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

I will never forgot the experience of deposing the coroner in a brain injury case.  The deposition was at the morgue.  Afterward, we, the attorneys for all parties and the court reporter, were treated to a tour.  What amazed me most was how numbed the folks working there were to the noxious fumes that pushed their way into your olfactory center.

Then as a personal favor to me, I was permitted to hold brains that had been removed from bodies.  I was able to get a never before view of the brain's structure, texture and size. 

I recently came across an interesting article from someone having a similar experience. Discover Magazine contributor, Carl Zimmer, published "The Brain The Big Similarities & Quirky Differences Between Our Left and Right Brains," in the May 2009 issue.  Brain lateralization is the cooperation of right and left brain.  He states:

No matter how lateralized the brain can get, though, the two sides still work together. The pop psychology notion of a left brain and a right brain doesn’t capture their intimate working relationship. The left hemisphere specializes in picking out the sounds that form words and working out the syntax of the words, for example, but it does not have a monopoly on language processing. The right hemisphere is actually more sensitive to the emotional features of language, tuning in to the slow rhythms of speech that carry intonation and stress.

Neuroscientists know that the hemispheres work together and that they do so by communicating through the corpus callosum. But exactly how the hemispheres cooperate is not so clear. Perhaps paired regions take turns being dominant. That is known to happen in some animals. For instance, dolphins use this strategy to sleep and swim at the same time: One hemisphere remains active for hours, then fades while the other takes over. Bird brains switch as well. In order to sing, a songbird makes the two sides of its lungs open and close. The two hemispheres of the bird’s brain take turns controlling the song, each dominating for a hundredth of a second.

The intimate cooperation between the two hemispheres makes it all the more remarkable that a person can survive with just one—a sign that the brain is far more malleable than we once thought. After a hemisphere is forced to manage on its own, it can rewire itself to handle all the tasks of a full brain. In fact, two hemispheres can cause more trouble than one if they cannot talk clearly to each other. Neuro­scientists have linked some mental disorders, including dyslexia and Alzheimer’s, with a breakdown in left-right communication.

The two sides of the brain may be a legacy that we inherited from our wormlike ancestors. But their delicate balance of symmetry and specialization is now woven into the very essence of human nature.

Read the full article here.

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Research is the key to understanding and dealing with Traumatic Brain injury.

National Institute of Neurological Disorders and Stroke (NINDS)conducts and supports research on Traumatic Brain Injury (TBI) to better understand the biological mechanisms of injury, to develop strategies and interventions to limit the primary and secondary brain damage that occur following TBI, and to devise effective treatment strategies to improve long-term recovery of function. NINDS areas of research include:

1.  Assessment of posttraumatic brain function and pathology
2.  Discovering mechanisms of brain injury and repair processes
3.  Identification of therapeutic targets
4.  Translational research for therapy development
5,  Clinical trials to evaluate therapeutic efficacy
6.  Current TBI clinical trials at NIH and other organizations
7.  NINDS Clinical Research Overview 

The NINDS publishes Traumatic Brain Injury: Hope through Research and NINDS Shaken Baby Syndrome Information Page.  Click on either link to see more.
 

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The Diagnsotic and Statistical Manual IV (DSM IV) serves as the psychiatric source book for diagnosing disorders.    The manual is used in worker's compensation cases, personal injury cases, including brain injury, and in clinical and forensic psychiatric practice.

Now the Diagnsotic and Statistical Manual V (DSM V) is being created.  Shari Roan of the LA Times writes:

Psychiatrists are debating what is normal and what constitutes an illness. When that edition of the book often referred to as the “bible of psychiatry” is released in 18 months, most agree it will contain significant revisions based on information gathered from newer imaging techniques and genetic studies. Mental health advocates hope that the new edition will include information to help with diagnoses of those with mild versions of disorders, as well as those suffering from multiple disorders.

Leaders from the APA, the World Health Organization (WHO) and World Psychiatric Association (WPA) determined that additional information and research planning was needed related to specific diagnostic areas. The manual is being updated to deal with things obesity, gambling, sex addiction and Internet addiction -- formerly dismissed as harmful habits that could be defeated with willpower -- may also be labeled illnesses.
 

Read more on DSM V by clicking here.

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Biotech Week reported on May 23, 2009:

Remembering what's most important is central to daily life. For example, if you went to the grocery store but left your shopping list at home, you'd at least want to remember the milk and bread, if not the jam. Or, when packing for a trip, you'd want to remember your wallet and tickets more than your slippers or belt.

Even very early in Alzheimer's disease, people become less efficient at separating important from less important information, a new study has found (see also American Psychological Association).

 Knowing this, clinicians may be able to train people in the early stages of Alzheimer's to remember high-value information better, according to a report in the May issue of Neuropsychology, published by the American Psychological Association.

Neuropsychology is the area of neuroscience that studies relationships between brain function and behavior, with a central focus on human brain-behavior relationships. Neuropsychological research attempts to map the brain structures and functions that are critical for particular mental/cognitive, emotional, and behavioral capacities.

As my father approaches 70 and my grandmother 87, early onset of Alzheimers is a reality for me.  Making sure they get proper diagnosis and treatment is paramount should signs and symptoms appear.  We should all be mindful of those we love as they age.

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The Brain Injury Association of America updates us on the legislative activities.

Health Care Reform Update

This week the Senate Finance Committee engaged in three daylong sessions to discuss various policy options that may be included in a Health Care Reform bill later this year.

As reported by Congressional Quarterly, Senator Baucus, the Chairman of the Senate Finance Committee, was not very enthusiastic when asked whether committee members had reached consensus on any issues. However, he did say that he sensed some common ground on broader issues and believes his committee is moving towards a "convergence" on these issues that are expected to be debated next month.

As always, BIAA will continue to monitor any health care reform related progress. If you have not yet taken action and emailed your Senators and Representatives regarding the brain injury guiding principles, you may still do so by clicking the following link:

http://capwiz.com/bia/home

Senate Finance Committee Health Care Delivery System Comments

On Friday, May 15, 2009, BIAA submitted comments to the Senate Finance Committee in response to their proposed set of recommendations regarding health care delivery system reform.

BIAA expressed support for several recommendations with respect to the coordination of chronic conditions but also made clear within the submission that the organization is strongly opposed to the bundling of post-acute care as it applies to persons with brain injury.

To view the full document, click on the link below:

http://www.biausa.org/elements/policy/2009/biaa_finance_committee_response.pdf

DCoE Launches Real Warriors Anti-Stigma Campaign

On Thursday May 21, 2009, The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) launched a public awareness campaign focused on combating the stigma associated with seeking care and treatment for psychological health and Traumatic Brain Injury (TBI).

For more information, visit http://www.realwarriors.net/ . The Real Warriors Web site features articles and resources as well as video interviews with service members, their families and others dealing with psychological health and/or TBI.

BIAA has been an active partner in this campaign and will continue to work towards its success with the DCoE.
 

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Researchers conducting a study on Whiplash, neck injury, and forces conclude The [DELTA]V value as measured in trauma impact does not represent a conclusive predictor for cervical spine injury in real-life motor vehicle accidents.

The article states Whiplash injuries remain a barely understood phenomenon. Biomechanical considerations have been based on the assumption that damage to a given material only occurs when the energy that acts on this material is high enough. Thus, energy doses below a defined threshold have been considered harmless. In this context, the parameter delta v ([DELTA]V), which describes the velocity change of a motor vehicle during a collision with another vehicle, has become a widely accepted criterion for the energy that acts on the vehicle during a collision.

The scientific community has not yet reached consensus regarding the threshold value for cervical spine injuries after whiplash. Nonetheless, [DELTA]V threshold values were adopted very early in the history of insurance law as a criterion to accept or deny the claim settlement for whiplash-associated disorders (WADs)

Variability of  factors makes it unclear how easily the results from laboratory crash tests can be transferred to real-life accident situations. In order to elucidate these issues, this study analyzes the correlation between [DELTA]V and cervical spine injuries in real-life accidents and questions whether [DELTA]V is a valid predictor for cervical spine injuries following whiplash.

Read the study at Elbel, Martin; Michael Kramer,; Markus Huber-Lang,; Erich Hartwig,; Christoph Dehner,. "Deceleration during 'real life' motor vehicle collisions - a sensitive predictor for the risk of sustaining a cervical spine injury?(Research)(Report)." Patient Safety in Surgery. BioMed Central Ltd. 2009. HighBeam Research. 19 May. 2009 http://www.highbeam.com/doc/1G1-193106338.html

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BIAA reports:

Health Care Reform Update

This week House Democratic leaders vowed to pass a comprehensive overhaul of the nation's health care system before the Congressional recess in August. Speaker Nancy Pelosi, Majority Leader Steny Hoyer, and the chairmen of three committees with jurisdiction over this issue made the pledge following a morning meeting with President Obama. The President restated the importance of the effort as a necessary step for containing long-term budget deficits.
 

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Wikipedia defines Diffuse axonal injury (DAI) as

one of the most common and devastating types of traumatic brain injury, , meaning that damage occurs over a more widespread area than in focal brain injury. DAI, which refers to extensive lesions in white matter tracts, is one of the major causes of unconsciousness and persistent vegetative state after head trauma. It occurs in about half of all cases of severe head trauma and also occurs in moderate and mild brain injury.

The outcome is frequently coma, with over 90% of patients with severe DAI never regaining consciousness. Those who do wake up often remain significantly impaired.

Nowadays, other authors state that DAI can occur in every degree of severity from (very) mild or moderate to (very) severe. Concussion may be a milder type of diffuse axonal injury.

DAI is not easily detected by physicians in mild and moderate cases. Imaging studies and neuropsychological evaluations in addition to observations of relatives, friends and co-workers are some of the devices used when diagnosing DAI. Cases involving mild to moderate brain injuries are harder to tackle than cases in which there is objectively discernible injury such as loss of consciousness, skull fracture, or intracranial bleeding on imaging studies. Often such cases involve allegations of diffuse axonal injury (DAI), an injury to the brain that can occur at the microscopic level and not be detectable even by computerized tomography or magnetic resonance imaging.

Nonetheless, DAI can cause significant changes in personality or cognition which can create significant life change.
 

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Senator Kennedy suffers from a specific cancer of the brain.  It had been more than 10 years since a new treatment for glioblastoma was approved, but the U.S. Food and Drug Administration has now granted accelerated approval for the cancer drug Avastin for use against the aggressive brain cancer tumors, Business Week reports.

The FDA (Food and Drug Administration, USA) approved Avastin (bevacizumab) for patients with GBM (glioblastoma multiforme) whose cancer carries on progressing after standard therapy. GBM is a rapidly progressing cancer - it invades brain tissue and can may have a significant effect on a patient´s mental abilities and physical activities. Approximately 6,700 people each year in the USA are affected by GBM.

Unfortunately, the cancer nearly always comes back, even when treated with surgery, radiation and/or chemotherapy.

Richard Pazdur, M.D., director of the Office of Oncology Drug Products in the FDA's Center for Drug Evaluation and Research, said "This type of cancer is very resistant to therapy and thus challenging to treat. Avastin provides a therapy for patients with progressive GBM who have not responded to other medications."
 

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The cells, tissues, and organs that compose the skeletal system provide a supportive yet flexible framework that allows vertebrates to withstand earth's gravity yet remain mobile. Current knowledge about the vertebrate skeleton, especially recent research on skeletal development from embryo to adult, is summarized in a new monograph, The Skeletal System. Recently released by Cold Spring Harbor Laboratory Press, this book will serve as a reference for both scientists and clinicians.
The editor, Olivier Pourquié, states in the preface. "The goal of this book is to provide a comprehensive and up-to-date summary of the field." Each of the 13 chapters in the book was written by an expert on a specific topic. 

The Skeletal System (Cold Spring Harbor Monograph Series 53) was edited by Olivier Pourquié (Stowers Institute for Medical Research) and published by Cold Spring Harbor Laboratory Press (ISBN 978-0-87969-825-6; © 2009). It is available in hardcover and is 365 pp. in length (illus., index). For a complete table of contents and additional information about the book, please see http://www.cshlpress.com/link/skelsys.htm. 

 

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The American Association of Neurological Surgeons reported research on Depression this month.

Electroconvulsive therapy (ECT) is effective in approximately 70 percent of cases in which antidepressant medications do not provide adequate relief of symptoms. However, as many as 20 to 50 percent of patients who initially respond well to ECT treatment, suffer a relapse within six months, therefore, periodic maintenance therapy is often required.

Researchers at three medical schools, Harvard, University of Pittsburg and Medical College of Wisconsin, counducted a study entitled "Long Term Follow-up of Cortical Stimulation to Treat Major Depressive Disorder."  They investigated ECT stimulation for patients with major depressive disorder.

The World Health Organization rates major depression as the top cause of disability worldwide, with an estimated 340 million people suffering from an episode of major depression every year. While most patients with major depression find relief through a combination of psychotherapy and medication, about 20 percent of patients fail to respond. Patients who are most resistant to medications, psychotherapies, and electroconvulsive therapy (ECT) have little hope of recovery, and suffer a heightened risk of suicide and mortality. Sadly, statistics show that the suicide rate in people with major depression is as high as 15 percent.

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The Las Vegas Review Journal reports on the state of legislative activity on un-capping medical malpractice lawsuits.  The caps limit injured individuals from recovering compensation from negligent doctors for their injuries.

An Assembly-approved bill to let some patients seek unlimited damages in medical malpractice lawsuits was being held up in the Senate in apparent retaliation for an Assembly committee chairman's decision to sit on two Senate-passed construction defect bills.

Though no one had told him directly, Assembly Judiciary Chairman Bernie Anderson, D-Sparks, said he had heard that the Senate Judiciary Committee won't act on Assembly Bill 495 unless his committee passes Senate bills 337 and 349.

The Senate committee on Wednesday cancelled a scheduled hearing on the medical malpractice bill. Under legislative rules, the bills must be approved by their respective committees by the end of business Friday or they cannot be passed during this Legislature.

The chairman of the Senate Judiciary Committee, Sen. Terry Care, D-Las Vegas, said only that he spoke with Anderson earlier Wednesday about the medical malpractice bill, which passed the Democrat-controlled Assembly in April on a 26-15 party-line vote.

The proposal would lift the $350,000 cap on pain and suffering damages in lawsuits where doctors are found guilty of gross negligence.

The bill was drawn up in part by colonoscopy patients in Las Vegas who believe they were hurt by the deliberate negligence of doctors and now are being hurt by a system that limits their damages.

More than 50,000 patients at two now-closed outpatient clinics in Las Vegas were notified last year that they might have been exposed to blood-borne diseases because of shoddy injection practices by clinic staffers. Nine people contracted hepatitis C, and another 105 cases might be linked to the clinics.

Anderson said the bill is straightforward and will help these patients. He also acknowledged the testimony of some doctors who said the bill would lead to higher malpractice insurance rates and drive them out of Nevada.

"Keeping doctors in Nevada is one of our priorities, but what happened in my mind in the South was gross negligence," he said.

http://www.lvrj.com/news/44970727.html 

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"The decision to resume driving after stroke can be complicated by the sequelae of stroke as well as the established finding that even healthy adults overestimate their driving ability. This study evaluated whether stroke survivors (n = 67) disproportionately overestimated their driving ability as compared to healthy significant others ( n = 67)," researchers in the United States report.

"Comparison to a known target reduced self-bias among both groups, but shift toward enhanced accuracy was significantly greater among survivors than significant others. Additionally, self-bias may reflect a pervasive trait of cognitive ability, as overestimation of driving ability was paralleled on a cognitive estimation task," wrote C.A. Scott and colleagues, Wayne State University.

The researchers concluded: "Use of a specific criterion can facilitate accurate self-ratings of driving ability among survivors; however, actual decisions regarding driving status may be unrelated to self-view."

Scott and colleagues published their study in the Journal of Clinical and Experimental Neuropsychology (Self-assessment of driving ability and the decision to resume driving following stroke. Journal of Clinical and Experimental Neuropsychology, 2009;31(3):353-362).

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Dr. Weisner, a physician in Las Vegas with specific training and interest in neurology, writes the following.

Tim,
As I read your blog I see an article that is written so any person can understand your subject matter. Topics relating to neurology can be difficult to understand especially to persons without a medical background. The range of subjects too is good in regards to the breadth. You are without doubt the authority in the legal community of Las Vegas. I would like to add your personal knowledge of matter of TBI rival that of many physicians I work and refer to. I would like all who read this that Tim has taken it upon himself to not only understanding the difficult issues of brain injury but, has taken the time and considerable effort to make sure he passes what he knows on to all who are interested. This takes considerable time and effort all of which cannot be financially motivated, he does it because he truly cares and is passionate about what he does. Don't believe me, just wait in his lobby sometime and overhear his phone conversations .... Sorry to joke but anyone who has been in your office knows what I'm saying.... For the general public you will not find a more concise and written blog made to be understood by the general public. For me personally, keep the links coming in regards to research and the medical review.

Excellent job !!

Dr. Brett Wiesner
Summerhill Chiropractic and Neurology Center,
Las Vegas 

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The BIAA keeps us apprised of the latest legislation:

Health Care Reform Update

Lawmakers are now developing policy options that could become part of the national health care reform, but currently no legislation has been introduced and there are no specific bills to support or oppose. In anticipation of both proposed and final legislation, BIAA has adopted five guiding principles (below) designed to aid Congress in drafting language that would increase access to treatment for individuals with brain injury.

Guiding Principles:

1. Recognize brain injury is a disease.
2. Focus on medical necessity.
3. Provide access to the full treatment continuum.
4. Use accredited programs, interdisciplinary team of qualified/specialized clinicians, and appropriate treatment settings based on patient and family choices and aspirations.
5. Hold private insurers accountable for the premiums they collect; avoid Medicare/Medicaid as first option for coverage.

These principles are explained in a Brain Injury Health Care Pledge that can be signed and supported by members of congress who want to make sure that the unique needs of those with brain injury are addressed in the final health care plan. Our goal is to encourage all Representatives and Senators to sign this pledge to raise awareness and understanding of how proposed policies could impact people with brain injury, family members, researchers and clinicians.

On May 6, 2009, BIAA circulated an action alert that included the pledge in the body of the message advocates send to their Representatives and Senators. If you haven't taken action by asking your members of congress to support the pledge, you may still do so by clicking on the following link:

http://capwiz.com/bia/home/

BIAA's full position paper explaining each guiding principle, an executive summary, and a detailed article from The Challenge! regarding our positions on health care reform can also be found on our website by clicking on the link below.

http://www.biausa.org/policyissues.htm#library

In support of BIAA's health care reform campaign, BIAA leaders and staff participated in several high level meetings in the House, Senate, and the White House to encourage support for these principles.

BIAA gained the support of the Co-Chairmen of the Congressional Brain Injury Task Force (Rep. Pascrell, Rep. Platts), who circulated a letter to their House of Representatives colleagues encouraging them to sign the Brain Injury pledge. BIAA will continue to reach out to members of both the House and the Senate to secure brain injury treatment in health care reform proposals.

Appropriations Update

President's FY10 Budget Proposal Released

TBI Act, Department of Health and Human Services

The White House proposes to sustain funding for the Health Resources and Services Administration (HRSA) Federal TBI Program, which provides grants to state agencies and protection and advocacy organizations to improve access to health and other services for individuals with traumatic brain injury (TBI) and their families. The President's plan proposes $10 million be allocated to HRSA, the same amount designated in FY09.

For the past three years, President Bush had proposed to eliminate the HRSA TBI Program funding in his budgets. BIAA applauds President Obama's decision to preserve this program, although still underfunded, so that we can continue to address the huge public health problem of traumatic brain injury

NIDRR, Department of Education

The President's budget proposal slates a $3 million increase for the National Institute on Disability and Rehabilitation Research (NIDDR), going from $108 million in FY09 to $111 million in FY10. Although BIAA is thrilled about this increase, we will continue to advocate for increased funding for the TBI Model Systems of Care as the appropriations process advances this summer.

BIAA submits FY10 testimony to both the House and Senate Appropriations Committees

This week, BIAA submitted testimony to the House and Senate Appropriations Committees, Subcommittees on Labor, Health and Human Services, Education and Related Agencies.

http://www.biausa.org/policyissues.htm#testimony

The testimony detailed the importance of appropriating $37 million to preserve and advance TBI Act Programs, as well as the need to designate $13.3 to sustain and bolster health and function research -- including the TBI Model Systems of Care, Rehabilitation, Research & Training Centers; and field-initiated investigations---within the National Institute on Disability and Rehabilitation Research (NIDRR).

NIDDR Releases notice of proposed priorities for RRTCs and RERCs

This week the Assistant Secretary for Special Education and Rehabilitative Services under the Department of Education proposed funding priorities for the Disability and Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this notice proposes four priorities for the Rehabilitation Research and Training Centers (RRTCs) and three priorities for the Rehabilitation Engineering Research Centers (RERCs).

Notably, the proposed priorities for RRTCs include "Developing Strategies to Foster Community Integration and Participation (CIP) for Individuals with Traumatic Brain Injury." The goal of this priority is to develop a classification system based on symptoms experienced by individuals with TBI who are living in the community.

This classification system can be used to link the post-rehabilitation consequences of TBI with CIP-oriented interventions. Such a classification will allow practitioners and researchers to better match individuals with TBI with specific interventions, and to better characterize their study samples.

BIAA applauds the Assistant Secretary for proposing this priority and will continue to advocate in its favor.

BIAA endorses the Heroes at Home Act of 2009

This week, BIAA submitted a letter to the House Veteran's Affairs Committee, Subcommittee on Health urging consideration of the Heroes at Home Act of 2009 (HR 667). The bill would significantly improve support for family caregivers of returning service members with TBI and acknowledge the critical role played by family caregivers in facilitating recovery from brain injury and the pressing need for training, certification and financial compensation of caregivers.

BIAA will continue to advocate for the swift passage of this bill as the 111th Congress progresses. The legislation currently has 36 cosponsors.

BIAA submits letter of endorsement for the Concussion Treatment and Care Tools Act of 2009 (conTACT)

BIAA submitted a letter to the House Energy and Commerce Committee encouraging swift passage of the conTACT Act of 2009 (HR 1347), applauding the bill's proposal to provide grants to states to ensure that elementary and secondary schools implement concussion management guidelines by funding computerized pre-season baseline and post-injury neuropsychological testing for student athletes.

BIAA will continue to track the progress of this measure and will advocate on its behalf.

BIAA Urges Cosponsorship of the National Neurotechnology Initiative Act

On April 22, 2009, BIAA circulated an action alert targeting House Members to cosponsor the National Neurotechnology Initiative Act of 2009 (HR 1483). The bill would promote discoveries and accelerate the development of new and safer treatments for brain-related illness, injury and disease.

The action alert message also details the need to initiate much-needed coordination among federal agencies with respect to research, while adding efficiency in the regulatory approval processes that would shorten development times and lead to more and better treatments for TBI and other neurological conditions.

You can still access this alert and take action by clicking on the link below!

http://capwiz.com/bia/issues/alert/?alertid=13209766
 

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Local and successful realtor, Frank Napoli, reads my blog.  He recently wrote: 

The Good The Bad The Ugly. It's all Good. I was introduced to your Blog & am looking foward to continued information & comments. A lot for me to catch up to but information I want to have. This is a side of life I am aware of but have very little knowledge. The more you know the less your blindsided.
Thankyou for your efforts.

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An interesting study comparing the effect of dual tests on memory and activities of daily living in truamatic brain injury patients was released.

According to a study from Nagoya, Japan, "We quantitatively evaluated memory performance in patients in the chronic stage of closed traumatic brain injury using dual visual tasks."

"Simple memory tests and questionnaires concerning activities of daily living (ADL) were also utilized to evaluate any correlation with the results of the dual tasks. The results of dual tasks and memory tests were correlated with the daily activity scores, but there was no correlation between the results of dual tasks and memory tests," wrote J. Hasegawa and colleagues, Nagoya University, Medical Department.

The researchers concluded: "We concluded that the dual task was effective for detecting memory and ADL disturbances, which were not disclosed by conventional memory tests."

"Data on clinical and experimental neuropsychology described by researchers at Nagoya University, Medical Department." Psychology & Psychiatry Journal. NewsRX. 2009. Retrieved May 08, 2009 from HighBeam Research: http://www.highbeam.com/doc/1G1-198635191.html
 

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You are very welcome. Thank you so much for the feedback and I will continue blogging and following articles like Dr. Kabin’s situation.

March saw a third indictment against Dr. Kabins.  Things are far from over for him as George Knapp posted in March 2009.

Readers might recall that one reason the charges against Gage and Awand were dismissed (and are now under appeal) is that Dr. Kabins demanded he be given immunity to testify for the defense in the Gage trial. Federal prosecutors had no intention of giving him immunity since he is considered one of the central targets in the massive investigation. Now Kabins will be facing his own charges.

Tim

Titolo Law Office
Timothy R. Titolo
tim@titololawoffice.com
www.titololawoffice.com
10100 W. Charleston Blvd. Suite 100
Las Vegas, Nevada 89135
tel: (702) 869-5100

 

Robert Simons posted:

Tim;Thank you for all your articles that you provide.This case with Dr.Mark Kabins i find very interesting because the 3-years i was under his care was hateful.Besides being lied to constantly and him shedding tears at every appt. and my denial of transfer of care was denied it has ruined me with what i think about trusting dr's (vegas). Keep up the great info web-site i find it very ood for me,thanks.

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The Nevada Assembly voted 26-15 on Monday to pass legislation that would remove a $350,000 cap on jury awards for non-economic damages in medical liability lawsuits, the Las Vegas Sun reports.

The cap was approved by voters in 2004 after concern was raised that higher medical malpractice insurance premiums were driving some doctors out of the state.

The bill would permit unlimited damages for instances of gross negligence and would give patients an additional 12 months to decide if they want to file a lawsuit (McGrath Schwartz, Las Vegas Sun, 4/20).

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The Associated Press reported that a woman experiencing airplane turbulence was rendered paralyzed in airspace over Texas.

A 47-year-old woman who was in the airplane's restroom at the time of the turbulence suffered a fractured neck, Dr. Trey Fulp, an orthopedic spine surgeon at McAllen Medical Center told The McAllen Monitor Monday. The woman, who Fulp did not identify for privacy reasons, was thrown against the ceiling.

Doctors spent six hours operating on her back after the plane landed Saturday and planned to operate on her neck Monday. The back injury left her paralyzed from the chest down,
 

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The National Alliance on Mental Illness (NAMI) has launched a new Web site, http://www.nami.org/soloist, as part of a social action campaign with Participant Media surrounding the release (April 24) of "The Soloist," starring Jamie Foxx and Robert Downey, Jr.

Schizophrenia is a serious and challenging medical illness, an illness that affects well over 2 million American adults, which is about 1 percent of the population age 18 and older.

Although it is often feared and misunderstood, schizophrenia is a treatable medical condition.

Scientists still do not know the specific causes of schizophrenia, but research has shown that the brains of people with schizophrenia are different from the brains of people without the illness.

Like many other medical illnesses such as cancer or diabetes, schizophrenia seems to be caused by a combination of problems including genetic vulnerability and environmental factors that occur during a person's development.
Read More Here.     

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This is a request I sent to my clients in an effort to get feedback on this BLOG.  I am sending it out for anyone's response and GREATLY appreciate your time and effort:  The good, the Bad and the Ugly.  Thanks.

Hello

Over the years I have tried to help you with your case and I hoped I achieved some level of success. Now I am hoping for you to do me a favor.

As you know I have a BRAIN and SPINE INJURY LAW BLOG http://www.brainandspine.titololawoffice.com that I write. I am hoping to get a little feedback from you. I would appreciate your taking 3-5 minutes to tell me what you think about the blog. Hate it, like it – whatever. How to improve it – what you would recommend I cover as topics.

To begin with please answer the following questions:
1. Do you receive the blog in your email? (please click on link http://www.brainandspine.titololawoffice.com to confirm the blog’s image.)
2. Do you immediately erase it a) always b) sometimes c) never and do you read it?

Please go to the COMMENTS section of any post as you look at the blog and let me know your thoughts. I greatly appreciate your time.

I wish you continuing health and prosperity.

Tim Titolo

Titolo Law Office
Timothy R. Titolo
tim@titololawoffice.com
www.titololawoffice.com
10100 W. Charleston Blvd. Suite 100
Las Vegas, Nevada 89135
tel: (702) 869-5100
 

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BIAA staying on top of the legislature reports the following:

Appropriations Update

On Wednesday, marking President Obama's first 100 days in office, Congress adopted a fiscal year 2010 budget resolution, setting the stage for action on many of his top legislative priorities. Being a non-binding framework used by Congress to make legislative decisions on taxes, appropriations and entitlement programs later in the year, it is important to note that the $3.56 trillion budget resolution includes reconciliation instructions that would allow the President's proposed healthcare overhaul to move through Congress immune from a Senate filibuster. (CQ)

BIAA will continue to monitor the appropriations process with a special edition of Policy Corner next Wednesday. The President's budget, in its entirety, is expected to be released early next week.
 

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