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Car Accident Seat Belt Chest Injuries

Seat beltSeat belts were invented in the 19th Century but didn't make their way into American cars until the 1950s. The first recorded seat belt injury was diagnosed in 1956. Since then, medical researchers have coined the term "seat belt syndrome" to describe the distinct pattern of injuries that accompany seat belt use.

Seat belts have been an important development for safe transportation, preventing ejection from the vehicle and decreasing the severity of impact during an accident - it is estimated that up to 80 percent of all car accident fatalities could have been prevented by seat belt usage. But in order to keep the wearer restrained even in the most forceful collisions, seat belts must be rigidly strong. 

When a vehicle comes to a sudden stop, as it would in an accident, the occupants' torsos slam against their seatbelts, sometimes with enough force to cause harm. The injuries caused by seat belts might be different from the injuries seen in unrestrained drivers. But seat belt injuries are always significantly less severe. Even so, seat belt injuries in high-velocity accidents can still be devastating.  It is worth underscoring that victims of seat belt injuries probably would have had far more serious injuries without wearing a belt.  But that does not change the fact that these injuries can still be brutal.  

Given the psychological sense of security that seat belts offer, combined with the fact that many seat belt-related injuries have delayed symptoms, some car accident victims will refuse medical attention at the scene of the accident, only seeking help after the pain sets in, sometimes hours or even months following the crash. Early recognition and treatment can be the key to ensuring that seat belt syndrome chest and abdominal injuries do not become permanently debilitating or fatal.

Types of Seat Belt Injuries

Up to 80 percent of serious blunt chest injuries result from motor vehicle crashes, among restrained and unrestrained car occupants alike. Even though seat belt restraint causes much less severe damage than ejection or impact with the dashboard, blunt chest trauma caused by seat belt usage can still lead to a wide range of injuries. Oftentimes, seat belt wearing drivers and passengers will only experience bruising and soreness after a crash; but, high-velocity impacts can cause serious injury even for restrained occupants.

Skin Abrasions are commonly found across the lower abdomen or extending diagonally across the chest and neck. The classic "seatbelt sign," marked in bruises or lacerations, can indicate internal injuries in 30 percent of cases, with abrasions in different locations indicating different internal injuries. Abdominal abrasions can be symptomatic of soft tissue injuries in the peritoneum, bowel perforation, hematoma, or particular kinds of spinal fractures. Chest abrasions are often associated with rib, sternum, or clavicle fractures and heart or lung injuries. Neck abrasions may indicate injury to the carotid artery, larynx, and cervical spine. Any appearance of the "seat belt sign" after an auto accident should prompt an immediate and thorough search for related internal injuries.

Skeletal Injuries are the most common car accident damages, with motor vehicle crashes accounting for 90 percent of all sternum fractures. While rib, sternal, or clavicle fractures are not particularly severe injuries in and of themselves, because of their location near the heart and lungs, chest fractures can potentially cause more serious visceral injuries if left untreated. Spinal fractures are also common seat belt injuries, particularly for passengers wearing lap belts. These "Chance" fractures are characterized by their horizontal direction.

Soft-Tissue and Visceral Injuries such as torn tendons and muscle fibers in the shoulder or abdominal perforations can also result from seatbelt restraint. Soft tissue injuries are rarely fatal, but they can cause decreased mobility. They will appear red in the first few hours after impact, rather than the more typical black-and-blue seatbelt bruising. In the most serious cases, blunt force trauma to the chest can cause bruising of the heart or lungs.

Tears, ruptures, and perforations in the abdominal area are the most common significant injuries caused by seat belts. They often occur directly beneath the site of the lap portion of the seatbelt and can be made significantly worse when the seat belt is not worn appropriately. When positioned properly, the lap belt should lay across the bony part of the wearer's pelvis, and the shoulder strap should run diagonally over the torso without cutting against the neck. Obesity, slouching, or moving the shoulder strap under the arm can cause much more significant damage to the liver and abdominal cavity. Abdominal soft tissue or visceral injuries are often asymptomatic at first, making it all the more important for a rapid and thorough medical evaluation even if the crash victim doesn't report any on-site pain.

Vascular Injuries are rare consequences of seat belt use. In some cases, the force of the collision can cause thoracic aortic tears (a rip in the body's largest artery). Most of the time, the shoulder strap will control chest deceleration well enough that the shearing force on the aorta won't be strong enough to cause a tear. Still, aortic injuries can still occur for seat belt wearers in the most forceful collisions.

Post-Accident Signs and Symptoms of Concern

Often, seat belt wearing crash victims will feel tenderness around their chest area, including soreness when breathing, laying down, or moving their arms. Such pains may result from deep bruising, which could last for days or weeks after an accident without requiring medical attention. It is, however, always a good idea to have any pains evaluated by a doctor to make sure they are not indicative of something more serious.

The most tell-tale sign of injury is seat-belt-shaped bruising across the chest, stomach, and neck, and should always motivate a visit to the emergency room. Sometimes more subtle symptoms such as chest pain, stiffness, or difficulty breathing will appear long after the initial crash. In the hours, days, even years after an accident of any severity, be on the lookout for the following symptoms.

  • Changes in the ability to urinate or move the bowels, including blood in the urine or stool
  • Coughing or vomiting blood
  • Dizziness, weakness, or pale, wet skin could be symptomatic of severe internal bleeding and shock
  • Leg weakness could indicate abdominal, lower back, or spinal nerve injuries
  • Labored or painful breathing and chest or back pain may be associated with lung, heart, or vascular injuries
  • Neck pain or stiffness, often resulting from whiplash
Sample Seat Belt Injury Settlements and Verdicts

While the following list of seat belt related settlements and verdicts may not be particularly useful for predicting the outcome of a future car accident case, they can help to paint a broader picture of how the severity of a seat belt injury, along with the jurisdiction and the extent of economic loss, can factor into the trial or settlement value. Explore our website for more information about how the type of injury or type of accident can impact the value of a claim.

  • 2014, Ohio, $344,458 Verdict. The 62-year-old male plaintiff sustained cervical, thoracic, lumbar strains and sprains,  closed head trauma, and mood disorders when his vehicle was rear-ended. Additionally, due to his seat belt and airbag deployment, the plaintiff suffered partial lung collapse and heart, chest wall, and sternal injuries. The plaintiff's spouse received an award for a loss of consortium claim.

  • 2014, Connecticut, $363,298 Verdict. The female plaintiff was stopped at an intersection for a stop sign when the defendant, attempting to make a left turn, collided with her vehicle. As a result of the accident the plaintiff suffered seat belt trauma to the chest wall, as well as nasal trauma, memory deficits, anosmia, left shoulder impingement, a left shoulder tendon tear, loss of hearing, a left toe fracture, coccyx pain, aggravation of a pre-existing right knee torn meniscus, and facial and left hand bruising.

  • 2013, Texas, $57,835 Verdict. A metro bus sideswiped a passenger car while attempting to change lanes, pushing the passenger car into the plaintiff's vehicle. The plaintiff suffered low back injuries and received a jury award of $33,906. Three people in the passenger car received jury awards for their damages, including $12,789 for the driver who sustained bruising to his chest due to his seat belt, as well as bruising to his chin and bleeding from his tongue.

  • 2012, New Hampshire, $21,500 Verdict. The plaintiff's vehicle, while stopped in traffic, was struck in the rear by the defendant's vehicle. The plaintiff sustained injuries to her neck, shoulder, and chest, and was diagnosed with a cervical strain and shoulder and chest bruising from her seat belt. The jury awarded $20,000 to the plaintiff in compensatory damages and $1,500 to her spouse for loss of consortium.

  • 2009, New Jersey, $200,000 Verdict. The plaintiff, a 45-year-old housewife, was wearing her seatbelt as the front-seat passenger when her car collided with the left-turning vehicle in front of her. The plaintiff, as a result of the accident, suffered considerable and highly visible bruising on her chest and torso, injured multiple ribs, and was diagnosed with disc herniation and radiculopathy. She was treated with physical therapy for eight months and had seven additional orthopedic visits.

  • 2009, Pennsylvania, $135,922 Verdict. The plaintiff and her daughter-in-law, who was 7.5 months pregnant at the time, were hit head-on by a vehicle that had crossed the center median into their lane of travel. The plaintiff suffered a burst lumbar fracture, a chest wall contusion, a left knee injury, and carotid artery damage from her seat belt. She was fitted with a back brace and continued to have mild discomfort in her back months after the accident. The daughter-in-law sustained shoulder dislocations that required surgical repairs and lost her job as an occupational therapist because of her injuries.

Medical and Legal Aid

Family DrivingIt is important to seek medical evaluation quickly after an accident, regardless of whether or not you were in pain at the scene of the crash. Many complications of seat belt syndrome, even if they don't cause immediate pain, can become much more severe, even fatal, if not treated soon after the initial injury. Car accident victims with bruises or lacerations from their seat belt should be tested for more serious internal injuries without exception. Patients with suspected chest trauma should expect to have a chest X-ray or a chest CT.

If your seat belt syndrome or other car accident injuries were caused by the negligence of another driver, call Miller & Zois at 800-553-8082 or click here for a free no obligation Internet consultation.

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