Opinion – Closed head brain injuries a serious threat and a legal dilemma


By Lawrence A. Goldberg of  Goldberg, Meanix, McCallin & Muth

When First Lady Michelle Obama visited Philadelphia on Wednesday to announce a new initiative involving post traumatic stress disorder and Traumatic Brain Injury, she touched on a medical and legal issue that greatly affects many people in our region and is, sadly, little understood.blank

Mrs. Obama’s focus was on military veterans. She called these injuries ”invisible wounds”. Robert Bales, the 38-year-old staff sergeant charged with murdering 16 Afghanistan civilians earlier this year, is believed to have been suffering from Traumatic Brain Injury at the time of the shooting.

A person suffering from a brain injury often can’t concentrate, has headaches and doesn’t have the ability to do common tasks. Victims can suffer outbursts of rage and bouts of depression. Head injuries can cause violent acts.

Brain injuries, also known as closed head injuries, can be a threat to those in private life. The most common cause of the injury is whiplash from a traffic accident. Serious head injuries are also suffered in sports, riding motorcycles, assaults, dog bites, the wrongful administration of drugs, or falls. Victims come from all age groups, occupations and income levels.

The family of a 13-year-old Chester County boy who had died from a closed head brain injury consulted me about his death. The boy fell and went to bed with a bad headache. He became incoherent and was taken to a local hospital. The hospital immediately determined it didn’t have the expertise to treat the boy and transferred him to a Delaware hospital. That hospital made the same determination and he was sent to a Philadelphia hospital. Within 14 hours of the fall, the boy died. No one diagnosed the seriousness of the injury in time to save the boy.

Another Traumatic Brain Injury took place when a three-year-old child suffered a puncture wound to the head from a dog. Last year, the Philadelphia Business Journal reported that 50 lawsuits have been filed on behalf of about 1,000 retired National Football League players because of brain injuries. More than 100 former Philadelphia Eagles are among the plaintiffs.

Actress Natasha Richardson died in March 2009 after sustaining a head injury while taking skiing lessons in Canada. At first she felt fine but within three hours she complained of a headache and eventually was admitted to a hospital and then died.

During my 45 years practicing law I’ve represented hundreds of people suffering from traumatic brain injuries. I first became aware of the injuries when I served as an administrative officer at a military hospital.

Of course, treating doctors are interested in saving a patient’s life and not in determining the cause of the closed head injuries. When cases enter the legal system, this lack of cause presents challenges for attorneys representing innocent victims of brain injuries.

The underlying cause of brain damage might not be evident. Symptoms of a brain injury may appear hours or many days after the injury was inflicted. A minor bump on the head can cause more serious head injuries than a fall from great heights. Qualified medical experts, such as those trained in neuropsychiatry, need to be engaged. Unfortunately, not many such experts are in the area.

A competent lawyer representing persons who have been diagnosed with closed head trauma has a duty to advise the client and his family to consult with qualified physicians so that potentially serious conditions are not ignored.

A common problem is when the client has suffered a concussion but has not lost consciousness. Often persons suffer concussions and remain unaware of the event until symptoms appear. Recent studies have shown that repeated concussions, such as those suffered by contact sport competitors in football, ice hockey, boxing and the martial arts, may lead to a severe degenerative brain condition which can lead to early dementia and/or Parkinson’s Disease.

Patients need to be evaluated for both immediate and long-term care. Attorneys advising clients to take a quick monetary settlement without investigating the future needs of victims are doing their clients a great disservice.

Significant brain injury victims often need special care in residential treatment facilities. Insurance issues may arise which add to family stress during the recovery period. Attorneys often have to intervene with insurance carriers to ensure that their client’s needs are being met. Rehabilitation and future medical expenses can be costly. Required long-term rehabilitation may become a problem as insurance carriers attempt to avoid the financial obligations for such care.

Specially trained medical personnel and sophisticated equipment are needed to treat a victim of a closed head injury and experienced legal representation is needed to protect the victim and to ensure proper compensation for such a serious and life-altering injury.

(Lawrence A. Goldberg is a partner in the law firm of Goldberg, Meanix, McCalli)

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