The injury record and the event record are two things
A burn has a cause and a course, and they are documented in different places. The cause, whether a flash fire in a process unit, a vapor cloud that ignited, a chemical that reached the skin, an electrical contact, a scald, or a vehicle fire, is investigated separately: as an explosion for how a fire or blast started, as a chemical exposure for what a substance was and how much of it reached a person, and through each setting for the companies that controlled the place. The injury record establishes the course: how clinicians described the burn, what treatment followed, what lasted, and which records connect all of it to the event.
That separation matters because the two records are held by different people. The event record sits with employers, facility operators, fire investigators, and agencies. The injury record sits with emergency responders, hospitals, burn units, surgeons, therapists, and the person who lived through it. The review gathers both and reads them together.
How clinicians describe a burn
A burn is damage to the body’s tissues from heat, chemicals, electricity, sunlight, or radiation. Clinicians describe it in three ways. The first is the mechanism: the contact with flame, hot liquid or steam, a hot surface, a chemical, or an electrical current. The second is depth. A superficial burn, formerly called first-degree, affects only the outer layer of skin; a partial-thickness burn, formerly second-degree, affects the outer layer and the layer beneath it; and a full-thickness burn, formerly third-degree, affects the deep layers of skin. The third is extent, expressed as the share of the body’s total surface area the burn covers.
Breathing smoke, steam, or hot gases can cause an inhalation injury, which clinicians treat as its own category alongside the skin injury and which can affect the airway and the lungs. The emergency department and burn-unit records state each of these descriptions for a particular person. They are the vocabulary of the medical record, and the review uses them as the clinicians did, without turning a depth term or a percentage into a conclusion about what the injury means.
Treatment records: wound care, grafts, and surgery
The treatment of a serious burn is documented across weeks and months: cleaning and dressing of the wound, fluids and nutrition, surgery to remove damaged tissue, and, where the skin cannot heal on its own, grafting. A skin graft is skin removed by surgery from one area of the body and attached to another, and the operative report records the graft, the donor site, and the type of graft used. The records that follow show whether the graft took, the healing of the donor site, and any of the complications clinicians watch for, including infection, loss of the grafted skin, discoloration, and scarring at either site.
Those records are the course of the injury. They are not a judgment about the surgeons, and this page does not treat a complication as one. What they establish is how the burn was treated and what the person went through to heal from it.
Scars, movement, and the consequences that last
Burns can leave permanent scars, and scarred skin can be more sensitive to temperature and light than the skin around it. Where a severe burn crosses a joint, the scar can tighten into a contracture that reduces the joint’s movement and function. An airway burn can leave reduced breathing capacity. The eyes, nose, ears, and hands are documented with particular care because a burn there can change function as well as appearance.
The lasting record is kept by the treating team and by the person. Follow-up notes, therapy records, and any later reconstruction document the medical course. The person’s own account of sleep, movement, appearance, and daily routine, kept close to the time, and the observations of the people around them document what the clinical notes do not. Employer records show whether and how the person returned to work. Where the future course of care is in question, a qualified professional evaluates the person and the record and sets out what is expected and why; that future-needs evidence is developed the same way for any catastrophic injury, and this page does not predict any person’s recovery.
Connecting the burn to the event
The link between the injury and the event is made by records created for other purposes. The emergency medical services run report and the emergency department record fix the time, the place, and the mechanism as the responders understood it. Fire investigators document origin and cause: the Houston Fire Department’s Fire Marshal’s Office within the City, the Harris County Fire Marshal’s Office in unincorporated Harris County, and the State Fire Marshal’s Office when a local authority requests its help, and their reports become available once the law allows. Where federal recordkeeping requirements apply, a recordable workplace burn belongs in the employer’s injury and illness log and incident report, and an inspection file from the Occupational Safety and Health Administration (OSHA) may follow. Utility records may describe an electrical event, and qualified custodians may preserve a product or appliance where safely possible without delaying protective action or an applicable recall remedy, because whether it failed is answered from the item, not from the injury.
The clothing and anything else that was on the person or in their hands are evidence too, and so are photographs of the injury over time. Retain existing photographs and records. Qualified custodians can coordinate physical preservation where safely possible; protective action and applicable recall instructions come first and require no firm permission.
A person burned in the Houston area may be treated at a local emergency department first and then transferred to a burn unit for the rest of the acute course, so several providers hold pieces of the record. Texas designates trauma facilities by level and keeps a registry of emergency medical services and trauma data. The firm identifies each provider from the first responders forward and requests the record from each.
Explosions, exposures, worksites, vehicles, and products
- How a fire, flash fire, or explosion started, and the fire-marshal, OSHA, and Chemical Safety Board investigations that follow, are the subject of an explosion review.
- What a substance was, how much reached the person, and what the employer knew are chemical exposure questions.
- The companies inside a refinery or plant, on a wellsite, or on a construction project, and the coverage question for each, are reviewed through each setting.
- A vehicle fire after a collision is investigated as a car accident or a truck accident.
What to gather before the first conversation
Gather what exists; none of it needs to be complete:
- the names of the responders and of every provider since, and the discharge papers;
- photographs of the burn over time, and the clothing if it was kept;
- any fire-marshal, employer, or claim reference number you have been given;
- for a death, the documents a wrongful death claim requires, because a death brings its own family and estate questions.
Leatherwood & Schindler represents people and families after catastrophic injuries. A consultation can start with any of those records, and we will explain which questions decide who is answerable for the event and the records that show it, request the injury record from each provider, and explain how the two are connected before any conclusion is drawn.