Richmond Virginia Personal Injury Lawyer - Head Injury

Alarming News Regarding Repetitive Head Trauma

Michael Phelan — Tue, 27 Jan 2009 17:37:51 GMT

Clinical researchers reported today that postmortem examination of the brain of a recently deceased 18 year old high school football player showed early signs of an incurable debilitating brain disease caused by repetitive head trauma. This finding has major significance in ongoing study of the effects of the sports-related concussion, which threatens athletes from Pop Warner football to the NFL. No scientist had previously documented the degenerative brain disease known as chronic traumatic encephalopathy (CTE) in a football player younger than 36.

CTE is caused by multiple head injuries and results in symptoms similar to early-onset Alzheimer's. Had the 18 year old lived, neurologists say he eventually would have developed early-onset dementia that would have advanced unabated until his death. CTE studies reveal brown tangles flecked throughout the brain tissue. The brain damage affects areas that control emotion, rage, hypersexuality, and even breathing. CTE is a progressive disease that eventually kills brain cells.

The New York Times ran a series of articles last year on CTE in retired NFL players. A confirmed feature of CTE is that years after a NFL player leaves football, the disease begins affecting his personality and behavior. Several former NFL players have recently died disturbing deaths. Houston linebacker John Grimsley, 45, accidentally shot himself; Eagles defensive back Andre Waters, 44, shot himself; and three Steelers, Mike Webster, 50, who died from exposure, Terry Long, 45, suicide by drinking antifreeze, and Jason Strzelczyk, 36, died in a head-on truck crash fleeing from police who were pursuing him after he left the scene of a previous crash.

This latest finding better cause all youth coaches, trainers, and parents to wake up to the very serious dangers from concussions.

Originally posted at InjuryBoard by Michael Phelan

Fake Bad Scale: Weapon of Defense Neuropsychologists

Michael Phelan — Wed, 05 Mar 2008 16:50:40 GMT

The Fake Bad Scale (FBS) is a bogus test created by Paul Lees-Haley to wrongly label personal injury claimants as "fakers." The FBS is junk science and should not be allowed in a court of law. Indeed, it violates the province of the jury by attempting to divine the credibility of witnesses. No test can act as a lie detector, which is how forensic defense neuropsychologists are trying to use the FBS. Determining the truthfulness of a witness is the job of the jury, not a paid defense psychologist. Dr. Lees-Haley is himself a professional defense expert who derives 95% of his business working against personal injury claimants. He charges $3,500 to evaluate a claimant and $600 an hour for depositions. In my opinion, Lees-Haley created the FBS to bolster his and and other defense experts' opinions in court. An on-line article in the Wall Street Journal skims the surface of the scientific problems with the Fake Bad Scale test.

I have had recent experience with the misapplication of the FBS. I represented a wonderful person who suffered a severe brain injury. Prior to the injury, she worked two jobs and was full of energy. She suffered in her accident a blow to her head which caused a subdural hematoma, which in turn caused her brain to swell like a tick. Surgeons had to remove half of her skull in order to evacuate the blood clots and relieve the swelling. This poor woman walked around with a piece of her skull missing for months, during which time her head resembled a squashed melon. Not surprisingly, she experienced permanent brain damage, with symptoms that included headaches, change in personality, loss of memory, word finding problems, problems thinking, anxiety, paranoia, depression, loss of sleep, and pain. It was a slam dunk brain injury case. The neuropsychologist hired by the defense administered to my nice client the FBS and concluded that she was a malingerer who was faking her symptoms.

The tragedy is that the publishers of the Minnesota Multiphasic Personality Inventory (MMPI) recently succumbed to the Lees-Haley defense crowd and made the FBS a subset of the MMPI. The FBS contains true/false questions designed to categorize people who are experiencing genuine psychological distress or physical injuries as malingerers. For example, agreeing that one experiences known symptoms of brain damage, such as headaches, nausea, dizziness, poor sleep, or fatigue are each counted as one point toward being a malingerer. Also, if the test taker happens to be a menopausal woman who admits to feeling occasional hot flashes, she has one point counted against her. These are not just my opinions. The MMPI and its progeny MMPI-2 and MMPI-A, are among the most commonly used personality inventories. Dr. James N. Butcher served on the MMPI Revision Committee and was the first author of the MMPI-2 in 1989. He has published 25 books specifically on the MMPI and MMPI-2 and 175 peer reviewed articles on MMPI/MMPI-2 or MMPI-A. He also developed the software to score the MMPI-2. Dr. Butcher has written that the FBS is scientifically unreliable because it does not accurately and reliably discriminate individuals with genuine physical or mental health problems from those who are malingering mental health symptoms. Dr. Butcher and others published the results of a study of patients in mental health facilities (i.e., patients with legitimate mental health problems) who scored high on the FBS, as if they were fakers. The flaw with the FBS is that these patients score high on the test by honestly describing their actual symptoms. Another flaw in the FBS, according to Dr. Butcher, is that it is gender biased against women. In fact, Dr. Butcher showed that administering the FBS test randomly to a group of women and a group of convicted felons resulted in the women scoring as malingerers at a rate of more than 10 times that of the convicted felons. There is no place in the courtroom for this junk science.

Originally posted at InjuryBoard by Michael Phelan

Brain Injury-What Are the Symptoms?

Michael Phelan — Thu, 14 Feb 2008 09:51:21 GMT

The American Academy of Neurology has expanded the definition of the acute or immediate signs of concussion. Symptoms of brain injury can be mild to severe with some symptoms showing up immediately and others not appearing until several days or weeks after the injury. The AAN categorizes the signs of concussion as follows:

Immediate Signs of Concussion
(Seen within seconds/minutes):
* Any loss of consciousness
* Impaired attention: vacant stare, delayed responses, inability to focus
* Lack of coordination
* Disorientation
* Emotional reactions out of proportion
* Memory problems

Later Signs of Concussion
If the following symptoms occur, hours or even days or weeks later, consult a neurologist:
* Persistent headache
* Dizziness/vertigo
* Poor attention and concentration
* Memory problems
* Nausea or vomiting
* Fatigue easily
* Irritability
* Intolerant of bright lights and/or loud noises
* Anxiety and/or depression
* Disturbed sleep
People with moderate to severe brain injury may have these same symptoms, as well as:
* Seizures
* Physical, cognitive or behavioral impairments that last for months or are permanent
* Prolonged unconscious state
* Coma

As the AAN recommends, if you or a family member suffers from any of the later signs of brain injury, please consult a physician who specializes in diagnosing and treating brain injuries. To discuss your legal rights, please contact an experienced brain injury attorney by clicking on the Ask an Attorney feature of this site.

Originally posted at InjuryBoard by Michael Phelan

Justice Dep't Fights to Deny Mental Health Care to Vets

Michael Phelan — Sat, 09 Feb 2008 17:07:16 GMT

No matter how politicians view the war in Iraq, they all say publically that they support the troops. The signature injury of this war, brain damage, results in a host of symptoms including depression, suicidal ideation, and post traumatic stress. In opposing a proposed class action lawsuit accusing the government of illegally denying mental health treatment to troops returning from Iraq and Afghanistan, the Bush administration argues that veterans have no legal rights to specific types of medical care. The administration says the veterans are entitled only to medical care which the secretary of Veterans Affairs determines is needed. This is the height of hypocrisy from a President who ran for re-election boasting of his support for the troops. As a result of the proliferation of IEDs in this war, our troops are suffering traumatic brain damage at epidemic rates. The troops need and deserve the very best brain injury rehabilitative and mental health care that is available. The plaintiffs in the class action suit say the VA has a backlog of over 600,000 disability claims and that 120 veterans per week commit suicide. The politicians need to stop paying lip service to the troops and actually support them.

Originally posted at InjuryBoard by Michael Phelan

Old Head Injuries Linked to Behavioral & Cognitive Problems

Michael Phelan — Sat, 02 Feb 2008 09:01:39 GMT

Researchers studying brain injury believe that people with unrelated social or cognitive problems may have something in common: a long-forgotten blow to the head. It is widely accepted that severe head injuries can lead to cognitive and behavioral problems. What is new, according to brain researchers Wayne A. Gordan, M.D. and Mary Hibbard, Ph.D., is the contention that there are many other cases where a past blow to the head resulting in unconsciousness or confusion is the unrecognized source of such problems. These problems include learning disabilities, alcoholism, drug abuse, and depression.

Dr Gordon, director of Brain Injury Research Center at Mount Sinaii School of Medicine in New York, says, "[unidentified traumatic brain injury is an unrecognized major source of social and vocational failure." According to one researcher, "[when you look at children with learning disabilities or behavior problems, there's often an underlying high percentage of children with traumatic brain injury. We're looking at about 20%."

I represent a child who, shortly after sustaining a traumatic brain injury, began exhibiting behavior problems in school. This child was fortunate to have a knowledgeable psychiatrist willing to spend the time educating the teachers that the cause of the change in behavior was the child's traumatic brain injury. Parents are often in the unfortunate position of being stuck with doctors who discount the effect of head injury on behavior and school performance. I recommend to such parents that they contact their state brain injury associations (e.g. Brain Injury Association of Virginia www.biav.com) to find medical professionals who are expert in brain injury care. Dr. Gordon's studies show that it is never too late to provide therapy for an underlying brain injury.

Originally posted at InjuryBoard by Michael Phelan

Mild Head Injuries Tied to Post Traumatic Stress Disorder

Michael Phelan — Sat, 02 Feb 2008 09:01:39 GMT

A study published in the New England Journal of Medicine represents the military's first large-scale effort to gauge the effect of mild head injuries -concussions (many from roadside blasts)- that some experts worry may cause a host of undiagnosed neurological problems. My last blog reported on a study concluding that undiagnosed head trauma is the cause of a host of later cognitive and behavioral problems. This military study found that soldiers who had concussions were more likely than those with other injuries to report a variety of physical and mental symptoms in their first months home from active duty, including headaches, poor sleep, and balance problems. Significantly, they were also at higher risk for Post Traumatic Stress Disorder (PTSD). Symptoms of PTSD include irritability, sleep problems, and flashbacks.

This study was not designed to detect common but subtle symptoms from brain damage, such as problems with concentration and short-term memory. In its excellent series on head injury symtoms in veterans returning from Iraq, the New York Times has documented the stories of many vets still struggling with these subtle problems. Many of our nation's high school, college, and professional sports programs have implemented base-line neuropsychological testing of athletes (e.g., the Impact program) in order to better treat an athlete who suffers a concussion. It is time for the military to institute a similar program in which each soldier's cognitive functioning is tested prior to and after combat duty. Experts agree that mild brain injuries have significant pyschological component, which can improve with treatment. The problem is the injuries often go undiagnosed. Before and after cognitive function studies for athletes and soldiers is a big step toward ensuring proper diagnosis and treatment.

Originally posted at InjuryBoard by Michael Phelan

Brain Injuries From Iraq War Worse Than Thought

Michael Phelan — Wed, 28 Nov 2007 15:32:58 GMT

Scientists studying traumatic brain injury from bomb blasts are finding disturbing news. The invisible surge of compressed air traveling from these blasts is causing cellular death in the brain that leads to symptoms like memory deficit, headaches, vertigo, anxiety, apathy, or lethargy that may not surface for months or years. This newly discovered brain damage at the cellular level can be permanent. Of additional concern is the fact that this level of brain damage cannot be detected with imaging tests such as head CT scans or brain MRI's. Pentagon scientists believe these findings could mean that the number of brain-damaged soldiers and Marines may be far greater than reported. These veterans deserve and need a lifetime of support for these insidious injuries.

For more information on this subject, please refer to the section on Head and Brain Injury.

Originally posted at InjuryBoard by Michael Phelan

$3.5 Million Settlement in Brain Damage Case

Michael Phelan — Wed, 14 Nov 2007 11:39:49 GMT

I am so proud to represent, along with co-counsel Yvonne Griffin, one of the finest people I've ever met. Our client taught third grade to inner-city kids for 33 years and also worked a second job in order to put three of her own children through college. Last year, a truck crashed into her car and she suffered a fractured femur. She stopped breathing at the ER, and a CT scan revealed that she suffered a subdural hematoma in the frontal lobe of her brain. My client underwent emergency brain surgery to address the brain bleed and evacuate the hemorrhage. She had thigh surgery to install metal rods and screws in her leg. On November 13, 2007, with the assistance of mediator Robert L. Harris, Sr., we settled our client's case for $3.5 million. Thanks also to my partner, Irv Cantor, for his insight during the mediation.

Like so many victims of severe frontal lobe brain damage, our client is not the same person she was before the crash. She used to be an outgoing, high-energy, articulate person. After the crash, she suffered memory loss, word finding problems, paranoia, depression, and extreme fatigue. She turned into an introvert who is uncomfortable around other people. The defense blamed all of her problems on pre-existing intra-cranial hypotension, wine drinking, tobacco use, obesity, and coronary artery disease. The key to our case was fabulous lay witnesses (friends, ex-husband, family, and employer) who painted a brilliant picture of our client before and after the crash. The defense neuropsychologist actually tried to portray our hard-working client as a malingerer and exaggerator. This "expert" relied upon a controversial malingering scale called the Fake Bad Scale, which has been rejected by the authors of the MMPI-2 and which has been shown to have a strong gender bias against women. The Fake Bad Scale is very controversial and should not have been used in this case. More to follow.

For more information on this subject, please refer to the section on Head and Brain Injury.

Originally posted at InjuryBoard by Michael Phelan

US Lacrosse Confronts Concussion Epidemic

Michael Phelan — Wed, 07 Nov 2007 08:55:54 GMT

Two days after his team won the National Lacrosse League championship, Jay Jalbert was laying in a hospital bed recovering from his seventh concussion. Jay was forced to retire from professional Lacrosse. Four weeks after taking a routine shot off his face mask, Denver Outlaws goalie Trevor Tierney was still experiencing symptoms of his seventh concussion. Concussions are prevalent in contact sports from the youth to the professional level. The bad news for Lacrosse is a recent report in the Journal of Athletic Training concluded that concussions were the third most common injury in men's and women's lacrosse.

The good news is that, unlike the NFL, US Lacrosse, through its Sports Science and Safety Committee is taking seriously the severe health hazards of concussions. US Lacrosse has taken a significant step toward addressing the issue by partnering with ImPACT, a concussion management firm. Two major issues being addressed are players returning too early from concussion and players who have suffered multiple concussions. Returning to play too early can lead to prolonged post-concussion symptoms or more severe brain damage if another head injury occurs before the first concussion heals completely. The league is also studying the cumulative damage of multiple concussions, something the NFL should have done long ago. The league is utilizing the ImPACT test to help determine if it is safe for a player to return from concussion. Players take a baseline neuropsychological test of cognitive function at the start of the season, and then retake the test if a concussion occurs. Medical professionals have quantitative data to assist in determining if the brain is healed.

Parents and other advocates should also push for better helmets and better/mandatory mouth guards. Water and air cushioned football helmets were available in the 1970's. There is no excuse for the flimsy helmets worn by hockey players, which do very little to protect the brain. Lacrosse helmets could also offer more protection.

Originally posted at InjuryBoard by Michael Phelan

Traumatic Brain Injury: Virginia's "Silent Epidemic"

Michael Phelan — Wed, 24 Oct 2007 16:44:27 GMT

The Virginian Pilot reported recently that an estimated 150,000 Virginians may have long-term disabilities because of brain injury. Brain damage typically is caused by trauma such as a fall, a car accident, or violence. Like so many other states, Virginia is ill equipped to deal with this epidemic. A study commission of the General Assembly found that Virginia has only 20 specialized beds providing intense neurobehavioral residential treatment for the brain injured. Since brain injury is the signature injury of the wars in Iraq and Afghanistan, one hopes that the General Assembly acts quickly to provide for our injured soldiers and other brain damaged citizens.

For more information on this subject, please refer to the section on Head and Brain Injury.

Originally posted at InjuryBoard by Michael Phelan