, development of symptoms temporally related to sodium overcorrection, and MRI findings showing osmotic demyelination syndrome (CPM or ODS). An attorney can arrange for qualified medical experts to review your records and provide an opinion on whether negligence occurred. Many hospitals try to attribute brain injury to the patient’s underlying condition, but medical records often clearly show whether proper protocols were followed.
What is the difference between hyponatremia and hypernatremia, and why does it matter for my case?
Hyponatremia means low blood sodium (below 136 mEq/L), while hypernatremia means high sodium (above 145 mEq/L). Both can cause brain injury but through opposite mechanisms. Hyponatremia causes water to enter brain cells, leading to swelling, while hypernatremia causes cells to shrink. The legal significance lies in what constitutes proper treatment: hyponatremia requires careful, slow correction to avoid osmotic demyelination syndrome, while hypernatremia requires gradual lowering of sodium with adequate fluid replacement. Your attorney and medical experts will analyze which imbalance occurred and whether treatment met the standard of care for that specific condition.
Can I still pursue a case if my family member with brain injury has passed away?
Yes. If improper electrolyte management caused death, surviving family members can pursue a wrongful death claim. New York law allows the personal representative of the deceased’s estate to file suit on behalf of eligible beneficiaries, typically including spouses, children, and parents. Wrongful death damages include medical expenses before death, funeral costs, lost financial support, loss of parental guidance (for children), and loss of consortium. The statute of limitations for wrongful death is generally two years from the date of death, making prompt action essential. Contact an attorney immediately if you suspect negligence contributed to a loved one’s death.
How long does a medical malpractice case for electrolyte-related brain injury typically take?
Most medical malpractice cases take 18 months to 3 years from filing to resolution, though complex cases can take longer. The timeline includes: initial investigation and record review (1-3 months), filing the lawsuit and certificate of merit (1-2 months), discovery phase including depositions (6-12 months), expert report preparation and exchange (2-4 months), settlement negotiations and mediation (2-6 months), and trial preparation and trial if needed (3-6 months). Cases involving clear liability and devastating injuries may settle more quickly, while disputed cases where the hospital denies fault may take longer. Your attorney can provide a more specific timeline based on the particulars of your case and the court’s schedule.
What if I signed consent forms before the treatment that caused my injury?
Signing consent forms does not waive your right to sue for negligence. Consent forms typically authorize the hospital to provide treatment; they do not give permission for substandard care. You consented to proper medical treatment following accepted standards, not to negligent monitoring or correction of electrolytes. Courts distinguish between inherent risks of medical treatment (which consent forms may cover) and negligence (which they do not). If healthcare providers failed to follow the 6-8 mEq/L correction rate, did not monitor appropriately, or made other preventable errors, consent forms do not protect them from liability. An attorney can review any forms you signed to assess their impact on your case.
Will my case require going to trial, or do most cases settle?
The majority of medical malpractice cases settle before trial, including electrolyte-related brain injury claims. However, achieving fair settlement requires credible trial preparation. Hospitals and insurers evaluate whether your attorney has the resources, expertise, and track record to successfully try the case. Strong cases with clear liability, substantial damages, and experienced counsel are more likely to receive fair settlement offers. Your attorney should prepare every case as if it will go to trial while simultaneously engaging in settlement negotiations. If settlement offers are inadequate given your lifetime care needs, taking the case to trial may be necessary. The Miranda Crohan case went to trial and resulted in a $68.6 million jury verdict, demonstrating that trials can be beneficial when hospitals refuse reasonable settlements.
What compensation can I recover in an electrolyte-related brain injury case?
Compensation in New York medical malpractice cases includes economic and non-economic damages. Economic damages cover past and future medical expenses, lost wages, lost earning capacity, costs of assistive devices, home modifications, and lifetime care needs. Non-economic damages compensate for pain and suffering, emotional distress, loss of enjoyment of life, and permanent disability. New York does not cap damages in medical malpractice cases, allowing juries to award compensation that truly reflects the severity of injuries. Recent electrolyte-related cases have resulted in verdicts and settlements ranging from $14.9 million to $68.6 million. The specific value of your case depends on the severity of your brain injury, your age and life expectancy, your earning capacity before the injury, the extent of permanent disabilities, and the strength of evidence showing negligence.
What should I do if I notice symptoms of electrolyte imbalance in a hospitalized family member right now?
Take immediate action. Inform the nurse of specific symptoms you are observing: confusion, behavioral changes, drowsiness, headache, nausea, weakness, or difficulty speaking. Ask when sodium levels were last checked and request that they be rechecked given the symptoms. If the nurse does not respond urgently, escalate to the charge nurse or nursing supervisor. Request that the attending physician be contacted. For head injury patients, emphasize that sodium levels below 130 mg/dL are critical and require immediate medical attention, not just the standard lab alarm threshold of 121 mg/dL. Document the time, symptoms you reported, who you spoke with, and their response. If you feel your concerns are being dismissed and the patient’s condition is worsening, do not hesitate to insist on immediate physician evaluation. Family advocacy can be lifesaving when staff are managing multiple patients.
Protecting Your Rights After Preventable Brain Injury
Electrolyte imbalances are common in hospitalized patients, particularly those with brain injuries, post-surgical status, or receiving IV fluids. When properly monitored and corrected according to established protocols—no faster than 6-8 mEq/L per 24 hours—these imbalances can be managed safely.
However, when healthcare providers fail to monitor appropriately, correct sodium too rapidly, or ignore warning signs of complications, preventable brain damage can occur. Conditions like central pontine myelinolysis and osmotic demyelination syndrome can cause permanent paralysis, speech impairment, cognitive deficits, and the need for lifelong care.
If you or a loved one suffered brain injury from improper electrolyte management in a New York hospital, you have limited time to protect your legal rights. Medical malpractice cases require extensive investigation, expert review, and careful preparation.
Schedule Your Free Case Evaluation
Our New York brain injury attorneys have the medical knowledge and trial experience to handle complex electrolyte-related malpractice claims. We work with top medical experts, calculate lifetime care costs accurately, and are prepared to take cases to trial when necessary to secure fair compensation.
Contact us today for a confidential review of your case. We work on contingency—you pay no fees unless we recover compensation for you.
