Category: Traumatic Brain Injury

Concussion symptoms can persist in children a year after injury

Each year about half of a million children suffer mild brain injuries. A new report says that, when a child has a head injury, there may be more damage than we initially suspect.

“The majority of kids in the study were injured in sports or recreational activities,” said Keith O. Yeates, PhD, director of Behavioral Health Services at Nationwide Children’s Hospital and one of the study authors. FoxNews.com. “A small number were injured in motor vehicle accidents, but most were sports-related or falls.  Not all mild traumatic brain injuries are alike. It’s important to assess risk factors for symptoms that persist.”

Young people with mild traumatic brain injury (TBI) are at heightened risk of developing postconcussive symptoms, including cognitive symptoms such as inattention and forgetfulness, report researchers.

Mild TBIs are common in children and adolescents, and every year more than 500,000 young people under the age of 15 sustain head injuries that require hospital care.

Health providers need to be able to identify children with mild TBI who are at risk for persistent postconcussive symptoms so that they can target such children for appropriate management.

The prospective, longitudinal study was published online March 5, 2012 in Archives of Pediatrics and Adolescent Medicine.

Spread the word. 

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.

 

Leading cause of death from sports-related injuries is traumatic brain injury

The American Association of Neurological Surgeons the leading cause of death from sports-related injuries is traumatic brain injury.  The AANS says a total of 446,788 Americans went to hospital emergency rooms in 2009 with sports-caused head injuries

They go on to report these numbers by the top 20 sports/recreational activities contributing to the highest number of estimated head injuries treated in U.S. hospital emergency rooms:

Cycling: 85,389

Football: 46,948

Baseball and Softball: 38,394

Basketball: 34,692

Water Sports (Diving, Scuba Diving, Surfing, Swimming, Water Polo, Water Skiing, Water Tubing): 28,716

Powered Recreational Vehicles (ATVs, Dune Buggies, Go-Carts, Mini bikes, Off-road): 26,606

Soccer: 24,184

Skateboards/Scooters: 23,114

Fitness/Exercise/Health Club: 18,012

Winter Sports (Skiing, Sledding, Snowboarding, Snowmobiling): 16,948

Horseback Riding: 14,466

Gymnastics/Dance/Cheerleading: 10,223

Golf: 10,035

Hockey: 8,145

Other Ball Sports and Balls, Unspecified: 6,883

Trampolines: 5,919

Rugby/Lacrosse: 5,794

Roller and Inline Skating: 3,320

Ice Skating: 4,608

The top 10 sports-related head-injury categories among children ages 14 and younger:

Cycling: 40,272

Football: 21,878

Baseball and Softball: 18,246

Basketball: 14,952

Skateboards/Scooters: 14,783

Water Sports: 12,843

Soccer: 8,392

Powered Recreational Vehicles: 6,818

Winter Sports: 6,750

Trampolines: 5,025

These numbers are frightening. Protect your brain. It’s the only one you have.

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.

Even mild head injuries can cause significant abnormalities in brain function

According to new research published in the Journal of Neuroscience even mild head injuries can cause significant abnormalities in brain function that last for several days.

Scientists at the Virginia Commonwealth University School of Medicine say this may explain the neurological symptoms experienced by those who have experienced a head injury associated with sports, accidents or combat.

Previous research has shown that even a mild case of traumatic brain injury (TBI) can result in long-lasting neurological issues, such as slowing of cognitive processes, confusion, chronic headaches, post-traumatic stress disorder, and depression.

Protect your brain. Head injuries can occur from playing sports, a motorcycle crash, an auto accident, falling on the ground and many other accidents. TBI affects all ages, all ethnic communities, and all professions, but is particularly prevalent in young children and older people where it is now the leading cause of death and disability. Among older people, falls are the primary cause of TBI, and among younger people, car crashes and sports injuries are significant contributors.

People are becoming more aware of brain trauma, but it’s important to continually educate yourself.

Drive safe, be aware of other drivers on the road, including motorcycle riders, bicyclists and pedestrians. Wear a helmet when you ride a motorcycle, a bicycle or play certain sports.

Share the road.

 

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.

Scientists are starting to map brain connectivity loss due to traumatic brain injury

Gray versus white: Which is more important?

“Use your gray matter,” we are told when someone believes we need to think a little harder.

Certain gray matter regions in the human brain are known to by affected disproportionately by traumatic injury. Yet, there is an ongoing debate about whether a less understood brain structure, the connections known as “white matter,” are as important as gray matter when assessing brain injury.

In recent years, scientists have begun describing the combined gray and white matter structures as a connected network. Injury to one part of the network, under this view, can result in consequences that are more or less severe, depending on the relative prominence of the injured structure.

There is a notion that, by using network theory, someday doctors will be able to map exactly why a certain type of insult (injury) to the brain will result in a certain type of problem for the patient.

Two University of Southern California researchers studied structural MRI findings from 110 healthy, right-handed males aged 25-36 in an effort to begin mapping how disruption in various brain circuits (white matter connecting gray matter) may lead to specific functional deficits. Their findings are published in the February 2014 edition of Frontiers in Human Neuroscience.  (Irimia, Van Horn, Front.Hum.Neurosci., 11 Feb. 2014 | doi:10:3389/fnhum.2014.0051.)

The researchers rely on network theory in discussing how the brain works – or doesn’t work – when it is injured. Their findings, they write, support the notion that even though gray matter nodes are critical in brain function, “the brain as a network also contains a distinct core of network edges consisting of [white matter] connections whose damage dramatically lowers the integrative properties of brain networks.”

“The findings of this study contribute substantially to current understanding of the human [white matter] connectome, it’s sensitivity to injury, and clarify a long-standing debate regarding the relative prominence of gray vs. [white matter] regions in the context of brain structure and connectomic architecture.”

Network theory and the brain

In network theory, gray matter is parsed into distinct regions with white matter acting as the connection. Think of a computer network, with the computers made up of gray matter and the wiring made up of white.

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.

A Brain in Hand and a Brain Test Out of Control

Holding a human brain in your two hands triggers odd thoughts. So does reading the Wall Street Journal, though I’m not suggesting the two experiences are exactly equivalent.

My close encounter with a thought organ took place on the last day of an excellent four Saturday UCLA Extension class: Gross Anatomy: The Fundamentals Litigators Need to Know. The course was the brainchild of CAALA Board of Governors member Steve Goldberg and UCLA Professor David A. Hovda, Ph.D. If it’s offered again in the future, I highly recommend you attend.

Briefly, UCLA/Goldberg/Hovda put together a science-based program designed to teach 26 enrolled attorneys human anatomy from top to bottom.The course materials closely track the basic human anatomy class every first year medical student must pass. Dr. Hovda assured me that, as a graduate of the program I am now entitled to wear a UCLA Medical School sweatshirt and, I guess, root against USC.

We’re talking detailed lectures, introductions to everything from functional MRIs and PET scans to cutting edge orthopedic surgery, followed by four afternoons in the laboratory dissecting human cadavers. Lawyers studying real science to improve their courtroom advocacy is a good thing. Especially since it goes directly against the stereotype that plaintiff attorneys care more about junk science than scientific fact when they bring a case in court.

On the other side of the spectrum was a Journal article that caught my eye. I found it on the front page just after my UCLA brain-holding experience, which is probably why I took such strong notice

“Malingerer Test Roils Personal-Injury Law” blared the headline. The subtitle offered a bit more explanation, adding: “’Fake Bad Scale’ Bars Real Victims, Its Critics Contend.” “Great,” I remember thinking. “What kind of junk have they come up with now?”

I found the news story both enlightening and disturbing. Enlightening, because I’ve always found traumatic brain injury cases to be among the most challenging and interesting matters a trial lawyer can handle.Disturbing because the Journal described a controversy surrounding the oddly named “Fake Bad Scale” validity (read “malingering”) test that was recently made an official subset of the Minnesota Multiphasic Personality Inventory, aka the MMPI.

The MMPI, just in case you aren’t familiar with it, is a psychological assessment test that has been around since the early 1940’s and is frequently used to evaluate personal injury victims, particularly those alleging mild traumatic brain injury.

Even though the story talked about the MMPI, I think the reporter meant the MMPI-II, since that’s the restandardized version of the original test and is the version most widely in use. Any way, it didn’t really matter, since the point of the story was, a widely used test has been compromised by an apparent junk scientific validity scale designed to wash out deserving brain injury victims. As the Journalexplained:

In two Florida court cases last year, state judges, before allowing the [Fake Bad Scale] test to be cited, held special hearings on whether it was valid enough to be used as courtroom evidence. Both judges ended up barring it.

“Virtually everyone is a malingerer according to this scale,” says a leading critic, James Butcher, a retired University of Minnesota psychologist who has published research faulting the Fake Bad Scale. “This is great for insurance companies, but not great for people.” . . .

Paul Lees-Haley, the psychologist who created the test, says that while individual items “can be made to seem like evidence for a flawed” measuring process, what’s important is the total score. He says the scale has “been tested empirically and shown to be effective.” . . .

Working for litigants is Dr. Lees-Haley’s main source of income. He has said in court cases that 95% of this work is on behalf of the defense. He charges $3,500 to evaluate a claimant and $600 an hour for depositions and court appearances, his fee schedule says.

In one episode mentioned in the article:

The experts’ disagreement spilled over into the courtroom in a case brought against a Florida gasoline carrier, Strawberry Petroleum Inc. Lloyd Davidson was sitting at a stoplight in May 2004 when his pickup was rear-ended by one of the gasoline company’s loaded tanker trucks, sending the pickup crashing into another truck ahead of him. His lawsuit said his head shattered the rear window and he ended up with diminished mental capacity and symptoms of depression and inattention.

A psychologist hired by the defense said in a deposition there was reason to believe Mr. Davidson was faking. The witness cited his “very high” score of 31 on the Fake Bad Scale.

Before the expert could testify at the trial, held in Hillsborough County Circuit Court, the plaintiffs moved for a hearing on the scientific validity of the Fake Bad Scale. Judge Sam Pendino ruled in June that “there is a genuine controversy surrounding use of this test” and “no hard medical science to support the use of this scale to predict truthfulness.” He said that drawing conclusions from a test that gives points for malingering when a plaintiff gives honest answers to questions based on actual injuries “has no place in this courtroom.”

In January, a jury determined that Mr. Davidson had suffered a permanent injury from the crash and awarded him $1.4 million from the gasoline carrier.

Okay, so what does all this add up to? I think the answer is simple.

There’s no shortage of quackery for hire that is ready, willing and able to use pretend science against our clients in the courtroom. Our best defense is to keep educating ourselves and improving our knowledge skills so that we can face trickery head-on and expose it effectively when it shows up on the defense side of our cases. Hence the importance of programs like what Steve Goldberg and Dr. Hovda put on at UCLA, or even just keeping up on changes in medical technology, like the abuse of the Fake Bad Scale.

The better educated we become, the better we can serve our clients and win the favor of Lady Justice. In the old days, maybe hitting a couple of seminars on tort law and getting your minimum MCLE was enough. I don’t think that’s the case any longer.

We need to find more ways to keep our skills at and beyond the state of the art. That’s one of the thoughts that went through my brain while I was holding someone else’s in my cupped hands. Another was a quiet prayer for a generous soul who made the most personal of gifts to help further human knowledge.

Sometimes you can’t help but be humbled in our profession.

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.

Make Sure Your Doctor Interprets Your Tests

If you suspect traumatic brain injury, make sure a doctor interpreted your tests.

No two brain injuries are exactly the same. The effects of a brain injury are complex and vary greatly from person to person. Outcomes can range from complete recovery to permanent disability or death.

“With the now common use of teleradiology, the doctors who read your scans may well be across town, several states over or on the other side of the world. And instead of discussing what they see with your M.D., the often far-flung radiologists may send only written reports with little or no interaction. The result can resemble a perilous game of telephone.”

“Although teleradiology can improve care by allowing access to specialists, a self investigation found that it also opens the door to confusion, errors and outright fraud. “Source MSNBC

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.

 

Brain damage makes some blind to the left

A car accident caused traumatic brain injury resulting in hemispatial neglect.

“The brain’s parietal lobe’s role in terms of vision is that it sees two frames of visual information. One form allows you to know what things are. The other form of visual processing lets you know where things are”, explains neuroscientist-turned-author Lisa Genova.

Almost all cases of hemispatial neglect affect the left side. That’s thought to be because both hemispheres process visual information for the right side, so if damage is done to the left hemisphere, the right can compensate for that loss — but it doesn’t work the other way around.

Read more about the condition at msnbc.msn.com

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.

 

Blood test shows promise in diagnosing TBI

 

The wars in Iraq and Afghanistan have resulted in huge numbers of traumatic brain injury cases, largely caused by improvised explosive devices (IED).

Tragic as this is, it has prompted advances in diagnosis of TBI that we would not have seen without the conflicts.

Recently, the Army Times reported that a blood test is being developed to attempt to diagnose TBI more easily in the field. If the technology proves successful, it will give us an important tool in helping to diagnose TBI victims earlier and with more precision.

Early and precise diagnosis can greatly impact how successfully TBI can be treated.

See the detailed article here: Blood test shows promise in diagnosing TBI

 

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.
 

Neurologists should screen their patients for abuse

People with certain disorders might be more vulnerable to violence, says American Academy of Neurology, as reported in US News.

Neurologists should screen their patients for abuse by family members, caregivers or other people, the American Academy of Neurology says in a new position statement.

Certain neurologic disorders, such as Parkinson’s disease, Alzheimer’s disease or stroke, may raise the risk for abuse and neglect, the academy said.

More than 90 percent of all injuries caused by intimate partner violence occur to the head, face or neck and can result in traumatic brain injury, according to the statement.

Read the full article on US News

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.

How to hire a personal injury lawyer

I’m writing about how to hire a personal injury lawyer because of something that happened to an old friend of mine.

Without giving away any confidences, the story goes something like this:

My friend’s wife was seriously injured in an automobile collision.

My friend hired a personal injury lawyer who holds himself out as a skilled P.I. attorney.  My friend found the lawyer on the internet and didn’t check references.

The P.I. lawyer took my friend’s case and then handed it over to a junior attorney.  The junior attorney spent almost two years working on the case.  I’m not sure what the junior attorney actually did during all those months.

The junior lawyer then told my friend that (1) the skilled personal injury lawyer my friend had hired was too busy to meet with my friend and discuss the case and (2) even so, the “skilled” lawyer had decided he would not file a lawsuit under any circumstances.  Since a deadline for filing the case was coming up, this created something of a problem for my friend.

Then, the junior lawyer disclosed he had a VERY low offer from an insurance company to settle the claim and began pressuring my friend to accept it. He applied this pressure even though the accident was already costing my friend an amount equal to the entire offer every single month.

My friend decided to ask for a second opinion. He came to me. I looked at the file. I did some investigation.

We are working on fixing the problem because it doesn’t seem like the very low offer is fair.

The point being, what I am describing is something that should NEVER happen.

When you hire a personal injury lawyer, that lawyer is supposed to work for you.  They should meet with you.  They should communicate with you.  They should work hard on your case.

Too often, a lawyer will forget those simple truths.

So, the first thing you need to know about hiring a personal injury lawyer is – don’t assume that just because the lawyer says they practice personal injury means they they have the skill and the drive to keep your best interests at heart.

A good P.I. lawyer puts you first.  You might not like what they tell you.  But they will not pressure you to do something that isn’t fair to you.

Some advertising lawyers are great attorneys.  Some are just great advertisers.  So, what I tell people is, when you are looking for a great P.I. lawyer, your best course is, ask someone you trust for a referral.

Ask your family and friends if they can help steer you to a trusted professional for advice.  Lawyers in the community generally know who the reputable personal injury attorneys are.  Also, reputable lawyers won’t charge if you simply consult with them to help you find the right attorney for your needs.

Also, don’t feel like you are asking for a favor when you ask an attorney to refer you to a reputable personal injury lawyer.

In many states – California being one – attorneys can often negotiate a referral fee when they connect you with the lawyer who takes your case.  That referral fee SHOULD NEVER increase the attorney fee you will be expected to pay.

So, it makes good sense to let a trusted expert help you find the right lawyer to represent you in your claim.

You know to shop smart at the supermarket. Apply those same skills when you or a loved one suffers a personal injury and needs to make a claim.

The problem is, if the injured party is not a US citizen and didn’t contribute to social security or pay any Medicare tax, they won’t qualify for Medicare benefits and the government will not (at this writing at least) provide any document that states there is no lien.

If the conditions are right, then the solution (short of having Medicare on the check and sending it off for endorsement, which takes months) is an indemnity clause in the settlement agreement.

Make sure this will not blow back on you or your client, but if you decide to go this route, here is some language that has worked for us with State Farm and Farmers:

FURTHER, as a condition of the settlement and release, Claimants represent and warrant that as of the date of this signing, Claimants have provided the released party’s(ies’) Insurer ______________________ (“Insurer”) all information Claimants know about any and all Medicare rights to recovery as of this date. Claimants agree to reimburse, indemnify and hold harmless each of the persons, firms or corporations released hereunder and their Insurers, including their agents and assigns, with respect to all known and unknown Medicare rights to recovery related to the Subject Accident for which the federal government may seek repayment, as well as any fine or penalty the federal government may seek resulting from the sufficiency and accuracy of the information Claimants have provided to Insurers regarding Medicare rights to recovery known as of this date.

Bill Daniels is a trial lawyer and shareholder with the law firm of DANIELS LAW in Sherman Oaks, CA.  A graduate of Loyola Law School of Los Angeles, he is a former member of the Consumer Attorneys Association of Los Angeles Board of Governors, a founding member of Loyola’s Civil Justice Program and a past president of the Encino Lawyers Association.  Since 2007, he has been named a Southern California “Super Lawyer” by Los Angeles Magazine.  Mr. Daniels focuses his practice on serious personal injury, insurance and employment. For information, visit our website at www.daniels.legal or contact us through e-mail: Info@danielslaw.com.