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.

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.

 

 

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.

 

 

 

Brain Injuries: Risk Of Suicide May Increase Three Fold After A Concussion

brainI’m part of a nation-wide group of lawyers who regularly exchange articles and other information with one another about brain injury cases.

This week, we were having an online discussion about suicide, and we shared a study from earlier this year finding that persons who have suffered even a single concussion may be at a much higher risk for suicide.

What really struck me is how these risks apply to my clients.

In a Scientific American article about the study, Dr. Donald Redelmeier, one of the study’s lead authors stated:

The typical patient I see is a middle-aged adult, not elite athlete.  And the usual circumstances for acquiring a concussion are not while playing football; it is when driving in traffic and getting into a crash, when missing a step and falling down a staircase, when getting overly ambitious about home repairs — the everyday activities of life.

These are the things we routinely see in our practice. Over the last year, I’ve represented clients who have had brain injuries in car wrecks, bicycle wrecks, slip-and-fall accidents, and more.

Too often the diagnoses of these injuries is slow, and in many cases, not recognized until very late in the process.   This delays the treatment, including the psychological treatment, that clients need to help them start the road to recovery from these devastating injuries.

 

Is Football Affecting Your Case?

American football on white background.

Summer is over and football is back.  My University of Texas Longhorns are off to a great start with a big season-opening win over Notre Dame.  Even my daughter’s high school is 2-0.  Everything about football season is great, right?

Maybe not.

You see, football season may be affecting your case.

Earlier this week, the Atlantic published a concerning story about a study from LSU economists Naci Mocan and Ozkan Eren, who found that the results of college football games affect how judges rule.  The story states:

In looking at decisions handed down by judges in Louisiana’s juvenile courts between 1996 and 2012, the pair found that when LSU lost football games it was expected to win, judges — specifically those who had earned their bachelor’s degrees from the school — issued harsher sentences following the loss.  When the team was ranked in the top 10 before the losing game, kids wound up behind bars for about two months longer, on average.  When the team was not as highly ranked, it was a little more than a month.

This was a pretty broad study, looking at over 8,200 cases involving 207 judges.  The economists screened for the kids’ behavior in court, economic background, and even tested placebos through non-LSU games, and none of those factors had the same impact as football.

Some have criticized the findings, but the economists hope that their research will strengthen a growing body of evidence that suggests emotions influence unrelated decisions and that the study will perhaps help judges become aware of the decision-making and make the judges more careful.

That emotion is an issue.  Those of us who are trial lawyers know that jurors and judges often make emotional decisions and then try to subconsciously rationalize those decisions through their view of the logic of the case.  We’ve factored in for that.  But I guess now, we need to start asking jurors in voir dire about their football teams too.

Having said all that, enjoy Friday Night Lights, college football and the NFL this weekend.

 

Posted on: September 9, 2016 | Tagged

No Pokemon (ing) While Driving

Fairly typical questions we ask and investigate in car wreck cases are whether the driver was distracted by talking on the phone or texting while driving.  Now, I might have to start another series of questions after the introduction of Pokemon Go.

Pokemon Go is an app game that was released a few days ago, and it’s already taking over the virtual worlds of kids and young adults.

But this morning, I was alerted by a reporter acquaintance that the new game is also quickly becoming a driving hazard.  A quick twitter search confirmed his fears.

I’m inserting a few of the concerning screen shots in the post.  Needless to say, don’t play PokemonGo or engage in other distracting conduct while driving.  Keep yourself focused while driving so your ultimate time for Pokemon isn’t cut short.

IMG_6907 IMG_6908 IMG_6909 IMG_6910 IMG_6911 IMG_6912 IMG_6913 IMG_6914 IMG_6915

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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