Internal injuries from blunt trauma can be deceptive. The patient may walk away from a crash or fall feeling sore but otherwise functional, only to deteriorate hours or days later as bleeding, organ damage, or hollow viscus injury becomes evident. By the time symptoms develop, the situation can be life-threatening. Delayed presentation is a hallmark of internal injuries, which is why thorough evaluation after any significant trauma is so important.
Schuster Jachetti LLP represents Delaware accident victims with internal injuries from motor vehicle crashes, falls, work incidents, and assaults. Joseph M. Jachetti, Delaware Bar #003744, has handled serious injury matters for over 25 years, and the firm works with qualified medical professionals to evaluate the trauma sequence and the medical response.
Internal injury cases often involve both the original trauma and questions about the timeliness of medical evaluation. Both fronts can be relevant to liability and damages.
How Internal Injuries Happen in Delaware
Common causes include high-energy motor vehicle crashes on I-95, Route 1, and other Delaware roads, falls from height, struck-by incidents at construction and industrial sites, motorcycle and pedestrian crashes, and assaults. Seat belts and airbags reduce mortality but can themselves contribute to specific patterns of internal injury.
Common Internal Injuries
- Solid organ injury — see organ damage (liver, spleen, kidney)
- Hollow viscus injury — bowel, stomach, bladder rupture
- Pulmonary contusion and hemothorax
- Cardiac contusion and pericardial effusion
- Vascular injury — aortic injury, mesenteric vessel tears
- Diaphragm rupture
- Pelvic fractures with associated bleeding
- Retroperitoneal hematoma
- Traumatic brain injury (often associated)
Who May Be Liable
Liability depends on cause. In motor vehicle cases, the at-fault driver and any commercial entity employing the driver. In premises cases, the property owner or manager. In work cases, third-party contractors and equipment manufacturers in addition to the workers’ compensation system. In medical settings, providers who failed to recognize delayed-presentation injuries.
How Delaware Law Applies to Internal Injury Cases
- 10 Del. C. § 8119 — two-year statute of limitations for personal injury
- 10 Del. C. § 8132 — modified comparative negligence with a 50 percent bar
- 21 Del. C. — Delaware motor vehicle code
- 18 Del. C. § 6856 — medical negligence SOL where applicable
Damages You May Be Able to Pursue
- Past and future medical expenses
- Lost wages and lost earning capacity
- Pain and suffering — see what is pain and suffering
- Loss of enjoyment of life
- Disfigurement from surgical scars
- Loss of consortium
- Wrongful death damages where applicable
The firm does not promise specific amounts.
The Deceptive Nature of Internal Injuries
What makes internal injuries dangerous is that they often do not announce themselves immediately. A patient who walks away from a high-energy crash may feel sore but stable, only to deteriorate hours later as a slow bleed becomes a critical hemorrhage. A bowel perforation may not produce peritonitis until enough contamination has accumulated. A delayed splenic rupture can occur days after the original injury. This is why thorough evaluation after significant trauma matters — and why a missed internal injury at the initial encounter can be the basis of a medical negligence claim.
The FAST Exam and Trauma Imaging
The Focused Assessment with Sonography for Trauma (FAST) exam is a rapid bedside ultrasound that evaluates for free fluid in the abdomen and pericardium. Combined with CT imaging, it forms the backbone of modern trauma evaluation. Failure to perform appropriate imaging in a high-energy trauma patient, or failure to act on findings, can support a claim.
Seat Belt Injuries
Seat belts save lives, but they also produce a recognized pattern of injuries. The “seat belt sign” — bruising across the abdomen — correlates with injury to underlying structures: bowel mesentery, bowel itself, spine, and abdominal vessels. The presence of a seat belt sign should prompt imaging and observation, and failure to do so when the sign is present can be a basis for review.
Pelvic Fractures and Hemorrhage
Pelvic fractures, particularly open-book fractures, can produce significant hemorrhage from disrupted vessels. Management includes pelvic binders, angiographic embolization, and external fixation. Time to definitive control of pelvic hemorrhage correlates with survival, and delays can be the basis for serious case review.
The Importance of Serial Examinations
Trauma patients require serial examinations because the picture changes. A patient stable on arrival may decompensate. The standard of care includes vital sign monitoring, repeat exams, and reimaging when concerning changes occur. When a patient deteriorates without the appropriate response, the resulting harm can be catastrophic.
The Mechanism of Injury
Different types of internal injuries follow different mechanisms. Steering wheel impact tends to produce sternal, cardiac, and pulmonary injuries. Lap belt forces can produce hollow viscus and lumbar spine injuries. Rapid deceleration can shear vascular structures, including the aorta. Side-impact crashes produce different injury patterns than frontal crashes. Understanding the mechanism helps anticipate the injury pattern and document the relationship between the crash and the injury.
The Trauma Center System
Delaware participates in the regional trauma system. Severely injured patients are transported to a trauma center — Christiana Hospital is the regional resource for Delaware — where dedicated trauma teams provide systematic evaluation. The trauma activation, the team response, and the structured evaluation are themselves standards of care, and deviations can be the basis for review.
The CT Scan and Its Limitations
CT scanning has revolutionized trauma evaluation, but it has limitations. Some bowel injuries are not visible on CT in the first hours. Some vascular injuries require specific imaging protocols. Some hollow viscus injuries are diagnosed only by clinical deterioration. The standard of care includes appropriate use of CT but also includes serial examinations and clinical judgment when CT is non-diagnostic.
Damage Control Surgery
For severely injured patients, modern trauma surgery uses damage control techniques: control bleeding and contamination first, return for definitive repair after stabilization. The strategy improves survival in severe injuries. Cases turn on whether the right strategy was chosen at the right time, whether bleeding was controlled adequately, and whether contamination was addressed before infection developed.
The Documented Risk of Delayed Presentation
Medical literature documents the phenomenon of delayed presentation in internal injuries. Splenic rupture days after the original injury, slow accumulation of intracranial blood, delayed bowel perforation — these are not unusual events. They are recognized in trauma practice. The standard of care includes anticipating delayed presentation in high-risk patients and arranging follow-up that catches deterioration early.
Discharge Decisions After Trauma
The decision to discharge a patient after trauma evaluation is high-stakes. A patient who has been observed and evaluated may safely go home. A patient who has not been adequately evaluated may have an undiagnosed injury that becomes apparent later. The standard of care includes a complete evaluation before discharge and clear return precautions for the patient.
Cumulative Damages in Internal Injury Cases
Internal injuries often produce cumulative damages — the original injury, the surgery to address it, the complications, and the long-term effects. A patient with a damaged kidney, a partial bowel resection, and chronic pain has multiple overlapping issues, each contributing to the damages picture. Comprehensive medical evaluation captures all of these dimensions.
Working With Trauma-Familiar Counsel
Trauma cases benefit from counsel who understand trauma medicine. Schuster Jachetti LLP has handled serious injury matters for over 25 years and works with qualified medical professionals familiar with trauma practice. The firm’s familiarity with trauma medicine informs the case theory and the medical professional selection.
Why Choose Schuster Jachetti LLP for a Delaware Catastrophic Injury Case
Joseph M. Jachetti, Delaware Bar #003744, has practiced personal injury law in Delaware for over 25 years. Before practicing law, he spent 10 years as an insurance claims adjuster, which gives him direct insight into how insurance carriers evaluate, defend, and resolve catastrophic injury claims. That background informs the firm’s approach to building catastrophic cases — anticipating defense strategies, documenting damages comprehensively, and pursuing all available coverage layers. The firm represents clients statewide from offices in Wilmington, Smyrna, Georgetown, and Lewes, and works on a contingency fee basis so that pursuing a serious injury claim does not require upfront payment.
Catastrophic cases require building the future as much as documenting the past. Life care plans, vocational projections, and economic analysis translate the medical reality into the financial reality. The firm works with qualified medical professionals, life care planners, vocational consultants, and economists to build these comprehensive damages models. When cases proceed to discovery, depositions, mediation, or trial, the firm prepares thoroughly to present the case in a way that captures the full scope of harm.
Talking With Schuster Jachetti About Your Case
The firm’s initial consultation is free and aims to understand the trauma event, the medical evaluation that followed, what was diagnosed and what was missed, and what the current condition is. Based on that information, the firm assesses whether the case has a realistic foundation. The firm explains the next steps in plain language so clients leave the consultation with a clear sense of the path forward.
How Insurance Companies Handle Internal Injury Cases
Joseph Jachetti spent 10 years as an insurance claims adjuster before practicing law. Carriers in internal injury cases commonly dispute the connection between the trauma and the injury, argue pre-existing conditions, and offer settlements before the full extent of damage is known. Joseph Jachetti uses his prior adjuster experience on behalf of clients during negotiations and advises clients not to settle before treatment is complete.
Steps to Take After a Suspected Internal Injury
- Seek immediate medical evaluation after any significant trauma — even if you feel fine
- Get all medical records, imaging, and bills
- Document the incident — photos, witnesses, police reports
- Do not sign anything without legal review
- Do not post on social media
- Contact a Delaware injury attorney quickly
Frequently Asked Questions
How long do I have to file an internal injury claim in Delaware?
Generally two years from the date of injury under 10 Del. C. § 8119. More on Delaware deadlines.
I felt fine after the crash. Can I still have an internal injury?
Yes. Many internal injuries present hours or days later. Always seek prompt medical evaluation after a significant trauma.
What if my internal injury was missed at the ER?
That can be a medical negligence claim under 18 Del. C. § 6853. The firm works with qualified medical professionals to evaluate whether the standard of care was met.
How much does a Delaware internal injury lawyer cost?
The firm works on a contingency fee. More on contingency fees.
What is my internal injury case worth?
Value depends on injuries, treatment, future care, fault, and insurance. Read about case valuation.
Schuster Jachetti LLP Serves Delaware Clients Statewide
From four offices: Wilmington ((302) 966-8684), Smyrna ((302) 775-0728), Georgetown ((302) 877-9524), Lewes ((302) 527-9513).
Talk to a Delaware Internal Injury Lawyer Today
Call (302) 984-1000 for a free consultation. Joseph M. Jachetti, Delaware Bar #003744, has handled catastrophic injury cases for over 25 years.
Free Internal Injury Case Review
Free consultation. No fee unless we recover compensation for you.
📞 Call (302) 984-1000
This page provides general legal information only. It is not legal advice and does not create an attorney-client relationship. Past results do not guarantee a similar outcome.
Talk to a Delaware Attorney
Free consultation. No fee unless we recover compensation for you.
📞 Call (302) 984-1000
This page provides general legal information only. It is not legal advice and does not create an attorney-client relationship. Past results do not guarantee a similar outcome.