The night Ashley Moser was shot in the Century 16 Aurora movie theater, she lost her daughter, the use of much of her body and the ability to be financially independent.
Like many victims, Moser, whose daughter was killed in the shooting and who suffered a miscarriage from her injuries, will face mental and physical trauma that will lead to a lifetime of medical costs. Her family and others will have to sort through dozens of victim funds and find their way through a maze of medical bills.
"It is going to cost a small fortune," said Mary Ellen Hansen, Moser's aunt. "She won't be able to work anymore. Her entire lifestyle is going to change."
Caring for a gunshot wound victim who is hospitalized for four to seven days can cost up to $56,000, according to Douglas Arvin, vice president and chief financial officer at University of Cincinnati Health.
Follow-up care at an inpatient rehabilitation facility can cost as much as $240,000 a year, said Frank Darras, an insurance attorney who has represented victims of Hurricane Katrina and 9/11. Seeing a psychiatrist can cost up to $400 an hour, and medications can average $100 a month even with the best co-pays and deductibles, he said.
Ten people remain hospitalized after the July 20 massacre that killed 12 people and injured 58. James Holmes, 24, is charged with 24 counts of first-degree murder and 116 counts of attempted murder in one of the worst mass shootings in U.S. history.
The Aurora Victim Relief Fund has already raised $3.6 million, and more than 10 non-profits have set up donation pages. Internet campaigns and social media pitches have also helped some victims collect hundreds of thousands of dollars in personal donations.
After such mass tragedies, hospitals and people sympathetic to victims often pour resources into helping meet immediate needs of patients, Darras said. The real struggle comes in rehabilitation and the mounds of bills for follow-up care, specialists, medications and therapy that will await people such as Moser once the nation's attention shifts.
"They are going to be overwhelmed with a mountain and maze of paperwork," he said. "It's going to be a nightmare to keep track of all of these bills and copays. They wind up in the process getting beat up and worn down."
Carolyn Tuft, 50, knows the feeling. She, her daughter, and seven other people were shot five years ago at a mall in Salt Lake City. Her daughter, Kirsten Hinckley, 15, died. Tuft, who was hit in the back, arm and lung, spent three weeks in the intensive care unit and had seven surgeries.
The hospital wrote off more than $100,000 in immediate care costs for Tuft, who was not insured. About $10,000 from a fund for victims and gifts from friends paid her expenses the first year after the shooting.
Since then though, Tuft, who is unemployed, has struggled to pay for the ongoing care she needs to treat chronic pain and lead poisoning from the bullet fragments still inside her.
"It's completely destroyed my credit and my life," Tuft said. "I can't rent an apartment or buy a car because of my medical bills."
She has about $12,000 worth of debt from visits to pain specialists, physical therapists, and from buying equipment to deal with her wounds.
Tuft is suing the pawn shop that sold the weapon to Sulejman Talovic, who killed five people and wounded four before being shot dead by police.
Meanwhile, debt collectors continue to call.
"I've been feeling really bad for these Aurora people," said Tuft, who lives in a home she inherited from her parents in Salt Like City. "They have no idea what they are in for - what is going to happen to their lives. It's a never ending battle. When all the hype dies down, people forget that we are still here and we're still stuck in it."
Eirz Scott thought her son, Jarell Brooks, who was hit in the leg during the Aurora shooting, would only be slightly impacted financially after he was released from the hospital the same day. Monday, however, Brooks, 18, who is insured, was readmitted and had surgery after his wound became infected.
Scott is concerned that he will need money for lost wages, transportation to school and ongoing counseling.
"I am worried about how much we're going to owe - how much money all these medical expenses are going to cost and being responsible for all of these bills," said Scott, 42. "We have no idea how and what's going to be covered."
She has tried to get information about victim funds but has learned little about how to access them. A donation Web page for Brooks has raised about $5,000. It's one of several personal pitches hosted on websites.
A Web page for another victim, Caleb Medley, who was shot in the head, has raised more than $369,000. A page for Petra Anderson, who was also shot in the head, and her mother, a cancer patient, has raised more than $254,000.
"Most of the payments are coming from people who shared it on Facebook or Twitter," said Rich Aberman, co-founder and chief operating officer of WePay.com, which is hosting Medley's page. "The story really resonates and people are getting more and more comfortable asking for help and giving it."
The six places that treated the victims - Medical Center of Aurora, Swedish Medical Center, University of Colorado Hospital, Children's Hospital, Denver Health, and Parker Adventist Hospital - say they plan to work with patients to offset costs on a case-by-case basis. Some said they would limit or eliminate bills entirely. At the University of Colorado, which saw the most patients, social workers and financial advisers have been going over costs with the victims.
Officials in Colorado are hoping to pool and distribute donations for victims based on recommendations by hospital workers, the Aurora police department, the local district attorney's office, and Colorado Organization for Victim Assistance, said Cheryl Haggstrom, executive vice president of Community First Foundation.
Her organization, along with the office of Gov. John Hickenlooper, is coordinating the Aurora Victim Relief Fund. It was also part of an advisory group that decided how to distribute donations after the 1999 shootings at Columbine High School. "We are using a very similar process that we used back then," Haggstrom said.
Moser was planning to begin classes in August or September toward a practical-nursing license, a nine-month program that she had hoped would allow her to work and support Veronica Moser-Sullivan, 6, Hansen said.
She had been a math tutor and was taking the summer off from work to spend time with Veronica, who was killed in the rampage, Hansen said.
Moser's rehabilitation and living expenses will be greatly affected by the extent of her paralysis. After fearing she would have no movement below the neck, Moser's aunt, Hansen, said doctors now believe the 25-year-old may eventually have some movement above the waist.
Doctors removed a bullet from Moser's abdomen, but a bullet remains lodged in her neck.
"The one in her neck is lodged where it may be too risky to remove," Hansen said. "Her prognosis looks positive. With some rehab she may end up getting use of her arms, which would be great."
Her family is trying to sort through several assistance funds that have been set up for her benefit and determine which will be the official fund. "We appreciate that people want to be generous and want to do something," Hansen said. "We've had a lot of people ask about donations but they want to be assured it's getting to Ashley."