Is This A Brain Injury Case?
Cash, Krugler and Fredericks, LLC
The Centers for Disease Control (CDC) defines a traumatic brain injury (TBI) as a disruption in the normal function of the brain that can be caused by a bump, blow, jolt to the head, or penetrating head injury. Everyone is at risk for a TBI, especially children and older adults.
According to the CDC, in 2013, approximately 2.8 million TBI-related Emergency Department visits, hospitalizations, and deaths occurred in the United States. This consisted of approximately 282,000 TBI-related hospitalizations, and approximately 56,000 TBI-related deaths. According to the CDC, motor-vehicle crashes were the leading cause of TBI-related deaths.
While progress has been made to prevent motor-vehicle crashes, resulting in a decrease in the number of TBI-related hospitalizations and deaths from 2007 to 2013, these numbers suggest that a significant number of Americans are receiving the diagnosis of traumatic brain injury. The diagnosed cases are easy to spot. The more difficult challenge is when there is little or no indication in the ED medical records that your client suffered a brain injury. Therefore, how do you identify the problem and prove up the case?
A closed head injury can be misleading. Often the person is awake, talking and oriented immediately after sustaining a blow to the head or no blow at all. This is often the case after a motor vehicle accident. The absence of any external injury coupled with seemingly normal cognition may give the false impression that everything is okay. Often you will hear the defense argue that the client went to the ED, had their examination charted on the Glasgow Coma Scale and the results were normal. However, Glasgow Coma Scales rarely identify traumatic brain injuries. The fact of the matter is that most of the time, the injury to the brain may take several days to manifest as bleeding and bruising, so don’t write off the case if your client is complaining about not feeling themselves.
Listen carefully to your client and push past where he or she says, “I did not bump my head”, “I did not lose consciousness” and “I did not go to the ED.” If the client indicates they are having headaches and they don’t usually get headaches or they get headaches from time to time of a very different nature, spend some time ferreting out that information.
If they tell you that they feel moody and irritable, ask them to detail what they mean. We have found that sometimes clients are unable to articulate what they mean and you need to spend time interviewing a husband, wife, significant other or their child in order to identify exactly what they mean.
Sometimes a normally happy-go-lucky person starts having feelings of sadness that aren’t attached to any emotional event. BrainLine.org says a person with a brain injury can have a range of emotional problems, including angry outbursts.
They may be having trouble concentrating or they have lost their job. Look into your client’s work history carefully. Is your client the type of person that does not have a problem holding a job? Even if they move around from job to job, is it something that they chose to do in the past? If the supervisor that recently fired them is willing to speak to you, interview them and find out what happened.
Other considerations include going home after the wreck and experiencing an upset stomach, nausea or vomiting. Perhaps the client had a seizure but had never previously experienced a seizure. Or the client finds themselves searching for words or names of people they have known for a while. Have they become clumsy. Has the client’s vision changed recently?
After you are able to identify that there may be a problem, you need to figure out how to show the problem to the defendants and the jury. Enlist the help of the treating physician or an expert. Neurologist, Neuropsychologist and Neuroradiologists can be helpful in explaining the medicine and helping you develop your demonstrative evidence. If you have questions about how to develop your demonstrative evidence, feel free to give me a call. Good luck and remember there is no such thing as a small brain injury!