How I Won This Case Using The “Two-Hit Theory”

Posted By: Tony Baratta | November 18th, 2013

Recently, I was successful in proving to a Judge, at trial, that a rear-end motor vehicle accident caused my 75 year old client to suffer a trauma to her knees (which banged up against the dashboard) which triggered rheumatoid arthritis.  My client required medication to treat the newly diagnosed rheumatoid arthritis.  This medication, Methotrexate and Prednisone, are both immuno-suppressant medications that make it difficult for individuals to fight infections including bacterial and opportunistic infections.  Unfortunately for my 75 year old client, she suffered from pneumonia and died.  With the assistance of an expert rheumatologist, I was able to connect the trauma suffered in the automobile accident to my client’s death a year later and her family was awarded substantial damages as a result.

I was able to prove with the assistance of expert testimony that trauma is one of many potential precipitants to the onset or exacerbation of rheumatoid arthritis. The cause of rheumatoid arthritis is felt to be a combination of genetic predisposition along with a superimposed environmental trigger.  This is called the “two-hit theory”.  In some individuals, this trigger may be a viral or other environmental factor.  It has been seen, for example, in identical twins with the same genetic makeup that one may develop rheumatoid arthritis and the other may not.  This, it is reasoned, is because the one that developed rheumatoid arthritis was exposed to that “second hit” or an external trigger.  Trauma is one of several potential external triggers to rheumatoid arthritis.

As we age, we obviously break down and deteriorate. If someone’s carelessness accelerates that process, our ability to live before we die has been greatly affected.  The law recognizes that where our ability to live life to the fullest is harmed, we are entitled to compensation in damages.

If you, a member of your family or someone special in your life is caused an injury by the carelessness of another and you would like to discuss it with me please feel free to contact me at 215-914-2222 or

About the Author

Anthony J. Baratta (Tony) is a trial attorney. He has tried more than 50 cases to Juries in State and Federal Courts and has litigated thousands of personal injury and medical malpractice cases in his 30-year career. Tony is the founding partner of Baratta, Russell, & Baratta and an active board member of the Pennsylvania Brain Injury Association (BPIA). Tony is also on the board for the Philadelphia VIP and performs pro bono work for the Laurel House, a non-profit for victims of domestic abuse. In addition, Tony is a member of the Million Dollar Advocates Forum for trial attorneys, voted one of Philadelphia’s Super Lawyers for the past 14 years, and a 2018 recipient of the First Judicial District Pro Bono Award for the Civil Trial Division.

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