Norfolk Personal Injury Lawyer Blog

Approx 250,000 adults in Virginia have Brain Injuries

According to an article in the Virginian Pilot, an estimated 250,000 adults in Virginia alone have brain injuries.  In many cases, personal income is rapidly exhausted to care for the brain injury victim, and families are forced to turn to Medicaid in order to try and continue caring for their loved one.  However, most facilities in Virginia are privately owned and Medicaid won’t cover the costs because they are not nursing homes. 

This has become a growing issue, particularly for those with behavioral problems related to the head injury, because they must sometimes bounce from facility to facility. 

Some people may qualify for a “Medicaid waiver” which would allow for more flexibility when it comes to home or community based care, but this does not include adults with brain injuries.  It does however include: people with mental disabilities, the elderly and disabled, the developmentally disabled, and children with brain injuries. 

Brain injury advocates would like to see such a waiver for brain injured adults, but are not very optimistic of this happening when there are already more than 6,000 people on waiting lists for waivers that are already available.  The state just doesn’t have enough money for the program.

“The four most popular places for a brain-injury survivor are jail, home with a parent, a state psychiatric center, a nursing home,” says Dr. Robert Voogt the owner of the Neurological Rehabilitation Living Center in Virginia Beach.  “Those are all inappropriate placements, except for at home. But when parents get to be 70 or 80, they can’t care for them. The brain-injured person who is not violent, who is passive, sits in his chair and doesn’t cause trouble, a nursing home will have them for 50 years. Plenty of nursing homes will take those guys.”

Brain injury and helmet standards

“Helmets both new and used are not – and have never been- formally tested against the forces believed to cause concucssions,” states a recent New York Times article.

This may be a very discomforting statement parents with children playing high impact sports requiring a helmet- especially with the increasing rate of head injuries in the sport.

So who regulates helmet safety standards? 

If you thought that there were national safety standards and requirements helmet makers are obligated to meet, think again.

The National Operating Committee on Standards for Athletic Equipment, more commonly known as Nocsae, is a voluteer group who developed one helmet standard.  Nocsae not only includes, but is also financed by the helmet makers themselves. However, according to the New York Times article, Nocsae does not accept the role for ensuring that helmets meet these requirements.

The standard, which was created in the 60s and implemented in the 70s, was formed after a sginificant number of football players were killed by skull fractures and acute brain bleeding. The requirement: helemts must be able to withstand a 60-inch free fall without allowing too much force to reach the skull.

This standard has not changed in a meaningful way since 1973.  With the increase in size and speed of players since then, the standard just isn’t adequate.

What is a Traumatic Brian Injury?

According to the Brain Injury Association of America (BIAA) , a traumatic brain injury (TBI) is defined as “a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. Not all blows or jolts to the head result in a TBI. The severity of such an injury may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury. A TBI can result in short or long-term problems with independent function.”

What are the Symptoms of a Traumatic Brain Injury?

Some traumatic brain injuries have obvious symptoms and are easy for doctors to diagnose. For example, victims that experience coma or seizures after an accident or traumatic event are often diagnosed with a TBI. Unfortunately, it isn’t always this easy. There are a myriad of ways that a less serious brain injury can manifest itself, and if the symptoms are subtle it can be weeks or years before doctors are able to determine the problem. Often doctors aren’t the ones to notice a potential brain injury, instead friends and family members notice changes in the way the injured person acts or changes in their physical condition.

Doctors often use the Glasgow Coma Scale (GCS) rating to classify brain injuries for acute medical and trauma patients. The scale measures eye, verbal, and motor responses separately and ranks a patient’s response level for each. The scores for the three responses are tallied, and a value is assigned. The lowest possible score on the GCS scale is a 3, which means that the patient is in a deep coma or is deceased, and the highest score on the scale is 15, which means that the patient is fully awake.

• Mild brain injury (GCS score greater than or equal to 13): the symptoms of a mild injury include: loss of consciousness, loss of short-term memory (events immediately before or after the accident), or an altered mental state such as dizziness, disorientation, or confusion. Typically symptoms last less than 30 minutes. Most patients who have suffered a mild brain injury will not have any major functional deficits, however there may be some subtle long-term impacts like headaches or cognitive or memory problems.
• Moderate brain injury (GCS score between and including 9 to 12): includes memory loss after the accident that lasts for longer than 30 minutes but less than 24 hours. Also includes patients that suffer a skull fracture from the accident. Patients suffering from a moderate brain injury may suffer from long-term physical or cognitive deficits, and the success of their recovery will depend on the area of the brain that was affected by the accident. Patients will often need rehabilitation to counter the effects of a moderate brain injury.
• Severe brain injury (GCS score less than or equal to 8): patients with a severe brain injury lose consciousness or suffer from post-accident amnesia for more than 24 hours after the accident. These kind of brain injuries can be life threatening, and patients that survive such injuries often suffer from long-term physical and cognitive impairments. The long-term prognosis for patients with severe brain injuries can vary from a vegetative state to more minor impairments, where the person can function with help. Most patients with this kind of serious injury will require extensive rehabilitation.

Gary Coleman Remains Sought by Parents, Next of Kin

Gary Coleman’s former manager and family spokesman, Victor Perillo, is asserting that Coleman’s parents are entitled to the custody of the late actor’s body.  (Reported by the Associated Press, available here, via PilotOnline.com)  The family apparently wishes to have the body returned to the Illinois home where Coleman was raised, so that they can hold a ceremony.

Perillo says that Coleman’s parents should be considered the “legal custodians” of the remains, because Coleman and former wife Shannon Price divorced in 2008.  Coleman and his parents – according to the grapevine – were not on good terms.  Perillo says though, that the family wished to reconcile prior to his passing.

The former child star suffered a brain hemorrhage and was taken off life support last week, according to the AP.  He was just 42 and suffered from an array of medical issues over the years.  The difficult decision to cease life support was made by Coleman’s ex-wife – Shannon Price.  Coleman had previously given the right to his ex-wife to make decisions regarding whether to remain on life support, also known as an advance medical directive.  Price told one website that she made the decision to take Coleman off life support when it became apparent to her that even if surgery was performed, he would have died or “never been the same.”

Perillo helped Coleman begin his acting career and has said that his parents hope to have a private memorial service in the town of Zion, Illinois.

An attorney for the estate, hired by Coleman’s parents, said that it is not the intention of his clients to “fight over his estate” – but rather the primary focus and concern at the moment is gaining custody of their son’s body, so they can proceed with a private ceremony.

Study: Traumatic Brain Injuries may Lead to Sleep Problems

In a recent study reported on by ScienceDaily,  scientists believe that they now know the reason behind the sleep issues sufferers of brain injuries often report.  The study suggests that brain injury victims may produce smaller amounts of melatonin in the brain, a hormone that plays a role in regulating sleep patterns.

The study is reported to have involved 23 subjects with brain injuries – the injury having occurred 14 months ago, on average, as well as 23 subjects with no such injuries.  For two nights, the subjects were studied. The results?  Those without brain injuries produced more melatonin.

The study was supported by the Australian National Health and Medical Research Council, and was conducted at Monash University in Victoria, Australia.  As far as how to combat sleep issues which stem from brain injuries, PhD Shantha Rajaratnam, alluded to supplementation when he commented on the study: “Future studies should examine whether taking supplemental melatonin can improve sleep in people with brain injuries.”

Sleep is important.  Click here for an interesting article provided by Harvard, which explains why.  It offers several common-sense reasons that should prompt prudent individuals to take sleep seriously.  Among the reasons to get adequate sleep include; learning and memory, weight, cardiovascular health, mood regulation, and disease related immunity.

Journal Reference: J.A. Shekleton, D.L. Parcell, J.R. Redman, J. Phipps-Nelson, J.L. Ponsford, and S.M.W. Rajaratnam. Sleep disturbance and melatonin levels following traumatic brain injury. Neurology, 2010; 74: 1732-1738.  Click Here.

Brain Injury Victims Diagnosed With Depression

Symptoms of traumatic brain injury cab include headaches, trouble seeing, memory loss, inability to concentrate, dizziness, seizures, and paralysis. In addition to physical and cognitive challenges, a new study reported by AboutLawsuits.com suggest that depression is also a factor.

Researchers at a Seattle Hospital found that of about 600 patients with mild to severe traumatic brain injury, half of them suffered from “major depressive disorder” within one year of the head blow. This is apparently eight times higher than the rate of depression among the general public. The study also found that only about 44 percent of those patients received mental health treatment for depression. The data also indicated that the patient group had a lower quality of life as compared to the non-depressed cohort.

Most of the patients in the study were injured in car crashes or slip-and-fall accidents.  As we have discussed previously in this blog, there is an increasing focus on treatment modalities for brain injuries suffered in combat and in competitive sports.

The findings were just published in the Journal of the American Medical Association.

Traumatic brain injuries are said to be one of the leading causes of death and permanent disability throughout the world. If you believe that you (or a love one) have sustained a traumatic brain injury in Virginia due to the negligence of someone else, it is always important to hire experienced legal counsel. The Virginia brain injury lawyers at the Law Offices of Richard J. Serpe, P.C. have the experience needed, and the requisite contacts with the best doctors in the area, to ensure you and your loved ones have the best representation possible. Call Toll Free 877-544–5323 for a no-obligation consultation.

Anticipating Impact May Minimize Traumatic Brain Injuries

In a study that focused on youth hockey, new research suggests that bracing for an impending blow to the head could reduce the harm from the hit, CNN reports. In the study, players wore high-tech helmets that measured impact and compared that to game videos and with the number of injuries the players suffered during the season. According to the findings, being prepared for an imminent concussion helped offset more serious injuries.

“If players anticipate collisions they can better absorb the forces related to impact,” said Jason Mihalik, lead study author and assistant professor in the Department of Exercise and Sport Science at the University of North Carolina at Chapel Hill. “[Athletes] who don’t expect to get body checked are not able to tense the neck muscles to absorb force, and that can lead to a more severe impact to the head.”

Coaches need to train players to avoid the “calamitous” effects of being blindsided, according to Dr. Mihalik. The full study will be published in the Journal of Pediatrics.

Governor McDonnell recently signed legislation to increase Virginia health protections for student athletes with suspected head injuries. Data from the National Center for Injury Protection and Control indicates that teenagers are the group at the highest risk for suffering a traumatic brain injury.

Traumatic Brain Injury: What To Look For

In a presentation to Virginia trial lawyers, neuropsychologist James P. Wade said that the most important factor in a brain trauma case is the victim’s condition immediately after the injury.

Dr. Wade identified four factors that personal injury attorneys should take into consideration when evaluating a brain-related case:

• Was the victim unconscious and if so,  for how long
• Did the victim remember the incident or what happened immediately before and afterward
• Any “hard” evidence such as a skull fracture, bleeding in the brain, or a seizure
• the victim’s Glasgow coma scale (CGS) on a 0-15 range as measured by an EMT

Dr. Wade added that mild concussions can sometimes be too subtle to show up on CAT scans but can be detected by neuropsychological tests.

A test of this nature has three parts, each of which must be evaluated individually: organic (cognitive abilities), emotional (state of mind), and motivation (ability to comply with the tests).

If you believe that you (or a love one) have sustained a traumatic brain injury in Virginia, it is always important to hire experienced legal counsel. The Virginia brain injury lawyers at the Law Offices of Richard J. Serpe, P.C. have the experience needed, and the requisite contacts with the best doctors in the area, to ensure you and your loved ones have the best representation possible. Call Toll Free 877-544–5323 for a no-obligation consultation.

Birth Injury Settlement Totals More than $9 Million

A mother reached a $9.5 million settlement with the healthcare providers who she claimed acted negligently during the birth of her son and were responsible for the boy developing cerebral palsy.

The delivery was fraught with complications, and was performed alone by a nurse midwife. The sponsoring doctor, who was supposed to be on call, was actually out of the country. The baby apparently suffered a brain injury after being deprived of oxygen for the last 15 minutes of delivery as a result of a compressed umbilical cord. The midwife allegedly did not call for help.

In the settlement, the hospital agreed to pay the Illinois mother $7.5 million, while the doctor and the midwife will pay her $1 million each.

AboutLawsuits.com explains the dangers of oxygen deprivation during childbirth:

Cerebral palsy can be caused by an injury to an infant’s brain before, during or shortly after birth. If the brain of a baby is deprived of oxygen, it can result in irreversible damage that leaves the child with developmental problems, loss of motor functions and other life-long injuries and disabilities associated with cerebral palsy. The condition is also commonly associated with seizures, sensory impairments and cognitive limitation.

Enhanced Virginia Student-Athlete Concussion Protection Is Now Law

Although it didn’t seem to get a lot of coverage in the media, the bill introduced by a Norfolk lawmaker to increase health protections for student athletes with suspected head injuries was signed into law by Governor McDonnell several weeks ago. The measure is meant to prevent athletes from getting back on the field or court prematurely.

Under the legislation sponsored by State Sen. Ralph S. Northam, a Norfolk a pediatric neurologist who has personally treated many teenage athletes for brain trauma, coaches are  required to sideline any player with concussion symptoms until the student is cleared to return to action by a licensed health professional in writing.

The law also requires players and their parents or guardians to review information on the health effects of concussions each year. They then must sign a statement acknowledging that they have received that information.

In the Falls Church News-Press, State Health Commissioner Karen Remley expressed strong support for the law.

“Any blow to the head in a child or youth that is followed by changes in behavior, thinking or physical function needs prompt medical attention,” Remley said.

She wants students to know that if they continue to play after sustaining a concussion, they are risking a serious, long-term brain injury and, in some cases, death.

Senate Bill 652 also requires the Virginia Board of Education to develop policies regarding concussions for local school districts with a deadline  of July 1, 2011.  A blow to the head is apparently one  of the most commonly reported injuries in children and teens who participate in extracurricular activities.

Researchers: Dark Chocolate May Decrease Risk of Brain Stroke

ScienceDaily reported recently that researchers at Johns Hopkins may have found protective qualities contained in dark chocolate.  In sum, the compound in chocolate might shield an affected brain following a stroke by multiplying signals produced by cells that naturally protect nerve cells.

The compound – known as “epicatechin” – occurs naturally in dark chocolate.  In a recent study, scientists tested mice which were previously induced with a stroke.  The mice that were given the compound epicatechin suffered far less damage to the brain, when compared to the test animals with no preventative treatment.  The dose of the compound was reportedly modest, yet the results were significant.

The correlation to humans is the obvious next step for researchers.  A particularly interesting note is that according to ScienceDaily, most treatments for humans who have suffered strokes must be administered within a narrow timeframe; two to three hours.  Epicatechin, however, may be different.  Researchers say that the compound seemed to limit neuronal damage in mice, when administered 3.5 hours following the stroke.  This is promising in that if the compound can be eventually used to treat human stroke victims, the window for treatment and mitigation of brain damage might be expanded.  It should be noted, though, that when administered six hours post-stroke, it was too late for the protective qualities of epicatechin to be noticed.

The mechanism of action by which epicatechin may be effective is explained by an associate professor at the Johns Hopkins University School of Medicine – apparently, the compound “stimulates two previously well-established pathways known to shield nerve cells in the brain from damage.” (See Science Daily article here).

$5 Million to Brain Injured Woman in Canada

After a 100-day trial, a British Columbia judge has entered a $5 million-plus judgment in favor of a homeless woman who suffered severe brain injuries after being run over by a truck.

According to the SurreyLeader.com, the woman was riding a bike at the time of the accident:

When the 27-year-old went around the pickup truck, she was hit in the head by a passing tractor-trailer truck that came too close, suffering a severe skull fracture and permanent brain damage as a result.

Her injuries have left her in a “child-like” state, impulsive and unable to care for herself, Justice William Ehrcke said.

The judge found the tractor-trailer driver 80 percent liable, and awarded the victim $5.3 million to cover the cost of future care, plus $320,000 in damages. The total judgment is worth about $5.4 million in American dollars.

If you believe that you (or a love one) have sustained a traumatic brain injury in Virginia, it is always important to hire experienced legal counsel. The Virginia brain injury lawyers at the Law Offices of Richard J. Serpe, P.C. have the experience needed, and the requisite contacts with the best doctors in the area, to ensure you and your loved ones have the best representation possible. Call Toll Free 877-544–5323 for a no-obligation consultation.

New Law Expands Benefits for Wounded Vets and their Caregivers

Legislation signed by President Obama is expected to improve treatment options for military vets with brain damage. The Caregivers and Veterans Omnibus Health Services Act will give veterans with traumatic brain injuries more access to private care outside the VA hospital system, increase services for female and homeless veterans, and provide more care in rural areas. Perhaps most significantly, the law provides training and stipends to those caring for wounded service members in their family.

According to the McClatchy news service, the measure that was signed by the president on May 5 “sets up new training and certification for the family caregivers, access to ongoing support services, counseling and mental-health services, respite care, medical care and a monthly personal-caregiver allowance.”

A North Carolina couple, Army Sgt. Ted Wade (a wounded Iraq veteran) and his wife Sarah, have been credited with lobbying for these expanded benefits; they attended the signing ceremony at the White House.