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

When someone forcefully shakes a baby, the child's head moves uncontrollably because the neck muscles aren't well developed and provide little support.  EACH YEAR, THOUSANDS OF YOUNG children suffer brain injury or die from being violently shaken. Children as old as 5 are vulnerable to shaken-baby syndrome (SBS), but infants between 2 and 4 months are especially at risk.

Time Magazine recently reported that the stressful effects of a faltering economy, skyrocketing unemployment and precarious personal finances can be dire. People take up smoking or use alcohol to cope, they become depressed or suicidal, and they develop stress-related illnesses like heart disease. Now researchers report that the harm may be spreading to children too, when parents' stress leads them to inadvertently injure their children.

Read more: http://www.time.com/time/health/article/0,8599,1986500,00.html#ixzz0n4NnGujJ

1.  The injuries may cause permanent disabilities such as blindness, seizures, mental retardation and cerebral palsy.

2.  Even if the shaking was not intended to injure the baby, it is child abuse. Also, when a baby is shaken its head may hit an object.

3.  Even a soft object can cause injury to newborns and small infants.

4.  Since their heads are large and heavy in proportion to their bodies and the skulls fragile, the shaking also causes whiplash.

5.  Researchers found that in more than 60 per cent of these cases the victims are boys.

 6.  The perpetrators are more likely to be men, either the caregiver or boyfriend of the mother.

 7.  Often, she adds, parents are not aware that their child has been abused and seek help only when they notice mild or severe symptoms such as decreased alertness, extreme irritability, lethargy, poor feeding, vomiting, loss of vision, seizures, and pale or bluish skin. Since there are no visible signs of injury the condition can be difficult to diagnose and may not be identified during a visit to a doctor.

8.  Injuries such as rib fractures however, can be seen with an X-ray.

9.  An estimated 1,200 to 1,400 cases of SBS occur each year in the United States.

10.  Some of these involve young, unmarried mothers with little education and who come from unstable family situations, or mothers who have had multiple pregnancies. 

Carole Jenny, MD, Professor, Department of Pediatrics, Warren Alpert Medical School of Brown University; Director, Child Protection Program, Hasbro Children's Hospital, published a relevant book entitled CHILD ABUSE AND NEGLECT in 2010.

Key Features include how to:

-Identify an abusive injury and treat it effectively by reviewing evidence and critical analyses from leading authorities in the field.

-Recognize the signs of shaken baby syndrome, sex offenders and abuse in religious organizations.

-Understand the biomechanics of injury to determine whether abuse was truly the cause of a child's injury.

-View illustrations that show first-hand examples of child abuse or neglect. 

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There are several reasons the damages in brain injury cases remain high, attorneys say.

One is the skyrocketing costs of medical care. In fact, Harper said, the legal system’s method of awarding damages cannot keep up with the cost of lifelong medical care because jurors are instructed to reduce the verdict to a present value amount. But medical costs don’t “reduce,” Harper said.

Neither do the costs of caring for the injured person in the home. “My goal is always to bring the client home. That is a cost that should be borne by the (party found to have committed the tort),” said Anoka attorney Fred Soucie.

Another reason is that brain injury cases are readily demonstrable, both by medical evidence and through changes in the plaintiff’s behavior and moods. A traumatic brain injury will affect the person’s personality, judgment and concentration — which in turn affect the person’s ability to earn a living.

When the injury is catastrophic, the damages usually are self-evident. “I have had jaded insurance company lawyers say that the person has no pain and suffering because they are [so injured that they are] oblivious. That’s immoral and tactically stupid,” Soucie said. If jurors feel that the injured person is aware and suffering, they will punish the defense lawyer who appears callous in the extreme, he explained.

But even a “mild” injury can be proven, Soucie continued.  In fact, calling the injury “mild” can be a misnomer. Technically, the term “mild” is defined by the period of post-injury amnesia or loss of consciousness but the effects can be severe. The person may change dramatically, and friends, family and co-workers can explain the difference, he said.

Emotional value for juries

Additionally, the injuries are very compelling to jurors, Soucie said. “There’s always some juror skepticism but their hearts and minds are easily wrapped around these injuries,” he said.

The injuries are also capable of medical demonstration, said Minneapolis attorney Peter Riley, who recently settled a $3.4 million case involving multiple skull fractures among other injuries. Often the injury will show up as a bleed on a CAT scan or on an MRI, he said. “The defense [then] has a hard time saying the injury is due to something else,” Riley said.

Additionally, neuropsychometric testing can test for memory and brain functioning, showing exactly where the brain is damaged, and the test results can be matched to the patient’s symptoms, Riley said.

The neuropsychometric testing also can reveal any compensatory measures the brain has taken to make up for the injury, Riley said. In those cases, the jury has to be educated about the test results. If his recent case had called for it, Riley said he would have “backloaded” the plaintiff’s testimony by educating the jury beforehand so they would not have an opportunity to form an inaccurate opinion about the brain damage.

Not all head injuries are the result of trauma that reveals itself physically. Bloomington attorney Richard Ruohonen recently received a $128,000 verdict for a man who received an electric shock. The defendant, the city of Glencoe, had offered $50,000. The man was injured when he touched a pole the city had installed in his yard, but which was connected to a power line. He received five to 10 seconds of electric shock.

An electrical injury is more diffuse than an injury to a lobe of the brain, explained Ruohonen. His client’s injuries included loss of attention and concentration, memory impairment, pain and headaches. He also had a sleep disorder caused by injury to the brain stem, Ruohonen said.

This was a case of a skeptical insurance company. “They basically were saying it was all in his head,” Ruohonen said.

Actually, the case would have been more valuable but the client had a subsequent workers’ compensation injury to his neck. “That was the day the city got lucky,” Ruohonen said. The case might have been worth as much as $250,000 without the second injury, he explained. However, he is pleased with the result.

It would be speculating to say that the economy played role in the size of the verdict, Ruohonen said. It could also be that people in rural communicates are more conservative or that there were a lot of younger jurors (under age 35), he said.

The personal injury business can actually pick up during a recession, Ruohonen said. He noted that he is getting more calls from people whose injuries are two or three years old, and thinks perhaps they are now more hesitant to pursue their own claims. Besides, he added, “people down on their luck can be more sympathetic plaintiffs.”

And jurors don’t have a lot of sympathy for corporate or commercial defendants right now, he added.

“You’ve got a lot better chance if you’re going against corporations or insurance companies because people are upset with them. Those are great cases to try right now,” Ruohonen said.
 

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It's finally here.  While there are hopeful and positive signs of economic recovery beginning to emerge, the brunt of the economic collapse on the legal system is just beginning.

In a recent article in the New York Times, New York’s chief judge, Jonathan Lippman, compares hospital emergency rooms to the courtroom in terms of healing society's economically wounded.

For most court systems nationally, official tallies of cases filed since the 2008 economic collapse are not yet complete. But the New York data, compiled by state court officials after a request from The New York Times, provide an early measure of the wave of recession cases nationally.

Legal actions involving foreclosures are up 446% in Florida; one of the worst hit housing markets, evictions up 77%, domestic violence attached to loss of work scenarios, as well as other recession related lawsuits.

Here in Nevada, the housing market may still be declining.  The effects of the recent opening of the multi-billion dollar City Center creating a glut of more housing are still to be seen.  Meanwhile several condominium projects are trying to secure closings.

While Mayor Oscar Goodman pushes through his agenda to build Las Vegas a new City Hall on predictions of recovery, Governor Gibbons is the budget cutter for Nevada's education and employees.  Nationally, court administrators say budget pressures are forcing them to do more with less. Note: Nevada was recently found to be 6th highest in the nation for government salaries.  FIrefighters making $200,000 are the highest paid in the country.

Another interesting component affecting "society" and the judicial system is the insurance companies' response to resolving matters.  More resolution means less weight on the courts.  But the debt of the insurance industry resulting from taxpayer credit (think bailout) may inhibit resolution resulting in more court time.

A New York Judge compares the situation to a "train wreck" that will go on for years.

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