Brain Injury Lawyer - New York

New legislation introduced in Senate to protect high school athletes with concussions

The movement to insure the safety of high school athletes who may have sustained a concussion has received a boost under legislation introduced yesterday in the United States Senate.

U.S. Senator Robert Menendez (D-NJ) introduced legislation in the Senate to create a grant program that would help ensure proper prevention, diagnosis and treatment of sports-related concussions in U.S. high schools and middle schools. The Concussion Treatment and Care Tools (ConTACT) Act establishes a five year grant program, authorized at $5 million for the first year, to be distributed to states to implement proven concussion management strategies.

The legislation was previously introduced in the House of Representatives by Rep. Bill Pascrell who is co-chair of the traumatic brain injury congressional task force.

Under the legislation, grants would be awarded to states to implement best practices in concussion management for school-sponsored sports and fund schools’ implementation of baseline and post-concussion neuropsychological testing technologies.  Best practices would be developed by a conference of medical, athletic, and education stakeholders and will be used to model grant guidelines.

Hopefully, this guidelines that are implemented will be far reaching and require any athlete who has sustained a concussion or a suspected concussion from returning to play in that game and any subsequent game until all signs and symptoms of a concussion resolve. This included the subtle symptoms that were omitted from recent changes in concussion policy by the N.F.L.

NFL New Concussion Policy Still Doesn't Go Far Enough

The NFL announced last evening new concussion policies regarding when it is appropriate to allow a player to return to play. Unfortunately these new policies while acknowledging the dangers of concussions and the need to keep a player out of the game until they have fully recovered, they fail to take into account all of the subtle signs of concussions and the mentality of players who try to minimize and mask their condition.  It's time that the league take the important step of absolutely prohibiting any player who has had a concussion or suspected concussion from returning to play until they are fully cleared by objective evaluations which can never be performed on the field. 

The NFL new concussion rule now prohibits any player who experiences amnesia, poor balance and who exhibits an abnormal neurological examination from returning to play during the same game, whether or not these symptoms quickly subside.  However, for more subtle brain injury symptoms such as dizziness and headache, a player is permitted to return to play unless these symptoms are "persistent" 

It is troubling that the league still chooses not to acknowledge the subtle signs of concussion and post concussion syndrome and still chooses to place players with these symptoms at risk for further injury. It is these subtle signs and symptoms and the fact that many signs and symptoms of concussion do not appear for hours or even days after the event that makes the NFL policy a dangerous one not only for its own players, but for all those who use the NFL as an example.

Still hoping that they get it right, WHEN IN DOUBT, KEEP THEM OUT!

You can read the full report in today's New York Times, New N.F.L. Rule on Concussions Benches Injured .

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.

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

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!

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.

Some important insights into concussions from Harry Carson

Hall of famer, Harry Carson has delivered some important messages on the tragedy of concussions in professional sports today.

Harry has devoted a great deal of time to alert the public and especially those participating in amateur athletics to the dangers associated with concussions. As Harry aptly observed while a guest of  honor at the recent Brain Injury Association of New York State Journey of Hope Gala, "According to the NFL and their physician, Dr. Ira Casson, they've been conducting studies for fifteen years.  How much longer do you have to extend your research to come up with any kind of definitive conclusion?"

Here are some more of his comments:

“It’s that train that’s coming down the track and it’s coming full speed and more and more players are being affected by lingering effect of concussions,”

“As a parent you really should be concerned,” -- “So if there is one thing that should come out of this thing, parents should have the information to determine whether they want their child to play a contact sport, football or not. Unfortunately for many of us who have played the game, there’s nothing really that can be done. The damage is already done."

Hopefully the league and congress will both hear these important messages and take appropriate steps to reduce the risk of permanent damage from concussions to all players, both professional and amateur.

A proposal to reduce brain injuries in football

Today's congressional hearing on the prevalence of brain injuries in the NFL produced few surprises.  The league unfortunately still refuses to concede the connection between chronic brain damage and repetitive concussions.  This denial in the face of overwhelming medical evidence is further evidence that the league may be incapable of policing itself and may cause congressional action including the revoking of the league's antitrust exemption.

Congress needs to go further and also needs to address the protection afforded to the league in erroneous decisions in regard to granting players disability benefits for the chronic and long term consequences of traumatic brain injury.  Injured players deserve access to the Federal court's to present their legitimate claims to a jury.

The following proposal to save the game of football and reduce the incident of concussions and other types of brain damage was presented at today's hearing by Chris Nowinski, president of the Sports Legacy Institute and co director of the Center of Traumatic Encephalopathy of the Boston University School of Medicine.  Chris is also the author of Heads Up, a book which provides a detailed look at the issues of concussions in athletes.

Here is the proposal presented at today's hearing:

10 Point Plan to Save Football:

In the past few years, former football players have begun being diagnosed with Chronic Traumatic Encephalopathy (CTE), a progressive neurodegenerative disease caused by repetitive trauma to the brain
which eventually leads to dementia. Some were famous NFL Hall of Famers like Mike Webster and Lou
Creekmur. Others, like Mike Borich, only played through college. All died sooner than they should have,
and all suffered terribly in their final years.

Since the discovery of CTE in 1928, the disease has been seen almost exclusively in boxers, which is why
it is often referred to as “punch drunk” syndrome. However, it is now diagnosed regularly in ex‐football
players, and in the past year, the Center for the Study of Traumatic Encephalopathy at Boston University
School of Medicine (CSTE) has diagnosed CTE post‐mortem in 11 of 11 former college and professional
football players that died at ages ranging from 37‐82 years. This is significant, as the disease should not
naturally exist in a single human being. The early stages of the disease have even been seen in an eighteen year‐old former football player. In 2009, it is clear that football is in the midst of a brain trauma
crisis.

The game of football has not always been played as it is today. In fact, the most consistent aspect of the
game has been change. In 1905 the game was so dangerous, regularly killing participants, that President
Theodore Roosevelt summoned the coaches of Harvard, Yale, and Princeton to Washington D.C. for a
summit on how to make the game safer and threatened to take action in the absence of significant
reform.

From this meeting the American Intercollegiate Football Rules Committee was created, and that Committee, among other things, legalized the forward pass and made other changes to eliminate dangerous collisions. Over and over, football has had to be changed to be made safer. Now it faces a new challenge.

CTE is a deceptive, quiet killer. The disease begins during a player’s career and then hides, slowly
killing brain cells until the athlete begins showing symptoms years later. Football has evolved into a something it was never intended to be. Football collisions may now be more dangerous for the brain than ever. With the combination of bigger, stronger, and faster players and hard‐shelled helmets that are often used as a weapon to initiate contact, we’ve created a type of repetitive trauma to the brain that has never existed before.

The discovery of CTE inside the brains of so many ex‐football players has shown us that it is again time
for change, and a new Committee. Only this time, it is a Committee to Save Football. Among high school
students, football is the most popular sport in America, played by one in eight American boys. While
football was first played by colleges, today football is a children’s game, with 95% of participants under
the age of 18.

These children are not old enough to make informed choices. Therefore, in light of the new evidence of
CTE in 100% of players studied at Boston University, it seems appropriate that we again reevaluate how
“Solving the Sports Concussion Crisis” we play the game of football before the 2010 season and at all levels of play: youth, high school, college, and professional.

If we can agree that the game is broken and needs to be fixed, we have an incredible number of paths to
a safer game without fundamentally changing football. If we know that practice collisions account for
over 50% of brain trauma, the proposals below could easily eliminate over 75% of brain trauma and
concussions today – it is simply a question of leadership.

Below are 10 paths to a safer game that can and should be used to reduce brain trauma. This would
serve as the basis for evaluating the options available to the Committee to Save Football.

1. Reevaluate how the game is practiced
• Greater than 50% of hits to the head occur outside of games. NFL teams rarely hit in practice due to risk of injury. Youth teams could only be allowed to have full‐contact once a week. Dangerous drills could be banned or used less frequently.

2. Encourage mandatory brain trauma and concussion education  for coaches, athletic trainers, parents, and athletes
• Coaches, athletic trainers, and athletes cannot diagnose concussions if they aren’t trained to look for them or know how to recognize them. Coaches, athletic trainers, and athletes will not voluntarily choose to rest concussions and reduce overall brain trauma if they don’t understand why it is good for the athlete’s short and long‐term health.

3. Reevaluate protective equipment
• Investigate changes to helmets, shoulder pads, and other types of protective equipment to reduce brain trauma.

4. Develop better methods of concussion detection and diagnosis
• The CDC provides clipboards with concussions diagnosis protocols on the back at no cost. Coaches could be required to carry them. We can invest more in research to find simple, objective ways to diagnose concussion that can be utilized in any program.

5. Develop better methods of concussion management
• Return‐to‐play too soon after concussion can result in more extensive brain damage, and can actually result in death. It is now law in Washington state that players are required to see a medical professional with brain trauma expertise before return‐to‐play. Minimum return‐to‐play standards should be enforced at all levels.

6. Consider minimum medical resources
• Football is a dangerous game. Minimum medical resource standards, like having an athletic trainer or doctor on the sideline, should be considered.

7. Reevaluate techniques of tackling and blocking
• We can teach and enforce different methods of tackling and blocking that minimize contact to the head.

8. Reevaluate the rules
• Recently the NFL banned the wedge on kickoffs to reduce trauma. Many other rules could be changed, at all levels of football, to reduce brain trauma.

9. Reevaluate rule enforcement and the role of referees
• The NCAA recently began suspending players for intentional helmet‐to‐helmet hits. Referees could eject players for illegal hits to the head. Referees could be trained to identify concussed players on the field.

10. Reconsider the culture of the game
• Television announcers could stop glorifying illegal hits. Children could stop being pressured to play through concussions.

The evidence now exists to support immediate and radical change to the game of football to dramatically reduce brain trauma. Let us not let this opportunity pass.

Concussions in the NFL--A problem that won't go away

On the heals of new medical evidence that chronic traumatic encephalopathy (CTE) is linked to repetitive concussive injuries in football players, the House Judiciary Committee has scheduled a hearing for tomorrow to examine the way that the NFL handles brain injuries both for present players and those who have unsuccessfully sought disability retirement benefits.

Last week, neurologists and pathologists associated with the Center for the Study of Traumatic Encephalopathy announced their findings that even college athletes who received multiple concussions were found to have this brain damage.  Dr. Ann McKee, an associate professor of neurology and pathology at the Boston University School of Medicine and co-director of the Institute is quoted in the New York Times as saying, "I've looked at more that 1,000 brains and I've never seen this in any individual living a normal life--it's only through head trauma. "

The health care crisis goes for beyond professional football players.  Evidence of this disease in younger athletes raises serious safety concerns and again raises the issue, is the NFL and their poor decisions setting the wrong example for younger athletes and leading to more brain injuries and permanent brain damage?

Here are some additional comments by Dr. McKee: "The fact that we are seeing this disease, it had a devastating effect on their lives, mow in a 42 year old who never played in the N.F.L. indicates that it's a more pervasive problem that we recognize.  What are we doing with our kids?  Are we doing enough to protect against their developing this awful condition?"

Tomorrow's hearing will focus on these issues.  Among those invited to testify are Dr. McKee and neurosurgeons, Robert Cantu and Julian Bailes who have also down extensive research on concussions and the effects of cumulative concussions in athletes.  Another witness, David Weir from the University of Michigan recently published research sponsored by the NFL that suggested that professional football players had rates of cognitive disease several time higher then the general population.

I also heard that Dr. Eleanor Perfetto, the wife of former lineman Ralph Wenzel who was institutionalized for dementia is also scheduled to testify.  I had the privilege of meeting Dr. Perfetto last week at the Sports Legacy Institute awards dinner in Boston, Mass. She has fought a long and hard battle with the NFL over this injury had has been a great friend and advocate for other football families who face the uphill battle with the league's disability plan to obtain benefits that these players are entitled to.

Chairman Conyers and the House Judiciary Committee must press NFL Commissioner Roger Goodell as well as players executive director Maurice Smith on why the league continues to try to minimize this serious condition and why players who suffer from traumatic brain injury can't obtain benefits that they bargained for as part of their collective bargaining agreement.

60 minutes looks at concussions and the long term damage that results

This evening's 60 minutes report on concussions and the long term dangers associated with this injury was an excellent over view of the hazards associated with multiple concussions.

Here is a brief excerpt from the show:

You can't separate violence from football - it's part of the thrill of the game. Players know what they're risking when they hit the field, including injuries such as torn ligaments and broken bones. But what about a blow to the brain? According to the Centers for Disease Control, concussions from sports are an epidemic in this country.

As many as three million sports related concussions happen every year.

And new research shows that their effects can be frighteningly long-lasting, even leading to permanent brain damage and the early onset of dementia. While concussions happen in many sports, most happen in football. They can happen to kids, to the pros, and as we saw recently, to one of today's top college players.

Watch the entire 60 minute concussion broadcast