Brain Injury Law Blog : Head Injury : Coma : Personal Injury : Las Vegas Nevada Lawyer & Attorney Tim Titolo

60 Minutes just aired an incredible piece on new findings for brain injured people in a minimally conscious state. 

The story describes fireman Don Herbert who was injured when a roof fell on him while making a rescue attempt.  Unconscious for 10 years, Don is shown waking up and being aware of the fact that he was "gone."

The next story is of George Menendez who also sustained brain injury and was minimally conscious.  His mother thought to give him Ambien for sleep one night when he was moaning.  George, for the first time, opened his eyes and was able to communicate with his family.

Experts believe there is a subset of brain injured people who may respond to Ambien.  PET scans were done before and after Ambien was ingested and the results were remarkable.  The brain showed distinctive functioning after Ambien.

This is an exciting discovery and I hope there is more to come.  To see the amazing 12 minute video click here.

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Rhode Island Hospital has been fined $50,000 and reprimanded by the state Department of Health after its third instance this year of a doctor performing brain surgery in the wrong side of a patient's head.

I've heard of doctor's who amputate the wrong leg while the patient is on the operating table.  This lead to patients writing "this leg" on their leg before going in for surgery.  How, I wonder, can we help the busy, busy medical community to not drill holes in the healthy part of our brains?

Check it out.

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I received a comment on my blog entry titled "TBI Rehabilitation" posted on by attorney Steve Doroghazi.  His wife Cynthia underwent surgery in 1990 that left her permanently brain injured. 

Fortunately Cynthia went on to recover from many of her impairments and graduated college some years later.

Cynthia has written a book which can be reviewed at http://www.newriverpublications.com/Searching_for_the_Open_Door.html. 

I am always appreciative and very interested in the writing and publication efforts of those who suffer brain injury.  Please take a look at Cynthia's work.

Thank you Steve for sharing this wonderful comment:

As an attorney and husband of a medical malpractice TBI PATIENT, I agree with your observations completely. My wife, Cynthia suffered a traumatic brain injury during a routine operation at George Washington University Medical Center in May 1990. That operation was designed to correct a condition known as hydrocephalus (water on the brain), by inserting a VP shunt in the meninges of her brain, thereby relieving intracranial pressure caused by the hydrocephalus. Unfortunately, a bleed occurred during the operation and went undetected long enough for her brain to begin collapsing in on itself, long enough for her to experience respiratory failure, and long enough for her to suffer permanent neurological damage.

After spending three months in the hospital, Cynthia was transferred by ambulance to Magee Rehabilitation hospital (Magee) in Philadelphia. After three months of intensive therapy at Magee, she was able to walk, with a quad cane, about sixty feet at a time. While she still wore diapers, her feeding tube had been removed, and she was beginning to communicate on an adult level, although with a flat affect to her speech. You can see from the photos on her web site that Cynthia has progressed far beyond this point, and far beyond all doctors' predictions.

Twenty-two months after her release from Magee, Cynthia resumed her master's program at The Johns Hopkins School of Advanced International Studies(SAIS)as a Philip Merrill fellow. She graduated in 1994; and, in 1995, her medical malpractice case was tried before the Superior Court of the District of Columbia.

Wanting to tell her amazing story and, simultaneously, communicate her messages of hope, inspiration and the overall power of family, friends and prayer, Cynthia has written a book - Searching For The Open Door, A Woman's Struggle For Survival After A Traumatic Brain Injury. Cynthia plans to donate ten to twenty percent of book sales to Magee. This is her attempt to "give back" and provide others with the hope and inspiration to put up a good fight. To read a sample chapter of Cynthia's book, go to: http://www.newriverpublications.com/Searching_for_the_Open_Door.html

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AAJ Education will present ten half-day CLE programs designed for the experienced plaintiff lawyer with a focus on advanced trial skills and popular specialized topics, plus one session of Litigation at Sunrise. Presenters include accomplished trial lawyers and other experts. Earn approximately 22 CLE* and AAJ Education credits, including 2 ethics credits, in 5 days, and gain a national perspective at these cutting-edge programs designed to help you better represent your clients.

ADVOCACY TRACK THEMES
• Proving Liability and Causation: Discovery in Complex Cases
• Focus Groups and Voir Dire
• Persuasion and Storytelling in Trial
• Motivating the Jury to Award Full Damages
• Defeating Mandatory Arbitration and Winning in Mediation

SPECIALIZED TRACK THEMES
• Traumatic Brain Injury (TBI) Cases—Proof of the Invisible
• Representing Veterans—Fighting for Our Troops on the Home Front
• Products Liability
• Medical Negligence
• Vioxx Settlement: You've Seen the Headlines--Now what happens?

NEW HOTEL ADDED

Registrations for the American Association for Justice 2008 Winter Convention are continuing to rise. Please note that due to overwhelming demand for hotel reservations, AAJ attendees have completely sold out the El Conquistador Resort & Golden Door Spa. A new overflow resort, The Rio Mar Beach Resort and Spa – a Wyndham Grand Resort, has been added to accommodate attendees. The Rio Mar Beach Resort and Spa will honor the AAJ Convention partial ocean view and ocean view rates offered at the El Conquistador Resort & Golden Door Spa.

Complimentary shuttle service will be provided between the Rio Mar Beach Resort and the El Conquistador. Final shuttle schedules will be posted on the AAJ Web site late November 2007.

Don't Delay –
Make sure to reserve a room today. Start your registration process by visiting http://www.justice.org/convention/PR08/. Special hotel rates are available at the convention hotel; these rates are valid only through our official agent, ETA. You must be an AAJ convention registrant in order to make hotel and travel reservations.

For more information and to register,
visit http://www.justice.org/convention/PR08/,
or call 800-424-2725 or 202-965-3500, ext. 613.

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The National Guard is now being checked for signs and symptoms of brain injury with comparisons to base line data.

Beth Pearson, senior research associate at Dartmouth Medical School in New Hampshire and the principal investigator on the National Guard project, said Thursday that explosive devices used in the wars in Iraq and Afghanistan are causing traumatic brain injuries in many service members. But without a pre-deployment baseline, it's impossible to tell whether an individual's abnormal brain function predates deployment or is related to military service, she said.

"Now we'll have a baseline measure of the neurological functioning of each person, and they'll be retested on their return for any changes," she said. That will help doctors determine which areas of the brain have been injured and improve medical treatment. Veterans Affairs officials at Togus are supportive of the project, Pearson added.

Read the full article here.

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This update comes from Laura Schiebelhut at the Brain Injury Association of America:

Last night, November 15, the House of Representatives failed to override President Bush's veto of the Fiscal Year 2008 Labor-HHS-Education appropriations bill, which contains important funding for TBI programs.

Despite a great deal of advocacy by many individuals and organizations, including BIAA, the House came up two votes short (277-141) of the necessary two-thirds majority needed to override the president’s veto.

The bill provides $9.455 million for the HRSA Federal TBI program, over the total $8.910 million allocated last year. Likewise, the bill includes $5.960 million in funding for CDC TBI programs, an increase from approximately $5.3 million last year. Also of key importance, the bill includes $900,000 in additional funding for the TBI Model Systems of Care program, which BIAA fought hard for this year, in order to prevent this important research program from being downsized.

When Congress reconvenes in December after a two-week Thanksgiving Recess, it is expected that Democratic leaders will pursue a compromise multi-bill “omnibus” appropriations package that would split the difference between the White House and Congressional budget proposals.

Such an omnibus bill is expected to include a cut of $3.5 billion in funding from the recently passed Labor-HHS-Education appropriations bill.

Please contact your Representative and Senators TODAY and urge them to retain the current funding levels for TBI programs - including the CDC and HRSA TBI programs, as well as the important stopgap funding for the TBI Model Systems of Care program. For the greatest impact, please call your Representative and Senators, in addition to sending an email. The Capitol switchboard number is 202-224-3121 -- just ask to be connected to your Representative and Senators.

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U.S. Rep. Harry E. Mitchell today joined members of an inter-organizational Military TBI Task Force by endorsing a paper highlighting the important role that neuropsychology plays in treating combat-related traumatic brain injury.

The paper, The Role of Neuropsychology and Rehabilitation Psychology in the Evaluation, Management and Research of Military Veterans with Traumatic Brain Injury, is currently in press and an executive summary will be released Nov. 13 at a press conference at the National Academy of Neuropsychology's 27th Annual Conference. The Military TBI Task Force, led by Drs. Neil Pliskin and Mike McCrea, were comprised of members from the American Psychological Association Divisions 40 (Neuropsychology) and 22 (Rehabilitation Psychology), the American Academy of Clinical Neuropsychology, and the National Academy Neuropsychology (NAN).

"Traumatic brain injury is one of the signature injuries of the current war," said Mitchell, who has held hearings on the trouble facing troops returning from war. "Better field medicine is bringing more of our troops home alive, but they are suffering from combat-related TBI or PTSD in greater numbers than in past wars. We owe it to them to invest in this kind of research that will help improve their quality of life in the years to come."

Frequently brain injury is not detected in emergency rooms.  Brain injury, especially mild brain injury, is undetected on MRI or CT.  The use of neuropsychological tests are often the best and only way to diagnose and treat brain injury.  It is only with hindsight of past war veteran's medical treatment that the horrifying realities thier wounds is now appreciated.  Bravo to the efforts being made now to alter past mistakes.

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I am invited to speak at the AAJ WInter Convention.  My presentation topic is on "Daubert Motions and Evidentiary Issues in the Brain Injury Case."  I look forward to meeting new and familiar faces in San Juan.

The 2008 Winter Convention of the American Association of Justice runs from Saturday, January 26 through Wednesday, January 30, 2008.  It will take place at the El Conquistador Resort and Golden Day Spa, 1000 Conquistador Avenue, Fajardo, Puerto Rico 00738.

The American Association for Justice (AAJ), formerly the American Association of Trial Lawyers (ATLA), is the leading national plaintiff organization.

I will post additional reminders as we get closer to the conference date.  If you would like more information or would like to register click here. 

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This just in from Laura Schiebelhut of the Brain Injury Association:

Last week, Congress passed the Fiscal Year 2008 Labor-HHS-Education appropriations bill (H.R. 3043), including some important funding increases for TBI programs. Yesterday, President Bush vetoed the bill.
A showdown between Democratic leaders in Congress and the White House is now expected to ensue over this critical domestic spending bill. The bill is now back in the hands of Congress, and the House of Representatives is expected to vote to override the president's veto TOMORROW, Thursday, November 15, 2007.
Please contact your Representative and Senators IMMEDIATELY and urge them to override the veto of the LHHS appropriations bill.
The bill provides $9.455 million for the HRSA Federal TBI program, over the total $8.910 million allocated last year. Likewise, the bill includes $5.960 million in funding for CDC TBI programs, an increase from approximately $5.3 million last year. Also of key importance, the bill includes $900,000 in additional funding for the TBI Model Systems of Care program, which BIAA fought hard for this year, in order to prevent this important research program from being downsized.
The bill also provides valuable funding for Lifespan Respite Care ($2 million) and trauma care systems ($3 million), as well as a 3.1% increase for the National Institutes of Health and a 6.6% increase for the Centers for Disease Control.

To take action click here.

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The reality of disability from brain injury can be seen in cases where individuals lose their ability to retain employment or function competitively at their job.  In cases of professionals like doctors, lawyers, engineers and others, this disability is a sensitive issue.

Cognitive impairments can diminish important aspects of a career.  Straying from the cutting edge of ones practice can seriously alter the effectiveness of that practice.  Lack of Initiative, insight, and abstract thinking, to name a few of the impairments associated with brain injury, can make former employment impossible.

For instance, The Louisville Kentucky Courier-Journal and United Press International reported a case of a former lawyer suing a transportation provider in Kentucky for not taking action to prevent a bus crash that left him incapable of practicing law.

Kevin Halbe, a former managing partner for Wyatt Tarrant & Combs in Louisville is suing the Transit Authority of River City for a 2005 traffic accident that left him with a traumatic brain injury that changed his life.

Hable contends TARC officials should have acted to prevent bus driver, Terra Walter, a convicted drug user, from operating the vehicle that smashed into his car.

Walter was fired by the transportation group three times prior to the accident in Louisville for her questionable behavior and Hable's attorneys allege medical tests have shown she was likely high at the time of the accident.

To Hable, the traffic accident completely changed his life. His attempt to gain $6.4 million in lost income plus punitive damages will begin in Jefferson Circuit Court on Tuesday, November 13.

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More than 800 of them have lost an arm, a leg, fingers or toes. More than 100 are blind. Dozens need tubes and machines to keep them alive. Hundreds are disfigured by burns, and thousands have brain injuries and mangled minds.

Soldiers hit in the head or knocked out by blasts — "getting your bell rung" is the military euphemism — sometimes have no visible wounds but a fog of war in their minds. They can be addled, irritable, depressed and unaware they are impaired.

Only an estimated 2,000 cases of brain injury have been treated, but doctors think many less obvious cases have gone undetected. One small study found that more than half of one group of wounded troops arriving at Walter Reed Army Medical Center had brain injuries. Around the nation, a new effort is under way to check every returning man and woman for this possibility.

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Congress passed the Fiscal Year 2008 Labor-HHS-Education appropriations bill this week, including some important funding increases for TBI programs, including the HRSA Federal TBI program and the TBI Model Systems of Care program.

The Labor-HHS-Education spending measure will now be sent to President Bush, who has pledged to veto it, because it contains $9.8 billion more than he requested in his budget earlier this year.

BIAA has also been busy on Capitol Hill working on several other issues this past week, including pushing for the inclusion of important TBI provisions in the final defense authorization bill.

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Brain injury does not only occur in violent car crashes.  In fact, from cases I have been involved in, I know that brain injury can occur in single blows to the head.  Similar to the "Hollywood Myth" of recovery after a fight or being knocked unconcious - think common western bar room brawl, or Captain Kirk punching an an alien intruder in Star Trek - people do not generally associate serious brain injury with a single punch or smack in the head.  Those knocked unconcious in movies always return fully recovered in the next scene.  That is a myth.

For instance, The Boston Globe recently reported a group of teenagers was harassing a Mattapan man last spring, when one of the boys punched the man in the face, causing him to fall and hit his head on the pavement, police said yesterday.

About a week later, the man, 41-year-old Michael Hansbury, died of complications of a brain injury. Yesterday, a 15-year-old boy was arrested at William McKinley South End Academy on charges of manslaughter.

To read the full article click hear.

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Seems like the political mood is affecting everyone.  From the president to rock stars, wounded veterans of war are getting their attention.

It was an unlikely combination of entertainers: Bruce Springsteen singing "Thunder Road," a Marine Corps band playing taps and "Amazing Grace," Robin Williams cracking off-color jokes.

They all shared the stage Wednesday night at a star-studded Manhattan benefit for wounded U.S. service members, organized by ABC's Bob Woodruff. The newsman became a champion of the cause after he was nearly killed by a roadside bomb while working in Iraq last year.

To read the full article click here.

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President Bush paid an emotional visit Thursday to soldiers maimed or badly burned in combat and said his administration is determined to mend the nation's system of caring for veterans.

It seems a good move politically since the attention on the care of military personnel is so ripe.

Medical advances provide troops with treatment unimaginable just a decade ago, but the system for managing that care has lagged, Bush said.

"Our system needs to be modernized," the president said after touring a new $45 million, privately funded rehabilitation center for veterans at Brooke Army Medical Center.

To read the full article click here.

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USA Today reports that military personnel are cheating on tests designed to detect brain injury to stay with their units.

By cheating troops risk being "exposed to a second concussion or mild traumatic brain injury. It could have more devastating effects not only on their health, but on the mission's success, or perhaps on the safety of the people on their patrol."

About one-third of war casualties brought to Walter Reed Army Medical Center in Washington, D.C., have some form of brain injury, Army records show.

The Pentagon lists 4,471 brain-injured casualties from Iraq and Afghanistan, but the actual number is likely higher because many cases go undetected.

Read the full article here.

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