Nearly seven years after two boys pushed a shopping cart off a walkway at a Manhattan mall, severely injuring a woman four stories below, a jury decided to award more than $45 million to her and her family.

The woman, Marion Hedges, had just shopped for Halloween candy with her son, Dayton, then 13, at the East River Plaza Mall in East Harlem in October 2011 and was at a parking kiosk when the two boys hoisted the cart over a railing above. It plummeted more than 70 feet and struck Ms. Hedges on the head.

Ms. Hedges, a philanthropist, stopped breathing and was rushed to the hospital. She suffered serious brain damage and today she struggles with diminished cognitive abilities, double vision, incontinence and memory loss, her lawyer, Thomas Moore, said.

Court documents show that Ms. Hedges and her family sued the mall and Planned Security Service, which was under contract to secure the mall’s common areas, including the walkway where the boys pushed the shopping cart over the edge.