Brain Injury Lawyer - New York

Brain Injury Legislative Update

The following brain injury legislative update has been prepared by the Brain Injury Association of America:

FY10 National Defense Authorization Act

On Wednesday, October 7, 2009, the House and Senate Armed Services Committees announced that they had reached an agreement on a conference report to H.R. 2647, the Fiscal Year 2010 National Defense Authorization Act.

In a major victory for the brain injury community, the report included an amendment that authorizes the Secretary of Defense to carry out a pilot program for providing cognitive rehabilitation therapy services under TRICARE.  BIAA worked with the Congressional Brain Injury Task Force to preserve its status as part of the final conference report.  We are thrilled to have contributed to this important step towards providing better access to care for returning service members.

A link to the full text of the amendment can be found here .

Brain damage caused by blast waves-new research can improve helmet design

New research on the effects of blast waves could lead to an enhanced understanding of head injuries, brain damage and improved military helmet design.

Scientists at the Lawrence Livermore Laboratory have determined that blast waves generate enough force to cause brain deformations even without direct contact with the skull and without a skull fracture.

In contrast to injuries to the brain caused by the movement of the brain within the skull cavity, the researchers found that blast waves cause pressure changes within the brain resulting in the squeezing of the brain.  The forces required to cause brain damage are much less than those required to cause a traumatic brain injury from direct impact.

Amazingly, although the skull is deformed in the injury process a distance of about 50 microns, which is the width of a human hair, this is enough deformation to cause brain injury.

Because blast waves and direct impact affect the head in fundamentally different ways, helmets that  are designed to protect soldiers from impacts and projectiles may not be optimal for blast wave protection.

The team studied how helmets and their suspension systems influence the blast-induced mechanical loads in the brain.  What they found was that the gaps within the helmet and between the cushioning within the helmet, allow brain waves to “wash” under the helmet and cause damage to the brain from within the interior of the helmet.

Work is now being undertaken to redesign helmets to minimize the risk of blast injury.

How many brain injuries are too many?

In a speech delivered at Harvard Medical School, Adm. Michael Mullen, chairman of the Joint Chief of Staff said that the military is considering pulling service members out of combat operations if they have sustained three concussions.

Mullen said, "I don't know what the right number is, but 30 is way too many. I'm literally on the verge of saying, you know, 'Hey, it's two or it's three (mild TBIs) and you're out,' "

It is estimated that A RAND Corp. study early last year estimated that up to 300,000 service members may have suffered a mild TBI in the Iraq and Afghanistan wars.

The defense department is reportedly following the lead of professional football in trying to place a limit on the number of concussions an individual can sustain before being pulled out of play for the season. 

Having acknowledged that any concussion can cause serious and permanent brain damage, allowing service members to sustain multiple concussions before being pulled out of combat, is not the full answer.  Before any service member who sustains a concussion is allowed to return to combat, that service member needs to be fully evaluated to determine that they are symptom free.  If they are not, then they should not be allowed to return to combat.

You can read the full story in USA Today: Joint Chief’s Chairman seeks brain injury limit.

Multiple Bombings Slowly Destroy Soldier's Brain

Thanks to the Huffington Report for reporting a story originally broadcast on CNN of a  U.S. soldier who served in Iraq and Afghanistan and was subjected to multiple bombings. Despite serious, multiple brain injuries, he was repeatedly sent back to duty. Doctors now believe that the bomb blasts were slowly destroying his brain. He was eventually sent back to the U.S., but the full extent of his ibrain damage was never treated, and he ended up committing suicide, police believe.

You can watch the news report by clicking here.

Baseline Testing Helps to Identify Returning Vets With Mild Brain Injury

An interesting story at NPR about baseline neuropsychological testing in returning vets, highlights the importance of screeing procedeures for early identification of victims of brain trauma.

According to the NPR story, one in five returning combat soldiers is a victim of traumatic brain injury.  Two years ago, the Department of Defense began a program of base line testing of soldiers before deployment.  The testing has proved to be effective in identifying returning vets suffering from post concussion syndrome. 

Read and listen to the full NPR story: Back from Iraq With Traumatic Brain Injury.   

Protecting service members from medical malpractice in the military

Senator Charles Schumer has introduced the Carmelo Rodriguez Medical Accountability Act of 2009 (S. 1347 / H.R. 1478), which would guarantee active military servicemen and women the right to sue for medical malpractice. Under the Feres Doctrine, a 1950 Supreme Court ruling, active military members cannot sue the government for non combat related injuries. The bill would offer service members injured by medical negligence the same protections currently provided to veterans. It is named after Carmelo Rodriguez, who died from skin cancer in 2008 after his doctor had failed to report his melanoma more than 10 years ago.

More details about the Feres Doctrine and the Carmelo Rodriguez Medical Accountability Act of 2009 can be found at the American Association for Justice website.

Our law firm, DeCaro & Kaplen, LLP  handles medical negligence cases causing brain injury as well as other catastrophic personal injuries. 

Blast Injuries and Traumatic Brain Damage

Blast-induced traumatic brain injury (TBI) has reached critical levels in modern-day warfare. The current issue of Journal of Neurotrauma focuses on the intensive efforts to develop effective treatment strategies and model systems for studying the cause and effects of explosive blast TBI. This special issue of Journal of Neurotrauma, can be viewewd free on line.  View blast exposure and traumatic brain injury here.

Traumatic Brain Injury Can Cause Premature Death

An interesting news report from ABC News examines the link between traumatic brain injury and premature death .Can Brain Iinjury Lead To Death Years Later? 

It is important to realize that the impact of a traumatic brain injury may have long term consequences including premature death. Traumatic Brain Injury (TBI) for to many years has been overlooked as a source of long term disability and premature death.  The investigation and the studies cited in the news report have serious implications for the many service members returning from oversees with brain damage.  This signature wound may be a cause of premature death.  Who would argue that these service connected deaths are not entitled to proper compensation?

Three Years and Not One Service Member Tested for Subtle Brain Damage

Subtle brain damage is often missed by conventional MRI testing, leading many to falsely conclude that no structural brain damage has taken place.  This false premise has subjected many individuals who have sustained brain injury, including returning veterans to have their claims rejected. 

The absence of proof is not proof of the absence of an injury and the fact that often times brain injury is not detected using MRI Studies does not mean that an individual did not suffer a traumatic brain injury. 

Newer MRI techniques such as the more powerful Tesla 3 MRI machines are now capable of detecting brain injuries that were missed in the past. Other useful techniques for detecting subtle brain injury include functional MRI studies (fMRI)
 
Three years ago, the Department of Veterans Affairs established a laboratory at the University of Texas at Austin with high expectations that it would conduct state-of-the art research into combat-related brain injuries using powerful MRI technology.  However after 3 years no studies have ever taken place!

Last month, the VA announced it was moving the facility to Waco, Texas, after spending more than $3 million without testing a single veteran with traumatic brain injury.  The Waco facility is reported to have the world’s most powerful research MRI machine.

The decision follows a two-year battle between VA and the former director of the Brain Injury and Recovery Laboratory, who has accused his superiors of fraud, mismanagement and wasting taxpayer money.

The uproar has sparked a congressional inquiry, an investigation by the federal Office of Special Counsel and several internal investigations.

Hopefully, research will finally get underway to objectively document subtle brain injuries in returning vets.

You can read more on the controversy and investigation of the Austin facility by clicking a story in the Washington Post , “VA Moves Texas Brain Laboratory After Years Pass Without Testing”

Comparing Brain Damage in Brains of Wounded Vets to Brain Damage in Football Players

The Sports Legacy Institute and the Boston University Center for the Study of Traumatic Encephalopathy have announced that they will be now examining the brain tissue of service members who have passed away after suffering from blast injuries.  They will be comparing the pathological findings in the brain tissue of victims of blast injury to the findings in tissue examined in football players who have sustained multiple concussions. The full story is reported in the New York Times article, "A Chance for Clues to Brain Injury in Combat Blasts".

The researchers hope to determine whether single, non-impact blasts in battle can cause the same type of brain damage found in the brains of football players who have been subject to years of repetitive head injury.

They researchers also are interested in determining whether their are physical changes to the brain in service members who have been diagnosed with post traumatic stress disorder (PTSD) since many of the symptoms associated with this condition, such as depression, erratic behavior , diminished ability to concentrate are all similar to the post concussion symptoms faced by professional athletes and other concussion victims.