We recently settled a case for $275,000 for negligent banding of esophageal varices. The medicine for this was complicated. So, was the calculation of potential damages (the money a plaintiff is legally allowed).

Esophageal varices are large veins in the esophagus. They may occur in people with advanced liver disease, as was the case here. Though, the veteran was a candidate for a liver transplant, that had not occurred yet, so her life was still at risk.

In many cases, doctors will "band" esophageal varices to prevent them from bleeding, especially, when they are large - as was this case with this veteran. So, very often, banding large esophageal varices is a life-saving step.

However, in this veteran's case, her medical record indicated she also had gastric varices. If esophageal varices are banded in the presence of gastric varices, the patient can be subject to unstoppable and often fatal bleeding from those gastric varices. But, if they do not band the esophageal varices, she could be subject to potentially fatal bleeding from the esophageal varices.

Our veteran's medical record indicated she had gastric varices. She informed a later care provider that she was not a candidate for banding, but that care provider, while providing an Esophagogastroduodenoscopy (or EGD), did not determine she had gastric varices and banded her esophageal varices. However, as a result of this banding, she suffered gastric bleeding and passed away.

Often, where a veteran has a co-morbidity, as was the case here with liver disease and large esophageal varices, the amount of damages available can be limited. Also, the medicine in this case was potentially tricky with questions about her prognosis if they had not banded her varices. Settlement offers in these situations can be limited, as well.

Even with that, however, we felt VA's initial offer was extremely low. In doing the research to determine what other damages were available, we discovered that one of her adult sons had a developmental disability and that she had provided for his care and education his entire life - even getting training in special education. Unlike other children, who become independent when they have grown, this son could not. This meant her estate was entitled to higher damages.

We gathered the substantial evidence of those facts and presented them to VA and continued to negotiate. As a result, we were able to obtain a much higher settlement than VA's original offer.