Personal Injury Blog

I once heard a comedian say that a “mild” heart attack is one that happens to somebody else.  Boy, isn’t that true!  Because when it happens to you it is anything but “mild”.

Does the same logic hold true for a brain injury? Does a “mild” brain injury only happen to somebody else? The answer is no.  But, surprisingly, you may not even know that you have a mid traumatic brain injury.  And, more surprisingly, the emergency room where you are seen may not be able to tell you that you have one.

Now, before we continue, we need to understand the difference between a “head” injury and a “brain” injury.  You may hear the terms used interchangeably, but they are very different.  A head injury is one that is clinically evident on physical examination – you can see it.  There are cuts, bumps, bruises, blood – visible evidence that an injury has occurred.  A brain injury, on the other hand, refers specifically to injury to the brain itself that cannot be seen by the naked eye on physical examination and is often not clinically evident.  The distinction between a head injury and a mild traumatic brain injury is critically important because when a brain injury goes undiagnosed 5% to 15% of patients may have compromised function one year or more after their injury.

Realizing that many mild traumatic brain injuries do go undiagnosed because there is no apparent head injury, The Centers for Disease Control (CDC) and the American College of Emergency Physicians (ACEP) convened a multidisciplinary panel to revise clinical diagnosis guidelines to help improve the diagnosis, treatment, and patient outcomes for mild traumatic brain injury patients.  With more than one million emergency department visits annually for brain injuries in the United States alone, the impact of an undiagnosed brain injury can be tremendous.  

Generally, the diagnosis of a mild traumatic brain injury can be made when at least one of the following criteria has been met:

1) Any period of loss of consciousness lasting 30 minutes or less
2) Any period of observed or self reported dysfunction of memory (amnesia) around the time of the injury
3) Any alteration of mental state at the time of the injury (feeling dazed, confused, disoriented)

The challenge of the emergency room physician and nursing staff is identifying which patients with a probable mild traumatic brain injury require extended diagnostic treatment to prevent further damage and which patients can be safely sent home.  The revised diagnostic guidelines answer the additional critical questions:

Which patients with mild traumatic brain injury should have a non-contrast head CT scan in the Emergency Department?
Is there a role for head MRI over non-contrast CT in the Emergency Department evaluation of a patient with acute mild traumatic brain injury?
In patients with mild traumatic brain injury, are brain-specific serum biomarkers predictive of an acute traumatic intracranial injury?
Can a patient with an isolated mild traumatic brain injury and a normal neurologic result be safely discharged from the Emergency Department if a non-contrast head CT sc an shows no evidence of intracranial injury?

It is widely believed that these new and enhanced guidelines will make a difference in the diagnosis and early treatment of brain injuries. For more information on the new guidelines, visit http://www.acep.org/practres.aspx?id=8814

A South Boston man who survived a traumatic brain injury returned with his family to the Virginia Commonwealth University Medical Center to present a $15,000 gift and to thank the doctors and health care providers who helped with his rehabilitation.

The donation was made in December at the annual holiday party for the Department of Physical Medicine and Rehabilitation.

On April 25, 1998, J.F. “Jeff” Gill was farming a piece of property in Lunenburg County when a cable that was towing machinery broke off, flew into the side of his head and left him with a traumatic brain injury.

Gill’s mother said surgeons at VCU Medical Center had to remove a fist-sized amount of damaged brain tissue, but the procedure saved her son’s life. Afterward he remained in a coma for six weeks. Barbara Gill said she expected her son would not be able to function independently, would never walk and would need a respirator for the rest of his life.

Gill endured more than four years of therapy and rehabilitation to beat the odds and regain a great deal of independence.

“He is walking, talking, dressing himself and has resumed farming,” said Barbara Gill. “Jeff operates machinery and even drives a tractor. We really are so grateful to Dr. Cifu and Dr. Kreutzer and everyone at VCU who was a part of his rehabilitation.”

Gill received a settlement from worker’s compensation, and his attorneys, Chip Kalbaugh and Brooke Anne Hunter, arranged to contribute a portion of his legal fees for the donation.

David X. Cifu, M.D., chair of Physical Medicine and Rehabilitation, announced that the department would match the $15,000 gift to establish the J.F. Gill, Jr. Lecture each year to promote public awareness of traumatic brain injury.

“We already host an annual three-day conference on traumatic brain injury and I think this new lecture can be a signature item to bring attention to the rehabilitation needs of people with brain injury,” Cifu said.

“Jeff and his family never gave up and that is a big piece of it,” he said.

The VCU Department of Physical Medicine and Rehabilitation is ranked among the top 20 programs in the country by U.S. News and World Report. The department has grant funded research investigating traumatic brain injury, spinal cord injury, return-to-work for people with disabilities and pain management. Other department programs focus on stroke, neural tumors, pediatric disability, pulmonary rehabilitation, limb deficiency and sports medicine.

(via vcu.edu)

Million dollar television and radio campaigns, a celebrity spokesman, and huge yellow page ads give you very little information about the skill and qualifications of a particular personal injury attorney. In fact, some of the best personal injury attorneys do not advertise at all. Instead, they get their cases from referrals by other attorneys and prior clients. So, how do you weed through all of the gimmicks and glossy advertisements to find a good attorney who will maximize your recovery after you’ve suffered a personal injury?

Look for an attorney who specializes in personal injury cases.
Personal injury law is complicated. You should find an attorney who devotes his or her practice to personal injury law, rather than someone who dabbles in these types of cases. If you are lucky enough to find an attorney who began his or her practice defending insurance companies then you are way ahead of the game. Insurance defense attorneys know what insurance companies look at when they evaluate personal injury cases. They know how to get a case moved through the insurance company’s various levels of review done before any settlement offers are made, and they have established relationships with insurance adjusters. Once an insurance defense attorney begins handling claims on behalf of the injured person, they are usually very well equipped to get the most compensation for an injured person’s claim. Essentially, these former defense attorneys take the knowledge they have gained by working for the insurance companies and use it to maximize the recovery for the personal injury client.

AV Rated by Martindale Hubble.
Choose a law firm and/or attorney that is rated by Martindale Hubble. Martindale Hubble is a legitimate and respected legal publication that rates lawyers and law firms based on the results of questionnaires completed by lawyers. The ratings are based on an attorney’s reputation, skill, and results as judged by other attorneys. An AV rating is the highest possible rating and reflects that a lawyer and/or his law firm is well-respected by the legal community.
 
Experience, a Good Communicator, and Someone You Like.
Next, conduct an interview of the prospective personal injury attorney. A personal injury case can take several years from the date of your injury until the conclusion of your case. You will spend a lot of time communicating with and putting your faith in an attorney who will guide you through the insurance claims handling process and the litigation process. So, you should try to find someone that you like and who is a good communicator. The attorney should have years of experience in handling cases just like yours. Don’t be afraid to ask how many cases the attorney has handled and how many have gone to trial versus settled. Most personal injury cases settle. But, you want to make sure you have someone who is capable of taking the case to trial if it is necessary.

Personal attention.
Finally, you should look for an attorney who will handle your case on a day to day basis. The law firms with multi-million dollar advertising campaigns generally have many more cases than individual lawyers can handle. That means that you case will likely be managed by a paralegal or legal assistant. You may never have any contact with an attorney at the firm. To avoid this situation, look for a personal injury attorney who is selective about the number and types of cases he or she accepts. You should have access to your attorney at any time and you should be given the name and phone number of any support staff who will be working on your file.