U.T. Looking To Cut Football Brain Injuries

My University of Texas football team hasn’t been on the cutting edge of winning the last few years (and we’re hoping that’s changing), but we are on the cutting edge of trying to protect players from brain injuries.

It’s no secret that an increasingly difficulty issue in football is the rise (or at least heightened awareness of) brain injuries suffered by players.  There are some things that can be done, such as teaching proper technique and making sure that helmets are state of the art, but until now, what a school or coach can do to protect kids has been largely limited.

Now however, Riddell and Texas are taking a big step towards safety by including monitoring devices in players’ helmets.  Starting this year, all University of Texas players’ helmets will have sensors that send signals to the trainers’ hand held devices when the player sustains a significant hit in the head.  The trainer can then monitor the player and look for signs of a concussion or head injury.  Texas will be the first Power 5 school to provide this technology to every player.

This is important.  While concussions are bad, one of the biggest risks in sports is known as second impact syndrome.  Second impact syndrome occurs when a player sustains a significant blow before the brain has healed from the original concussion.  The second impact, which can occur minutes, days or weeks after the first concussion, typically causes much more severe problems than the original impact.    While some concussions are obvious, some people don’t show signs of symptoms until hours or even days after the event.  Thus, the ability to monitor the impact of a hit in real time, will make it much easier to look for problems in real time, minimizing the risk of second impact syndrome.

Now, if we can only find some technology to help us find a few more wins each year…..

 

 

Emergency Room Not Diagnosing A Concussion, Revisited

A few months ago, I wrote a short article describing why emergency rooms do such a bad job at diagnosing concussions/brain injuries: The emergency room didn’t say anything about a concussion. Does that mean I don’t have a brain injury?

Recently,  I came across a study that really quantifies the problem I discussed.

The study, primarily led by several doctors from the University of Washington, was laid out in an article entitled Accuracy of Mild Traumatic Brain Injury Diagnosis, which was published in the August 2008 issue of the Archives of Physical Medical Rehabilitation.

The article starts by noting:

Accurate identification and diagnosis of a mild TBI is the first step toward providing clinical care.

Unfortunately, despite the accurate diagnosis of a brain injury being so important, the study found that emergency rooms are not very good at making the diagnoses.

The study looked at 197 patients who had been to emergency rooms.  They looked at medical records, and in some cases interviewed the patients, to determine whether they patients had a brain injury, as defined by the Centers for Disease Control mild Traumatic Brain Injury work group.  The researchers then took those patients who were diagnosed with a brain injury and looked at the patients’ emergency room records to see what was diagnosed in the emergency room.

The results were startling.

The emergency room doctors failed to make a diagnoses of a head injury or concussion in 56% of the patients who were later determined to have a brain injury.

That’s a stunning number.

There are some things that can help improve the accuracy of the emergency department physicians.  If the patient complained in the emergency room about confusion, feeling dazed, or having memory problems, then the diagnoses was more accurate.  However, even with those findings, the emergency department still missed the diagnoses on 37% of the patients.  That’s still a substantial number of patients who have a brain injury that doctors are missing.

Oddly, the emergency room physicians’ diagnoses weren’t dramatically better even when the patient reported a loss of consciousness — which should be a red flag.  The doctors still failed to make the proper diagnoses of a head injury in about 50% of the patients who had told the doctors that they had lost consciousness.

This means that you have to be diligent about noticing symptoms.  I’ve repeatedly written that misdiagnoses is a problem and that the best way to find the problem and to get proper treatment for the problem is for someone close to the person to look for symptoms.

To learn more details about potential symptoms, you can read our other articles:

If you or a loved one has sustained a brain injury in an accident, please call us at (512)476-4944 and we’d be happy to see if we can help.

Brain Injuries: New Study Finds Fewer People Recover From Post-Concussive Syndrome

The April 2017 issue of the Journal of Neurotrauma reports on a new study about post-concussion syndrome.

The study followed 110 patients who had post-concussive syndrome symptoms for more than three months, and the findings were stunning.  Of those patients, only 27% made a full recovery.  Of the 27% who made a recovery, 67% made a recovery within the first year.  And no one who had symptoms over three years ever made a recovery.

For those groups that didn’t recover, the continuing symptoms (in order of frequency) were:

  • Headache
  • Difficulty concentrating
  • Fatigue
  • Dazed/don’t feel right/in a fog
  • Pressure in the head
  • Sensitivity to light
  • Difficulty remembering events
  • Neck pain
  • Sensitivity to noise
  • Depression/sadness
  • Insomnia/sleep disturbance
  • Irritability
  • Anxiety
  • Frustration
  • Feeling slowed down
  • Noise in the ears
  • Vision changes
  • Lightheadedness
  • Imbalance
  • More emotional
  • Dizziness
  • Nausea
  • Increased sensitivity to alcohol
  • Confusion
  • Personality changes
  • Vivid dreams
  • Numbness
  • Vertigo
  • Panic attacks
  • Disorientation
  • Stomach ache
  • Loss of appetite
  • Slurred speech
  • Seizures
  • Vomiting

These findings are significant to our brain injury cases.

Most insurance companies argue that brain injuries typically heal themselves and symptoms disappear after six months or a year. The insurance companies use that argument to reduce the value of the claim.

This study refutes that.  If a client has had symptoms lasting more than three months, then this study is evidence that the client will likely never make a full recovery.   Obviously, if an injury is permanent then the value of the case is higher.

The study is also interesting because it has a good list of symptoms of a brain injury.  It’s important for people to know these symptoms to help them recognize when they might have a brain injury.

Another interesting fact was the distribution of the symptoms.  Generally, post concussion syndrome has three classes of symptoms:

  1. Cognitive symptoms — affect your thinking
  2. Affective symptoms — affect your mood (depression, irritability, etc)
  3. Somatic symptoms — separate symptoms (headaches, light sensitivity, etc).

The study found that the persisting symptoms were quite evenly distributed between the three classes of symptoms.

 

 

Thanks For Your Support – Here’s Some Of Who You’re Helping

The support we get from our clients and referral sources allow us to support a number of other good causes both in Austin and around the world.  Today, I thought I would let you know about some of the programs you’re supporting.

  1. Friends of Scouting

As some you know, my son is a Boy Scout, and he’s had a number of great experiences through scouting.  He’s been to summer camps in California and Maine, and this year, he and I are going on a 10 day backpacking trip at the Scout mecca, Philmont Scout Ranch in New Mexico.

But we also know that too many kids don’t get those opportunities.  As a result, for the last few years, our firm has made significant donations to Friends of Scouting.  This group helps support Scouting opportunities for low income kids throughout Central Texas.  I hope some of these kids will get the same benefits that my son receives.  You can learn more about Scouting in the Central Texas area by clicking the link here.

 

  1. Justice For Our Neighbors

 Justice For Our Neighbors is a United Methodist Church based non-profit that provides free or low cost legal services on immigration related issues to immigrants.  I was one of three co-founders who helped bring JFON to Austin three years ago.  Since that time, JFON has served numerous clients.  Now, the group specializes in helping unaccompanied minors learn about and exercise their rights.  While I acknowledge that immigration is a bit controversial, as a lawyer, one thing I’m clear about is that rights matter.  When our country grants people rights, the people should be able to exercise those rights.  And that’s what JFON does — helps people exercise their rights.

 

  1. Free Store Austin

The Free Store is another United Methodist related non-profit that I helped start and that you have helped us support.  Like it sounds, it takes items and gives them away to anyone who needs them for free.  But the store is about much more than that. The store creates opportunities for volunteers to meet and get to know people who are very different from the volunteers.  Creating a diverse community is really what this group strives to create.

  1. Zoe Helps

Zoe is an international group that helps orphans in Africa and other countries become self-sufficient.  Zoe organizes the orphans into working groups of 60-100 kids.  The organization then trains the kids about health, entrepreneurship, and more.  Zoe also helps the kids choose and start businesses.  About 85% of the kids who complete the three year program are self-sufficient, help support other kids, and are leaders in their communities.  In the last couple of months, Zoe was named one of the 100 most innovative non-profits in the world.

  1. Seedling Foundation

The Seedling Foundation is a local non-profit that provides mentors to children whose care-givers are incarcerated.  Mentors meet with the kids once a week to check in the with the kids and to be a consistent, stabilizing force in the kids’ lives.  This is my 10th year to be a mentor through the Seedling Foundation, including my eighth year with my current mentee.  I started mentoring him in Pre-K and have now moved with him up to middle school.  I enjoy the mentoring process and encourage anyone with a little free time to get involved with Seedling.

There are many more things you’re helping us support, but these are some of the biggest.  We hope you’ll continue to think of us and refer your friends and family members so we can continue to do this good work together.

Thanks,

Brooks Schuelke

 

 

Posted on: May 1, 2017 |

Dog Attacks/Dog Bites: Which Dogs Attack Humans The Most?

This is an older article, which was recently pointed out to me, tries to identify the dog breeds that have attacked the most.  The results probably won’t surprise you much.  According to the article, the top 5 breeds for most attacks on people are:

  1. Pit Bull
  2. Rottweiler
  3. German Shepherd
  4. Siberian Husky
  5. Akita

These results would follow what we’ve found in our practice.  Most of the attacks we see involve either Pit Bulls or Rottweilers.  The worst dog attack case we worked on involved a Bull Mastiff, another large dog that has been bred to be a guard dog.

There is a caveat in this article and in my findings.  The article is based on a study about reported dog bites or dog attacks.  I’m sure there are many smaller breeds who are also involved in a significant number of bites or attacks.  But because these dogs don’t do the damage that these dogs can do, the bites or attacks may go unreported.  Similarly, when we are asked to represent victims of dog attacks, they are usually from serious injuries, more likely to be caused by big dogs.

To see if others agreed with the dangerous breed list, I did a quick Google search to see what others might be saying.  In doing so, I found a couple of results that were a bit surprising.

This article from Europe found that labradors were most likely to be involved in attacks.  Part of this might have to do with the sheer number of labradors as pets.  In fact, the article noted that the labrador was the most popular dog in Europe.

This article, also from Europe, found that police officers were more likely to be bitten by Jack Russell Terriers.

These articles only go to show that persons should be cautious around any types of dogs.  In the wrong situation, dogs of any breeds can attack and cause significant, and perhaps fatal, injuries.

My MRI or CT Scan Was Negative. Does This Mean I Don’t Have A Brain Injury?

This is another question I’ve recently received from potential clients.  They were involved in an incident — a car wreck, a slip and fall, or something similar.  They went to the ER, and the ER performed an MRI or a CT san looking for problems, but scan came back negative.  Does this mean that the was no brain injury?

Absolutely not.

While an MRI or a CT scan can find some brain bleeds or some damage, they don’t find most problems.  As a result, the vast majority of people who have brain injuries have a normal (what we call negative) MRI or CT scan.

Indeed, while insurance companies sometimes try to argue about claims when you have a normal MRI or CT scan, virtually all scientific literature and all neurologists agree that you can still have a normal scan.  Not only that, virtually all neurologists will agree that most of the patients they see for brain injuries have normal scans.

So if you feel like you’re off or your family members are telling you that you’re different after a car wreck, a fall, or another event, don’t rule out a possible brain injury just because you had a normal CT scan or MRI.  You may very well still have a mild traumatic brain injury that needs to be treated

The Emergency Room Didn’t Say Anything About A Concussion. Does That Mean I Don’t Have A Brain Injury?

This is a question I’ve seemed to be answering for clients lately.  You are in a wreck or other event.  You go to the emergency room.  They look you over, they never say anything about a brain injury, and they send you home.  Does this mean you don’t have some type of brain injury?

Absolutely not.

Emergency rooms (and even other doctors) are notoriously bad at diagnosing brain injuries.  Why is that?

First, emergency rooms are triage facilities.  They are only really looking for the things that are life-threatening or need to be treated immediately.  Too often, this means that they don’t look for brain injuries unless the brain injury is the type that’s completely obvious.

Second, emergency rooms (and most other doctors) don’t know you.  For the most part, there’s not a readily available test that we can use during a doctor’s visit to say whether you have a brain injury.  The first time a brain injury is diagnosed is usually based on your complaints of your symptoms and comparisons of how you were before you got hurt to how you are after you got hurt.  Doctors can compare your symptoms to common brain injury symptoms, but the doctors have to be looking to put two and two together.  And doctors usually don’t know you well enough to compare your condition from before the wreck to your condition after the wreck.  As a result, it’s often difficult for a doctor to make the diagnoses of a brain injury.

That’s why I tell clients that it’s so important to have friends and family members look for changes in your condition or behavior.  For our clients, we have forms that we give you to fill out that can help figure out what problems you’re having.  That way, you’ll be in a better position to articulate to your doctor the problems you’re having and the doctor can more easily and quickly make a referral to a neurologist or other treating physician.

Don’t Let GEICO Or Other Insurance Companies Take Advantage Of You After A Car Wreck

Insurance claim forme

Here are today’s two lessons from a court decision yesterday:  (1) Take your time before settling your case.  (2) Talk to a lawyer before settling a case.

I often warn victims of car wrecks or other accidents to be aware of insurance companies’ “swoop and settle” tactics.  In these situations, the insurance company (GEICO seems to be the worst) contacts you immediately after a wreck and makes an immediate settlement offer to try to get you to give up your rights before you know how bad you are hurt or before you know your rights.

Yesterday, the Dallas Court of Appeals handed down a new case that shows just how this terrible practice works.

In the case, Windell Gilbert was injured in a car wreck.  GEICO was the insurance company that covered the driver who caused the wreck.

Eight days after the wreck, GEICO called and suggested to Mr. Gilbert that they settle the case for GEICO’s payment of the medical expenses incurred on the date of the accident (which totaled $4,806.75) and $500.00 to Mr. Gilbert.  Mr. Gilbert agreed, and the GEICO representative had them do a recorded call confirming that settlement.

Not surprisingly, but Mr. Gilbert ended up being hurt much worse than he thought.  He went to a doctor and had over $15,000.00 more in medical expenses.

Mr. Gilbert later sued the other driving, arguing that the first settlement was unfair.  But yesterday’s opinion held that Mr. Gilbert and GEICO had a binding agreement and that Mr. Gilbert was bound to the $500.00 agreement.  Moreover, the court awarded GEICO (through the other driver) $10,000.00 in attorneys’ fees against Mr. Gilbert.

This case is a perfect example of why car wreck victims should wait to talk to an attorney and to take a little time before settling a case.  Initially, even if Mr. Gilbert wasn’t hurt more than just needing medical care on the first day, the offer from GEICO was a terrible offer.  But more importantly, people are often hurt more than they realize.  Problems linger or don’t show up until later.  I typically advise my clients that in most cases, you shouldn’t settle until you know you’re better or until a doctor tells you you’re not better, but you’re as good as you’re going to get.

So remember the lessons for car wreck (and really all injury) claims. Don’t settle too early, and don’t settle without talking to a personal injury lawyer.

 

 

A Lesson In Arbitration From A Weird College Basketball Story

basketballCollege basketball coach Billy Gillispie is no stranger to the news.  He’s been the coach at Texas A&M, Kentucky, and Texas Tech, among others.  But this story is a little odd.

Having been fired from his last two jobs, Gillispie finds himself the coach of Ranger College, a Texas junior college.  In his first year, Gillispie created quite the turn-around, taking the program from a 2-23 record to a 31-7 record in his first year.

Or so he thought.

The National Junior College Athletic Association had different ideas.

Joshua Simmons was one of the players on Gillispie’s team.  Prior to joining Ranger College, Simmons played (very sparingly) for Spartansburg Methodist College.  While there, a team trainer filled out an NBA draft declaration form on Simmons’ behalf, signed Simmons’ name, and submitted the form to the NBA.

After the season, the NJCAA began investigating whether Simmons was an ineligible player, potentially having violated the NJCAA’s rules that students who have entered the NBA draft are not eligible to play.

After an investigation, the NJCAA ruled Simmons was ineligible and ordered Ranger College to forfeit all of its wins for the season.

Ranger College appealed the decision to an arbitrator, and that’s where the lessons come in.

This case seems like a no-brainer.  Simmons didn’t enter the draft himself, the evidence established that Simmons never filled out  the NBA’s packet of information to try and become draft-eligible, and prior to the draft, Simmons’ family sent a letter to the NBA trying to clarify that he did not want to be considered draft-eligible.

Surely an arbitrator would do what’s right.

Of course not.  Ranger College learned hard lessons about arbitration that we often warn our clients about.

Arbitrators often don’t do what is right or fair.  Too often, arbitrators are biased in favor of the parties whom they routinely see before them — whether that’s the NJCAA, an insurance company, or a credit card company.

Lesson number two: you can’t appeal the arbitrator’s opinion.  In the court system, if the judge or jury makes an error, then the party can appeal the wrong decision.  That’s not true with arbitration.  Arbitrators have an almost unbridled authority to do what they want.  They make a mistake?  No appeal.  They don’t understand evidence? No appeal.  They refuse to listen to you? No appeal.  A party to arbitration is stuck with a decision no matter how big a mistake an arbitrator makes.

Those are hard lessons to accept for clients who have to endure arbitrations, whatever the nature.

 

 

Brain Injuries: New Study Finds Even One Concussion Can Have Lasting Effects

The human brainMany of us that deal with these injuries routinely have suspected it, but a new study confirms that even one concussion can have lasting effects.

The study was based on extensive data on the health of people in Sweden.  The researchers found 104,000 people who experienced head injuries between 1973 and 1985.  The researches then looked at the these brain injured persons’ records after their injuries and compared those results with the results and history of the siblings of the brain injured persons.

The researchers found that persons who had even one concussion were more likely to receive future disability payments, more likely to need mental health care, less likely to graduate high school, and much more likely to die prematurely.

The researchers also found that the problems increased significantly if the person had more than one concussion, and if the persons had their head injuries after the age of 15.

The good news is that most of the people who had just one concussion were fine.  But people who have suffered concussions will still have to worry about what their future must hold.

The article also noted that the leading causes of brain injuries are what we see often in our practice.  For the very young, the leading cause of concussions is falls.  For teens, the leading cause becomes sports.  And for adults, the leading cause of brain injuries is car wrecks.

If you or a loved one has experienced a concussion or other brain injury because of another person or business’s carelessness, call us at (512)476-4944.  We will try to help you navigate the difficult process of pursuing your claim.

 

 

 

Perlmutter & Schuelke, PLLC maintains offices in Austin, Texas. However, our attorneys and lawyers represent clients throughout the state of Texas, including Dallas, Houston, San Antonio, Forth Worth, El Paso, New Braunfels, San Marcos, Kyle, Buda, Round Rock, Georgetown, Lockhart, Bastrop, Elgin, Manor, Brenham, Cedar Park, Burnet, Marble Falls, Temple and Killeen. By Brooks Schuelke


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