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Burn Injuries

Burn Injuries – True, but Upsetting Facts and Statistics

According to the American Burn Association, each year there are 1.1 million burn injuries in the United States, which require treatment. Approximately 45,000 of these injuries require hospitalization and approximately 4,500 of these victims die. Many of these injuries are caused by the negligent, reckless or intentional conduct of another party.

Burns may result from fires, automobile accidents, work-related injuries, defective products and many other causes. These injuries often cause extreme pain and can lead to life-threatening infections and severe disfigurement.

Often a victim faces many years of on-going treatment and surgeries, resulting in extremely high medical bills. Many people find themselves temporarily or permanently disabled, and may have many months or years of lost income.

Burn injuries are the second leading cause of accidental death in the United States. They are also some of the most painful and disfiguring injuries an individual can sustain. Healing can take years before reconstructive surgery can be performed, which can cause severe emotional anguish.

Each year in America, an estimated 3.5 million burn injuries are reported, and about 1.1 million burn victims suffer considerable disabilities from their burn accident. A burn can damage your skin, muscle, tissue, and nerves.

Common Places of Occurrence:

  • Home 73%
  • Work 8%
  • Street or Highway 5%
  • Recreation or Sport Activity 5%
  • Other 9%

Average Yearly Burn Injuries Receiving Medical Treatment: 486,000

This general estimate is derived mainly from federal surveys which provide annual estimates of hospital admissions and visits to hospital emergency departments. The estimate range acknowledges that some burns may have been treated solely at hospital clinics, community health centers, or private medical offices. Such burns are more likely to be minor, and the number of such facilities sampled is too small to provide reliable estimates for burns.

Average Yearly Fire/Smoke Inhalation Deaths: 3,275

This total includes 2,745 deaths from residential fires, 310 from vehicle crash fires, and 220 from other sources. One civilian fire death occurs every 2 hours and 41 minutes. The odds of a U.S. resident dying from exposure to fire, flames or smoke is 1 in 1442. Fire and inhalation deaths are combined because deaths from thermal burns in fires cannot always be distinguished from deaths from inhalation of toxins in smoke.

Average Yearly Hospitalizations Related to Burn Injury: 40,000, including 30,000 at hospital burn centers

Over 60% of the estimated U.S. acute hospitalizations related to burn injury were admitted to 128 burn centers. 

Causes of Burns

Burns from Domestic / Industrial Fires and Accidents

Not all fires are caused by Mother Nature, and burns may also be caused by harmful substances such as acids and other chemicals.

Home or apartment building fires may arise as a result of defective products used in constructing the buildings. Gas explosions are often caused by a variety of factors either standing alone or in combination:

  • Violations of applicable codes, standards or recommended safe practices
  • Defective products or combinations of defective products
  • Minimal or no consumer information on the safe handling and use of propane or natural gas.

Other causes can be:

  • Motor vehicle accidents – When a careless driver causes a cartruckbuspublic transportation, or motorcycle crash, burns can result from fires and sparks from gasoline, fluids or exposed wires. Friction burns may also occur.
  • Boating and aviation accidents – Although they occur less frequently than motor vehicle accidents, accidents caused by careless or reckless boaters can produce the same types of burn injuries. Gasoline fires may be more catastrophic due to exposed fuel tanks in boats.
  • Workplace accidents – Serious burns are among the leading types of workplace injuries. These burns can include chemical burns and scalding. They can occur at restaurants, factories, construction sites or warehouses. They may be caused by exposure to fires, explosions, wiring, hazardous chemicals, compressed gases and hot liquids.
  • Radiation – A patient undergoing cancer treatment, for instance, may suffer radiation burns due to the negligence of a medical professional.
  • Electrocution – An electrical shock from exposed, dangling wires can produce burns that harm skin, muscles and nerves. These accidents frequently occur in the construction industry. However, they also can occur in residential settings and may be due to the negligence of a landlord.
  • Propane gas tanks – Improperly filled or defective propane tanks that are used for cooking or heating can lead to fires and explosions. Manufacturers and distributors of faulty tanks may be liable.
  • Defective appliances – An electrical burn can result from faulty wiring in a household appliance. Burns may also result from defective grills, griddles, stoves, water heaters and space heaters. The manufacturer may be liable for failing to provide proper safety features or adequate warning labels.

Type of Burn Injuries

Burns generally are described as falling within one of four categories:

  • First degree – These burns are the least dangerous even though they can be very painful. Damage to the outer layer of skin (epidermis) could make it appear to be red and dry. However, your skin will not blister.
  • Second degree – This degree of burn damages the outer skin and part of the underlying layer of skin (dermis). Burned skin can become red and blistered. It may become swollen. Pain from a second-degree burn can be severe. A deep second-degree burn can leave a scar.
  • Third-degree – These burns are severe injuries. The damage can reach the level of fat under the dermis and destroy nerves. Burned skin may become stiff, waxy white, leathery or tan. Because of nerve damage, a victim of third-degree burns may feel numbness instead of pain.
  • Fourth-degree – This burn is potentially fatal. The damage will extend to muscle, tendons and bones. It may leave your skin blackened or charred. A fourth-degree burn victim actually may have no pain because of extensive nerve damage.

The more severe the burn, the more likely that one will experience:

  • Skin, bone, muscle and nerve damage
  • Scarring and disfigurement
  • Contracture (tightening of soft tissue which restricts movement)
  • Lung, and other internal organ damage
  • Chronic pain

A concern is that an injured victim may also suffer complications that can include infections, respiratory failure and arrhythmia (or irregular heartbeat). A burn survivor may also suffer emotional harm, including anxiety and depression.

As explained above, the costs of treating burn injuries and related physical and mental complications should be taken into account when seeking just compensation for your losses.

Treatment For Burn Injuries

Burn treatment often starts at a general hospital before a patient is transferred to a specialized burn center. The treatment may include:

  • Emergency medical care
  • Hospitalization
  • Medication
  • Compression therapy (use of burn garments to prevent contracture)
  • Debridement (removal of dead or contaminated skin tissue)
  • Skin grafting (replacing dead skin tissue with tissue from another area of the body)
  • Plastic surgery (to remove or mask scars)
  • Mental health counseling
  • Physical burn rehabilitation.

Also, as described above, the costs of a burn injury may also include the wages a person loses while recovering from the injury as well as the decreased ability to earn a living in the future.

After the required immediate medical care, patients who have sustained serious burns often need specialized care, including plastic or reconstructive surgery. In addition, burn victims often require counseling by trained psychologists who specialize in helping burn patients cope with issues related to physically disfigured facial and other physical body features. Further, burn victims may also require future treatment, if future psychological issues arise that relate to their injuries. We understand that your immediate concern, after getting the best medical treatment possible, is to get reimbursed for any medical costs that you or loved ones incurred as soon as possible, as well as the security of coverage for future medical expenses.

Often times burn injuries occur as a result of another person or person’s negligence, and such negligence may be overlooked by the burn victim. For example, burns may occur when your landlord has the temperature of the water set at a level exceeding the maximum temperature proscribed by Virginia or Maryland law.

What is the Rule of Nines and why is it used?

The rule of nines is a method doctors and emergency medical providers use to easily calculate the treatment needs for a person who has been burned.

It’s sometimes referred to as the Wallace rule of nines after Dr. Alexander Wallace, the surgeon who first published the method.  

A medical professional will do a visual examination to look for seriously burned areas and use the rule of nines to quickly add up what percentage of a person’s body is burned. While doctors will perform more thorough examinations for burn estimation, they can use the rule of nines to quickly assess a person and start recommending treatment centers and interventions to help a person.

What exactly is the Rule of Nines?

The rule of nines is meant to be used for:

  • second-degree burns, also known as partial-thickness burns
  • third-degree burns, known as full-thickness burns

The rule of nines assigns a percentage that’s either nine or a multiple of nine to determine how much body surface area is damaged. For adults, the rule of nines is:

Body part


Arm (including the hand)

9 percent each

Anterior trunk (front of the body)

18 percent


1 percent

Head and neck

9 percent

Legs (including the feet)

18 percent each

Posterior trunk (back of the body)

18 percent

If a person’s injured due to a burn, a doctor may assess them quickly. For example, if they were burned on each hand and arm as well as the front trunk portion of the body, using the rule of nines, they’d estimate the burned area as 36 percent of a person’s body.

How is the Rule of Nines used?

A medical provider can use calculations from the rule of nines in several ways. This includes the amount of fluid replacement and degree of care a person needs.

When a person experiences a second-degree burn or worse, the protective layer of skin is destroyed. As a result, they’ll lose a significant amount of body water. This makes providing fluids vital to helping a person maintain their total body water. According to the National Institutes of Health, burns that are greater than 20 to 25 percent of total body surface area require significant intravenous (IV) fluids. Doctors will also use the estimated body surface area burned to determine how much fluid to administer.

The rule of nines can also relay to a medical team receiving the patient how serious the injury is. Providers also know that burns that exceed 30 percent of a person’s body can be potentially fatal, according to the National Institutes of Health.

If a person has burns on 10 percent of their body surface area or greater, a specialized burn center should treat their wounds. Other circumstances where a burn center should treat the wounds include:

  • when the person is a child
  • when the burned areas involve key areas of the body, such as the hands, feet, genitalia, face, or major joints
  • chemical burns
  • electrical burns
  • the presence of third-degree burns

Another example of how a provider may use the rule of nines is to determine how much IV access is needed. If a person has 15 percent or more of their total body surface area burned, they’ll need at least one peripheral line to provide IV fluids. If a person’s body is burned 40 percent or more, they’ll need at least two IVs.

Rule of Nines in children

Doctors don’t typically use the same calculations in the rule of nines to children. This is because children tend to have different body proportions than adults do, including larger heads and smaller legs. For example, children tend to proportionally have a 20 percent larger head than adults, according to the National Institutes of Health. Infants also have 13 percent smaller legs than adults.

Therefore, there are a few adjustments for the rule of nines in children:

Body part


Arm (including the hand)

9 percent each

Anterior trunk (front of the body)

18 percent

Head and neck

18 percent

Legs (including the feet)

14 percent each

Posterior trunk (back of the body)

18 percent

Burns are serious, painful injuries that require immediate treatment and intervention. The rule of nines serves as a quick method of assessment for a medical provider to estimate the extent of a person’s injuries. If the person with burns is a child, the rule of nines should be adjusted due to differences in a child’s proportions.



While your case is pending, our burn injury law firm will do everything we can to make sure that you receive proper medical treatment for your injury.

We will provide a comprehensive investigation of your case. We can compile evidence and consult with highly qualified experts who can help us to determine why your burn injury occurred, who should be held responsible and how much should be pursued in compensation.

The legal issues surrounding fires tend to be quite complicated. It’s generally a good idea to consult an experienced lawyer to learn your best courses of action.

Our clients do not incur any costs for our fee, or for expenses.  We work on a contingency fee basis, that is, we take a percentage of the recovery, and then, at the end, we reimburse ourselves for advancing the costs of the litigation.  These cases can be very expensive and include costs for filing fees, investigations, depositions, and expert witness fees.  The last thing our clients need is to be concerned about these expenses, so they can rest assured that if we take on their case, they will get excellent representation and they will not have to worry about having money to pay for expenses.  We want our clients to be able to have peace of mind and concern themselves only with getting better.

A burn injury can result in extensive care and treatment costs. It will depend, in large part, on the severity of the burn injury. Here, hopefully there is health insurance.  If not, we work with the medical care providers and ask them to wait until the case is over to be paid.  As well, we have resources for “free care.”

Your right to recover compensation as a victim includes:

  • Reasonable and necessary past, ongoing and future medical expenses
  • Loss of past and future earnings and profits
  • Scarring and disfigurement
  • Loss of a normal life
  • Shortened life expectancy
  • Pain and suffering
  • Emotional distress.


Generally speaking, under Virginia law, you will have two years from the date of your accident in which to file a claim for compensation and in Maryland, three years. It is important to contact an experienced personal injury as soon as possible to preserve evidence.

In the case of children, or minors (under age 18), the time limit “starts” to run when the child reaches age 18.  Thus, in Virginia, the deadline is one day before the child’s 20th birthday, and in Maryland, one day before the child’s 21st birthday.


There are too many things you cannot possibly know, and to obtain compensation, you must have knowledge of the law, procedures, and access to experts who can prove your case. We can help you to avoid the costly mistakes that many victims in Virginia and Maryland make when they attempt to handle a case on their own. For instance, we can make sure that you do not accept a settlement agreement that fails to fully compensate you for all of your losses. Our goal, ultimately, is to protect you at every stage of your case and obtain the maximum amount of compensation for you.