She can't walk.

She can't dress herself.

She can't bathe herself.

For most of the past 20 years, Lisa Little, now 39, has been confined to a wheelchair, permanently disabled physically and mentally because Tripler Army Medical Center botched treatment when she was injured in a car accident.

Little was deprived of adequate levels of oxygen after she was transported to the hospital in 1986 with arm and leg fractures and in respiratory distress. Tripler failed to deal appropriately with the respiratory problem, a judge determined, and the resulting lack of oxygen caused severe brain damage.

Since then, even basic tasks can be exceedingly difficult for Little, if she can do them at all.

She has a short attention span.

She can remember what happened years ago but has trouble recalling what she had for breakfast that morning.

She can carry on a basic conversation, but it's at the level of an adolescent.

A hired caregiver tends to Little during most of her waking hours. And her father and stepmother, who live with Little in Kane'ohe, also help. It's a daily challenge.

"This is life for all of us, for the whole family," Tish Little said. "It's horrible. No one should have to go through this."

If only that were the case.

But the struggles that Little and her family go through every day ring familiar to other families of former Tripler patients who suffered brain injuries because of substandard care.

Of the 14 medical malpractice lawsuits involving Tripler care that the U.S. government lost at trial over the past 20 years, six involved patients who were brain-damaged, according to Personal Injury Judgments Hawaii, a publication that summarizes court verdicts in federal and state tort trials.

At least two pending lawsuits also involve babies who allegedly suffered brain injuries because of Tripler negligence.

In the case of Izzy Peterson, an infant who was mistakenly given carbon dioxide instead of oxygen moments after his birth in January 2005, the brain damage was so severe that he requires around-the-clock care and is dependent on medical devices to breathe and eat.

Depending on the severity of the brain damage, a family's life can be substantially altered in dealing with the aftermath.

'WE HAVE TO ADJUST'

The Little family knows that intimately. They say they find ways to make the best of the situation.

"Things are very limited to what she can do," said Dell Little, a retired Army man and Lisa Little's father. "She just can't get up and go like a normal person. We have to adjust to that."

A federal judge in 1989 awarded the Littles $5.5 million in damages after he ruled that Tripler breached its duty to provide sufficient care for Lisa Little.

Investment income from that judgment is being used to pay for Little's home care.

The money is helpful, the Littles say, but it can never replace what was lost.

"All that money doesn't bring back that child, that happiness, that normal life," Tish Little said.

Asked to comment on Little's case, Tripler officials said in an October statement:

"Whether it's natural disease or malpractice, our sympathies are with families who suffer losses. We know dealing with any disabled person is a hardship. When malpractice is the cause, it is a tragedy, and money does not make things the way they were, but it is the way to compensate people for their losses."

GOOD DAYS, BAD DAYS

Little's family said she relies on a sense of humor and a positive attitude to help her cope, but like anyone, has her good moments and bad. On this particular day, Little was radiant and smiling in her wheelchair, happily telling a visitor what she likes to do.

She enjoys watching television, shopping, going to the beach, hearing the sound of waves. She also likes talking on the phone with her sister on the Mainland.

For exercise, Little uses a weight machine at her home and navigates, with great difficulty, backyard parallel bars while on her feet, using her arms to help guide her.

Despite her condition, Little doesn't criticize Tripler for what happened. "I know Tripler tried to help me, but they didn't do very good," she said.

Dell Little said he, too, is long past being angry at Tripler.

"You've got to move on with life," he said. "But you can't forget. You never do."

Reach Rob Perez at rperez@honoluluadvertiser.com.