Massachusetts SJC: Neurologist Not Liable for Patient’s Harm to Third Party; Failure to Warn Patient About Driving Does Not Create Liability

A man who was injured by a driver who suffered a seizure due to his brain tumor could not sue the driver’s neurologist for allegedly failing to warn him not to drive, or for otherwise failing to control his driving.

On December 21, 2001, the plaintiff suffered serious personal injury when he was struck by a car operated by the defendant driver. The driver had been diagnosed with a brain tumor in September 2000 after he had suffered a grand mal seizure. The tumor was malignant and inoperable.

The driver waited six months before he began driving again, as required by Massachusetts law. His treating neurologist, Frederick Hochberg, M.D. of Massachusetts General Hospital, allegedly did not attempt to prevent his patient from driving again and did not warn him not to drive. 

After he was hurt, the plaintiff sued the driver’s estate (the driver had passed away). He also brought a medical negligence claim against Dr. Hochberg. The plaintiff claimed that Dr. Hochberg owed a general duty to the public who might be injured due to the nature of the underlying medical condition that he was treating. The plaintiff argued that the duty rose from the special relationship between a physician and a patient. The plaintiff argued that general negligence principles created a duty in Dr. Hochberg to warn his patient of the dangers of driving while suffering from the brain tumor. The Supreme Judicial Court rejected both arguments.

The court found that this doctor-patient relationship was not a “special relationship” which would give rise to a duty to prevent harm to a third person. Absent such a special relationship, the court said, “there is no duty to control another person’s conduct to prevent that person from causing harm to a third party.”

In 2007, the court had found, in Coombes v. Florio, 450 Mass 182 (2007), that a physician may have a duty to warn his or her patient about the side effects of medication being prescribed. The court ruled that this duty extended to third parties who might be injured if the warning had not been given. But the court refused to extend that ruling to include medical conditions under treatment.

The Coombes case was seen by the court as a very narrow exception to the general rule that a physician owes no duty to third parties who might be injured by a patient. The court stated that the duty sought by the plaintiff would “impose on physicians an affirmative duty … to nonpatients to warn patient of the risks of driving due to any underlying medical condition. We conclude this is an unwarranted and ill-advised expansion of liability for several reasons.”

The main concern of the court was that the physician did not do anything to increase the likelihood of harm by the patient, compared to the physician who might be liable for prescribing medication and thus creating additional risk. The court also believed that further imposition of duty would intrude on the doctor-patient relationship and might increase collateral costs. 

This case represents the second time the court has stated that it will not be expanding the duty recognized in the Coombes case.  At least that narrow exception survived.

The case is Medina v. Hochberg, SJC-11178 (May 13, 2013).

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Housing Code Violations and Over-Crowding in Boston Student Housing

The fire on April 26, 2013 at 87 Linden Street in Allston, the second serious fire in less than two years on the same block, is a tragic reminder of what can happen with overcrowded, substandard student housing.

The Fire Marshall will now investigate the cause of the Allston fire. In addition, The Boston Inspectional Services Division should examine whether the unit was overcrowded in violation of the Boston Zoning Ordinance, and whether housing codes and accessibility codes were violated. Enforcement of city ordinances is,
unfortunately, inconsistent, and usually after the fact. Knowing this,
landlords and realty companies frequently violate these ordinances in the name of profits. The victims are often unsuspecting college students. As a result,
students, who pay high rents, are subjected to increased risks from their overcrowded housing.

The law in Massachusetts governs how homes must be safely maintained in order to prevent personal injury to occupants of the property. In Boston, zoning ordinances require building owners to declare whether their properties are single-family or multi-family units. In either case, under Boston’s zoning ordinances, under the definition of “family,” no unit may be occupied by more than four unrelated students unless the building meets much stricter building requirements.

It is also generally illegal for a landlord to create bedrooms in basements, and it may be against code to create a bedroom in an attic. No matter how it is configured, every house or apartment must have working smoke detectors throughout the unit.

Once a unit exceeds the four unrelated-occupant threshold, it technically becomes a rooming house, which makes it subject to very strict fire-prevention regulations under M.G.L. c. 148, Sec. 26I and other regulations. For example, a rooming house must have walls and ceilings made from fire-rated materials to slow flames in the event of a fire. Smoke detectors must be in every bedroom,
and must be interconnected. Even more important, every boarding house must have a working sprinkler system. Boarding houses must also meet accessibility guideline and provide multiple means of egress for upper floors, which may include fire escapes.

Real estate brokers and leasing agents share responsibility for student overcrowding and exposure to risk from substandard housing. A quick look at any leasing agent’s website will reveal scores of units available for student occupancy which are intended to house more than four unrelated individuals. Leasing agents collect a single month’s rent, sometimes more, for their services. Since they also take the responsibility to collect signatures on leases, they know exactly how many students will be in the unit. Leasing agents simply cannot claim ignorance of the laws regarding overcrowding.

Who May Be Liable
It is our firm’s opinion that violations of the boarding house rules are evidence of negligence and may create liability for the responsible landlord.
We also believe that knowing and willful violations of the boarding house rules by real estate companies or leasing agents may subject them to liability as well. Violations of these standards may also be violations of the Massachusetts Consumer Protection Act, which may subject landlords and their leasing agents to multiple damages and attorneys’ fees.

Other Cases
Injuries and death from substandard housing may also lead to criminal charges against landlords. For example, in January 2012, two absentee landlords were convicted of manslaughter after a fire in an illegal apartment in Quincy led to the deaths of three tenants. The landlords were accused of wantonly violating building and fire codes.

The question of the enforceability of rooming house regulations is also pending at the Massachusetts Supreme Judicial Court. In that case, civil claims were brought against a Worcester landlord for violation of the Worcester zoning bylaw. In that city, no more than four unrelated persons can occupy a home. The city brought the violation because there were more than four students in the unit. The decision in that case is expected to be handed down in the next few weeks.

Update: The City of Boston later cited the owner of the two-family structure, Anna Belokurova, for running an illegal rooming house and not obtaining the permits needed to create bedrooms in the basement, according to The Boston GlobeRead more.


Woman killed, firefighters and occupants injured in raging Allston fire, Boston Herald.

One dead, 15 injured in Allston house fire, The Boston Globe.

Jury finds landlords guilty of involuntary manslaughter in Quincy apartment fire, The Patriot Ledger.

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Massachusetts Law on Waivers and Releases

WaiverThe proposition is all too familiar: You or your children want to participate in an activity. It could be at school, for a sporting event, in connection with a walk-a-thon or bike-a-thon, or in some other activity where there is a risk involved. Maybe the event is really risky, such as learning to drive a race car, or learning how to rock climb. Part of the price of admission to all of these activities is your signature at the bottom of a release or waiver of liability.

The language of the typical release is usually very broad and even includes the requirement that you indemnify the organization against related claims. You will be binding not only yourself, but your family, and in the case of a wrongful death, your heirs.

Are they legal? Most of the time yes, though there are some important exceptions which will be discussed below.

The Massachusetts courts generally uphold the validity of releases and waivers that are entered into knowingly. This includes pre-accident releases as well as releases in connection with settlements. Our courts have repeatedly affirmed just how broadly Massachusetts law favors the enforcement of releases.

Simply put, a defendant ordinarily may “validly exempt itself from liability which it might subsequently incur as a result of its own negligence.” Lee v. Allied Sports Assocs., 349 Mass. 544 , 550 (1965) (car racetrack accident).

In the more recent case of Sharon v. City of Newton, 437 Mass. 99 (2002), the court enforced a release signed by a father on behalf of his daughter as a condition of her participation in cheerleading in her high school. After she was injured, the family brought suit for the school’s negligence. The release was raised as a defense, and the court strongly affirmed the enforceability of the release, citing a host of public policy arguments.

The requirements for a binding release include clear and conspicuous language, proper naming of the party, the signature of the party, and valid contractual “consideration.” Consideration, meaning something of value that is exchanged, is satisfied by the participation in the activity.

Some particularly disturbing releases seek to include third parties who may be related to the activity named in the release. For example, your school child may wish to participate in after-school volunteer activities, and the release required to participate may include all the companies participating in the program. Now assume something horrible–the contracting company had failed to screen its employees, and a dangerous criminal was employed and caused your child harm. The negligent hiring would likely be within the scope of the release.

There are some exceptions to enforceability of releases. There are certain statutory exceptions that apply. One exception (and it is one that is frequently violated) is a release of liability to join a gym or health club. G.L. c. 93, Section 80 makes such language unenforceable and, in fact, a violation of G.L. c. 93A, the Consumer Protection Act. If you are injured in a health club due to equipment failure, a defect on the premises, or the negligence of a staff person, you will be able to bring your claim. Here is a related blog on health club waivers and releases.

Although a party may contract against liability for harm caused by its own negligence, it may not do so with respect to harm caused by its gross negligence. Zavras v. Capeway Rovers Motorcycle Club, Inc., 44 Mass. App. Ct. 17 (1997). See also Gillespie v. Papale, 541 F. Supp. 1042, 1046 (D. Mass. 1982).

A party may not contract against liability for harm caused by violation of a statutory duty. Zavras v. Capeway Rovers Motorcycle Club, Inc., 44 Mass. App. Ct. 17, 19 (1997), citing Gillespie v. Papale, 541 F. Supp. 1042, 1046 (D. Mass. 1982).

A release may be avoided, in part, if it is the result of a “mutual mistake.” In the exceptionally rare case of Leblanc v. Friedman, 53 Mass. App. Ct. 697 (2002), a settlement release was not a complete bar to a subsequent claim by the plaintiff. The plaintiff settled a medical malpractice case arising from an instrument left in her body, and although the release was worded broadly, the court found there was a question of fact whether it was meant to include another injury not described in the release itself.

What Should You Do?
Entering into a release is an important contractual event. You should consider whether the reward overrides the risk. Some pre-enrollment due diligence is a good idea–ask about the staff involved, inspect the premises, get some references. If you are not willing to release all of your claims, try crossing out the offending language or simply not signing the release. However, most organizations are wise enough to recognize and disallow both of those techniques.

It would be appropriate for the Massachusetts legislature to consider revising the law of pre-accident releases. Sadly, that day does not look likely to come any time soon.

Our Practice
The lawyers at the Boston, Massachusetts firm of Breakstone, White & Gluck represent clients who have suffered personal injury as a result of the negligence of others. We have had experience identifying unenforceable releases which has allowed our clients to proceed with their claims for compensation. For more information and a free consultation, contact us today at 800-379-1244 or 617-723-7676 or use our contact form.

What Massachusetts Consumers Need to Know about Health Club Contracts


If you exercise at a health club, you may not be aware that Massachusetts law protects you in many ways from unlawful club contracts.  But many local health clubs – yours may be included – are regularly violating the law.

Health clubs are serving larger numbers than in the past. Over 50.2 million Americans now hold gym memberships, a 10 percent increase over the past three years, according to the International Health, Racquet & Sportsclub Association.

The industry has been known to make it challenging for members to cancel or put their memberships on hold. Sometimes, after you sign the cancellation agreement, they require you to pay until month’s end, then another full “last month.” In addition to monthly membership fees, many are also now adding new fees for “annual” memberships and equipment maintenance. Some are even charging cancellation fees up to $200. This is still legal in Massachusetts, though not at all consumer friendly.

But did you notice the fees clearly posted the last time you visited your gym? If not, your gym is violating the law. The Massachusetts Office of Consumer Affairs and Business Regulation recently inspected 15 local health clubs and found none were displaying fees or informing consumers of their right to cancel within three days, according to WBZ-TV. The office is referring the results to the state Attorney General’s office.

Health clubs cannot ask a member to sign a waiver of liability but, surprisingly, many still do. While waivers of liability, also known as releases, are generally enforceable in Massachusetts, G.L. c. 93, Sec. 80 specifically states, “No contract for health club services may contain any provisions whereby the buyer agrees not to assert against the seller or any assignee or transferee of the health club services contract any claim or defense arising out of the health club services contract or the buyer’s activities at the health club.”

This means gyms have a duty to properly maintain their premises and equipment and make sure they are being used in a safe manner, according to the manufacturer’s guidelines. If they do not, and they were negligent, they may be responsible for your damages. If you have been injured in a Massachusetts gym, the court should find the liability waiver void. Over the years, our injury lawyers have successfully challenged these agreements.

Gyms also cannot ask members to sign up for terms longer than 36 months or require that members agree to financing that lasts longer than one month beyond the membership period. Members cannot be required to agree to monthly automatic withdrawals from a bank account.

If you are joining a gym, the best thing you can do is read the fine print on your member agreement before signing. Research the organization online through your local Better Business Bureau website.

Consumer remedies for health club violations are limited. No health club will be permitted by the courts to enforce an illegal contract. A consumer may bring claims under the Massachusetts Consumer Protection Act, G.L. c. 93A, but damages will usually be  nominal, although attorneys’ fees would be available.

Recent Court Ruling

The possibility of class actions was virtually eliminated by the recent ruling by the Supreme Judicial Court in Tyler v. Michaels Stores, Inc., 464 Mass. 492 (2013). An invasion of a consumer’s rights may be a violation of G.L. c. 93A, but unless the consumer has suffered a separate, identifiable harm arising from the violation, there will be no remedy. This case put a disappointing crimp into collective consumer action to prevent violations of the Consumer Protection Act, leaving overworked state officials to take up the slack.

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Massachusetts Court Requires Medical Malpractice Tribunal in Third Party Claims

The Massachusetts Supreme Judicial Court has ruled that non-patient claims for personal injury resulting from medical malpractice must first be presented to the Massachusetts medical malpractice tribunal.  The tribunal’s job is to review medical malpractice personal injury claims and decide whether there was actual medical malpractice involved or if the injury was merely an unfortunate medical result.

The decision concerned a hospital worker who was killed when a heavily medicated woman lost control of her car and drove it into an entrance to the Brockton Hospital where the victim worked.  The victim’s wife sued the doctors for her husband’s wrongful death, alleging they had failed to warn the woman that it was dangerous to drive while on her medications.

Ordinarily, medical negligence cases may only be brought by a patient against his or her medical provider. However, third parties may bring claims against a provider if the provider failed to warn the patient of the effects of medication, and the patient then injured the third party. The exception is a narrow one.

The case clarifies pre-trial procedures in such third party cases, as it was unclear whether or not an injured non-patient was required to bring their medical malpractice claim before the tribunal.  However, with today’s Massachusetts Supreme Judicial Court ruling, it is now clear that any person looking to bring a claim for personal injury resulting from medical malpractice must first present their claim to the medical malpractice tribunal, whether or not they were the patient.

The case was Vasa v. Compass Medical, P.C., SJC-10457, March 2, 2010.

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Radiologists May be Reluctant to Admit Medical Errors to Patients

In a recent article in the medical journal Radiology, a study of several hundred radiologists reveals that mammographers may be reluctant to reveal medical mistakes, even if the mistakes relate to potential risk of breast cancer.

In the study the radiologists were given a hypothetical question. They were asked to assume that films were read out of order; that the calcifications in the films were actually increasing and not decreasing, and that they discovered the mistake after initially reading and reporting the results to their patients. Calcifications may be associated with the growth of breast tumors.

Only 14% of the physicians said they would definitely disclose the error. Twenty-six percent said they would probably report the error. The rest would either disclosed the error only if asked by the patient, or not at all.

In the hypothetical conversations with the patients after the mistake was revealed, only 15% of the doctors polled would admit that they made a mistake during the reading of the films.

Failure to diagnose breast cancer due to mammography errors is a common cause of medical malpractice claims, and almost half of the doctors in the study had been party to a suit alleging negligence.

The authors concluded that even though there is a trend towards more physician openness regarding mistakes, disclosure is “the exception, not the rule.”


Radiology: Radiologists reluctant to disclose mammo errors to patients. October 30, 2009.


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Massachusetts Appeals Court Allows Dog Bite Case Against Landlord to Proceed

The Massachusetts Appeals Court has allowed the claim of a child who was bitten by a dog to proceed to trial against the landlords, even though the landlords did not own the dog.  The ruling reverses a lower court ruling in favor of the landlord.

The plaintiff was ten years old when he was attacked by a pit bull named Tiny. Tiny belonged to another tenant in the same 4-family building. Tiny had been found in the woods and adopted by the family. Tiny had demonstrated some aggressive behavior prior to the date of the incident.  The plaintiff’s family maintained that they had lodged multiple complaints with the landlords about not just the presence of the dog, but also its aggressive behavior. The landlords were also informed that Tiny was allowed to roam unrestrained, a violation of the Waltham leash law. The landlords claimed they had no knowledge that the dog might be dangerous.

The landlords had a no-dog policy for the premises, but failed to enforce that policy with regard to Tiny.  In fact, the plaintiff’s family had previously given up its dogs because of the landlords’ policy.

On the date of the incident, Tiny was sitting on a porch, unrestrained, then ran across the yard, jumped a fence, and bit the plaintiff who was playing in the neighbor’s yard. The ten-year old had mulitiple dog bite injuries to his leg.

The Superior Court judge ruled that the landlords were not negligent, and that the fears of the pit bull were “subjective.”  The Appeals Court disagreed.

In Massachusetts, a third party such as a landlord, is not liable under the Massachusetts strict liability statute governing dogs. While a dogs owner or keeper is strictly liable for injuries caused by their dog, a third party can be liable only if he or she is negligent. A landlord does not insure that the property will be safe, and has a duty to use reasonable care for the premises.  Thus, in this case, the plaintiff is required to prove that the landlord knew or should have known of the dangers of the dog.  The landlords could not be held liable just on the fact that the dog was of a dangerous breed, but could be held liable if they had knowledge of its dangerous behavior.

The Appeals Court also noted that negligence cases are ordinarily best left to a jury’s consideration, since the cases often turn on disputed facts. Given the disputed facts in this case, namely whether the landlord had received reports of the dog’s dangerous behavior, the case was sent back to the Superior Court for trial.

The name of the case is Nutt v. Florio, Appeals Court No. 08-P-81 (October 19, 2009).  

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Massachusetts Commuter Rail Accident at Boston South Station, September 15, 2009

There has been another train accident on the commuter rail, this time at South Station in Boston. The Boston Herald reports that approximately 9AM, train 512, which originated in Worcester, failed to stop in time and collided with the end-of-track bumper at South Station, the last stop on the route.  Of the approximately 100 passengers on the train, at least 18 people suffered personal injuries, many of whom were treated at local hospitals. 

Although the train was allegedly traveling at a speed of 5 miles per hour at the time of the collision, many passengers were standing in preparation for getting off the train and were thrown to the floor and suffered personal injuries.  Many patients were taken off the train on backboards by emergency personnel.  Boston Medical Center activated its emergency plan in case a large number of injured passengers.

Transportation officials have already suggested that operator error contributed to the collision.  Investigations by the MBTA and the National Transportation Safety Board are underway.  Preliminary reports have ruled out signal, dispatching, or equipment problems as a cause.  The Boston Herald has reported that the train’s engineer told supervisors that he misjudged the stopping distance at the South Station platform. The engineer will be tested for drugs and alcohol.

Ordinarily, trains stop dozens of yards back from the bumpers, which are the emergency devices designed to stop the train at the end of the track and to protect people in the train station. There are no recent reports of other crashes into the bumpers.

If you would like more information about what to do if you were injured in this train accident, please call us at 1-800-379-1244 or visit us at

For More Information

Train hits South Station bumper, 16 passengers hurt, Boston Herald, September 15, 2009

18 injured in commuter rail mishap at South Station,, September 15, 2009

Massachusetts Court Upholds Verdict in Premises Liability Case; Discusses Innovative Jury Techniques and Question of “Control”

On August 29, 2003, several people suffered personal injuries and one person was killed when an improperly secured gate arm at the Gillette Stadium in Foxboro swung into a bus traveling on an access road. The stadium, which is the home of the New England Patriots, is on property managed by Foxboro Realty Associates, LLC, with security provided by Apollo Security, Inc,. parking operations managed by Standard Parking Systems.

According to the evidence, the accident occurred when the gate arm was not properly secured by its three pound pin, and a gust of wind blew it from the open position. The evidence demonstrated that Foxboro Realty Associates had promulgated a policy on securing the gate, but had failed to put the policy in writing. It was the job of Apollo to unlock the gate and the job of Standard to open and secure the gates at the appropriate times.

After a trial lasting several weeks, the plaintiff (who was the wife of the deceased passenger from the van) was awarded $4,400,000 for her husband’s conscious pain and suffering and wrongful death arising from the negligence of the defendants.

There were two issues on appeal: The instructions the trial judge gave the jury about discussing the evidence; and the issue of control, and whether Foxboro had sufficient control over the parking operations to be found negligent for the actions of its indpendent contractor.

The Massachusetts Supreme Judicial Court ruled that the judge’s instructions to the jury that they could discuss the evidence in the case during the trial (which is most unusual in Massachusetts) were improper, because such discussions can only be allowed in civil cases when all parties agree. One party had objected. However, the court found that the error was harmless, because the evidence of the defendant’s negligence was very strong.

The Court also ruled that the trial judge had given proper instructions to the jury on control. Under Massachusetts law, an employer is not liable for the acts of an independent contractor unless the employer “retained some level of control over the manner inwhich the work was performed.”  The judge had instructed the jury that the employer could be found liable if it failed to exercise its control with reasonable care. The judge’s instructions were found to be consistent with Massachusetts law, and the judge was not required to give the instructions requested by one of the defendants. 

The case is Kelly v. Roxboro Realty Associates, LLC, 454 Mass. 306 (2009).

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Massachusetts Elderly Drivers Involved in Motor Vehicle Accidents Ignite Debate Regarding New Licensing Requirements

A large number of motor vehicle accidents involving elderly drivers has prompted the Transportation Committee of the Massachusetts Legislature to enact a bill that would impose driving tests on people over 85 years of age. Currently, Massachusetts only mandates a vision test every ten years.  However, a group of lawmakers is trying to enact tougher regulations on the elderly.

Several recent tragedies have drawn attention to safety issues related to elderly drivers. Concerns about reaction time and vision of the elderly have arisen from the wrongful death of 4-year old Diya Patel who was allegedly killed by an 86-year-old woman in Canton earlier this month.  Similar stories this year alone accuse elderly drivers of crashing into a Wal-Mart, a group of cyclists at UMASS, and even a Vietnam Memorial in Plymouth.  Furthermore, an 84-year-old woman remains in critical condition after an 86-year-old man allegedly hit her while she was crossing the street near downtown Melrose yesterday.

According to an article in the Lawrence Eagle Tribune, Rep. Joseph Wagner (D-Chicopee) and Sen. Brian Joyce (D-Milton) want to enact a law similar to those in nearly 30 other states which mandate road tests alongside the vision test every five years for drivers over 85. This would override the current system, where drivers take a simple vision test every ten years after their initial licensure.

Not surprisingly, the issue is a sensitive one for many who say that regulating senior driving and treating them more like adolescents is demeaning and insulting. Even some suspects, such as 85-year-old Dominick Perry who stands accused of pinning a young boy against another car in a parking lot complain that “age discrimination” is the sole reason for the revocation of his license.  A story in The Boston Globe tells of a former race-car driver who took a long and difficult mock test similar to the road test which would be required of someone his age under the new law.  However, the anecdotal evidence from the elderly about the tedious nature of the test doesn’t outweigh the substantial evidence which links many elderly people to acts of negligent driving.

More Information

Lawmakers Hear Call for More Legislation Regarding Elderly Drivers – Boston Globe July 1, 2009.
Legislators Discuss Proposed Elderly Driving Bill Tomorrow – Lawrence Eagle Tribune – June 29, 2009.
Tested for the Road – Hospital Test Gauges Older Drivers’ Capability. – Boston Globe July 1, 2009.
Registry Revokes License of Driver, 86, in Melrose Accident. – Boston Globe June 29, 2009.
Passenger Dies in Elderly Driving Case – Boston Herald July 1, 2009.
Driver Charges Elderly Bias – Boston Herald July 2, 2009.
Malden Man Involved in Fatal Wreck Has Recent Road Woes – Boston Herald July 2, 2009.

If you’ve been injured in a motor vehicle accident<

The attorneys at Breakstone, White and Gluck have a proven record in dealing with elderly drivers envolved in cases of wrongful death and car accidents. Recently, Ronald E. Gluck  obtained a significant recovery for a 33 year old school teacher and avid sports enthusiast who was struck by an elderly woman in a parking lot.  If you or anyone you know has suffered injury  as the result of an elderly driver or any motor vehicle accident, please visit or call 617-723-7676.  Experience Matters.