Burn Injury Resource Center

In the United States, approximately 2.4 million burn injuries are reported every year. Burns can be one of the most painful injuries one can sustain. Those who suffer from such injuries can face a lifetime of serious healthcare challenges. Last year, an estimated 650,000 burn injuries were treated by medical professionals. 75,000 of those injuries required hospitalization.
Several factors are used to determine the severity of a burn injury, including the patient's age, size and depth of burn, and the location of the burn.

Since 1936, the law offices of Keller & Keller have successfully protected our client’s rights relative to their burn injury case. If you or a loved one has been the victim of this type of injury, please call for a free consultation so that we can consult with you and offer advice that is trusted, professional and only has your interests in mind.

Burn Types:

First Degree Burns
First-degree burns are red and very sensitive to touch, and the skin will appear blanched when light pressure is applied. First-degree burns involve minimal tissue damage and they involve the epidermis (skin surface). These burns affect the outer-layer of skin causing pain, redness and swelling. Sunburn is a good example of a first-degree burn.

Second Degree Burns
Second-degree burns affect both the outer-layer (epidermis) and the under lying layer of skin (dermis) causing redness, pain, swelling and blisters. These burns often affect sweat glands, and hair follicles. If a deep second-degree burn is not properly treated, swelling and decreased blood flow in the tissue can result in the burn becoming a third-degree burn.

Third Degree Burns
Third-degree burns affect the epidermis, dermis and hypodermis, causing charring of skin or a translucent white color, with coagulated vessels visible just below the skin surface. These burn areas may be numb, but the person may complain of pain. This pain is usually because of second-degree burns. Healing from third-degree burns is very slow due the skin tissue and structures being destroyed. Third-degree burns usually result in extensive scarring.

Inhalation Injuries
Fire has been associated with 3 different types of inhalation injuries. More than a hundred known toxic substances are present in fire smoke. When inhalation injuries are combined with external burns the chance of death can increase significantly. The three types of inhalation injuries are:

1. Damage from Heat Inhalation: True lung burn occurs only if you directly breathe in a hot air/flame source, or have high pressure force the heat into you. In most cases, thermal injury is confined to the upper airways, because the trachea usually shields the lung from thermal loads. However, secondary airway involvement can occur after inhalation of steam as it has a greater thermal capacity than dry air. When hot air enters the nose, damage to the mucous membranes can readily transpire as the upper airway acts as a cooling chamber.
   
   
2. Damage from Systemic Toxins: Systemic Toxins affect our ability to absorb oxygen. If someone is found unconscious or acting confused in the surroundings of an enclosed fire, systemic toxins could be a possible cause. Toxin poisoning can cause permanent damage to organs including the brain. Carbon Monoxide poisoning can appear symptomless up until the point where the victim falls into a coma.
   
   
3. Damage from Smoke Inhalation: Smoke intoxication is frequently hidden by more visible injuries such as burns as a result of fire. In a disaster situation can lead to not receiving the medical attention needed, due to the rescue teams taking care of the more apparent patients. Patients that appear apparently unharmed can collapse due to major smoke inhalation, 60% to 80% of fatalities resulting from burn injuries can be attributed to smoke inhalation.

According to the National Fire Protection Association survey, in 1997, 4,675 Firefighters suffered burn injuries as a result of performing their assigned duties, of which 3,770 also suffered inhalation injuries.

A burn accident can take place almost anywhere and can happen when you least expect it. Did you know that every 19 seconds a local fire department is responding to an emergency fire call somewhere in the United States? Burn accident statistics show that the most vulnerable victims of these incidents are children under 5 and elderly individuals over 65.
Many burn injury victims have suffered their injuries as a result of defective products or improperly maintained property. As a consequence of such negligence, some have spent years in a painful rehabilitation process and going through reconstructive surgeries in an attempt to rebuild their lives.

Auto Fires

A car collision can turn deadly when a fuel tank is punctured and a fuel-fed fire explodes into flames and engulfs the car with its passengers still inside. While most car fires are not caused by collisions, collisions are responsible for most car fire fatalities. Keller & Keller’s attorneys and professional staff are successful in prosecuting these types of cases.

According to AAA and the National Fire Protection Association, there were 266,000 car fires in 2004 that resulted in 520 deaths. Every year in the U.S., more people die in vehicle fires than apartment fires. In addition to deaths, there are tens of thousands of serious burn injuries from car fires.

Car crash fires: A rear-end collision may damage a gas tank or a drive shaft may pierce the gas tank. Badly placed gas tanks and unshielded fuel systems can cause fuel-fed fires and serious burns or wrongful death.

Faulty wiring car fires: Ignition system wires and other car electrical system wiring can short out and cause a spark that causes a car fire.

Fluid leak car fires: Damaged fuel lines, hoses, caps, and filters can cause flammable fluid leaks that catch fire.

Exhaust system fires: An improperly installed muffler and exhaust system can ignite a dangerous car fire.

A fuel-fed car fire is rarely a fire that slowly develops. A fire fed by gas, oil, grease, and other flammable liquids expands quickly, causing severe burns to people in or near the car, including those trying to rescue people from the car.

Home and Apartment Fires

When a smoke alarm fails, when there is no smoke alarm, when fire safety equipment fails to work properly, a fire can cause terrible, unnecessary tragedy in the home. Who is responsible? The attorneys at Keller & Keller can help determine responsibility in this instance.

All buildings must meet minimal fire code standards. If the structure was built without required fire safety equipment, the builder and any inspectors should be held accountable. For instance, a missing or broken fire escape that keeps someone from escaping a fire can result in severe burns and smoke inhalation injuries. As well, fire doors that are missing or left open can cause a fire to expand quickly throughout a building.

If a landlord or building owner fails to maintain smoke alarms according to law, that person should be held responsible for burn injuries. By law, a landlord cannot delegate responsibility for smoke alarm maintenance.

A housing authority that fails to keep fire safety equipment and alarm systems in good working order can be sued for burn injuries or wrongful deaths caused by negligence.

Additionally, when a building owner fails to maintain furnaces and water heaters in good condition, if a fire starts and injures innocent people, the building owner is liable for damages.

A fire can engulf an entire building in a matter of minutes. If that building does not have properly installed and maintained smoke alarms, residents may not have time to escape without serious burns. If the building was constructed using dangerous flammable materials, the fire will travel faster and more furiously. If the building owner does not adequately maintain fire escapes, fire extinguishers, and other safety equipment, the result could be wrongful death or years of recovery from painful burn injuries. If your burn injuries were caused by landlord liability, the law offices of Keller & Keller can pursue a premises liability claim on your behalf.

Burn Unit Referral Criteria

Every year over a million people suffer burn injuries that require medical attention. A Congressional report dated January 24, 2007 found that there are only 128 burn centers in the United States. "The total burn-bed capacity at all burn centers in the United States is 1,835 beds. Burn centers in four States have closed..." Despite this, the most recent statistics from the Centers for Disease Control and Prevention lists burns as the sixth leading cause of unintentional accidental deaths.

According to the American Burn Association the average size of a burn injury admitted to a burn center is about 14% of total body surface area. Burns of 10% TBSA or less account for 54% of burn center admissions, while burns of 60% TBSA or more account for 4% of admissions. About 6% of burn center admissions do not survive, most of whom have suffered severe inhalation injury in fires.

Below is the American Burn Associations criteria for referral to a burn unit:

1. Burns that involve the face, hands, feet, genitalia, perineum, or major joints
2. Partial thickness burns greater than 10% total body surface area (TBSA)
3. Third-degree burns in any age group
4. Electrical burns, including lightning injury
5. Chemical burns
6. Inhalation Injury
7. Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality.
8. Any patients with burns and concomitant trauma (such as fractures) in which the burn injury poses the greatest risk of morbidity or mortality. In such cases, if the trauma poses the greater immediate risk, the patient may be initially stabilized in a trauma center before being transferred to a burn unit. Physician judgment will be necessary in such situations and should be in concert with the regional medical control plan and triage protocols.
9. Burned children in hospitals without qualified personnel or equipment for the care of children
10. Burn injury in patients who will require special social, emotional, or long-term rehabilitative intervention

Defective Products

Because burn injuries are so devastating and involve complex medical issues, the burn injury lawyers at Keller & Keller investigate to discover all the causes of burn injuries.

• A house fire may result in injury because of defective, missing, or poorly maintained smoke alarms. Our law firm will look not only at the smoke alarm, but also at the fire's main cause-a defective heater or faulty wiring, perhaps. The manufacturer or distributor may be responsible for a defective product.
• A car fire may be caused because the product was poorly designed or manufactured. Was the fire caused because of a badly placed or badly shielded fuel tank? Was the car's ignition system poorly wired?
• If an industrial accident was caused by an improperly shielded vat of molten material, the manufacturer may be responsible.

When products are poorly designed or badly manufactured or when they are improperly installed, serious burn injuries can result.

By examining all the causes of burn injuries, our law firm may be able to hold a number of different parties accountable for the injuries. A great deal of money is needed to treat serious burn injuries and to compensate for pain and suffering. We will investigate the fire to determine the cause (or causes) and the factors that contributed to burn injuries (such as defective smoke alarms or fire extinguishers or stored flammable liquids that made a bad situation worse).

Electrocution Injury

Electricity is a powerful force that has to be handled with care. When a subcontractor installs dangerous temporary wiring or when a utility pole fails because of improper maintenance, the result can be serious electrical burns or electrocution. The law offices of Keller & Keller understand the technology that leads to electrical accidents. We also understand the medical issues involved.

• When a utility pole rots and collapses causing an electrocution, the subcontractor responsible for pole maintenance can be held accountable.
• A worker in a poorly insulated bucket truck can suffer electrical burns or electrocution while working on live power lines. When a crane operator or backhoe or jackhammer cuts through an underground cable, workers can be electrocuted.
• A cable in an excavation could be declared to be dead (not carrying electricity), and in reality it could still be live and cause the electrocution of a worker.
• Temporary wiring installed at a construction site can turn a puddle of water into a dangerous electrified pool that will terribly injure workers.

Many electrocution and electrical burn accidents cause a wrongful death. Other electrical burns require a long, painful, difficult recovery and, in many cases, lifelong disability.

Explosion Burns

Explosions-especially those on industrial work sites -can usually be traced back to negligence. When many independent companies are delivering, storing, or using flammable liquids at a work site, there is a huge potential for an injury-causing explosion.

• At an oil refinery, flammable liquids are transported in, stored, and transferred out. Each transfer must adhere to strict safety standards to prevent explosions.
• Utilities use flammable fuels to produce electricity. If the processes and systems are not properly managed, life-threatening explosions can result.
• Propane tanks that are used to heat rural homes can be dangerous when refilling and reconnect processes are not properly done. Such explosions put the home and its residents at risk for burn injuries.
• A punctured car or truck gasoline tank can suddenly explode making a serious auto accident even worse. Car fires -whether after an accident or as a result of leaking flammable fluids-can cause serious burn injuries and wrongful death.

At Keller & Keller, our attorneys have the experience and resources necessary to investigate explosion accidents, understand the technology, and determine the liable parties. We also understand the complex medical issues surrounding explosion burn injuries.

Flammable Clothing

When clothing catches fire and burns the victim, an essential question needs to be answered: What caused the fire? While your clothing may have burned, the clothing itself was not the fire's cause. Does the clothing meet national standards for fire retardant performance?

By establishing the reason for the fire, Keller & Keller can help you recover the compensation you need for recovery from burn injuries.

• When a woman rescued her son from a burning car fire, her clothing caught fire. In this case, the burns were caused by the car fire and made worse by her clothes.
• In some cases, clothing does not meet the standards set by the Flammable Fabrics Act. If that is the case, the clothing may intensify the burn injuries.
• In every injury case involving fire, Keller & Keller will consider all the factors that contributed to the burns-including the flammable clothing factor. Flammable fabric regulations are especially important in children's clothing, and Keller & Keller’s burn injury lawyers have successfully prosecuted the makers of flammable children’s clothing.

Burn injuries are extremely painful. The medical issues can be complex and include years of skin grafting and surgery. It is important to discuss your situation with a burn injury attorney who has the experience and knowledge to fully assess all possible avenues for compensation.

All clothing will burn given enough heat and flames. But when a fabric does not meet minimal standards, it will ignite easily-perhaps with only a fireplace spark. In those cases, the manufacturer can be held accountable for burn injuries. Prompt investigation is key.

Flammable Liquids

Liquid chemicals, gas, or oil needs to be transported, stored, and used with great concern for safety. If safety processes are not followed, these flammable liquids can catch on fire or explode, causing serious burn injuries and wrongful death.

• A badly designed or badly placed gas tank can turn a car accident into a deadly fire.
• If there is a gas leak in a furnace or water heater, simply lighting the pilot light can cause an explosion and result in serious burn injuries.
• A chemical fire at an industrial site or a refinery fire can quickly grow out of control and severely burn workers.
• A poorly connected propane tank can burn and explode, harming anyone in the vicinity.

Flammable liquids can create an extraordinarily dangerous situation. In many cases, the leak is the result of a bad design, incorrect installation, or poor maintenance. Anyone and everyone responsible for placing lives in a deadly situation caused by flammable liquids should be held accountable for their negligence.

Our law office has the experience needed to investigate and try oil and gas leak cases that result in burns or wrongful death. If you or a loved one has been burned by oil, gasoline, or chemicals, talk to a lawyer who understands how the accident happened and how the injury has affected your life.

Industrial Burns

An industrial work site is typically filled with a lot of activity, a lot of workers, and many independent companies coordinating activities. When the worst happens, and an explosion or fire erupts and injures or kills workers, it can be challenging to understand the causes and the liable parties.

We have a team of attorneys at the Keller & Keller law firm who have the experience it takes to sort through all the information about an accident and determine who should be held responsible.

• With fuel deliveries, huge boilers, and high temperatures, electrical utilities and their suppliers have to exercise extreme caution in handling and burning fuels. Fires and explosions can cause devastating injuries and wrongful death.
• On any industrial site or construction site, temporary electrical wiring, when not properly installed and maintained, can cause electrical burns and electrocution.
• Chemicals are important in manufacturing and other industrial businesses. When chemicals are mishandled, mislabeled, improperly stored, or improperly mixed, workers can be victims of painful, life-threatening chemical burns.
• An unshielded vat on a glazing machine can destroy an arm or leg. An unshielded saw can cut off a limb. Safety shields need to be in place and work properly at all times to prevent burn injuries and other industrial accidents.

Chemical burns, fires, explosions, and other industrial accidents are often dismissed as "accidental." Keller & Keller’s attorneys have the technical understanding to get beyond simplified explanations. We know how to investigate an accident and determine the causes for chemical burn injuries.

When safety procedures are not in place or are not followed, injuries are not accidental. They are the result of negligence. If you have suffered electrical or chemical burns at work or if a loved one has died because of chemical burns, we can help.

Propane Gas Fires

Propane gas tanks can be a practical source of heating fuel, especially in rural areas or for mobile homes. Like any flammable fluid, however, propane and propane tanks need to be built, filled, and maintained with great caution.

• If the pressure valve on the tank does not work properly, there is a potential for the tank to rupture and explode.
• If reconnection was not properly done after the propane tank was refilled, there is a potential for a leak and an explosion.
• Lack of care around a propane tank can cause leaks. For example, a lawn mower bumping into the tank or a snow shovel gouging the tank can cause leaks that later cause a fire or explosion.
• Any partial failure, leak, or break of the tank or the lines leading from the tank can cause an explosion.

Liquid gas should always be handled with great care and respect for the damage that can be done. When the tank has defective parts that caused an explosion, the manufacturer may be to blame. If the tank was damaged by a landscaping or construction crew, the contractor may be liable. If the propane supplier failed to make a safe reconnection, the supplier may be held liable for damages.

If you or a family member has suffered burn injuries from a propane tank explosion and fire, talk to a lawyer who understands the technology of propane tanks and who understands your rights.

Smoke Detectors

Most all jurisdictions have extensive regulations regulating and requiring the use of smoke detectors/alarms. The reason is that smoke alarms have proven very effective in reducing the number of fatalities due to structure fires. However, despite these regulations many landlords and building owners still do not equip their buildings with adequate functioning smoke detectors. Often times, following a residential fire the Fire Department notes the presence of ceiling mounted smoke detectors only to open them up and discover they do not have batteries.

The National SAFE KIDS Campaign and the United States Fire Administration (part of the Federal Emergency Management Agency) stated that in 1995, the majority of homes (93 percent) in the United States had at least one smoke alarm. However, only 74 percent of all homes had at least one working smoke alarm.

Smoke Inhalation Injury

Smoke inhalation is a serous, life-threatening situation that can result from being in a fire for just a few minutes. When a person breathes in extremely hot air and the gases, vapors, and particulate matter present in smoke, physical damage can include burning or swelling of the air passages and the lungs.

• Smoke inhalation symptoms may not appear for 24-48 hours after the fire. That can mean a delay in seeking medical help and starting treatment.
• The worse the victim is burned, the worse the smoke inhalation symptoms are likely to be.
• Those most vulnerable to smoke inhalation are young children (under 11) and elderly people (over 70).

In residential fires and in fuel-fed car fires, the carbon monoxide poisoning from smoke inhalation can be deadly. While skin burns are more obvious and more likely to receive treatment, oxygen therapy is needed for the smoke inhalation injury.

Smoke inhalation damage can occur any time there is prolonged exposure to smoke-as little as a few minutes. If you have suffered from smoke inhalation, talk to a burn injury lawyer about the circumstances. You have the right to compensation from the person or entity responsible for the fire.

Recovery from burn injuries and smoke inhalation can take years. Even then, the smoke inhalation victim may have chronic pulmonary problems for a lifetime. At the Keller & Keller law firm, our attorneys understand the long-term consequences of smoke inhalation and burn injuries.

Burn Treatment

Our skin controls the amount of heat our bodies retain or release, holds in fluids, and protects us from infection. Burns destroy skin, and this is the reason why even burn injuries to relatively small parts of our bodies may be very serious. While burns on fingers and hands are usually not dangerous, burns injuring even relatively small areas of skin can develop serious complications. Nothing but the most minor burn injury should be self-treated. All other burns require immediate medical attention. For this reason, if you have suffered a burn within the past 48 hours and consider it serious enough to search the internet for possible complications, you are strongly encouraged to consult a doctor immediately. The below information is provided for informational purposes only, and is not a substitute for consulting a medical doctor.

If you feel you have received minor/superficial burn, the care is straightforward. Cover the burn with a cool, wet towel or soak the burned area in cold water for about five minutes. Do not ice the burn as applying ice can further damage your skin. Next, cover the burn with a clean, sterile cloth, but keep in mind that friction against the cloth can make the burn worse. Do not apply a band-aid or other adhesive, as you could run the risk of tearing away skin when removing the bandage. Your skin will probably feel tight and maybe even itchy over the next few days, but the burn should heal itself in a few days to a week.

If you feel you have received a more serious burn, then don't take chances and go straight to the hospital or doctor's office. Immediate action can prevent a lot of unnecessary damage and trained medical staff will assist you in the proper care. You will know if your burn is serious by seeing if any blisters result. If your burn involved clothing, do not try and remove the clothing if it is stuck to the burn. This could peel off important skin and/or tissue and make the situation much worse. If you must remove the clothing, cut it away.

One of the most common signs of a partial or full thickness burn is a blister. It is important that you resist the urge to pop the blisters as well apply any type of cream - even burn cream - to the blisters immediately after the incident occurs. The best type of immediate care is to apply a smooth, dampened fabric to cover the burn. Or, if nothing like this is available, run the burn under cool water. You will want to cool the burn down so that it does not do any more damage to your skin. Remember, do not apply ice to it. Also, it may take as long as 48 hours for blisters to form so the lack of blisters immediately after the burn may not be a reliable indicator of the severity of the burn. The degree of pain may be a more reliable immediate indicator.

If the burn is located on the face, be especially careful. The skin on the face is extremely sensitive, and very susceptible to scarring. If you are burned around your eyes or mouth and are have trouble opening them, stay as still as possible. Do not use band-aids, creams or oils - at this point these things can potentially make the burn worse. The best thing to do is cover the burn with a smooth, cool, damp cloth and seek immediate medical attention.

If you are witnessing a serious burn on another person, keep them conscious and talking to you. This will help prevent them from going into shock. Signs of shock include pale and clammy skin, loss of consciousness or a dropping pulse.

Injury Resulting From Burns

Unfortunately, burn injuries often cause permanent scarring on the victim. This is why these injuries are often associated with severe emotional injuries as well.

Scarring is an essential part of the natural healing process following any injury to our skin. The type and severity of the scar depends on many factors, some of which are unrelated to the injury and involve our genetic predisposition. However, the severity of the injury also plays an important role in the severity of the scar. Our skin is comprised of a thick layer of skin, called the dermis, and a thinner outer layer of skin, called the epidermis. Damage to the outer layer of skin is healed by rebuilding the tissue, and in these instances, scarring is slight. When we damage the thick layer of tissue beneath the skin, healing becomes more complicated. In these cases our bodies lay down collagen fibers (a protein which is naturally produced by the body) and this usually results in a more severe scar. Scarring has serious emotional implications for the victim. Obviously as with any disfiguring injury, scars impact the way we look at ourselves, and the way other perceive us as well. However, for burn victims any scar leaves a permanent reminder of the event that caused the injury.

A burn injury usually results in one of the following types of scars: Keloid, Hypertrophic and/or Contractures. Keloid scars are an overgrowth of scar tissue. The scar will grow beyond the site of the injury. These scars are generally red or pink and will become a dark tan over time. Unfortunately, Keloid scars do have a tendency to re-occur. Hypertrophic scars are similar in appearance to Keloid scars and, for this reason, the two are often confused with each other. The distinguishing characteristic is that unlike with Keloid scars, Hypertrophic scars are limited to the site of initial injury or incision. A contracture scar is a permanent tightening of skin that may affect the underlying muscles and tendons that limit mobility and possible damage or degeneration of the nerves.

Contractures develop when normal elastic/pliable skin becomes inelastic due to a serious burn injury. Although physical therapy may help relieve this condition, surgery may be required. The surgery may involve a skin flap, or a procedure called a Z-Plasty, a common technique is plastic and reconstructive surgery to improve the function and cosmetic appearance of scars. A burn injury can take up to two years for the scarring to finally stabilize.

Skin Grafting

Our skin is the largest organ in our body. It provides our internal body with protection from harmful agents that lead to infections and plays a vital role in regulating our body temperature. Often times, when someone has suffered a severe burn, the damaged skin cannot heal properly. Under these circumstances the destroyed skin must be replaced with healthy skin. The surgical procedure used to replace damaged or destroyed skin with healthy, viable skin is called a skin graft surgery. The specifics of skin graft surgery depend on the location and severity of your burns.

The medical textbook definition of a skin graft is the transplantation of a piece of skin from one part of a body to another. As discussed below, the healthy skin preferably comes from the same person needing the graft. In other words, doctors highly prefer to take the donor skin from the injured person who needs the graft. The reason is that our body is much more likely to accept the grafted skin when it recognizes it a

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