Brain Injury Lawyer - New York

NFL to tell teams to keep players out following any concussion or suspected concussion

The Associated Press reports that NFL commissioner Roger Goodell will tighten the restrictions on returning to play following a concussion or a suspected concussion.

Citing information obtain by Fox Sports, it is reported that Goodell will issue a memo this week to all 32 teams expanding grounds for the removal of a player with a head injury or concussion. Under the new rule, any concussion or suspected concussion will ban the individual from competing for the remainder of the game.  Currently, a player can return to the game after being diagnosed with a concussion if he is asymptomatic at rest and under exertion, and is cleared by the team doctor. The lone exception is if the medical staff determines the player lost consciousness, in which case he is ruled out for the remainder of the game.

The report said that if a player is "woozy, has general dementia or memory loss," Goodell wants him barred from returning to a game.

While it has taken some time, it is encouraging to see that the league is now taking a more aggressive stance on concussions.  At least they are beginning to read the medical literature and understand that a concussion can happen even without loss of consciousness and that it takes time for the full array of concussion symptoms to develop.

When in doubt, keep them out!

Read the full AP story here.

A thanksgiving prayer

On this thanksgiving day, let us pray that all brain injuries that are preventable are prevented and that all those in need of treatment for their brain injuries receive the treatment they deserve. Let us remember in our hearts and prayers all those who have been victims of traumatic brain injury and pray for their recovery.

Thanksgiving is a difficult time for all those families and friends with a loved one who has recently experienced a traumatic event.  A helpful article on coping on this holiday can be found Facing Thanksgiving Together After Trauma published at Psych Central.

Heads of NFL Concussion Committee Quit

In the latest development concerning implementation of a new concussion policy by the National Football League, the co chairpersons of the league’s brain injury committee have resigned.

 

In newspapers this morning, it is reported that the panel’s co-chairs, Dr. Ira Casson and Dr. David Viano have resigned.  Good riddance to both of these individuals who should have been replaced by the league a long time ago.

 

The opinions of Drs Casson and Viano concerning concussions have for many years been criticized by world renowed experts on concussions and their long term effects.  As a result of their backward thinking and insistence that concussions were a minor problem and posed no danger to the health and safety of players, they not only placed the lives and health of professional athletes in danger, they also placed in danger the health and safety of every child who plays football and engages in other sporting activities where here is a risk of concussion and head injury.

 

The National Football League is looked to by student players, parents, coaches and trainers throughout the country for guidance on how to handle the important decisions of when to allow an athlete to return to play.  By minimizing, trivializing and by issue false and misleading statements, these two individuals, unfortunately set the wrong example.

 

It is time that the league get its house in order and come to grips with the realities and dangers of concussions.  If it means that players must not play, that some will be required to retire and that the league’s disability plan will be required to provide benefits, that’s the reality of the dangers in dealing with head injuries and contact sports.

 

You can read the full story on the resignation of these two “experts”: NFL Head Injury Study Leaders Quit

More evidence that those previously thought to be in a vegetative state are capable of conscious awareness

There is more evidence that those previously thought to be in a vegetative state and incapable of appreciating the world around them, do have conscious thoughts and are aware of their surroundings.

The New York Times reports about a car accident victim who was thought to be in a deep coma for 23 years.  In fact, this gentlemen was conscious all the time, but no one realized it! 

With the assistance of modern imaging techniques, using brain scans, researchers  in Belgium discovered that his brain was still active.  Now, techniques are being developed so that he will be able to communicate with those who are caring for him.
 
The lead researcher, Dr. Laureys, who recently published a paper on comas, said that as many as 4 out of 10 similar patients may have been misdiagnosed.

Read the full New York Times story:  Misdiagnosed with coma, Belgium man communicates after 23 years.

Can cinnamon extract prevent cell death following a traumatic brain injury?

The United States Department of Agriculture reports on new research being conducting on the use of cinnamon extracts to prevent cell death following a traumatic brain injury.

According the department, the researchers have reported findings that the cinnamon compounds studied prevented isolated brain cells from swelling, one of the many abnormal conditions resulting from traumatic brain injury and stroke due to impaired blood flow to the brain.

The scientists used isolated glial cells—cells that support essential elements of neural tissue found in the brain and spinal cord—and put them in a culture solution. When the cell cultures were deprived of oxygen and glucose for five hours, the researchers measured the function of the mitochondrial inner membrane in the glial cells. They found a nearly 40 percent decline in the mitochondrial membrane potential due to the lack of oxygen and glucose.

The researchers then exposed some of the cells to a cinnamon extract, while other cells served as “nonexposed” controls. The reduction in the membrane potential was alleviated in the presence of the cinnamon extract.

Ninety minutes later, the researchers measured volume of the glial cells. They found that cell volume among the oxygen- and glucose-deprived cells had increased by more than 34 percent. But this increased swelling was absent in the presence of cinnamon polyphenol extract at the highest level tested.

Because neuroglial cell swelling can contribute to further neuronal injury, the study indicates that further animal-model research is warranted, according to the authors. The researchers caution that table cinnamon compounds may accumulate in the body and should not be ingested consistently as more than a spice over long periods of time.

The study was published this year in Experimental Neurology.

NFL to require "independent" medical examinations following concussions--will they truly be independent?

FOX Sports has reported an important new policy development in the NFL policies toward concussions.  According to FOX, the NFL  will now require teams to retain the services of independent neurologists and neurosurgeons to assess players following a concussion or head injury.

FOX Sports has learned that the teams were instructed to immediately find "independent" doctors and send names to the league for approval. The league will then team with the NFL Players Association's medical people to determine that each doctor is in fact an expert in this field as well as impartial to the team they are handling.   You can read the full Fox report:  NFL Implements new concussion policy. The New York Times has also followed up with a story of its own on this same subject, NFL To Shift In Its Handling of Concussions.

While this all sounds good, the concept of an “independent” examination is always something I am always cautious of.  In the area of personal injury, insurance companies routinely seek the service of “independent” medical examiners to assess our clients.  Unfortunately, these physicians are anything but independent and are in reality doctors for hire.  They understand who pays the bills and what the insurance company wants them to find and/or not find.  Time and time again, in the context of traumatic brain injury litigation my clients have been subject to phony medical examinations by neuropsychologists and neurologists who were anything but independent, ignored the available medical evidence, gave improper and incomplete examinations, relied upon faulty data and made up medicine to come to a conclusion that insurance company who was paying the bill wanted.  In fact, I call these “independent” medical examiners, Paid doctors for hire.  Other professions have different names for paid services.

The travesty of these exams came to light recently in a three part New York Times expose on “independent” medical examinations in the workers compensation context.  The physicians were retained by third party providers and understood what expectations were regarding their opinions.  These physicians tailored their opinions in favor of those who were paying for their services.

The NFL is no stranger to these biased examinations.  In fact, the examinations conducted by the league's disability plan are anything but independent.  The medical providers hired to perform these examinations to determine a player's entitlement to disability benefits routinely come to conclusions that are biased and faulty.  If the league goes to these same "experts" this time, the results will be predictable and more players will suffer from the life long consequences of a traumatic brain injury.

I am all in favor of taking the decision away from team physicians and team trainers, but I believe that players need the ability to retain their own physicians to provide advice and make important decisions for them.

Is it time that NFL fire the head of its concussion committee?

According to the New York Times and AP, the  National Football League Players Association has called for the removal of Dr. Ira Casson as co-chairman of the league's committee on concussions, saying that he is too biased to lead research efforts and fails to appreciate the dangers inherent with the post concussion syndrome.

Without commenting on the association's position, I can only add that I have had my own difficulties in trying to discuss the important issues of player safety with Dr. Casson.  While president of the Brain Injury Association of New York State an chair of its major sports concussion conference at Madison Square Garden, I invited both Dr. Casson and his co-chair, to participate.  I was amazed that despite the participation of the leading experts in sports concussions from throughout the nation, the NFL "experts" refused to participate.  Later, when the league was holding open meetings on the subject, I asked for permission to attend.  I was curtly informed that as an attorney and president of the Brain Injury Association, I was not welcome.

The player's association has said that they do not feel that Dr. Casson is impartial.  He has dismissed all studies which have found a link between football concussions and early onset dementia. 

It is time that the NFL examines the important public health crisis of concussions in sports in an objective and forthright manner.  It is not only the professional players that need this protection, but also all those involved in youth sports who look to the NFL for advice and guidance on this safety issue.

WHEN IN DOUBT, KEEP THEM OUT!

A refreshing bit of honesty about concussion management

USA Today reports a refreshing bit of honesty regarding the manner in which sports concussions have been treated in the past with the NFL.

The article reports on information obtained by the Huffington Post in which former Packers VP Andrew Brandt questioned whether he had acted appropriately to combat the effect of concussions during his stint with the team.

According to Brandt, "The honest answer is: I don't know. ... I saw the fuzzy looks when some of our players came off the field. I took calls from wives, mothers, fathers and brothers of players who had suffered concussions. I watched players vomit in the triage of the training room after concussions."

The paper also reports that, Brandt, who now serves as a consultant to the Eagles (in addition to writing for the National Football Post), said teams must yield decisions about the playing status of concussed players entirely to doctors and not allow coaches -- or players -- to have a say.

With the current information about concussions now available to teams, coaches and trainers, there can no longer be an acceptable excuse for allowing players who have sustained a concussion or a suspected concussion to return to play in the same game or even in a subsequent game without proper medical clearance.

You can read the full story by clicking here.

WHEN IN DOUBT, KEEP THEM OUT!

Congratulatons to ThinkFirst on receiving distinguished service award from Congress of Neurological Surgeons

Congratulations to the ThinkFirst National Injury Prevention Foundation `which was recognized as a leader in injury prevention by the Congress of Neurological Surgeons (CNS). CNS presented the 2009 Distinguished Service Award to the ThinkFirst Foundation at the CNS Annual Meeting of over 2,000 neurosurgeons in New Orleans.

The ThinkFirst National Injury Prevention Foundation has been focused on teaching children and teens the importance of making safe choices since 1986. Educational programs for first through twelfth grades have a major impact on impressing kids to “Think First” when it comes to safety. 

We all know that the best cure for brain injury is prevention and this organization has had a long standing commitment to head injury prevention programs. 

ThinkFirst was recognized for its work in providing meaningful, educational injury prevention programs to thousands of children and teens each year. One hundred and thirty national and 39 international chapters visit health, science and driver education classes to teach students how to reduce their risk for injury. Based largely in injury prevention departments within hospitals and medical universities, nurses, health educators and their sponsoring physicians schedule programs with schools to assure every child and teen in a given community learns simple measures for protecting themselves from the most common causes of injury: vehicle crashes, violence, falls and sports.

Formerly known as the National Head and Spinal Cord Injury Prevention Program, ThinkFirst was established in 1986. The American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) directed two neurosurgeons, to develop a national injury prevention program. ThinkFirst has since developed into one of the largest injury prevention programs in both the U.S. and Canada.

One of the most recent projects was the production of a new educational film for teens titled “Think About Your Choices,” with support from the Christopher and Dana Reeve Foundation. For more information on ThinkFirst visit the ThinkFirst web site. 

Nearly 20 percent of professional football players fail to report their concussion symtoms according to an AP study

A study sponsored by the Associated Press reports that nearly 20 percent of professional football players have hidden the fact that they sustained a concussion or down played their concussion symptoms.

The AP concussion study interviewed a cross section of NFL players, talking to five players on each of the 32 teams, which amounts to approximately  10 percent of all players.  The interview results confirms what we all know, concussions are a bigger problem in football then the NFL or its players association wants to admit to.

Players reported feeling there head vibrate like a bell, but going back to play within minutes and never reporting their symptoms.   Another player said,
"You get back up, and things are spinning," but he didn’t tell anyone.
 
Now the NFL wants players to keep tabs on each other and tell their teams if they believe someone else has a head injury.

The NFL told the AP that they believe all concussion symptoms need to be reported and that team members should be encouraged to report observations of their team mates to the medical staff.

According to the AP,  “What emerged from the AP's interviews was a wide-ranging, unprecedented look at the way active players think about head injuries in a world where "getting dinged" and "seeing stars" — and the potential long-term effects of concussions — are deemed a frightening but perhaps inevitable consequence of their job.”

The NFL says its data shows an average of one reported concussion every other game — about 120 to 130 concussions per regular season.

Of the 160 players interviewed by the AP, half said they've had at least one concussion playing football; 61 said they missed playing time because of the injury.

Players acknowledged staying on the field despite feeling "dazed" or "woozy" or having blurred vision, because, "It's what you're taught."

One thing is clear, the efforts by the NFL and the players association to educate players about the dangers and long term consequences of concussions, to date, have not worked.  Much more is needed and needed now.  Merely handing out brochures to warriors in the locker room about the dangers of concussions is not doing the job.  More serious efforts must be undertaken.  In addition to educational films which should be mandatory of former players who describe their disabling injuries and the need for vigilance, player’s wives and mothers should also be told about the dangers faced by their loved ones.  Maybe it’s time that we bring in the heavy guns to tell players, WHEN IN DOUBT, STAY OUT!

The full AP story can be read by clicking here.