Value of a Brain Injury Lawyer

Many traumatic brain injuries are caused by the negligence of others, as in the case of some car accidents. Other brain injuries may be caused by defective or dangerous products, or they may occur on the jobsite. If you or a loved one has suffered a lifelong disability from a TBI where someone else is liable, then you have likely been approached by the individual’s insurance company looking to make a settlement with you for your injuries. The amount of money offered may seem large and adequate for the injuries that you or loved one has suffered.

Remember, however, that the insurance company is not necessarily working in your best interest . It is important for you to discuss insurance offers with your attorney before you agree to any settlement . If you do not currently have an attorney, look for one who specializes in traumatic brain injuries, disability, and personal injury law.

An attorney will be able to help you generate an estimate that covers all anticipated expenses over the remainder of your or your loved one’s lifetime. To create such an estimate, your attorney will work with your medical providers in order to assess the extent of your disabilities, what support you will need over the course of your lifetime, and what those needs will cost. Your attorney will ask:

• How well will you or your loved one be able to provide a living for themselves and their family?

• Will you or your loved one be capable of self-care, or will you need long-term caregivers?

• Will you or your loved one need long-term therapy or medical care?

• How will inflation affect these costs over the long run?

All of these factors will be turned into a financial assessment that your attorney can present to the responsible insurance company. Your attorney will make sure that all costs are accounted for and not overlooked by the insurance company.

Lifelong disabilities are difficult enough to deal with, even without the financial burdens that they can incur. If someone else was liable for your or your loved one’s TBI disability, then settling with the insurance company will be a great relief, but you don’t want to find out later that the settlement originally offered wasn’t enough to meet all the needs created by a lifelong disability.

Working with an attorney who specializes in traumatic brain injuries, disability, and personal injury settlements will ensure that you are compensated with an adequate amount to meet all of the needs associated with your or your loved one’s disability over the course of a lifetime.

Patrick is a freelance copywriter with expertise covering various industries. This article aims to help people understand their legal options when it comes to personal injury and how they can effectively navigate the system for obtaining compensation and justice for their injuries. For Tennessee personal injury attorney services, please visit sidgilreath.com.

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Rod was hurtling down a mountain single track on his mountain bike when he misjudged the bend in the track. He lost it and broke his arm. After one night in hospital he was discharged.

Peter was playing for his schools 1st XV in the penultimate rugby match of the season when he was tackled and broke two ribs. He was admitted for x-rays and discharged with a strapped torso and instructions not to play rugby for six weeks.

I was out in the mountains marking a route for an adventure race when we got stuck. In the process of pulling the 4X4 truck out of a mud hole a metal bar struck me in the face, shattering my left cheek, sinus cavity and eye socket. After two days in hospital, which included six hours of reconstructive surgery I was discharged.

Peter, Rod and I were happy that we weren’t injured seriously. None of us knew that we were suffering from TBI, also known as Traumatic Brain Injury and that the life as we knew it had already started changing dramatically.

Peter and Rod barely knew that they had taken a knock on the head. In the adrenaline rush of falling of his bike and the ensuing pain from his arm, Rod didn’t take the bump on his head seriously; besides, the painkillers took care of the headache.

Peter remembered knocking his head on someone’s knee as he went down in the tackle. He had a bit of a blank spot and felt a bit groggy, but it cleared up quickly.

In the USA 1,5 million people will be admitted for non-fatal TBI annually. It is estimated that a further 3 million sports related TBI incidents are never admitted. In South Africa 89000 new TBI cases are treated annually; in keeping with international statistics an estimated 200 000 sports related incidents are never reported.

Traumatic Brain Injury is classified based on the level of severity. Sports people will most likely suffer from Mild Traumatic Brain Injury (MTBI), which presents a unique framework primarily owing to the fact that you can suffer from MTBI without ever losing consciousness! Further to this the changes in the brain are microscopic and will not be seen on a CT or MRI scan; and worst of all, the symptoms can start manifesting as much as 2 weeks after the incident. A Scottish study found that 47% of people classified as having MTBI were disabled to some extend a year after the incident.

But what are the practical realities for Peter, Rod and I?

We can expect to have to deal with problems in our cognitive skills, such as impaired reasoning and problem solving skills. To make this worse there is also the possibility of not being able to express ourselves verbally.

Then we can also expect be irritable and emotional to the extent of suffering from depression.

The sum total is that we will be severely challenged in our abilities to cope with challenging situations, to plan and implement strategies or to stay focused and motivated.

To understand this we have to understand the neurology of TBI. What usually happens in brain injury at the cellular level is known as “axonal injury.” Axons are the microscopic nerve fibers of neurons, the brain cells that communicate with each other. This axonal injury can occur in localized areas or throughout the brain.

Axonal injury occurs as a microscopic tear along the myelin sheath surrounding the nerve fiber that is often followed by micro swelling and the formation of scar tissue. According to Kit W. Harrison, Ph.D., at the Houston Behavioral Health Associates.

The process of scarring, can take weeks, months, or even years, to complete. As the axon scars over, fewer and fewer impulses can be carried through the tough scar tissue, and the axon may begin to die and lose connectivity function over time. This accounts for a number of symptoms which could worsen with time.

For a business owner or any person in a position of authority and leadership TBI spells disaster. Within months the impact of the injury became evident as Peter was unable to complete his homework and started withdrawing from his friends. At home he was moody and quarreled with his sister for apparently no reason. Rod, as a senior manager tried to keep things together, but he wasn’t up to his normal creativity and his department started losing money owing to poor decision making. Senior management had no option but to retrench him.

As for me, as an adventure sportsman and founding member of the Adventure Racing World Series I was forced to sell my house at a loss and had the bank repossess my car after 8 months. My sports marketing business closed down shortly thereafter.

Most of my problems could have been avoided if I had known that I was suffering from TBI. My natural reasoning was impaired so I never thought to move in with a friend or family and rent my house out to cover the bond. I never told anybody that I was having problems with motivation and managing my company so nobody new or though t to help and this is the first step to keeping your life normal, which is vital to a quick recovery.

Traumatic brain injury is a silent epidemic and requires a pro-active response from people suffering from it, but even more so from friends and family identifying the possible symptoms in those they love.

If you think you are potentially suffering from TBI you have to tell those closest to you and get a specialized diagnosis. Unfortunately you cannot rely on an opinion from your GP; you have to see a neurologist.

To help with recovery you have to do three things. Firstly you have to start exercising; join a running club, not a rugby club! The cross motor exercises will hasten the recovery as it assists with the creation of new neurological connections. If you can’t run, join a walking club, but get out there.

Secondly you must eat healthily. A pro-brain diet excludes sugar and refined carbohydrates and is high in protein and Essential Fatty Acids such as Omega 3 and 6.

Lastly you have to hang in there. Recovery is an extended process and could take anything up to 8 years!

If you are in a position to think that a family member, friend or colleague might be suffering from TBI, you have to give them support and encouragement. Chances are that they are confused and feeling frustratingly helpless. If they are not helped to a correct diagnosis soon after the TBI incident they might lose self esteem, motivation and all confidence.

A comparative study in the USA came to the conclusion that a alarming proportion of homeless people could be in their current situation as a result of an incident of TBI in their past. Without help and support I believe that it is quite likely that I could have become a statistic. Your knowledge can make a difference.

Zirk Botha is a Keynote Speaker who uses his experiences as a TBI survivor to teach his audiences 5 Steps to Significance. Visit http://www.zirkbotha.com for more information.

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One of the most important decisions a traumatic brain injury survivor must make following an accident is choosing the right attorney. Finding the best attorney for your case can be a daunting task, especially for someone with a brain injury.

Choosing an attorney should not be taken lightly in Wisconsin, because the law here makes it extremely difficult to fire your personal injury attorney and find a new attorney to take over your case. The following 5 simple steps will help you find the right Brain Injury Attorney for your case.

1. Identify the Type of Case You Have

Start by identifying your particular accident. If you were injured in an automobile crash, then you need an attorney handling auto accident claims. If, on the other hand, you were injured in a semi-truck crash, then you need an attorney that has successfully handled tractor-trailer accidents in the past. The Internet is a great resource to gather general information about your particular accident and finding an attorney with experience handling such a case. For example, conduct a web search for “(your state) Car Accident Attorney,” “(your state) Truck Accident Attorney,” etc.

2. Research Your Specific Type of Injury and Your Symptoms

You should also conduct research on your specific type of injury and symptoms. For example, you could conduct a web search for “Mild Traumatic Brain Injury,” “Moderate Traumatic Brain Injury,” “Severe Traumatic Brain Injury,” “Post-Traumatic Headache,” “Dizziness,” etc.

3. Search for Names of Potential Attorneys

Once you have identified what type of case and the type of injury you have, and have done some preliminary internet research, you can begin searching for attorneys that have experience in accident cases that result in injuries to the brain. Again you should turn to the Internet. The Yellow Pages may also be of benefit, however, because there is a limited amount of information that can fit on one page it is usually an inadequate resource. Television is even less helpful, because of the time limit on the ads and the insistence of some personal injury attorneys to run generic catch-all commercials promising a big settlement on all types of case and injuries. Search the web for an attorney with experience handling your particular type of accident and your particular type of injury, including your symptoms.

Once you have your list of possible attorneys, you should read their particular websites closely. Check out the organizations to which they belong. They should belong to organizations that advocate for victims that have survived traumatic brain injuries. Also, look for past settlements and jury verdicts concerning traumatic brain injury.

4. Call and Request Written Material From the Attorney

It is critical that you choose the right attorney from the outset. You can simply call the first attorney you see on TV and set up an appointment. However, this is not recommended as it is hard for you to determine whether this attorney is truly experienced with traumatic brain injury based simply upon a TV advertisement. Instead, call and ask the potential attorney to send you information this attorney uses to develop and document his client’s traumatic brain injury symptoms. If you request written material before meeting with the attorney, then you cannot be pressured into signing something you may later regret. You will be able to first read the attorney’s educational materials and then decide on your own time whether this attorney is right for your case.

If you do call an attorney for written materials and instead of politely sending you some free educational information, they attempt to get you into their office or offer to send someone out to your house or hospital room, then beware. Brain injury victims are usually quite vulnerable following an accident and they should never feel pressured into signing anything, including an attorney’s fee agreement.

If the attorney or law firm does not offer informative, written materials, or if they are pressuring you to come in and sign a retainer, then they may not be reputable.

Keep in mind that the ethics rules prevent attorneys from directly contacting you in person, by telephone, or by email, unless you contact them first. If an attorney solicits you without your request, then you should immediately report them to the Office of Lawyer Regulation (877) 315-6941.

5. Schedule an In-Person Appointment with the Attorney and Ask Questions

Once you have done the necessary background research, it’s time to set up a face-to-face meeting with the attorney. Make a list of questions and bring the list with you to the appointment. If the attorney is competent and experienced with traumatic brain injury, he/she will likely appreciate your persistence and answer your question much more directly.

Here are some suggested questions to ask:

Will you be the one handling my case from start to finish? (If the answer is “no,” immediately request to meet with the attorney that will be handling your case from beginning to end).

What is the process for handling my case? What steps will you go through?

When will my case be ready to be resolved? (If the attorney promises a quick settlement, they may be telling you what they think you want to hear as opposed to the actual truth).

How many active cases are you personally handling at the present time?

Have you ever represented people with traumatic brain injuries before? What were some of the results?

How do you obtain most of your brain injury cases? (Referrals from attorneys, other professionals and former clients is the right answer).

Have you attended or presented at any brain injury conferences or seminars?

Do you belong to any trial lawyer brain injury organizations?

Are you a member of any national brain injury associations?

Are you a member of your state’s Brain Injury Association?

What is your AVVO ranking? (A rank of 9+ is excellent).

Attorneys that devote a majority of their practice to the representation of traumatic brain injury survivors will not be learning on the job during your case. They will not have to learn new medicine for your case.

Instead, you can be comfortable with an attorney experienced in the representation of brain injury victims knowing they have worked with some of the best experts in the fields of medicine for brain injuries and an experienced brain injury attorney will not be intimidated when faced with brain injury medical experts that have been retained by the insurance companies to say that you did not sustain a life-changing injury. As a result, experienced traumatic brain injury attorneys are usually in a much better position to obtain the appropriate amount of damages for their clients with traumatic brain injuries because they have a better idea as to the amount a jury may award for this specific kind of injury.

Randy Rozek, Wisconsin Traumatic Brain Injury Attorney and owner of Rozek Law Offices SC, invites you to visit Wisconsin’s leading website at http://rozeklaw.com/wisconsin-traumatic-brain-injury.htm for more articles and legal information on traumatic brain injury. You may also feel free to contact Attorney Rozek via the web contact form or live chat for legal advise.

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To be involved in an auto crash is harrowing enough. Sustaining traumatic brain injury from this accident will be very agonizing and gut-wrenching. Not just will you as well as your loved ones be undergoing psychological pressure, but monetary concerns will arise as hospital expenses will mount on every passing day you spend in the hospital. If you’re the victim from this kind of an incident, you or your loved ones should go to and even retain a personal injury lawyer so that you can claim damages from the person who triggered the incident.

Traumatic Brain Injury (TBI) in car crashes is among the most prevalent reasons of death among kids and teens. Preventive measures may be observed and duly practiced in order to decrease the chances of TBI to arrive during car accidents. Some of these safety measures consist of putting on seat belts in cars or putting on helmets while riding on a motorcycle. Brain injuries may stem from direct impact, rapid acceleration or deceleration in auto accidents. Acquired brain injuries are classified as injuries suffered involving outside mechanical pressure such as vehicle crashes where impact occurs between two automobiles or an auto with another object. Mechanism-related crashes are further categorized as closed and penetrating head trauma. Closed injury happens when the brain is not exposed while the penetrating head injury comes about when the skull is pierced by an object and the brain might be uncovered.

What are the significant factors of traumatic brain injury? One of the most common cause for traumatic brain injury in automobile accidents involves driving under the influence of alcohol or medications. In addition, this is most widespread among teenagers who feel that they are invincible and no injury will happen if they drink and drive. To worsen the issue, most of these teens have just acquired their driver’s license and do not have the crucial skills and reflexes to do defensive driving. Unbeknownst to them, should they be kept from harm’s way, they may wind up harming other innocent drivers instead.

Becoming a sufferer of a traumatic brain injury in vehicle crashes is genuinely an overwhelming predicament to be in. Retaining a compassionate and trusted personal injury law firm is the most effective solution to be compensated for the emotional and physical injury you are experiencing. Not just will you be able to receive damages from the perpetrator of the collision, you will be able to bring to justice reckless drivers that have no business driving while they are under the influence of alcohol or drugs. Being forced to suffer agonizing operations and having to undergo the possibility of becoming physically disabled for the rest of your life is a dreadful option no one needs to go through.

Figuring in a vehicle incident you did not bring about is a life altering situation no one wishes to go through in their lifetime. Sustaining traumatic brain injury in car crashes is a nightmarish scenario you would not wish on yourself or your family members. Being compensated for the complete damages this has wrought your life and that of your relatives is something which may seem difficult and mind boggling. However, deciding upon the correct personal injury attorneys will definitely ease the burden you are currently undergoing. Not only will they assist you in obtaining the damages you seek, they are going to be ready to put your mind at ease and assist you with all the complicated legal matters which may seem daunting initially.

James D. Garrett is a Virginia Beach criminal attorney and the founding member of the Garrett Law Group, PLC in Virginia Beach, VA. If you have questions or comments regarding this article, please contact him at (757) 422-4646 for a free consultation regarding your case.

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There are essentially two main types of acquired brain injuries. Namely, those which are traumatic and those which are non-traumatic.

Acquired Brain Injuries

An acquired brain injury may otherwise be known as ABI.

This relates to something which has specifically occurred and affected the brain as a result of an event after birth and does not relate to damage to the brain which has developed from neurodegenerative disorders, but rather event based occurrences which could be accidents, head injury, an assault or even as a by-product of neurosurgery. They can also occur as a result of changes to the brain as a direct result of the contraction of medical conditions, such as brain tumours.

This type of injury to the brain can be classified further into non-traumatic and traumatic.

Traumatic Brain Injuries

These often occur as a result of a blow to the head, which in turn causes the brain to bleed, move about, or become bruised within the skull.

Unfortunately, many types of accidents can result in traumatic brain injury being suffered, and these can include the following events and scenarios:

A sharp blow to the skull with a blunt or heavy object

Banging your head as a result of a fall

Falling from ladders, from a motorbike or even a slip or trip

As a result of an involvement in a car accident or other vehicle road traffic accident

As a result of an accident at work

Being hit by a car

Falling from a horse or bicycle

Minor slips, trips or falls

Non Traumatic Brain Injuries

This type of injury occurs as an effect of an intervention via an external or internal source which could relate to brain tumours, alcohol or other substance abuse, infection (viral or non-viral), poisoning or indeed as the product of other contracted diseases or medical conditions. This type of injury to the brain does not generally relate to the types of injuries which are sustained as a result of an accident or injury, but rather lean more towards those which occur as a result of a contracted medical condition or disease.

The Effects Of Acquired Brain Injuries

The effects of any type of brain injury are far reaching, affecting both the physical and mental condition of those affected. Each individual will be affected differently, but needless to say that the results will be far reaching and influential to all parts of a person’s life and well being.

Rick Wilshaw is a copywriter and PR professional who specialises in working with legal and medical firms. He is currently working with Jefferies Solicitors Altrincham, a firm of solicitors established for over 18 years, who provide personal injury law services covering accident claims and personal injury claims including medical negligence claims, head and brain injury claims, accidents at work.

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Ask any experienced plaintiff’s personal injury trial attorney which cases are the hardest to win and the universal answer will be medical malpractice. These cases include:

• Medical Malpractice
• Birth Injury
• Nursing Home Malpractice
• Brain Injury
• Spinal Cord Injury
• Wrongful Death

From the moment the case begins, the attorney knows that he or she is in for a battle. When sued, medical doctors immediately fall into a state of denial if not righteous indignation. How could they possibly be responsible for a patient’s injury or death? Medical malpractice insurance companies further empower physicians by granting them the absolute right to have their case tried to verdict before a jury, no matter how egregious their conduct.

The plaintiffs’ attorney is also faced with the mandatory requirement of retaining a physician in the same specialty to testify against the defendant doctor. At one time this task was extremely difficult, especially on a local level, as the testifying doctor feared retribution from the medical community and the malpractice insurance companies. In fact, for a period of time one major insurance company sent notices to its insured’s “encouraging” (sic) them to not testify for plaintiffs’ in malpractice cases. However, as doctors incomes have continued to decline due to lower PPO and Medicare reimbursements, many have welcomed the opportunity to increase their incomes by testifying against their colleagues as expert witnesses. These physicians charge plaintiffs’ attorneys from $5,000-$10,000 to review records sit for a deposition and testify at trial.

The typical defense in malpractice cases is that any and all mistakes have resulted from “a known complication”. Taken to its extreme just about anything can be labeled “a know complication”. Defense attorneys refer to medicine as an “art” which is not perfect. Using this logic the same can be said for the negligent operation of a motor vehicle which is never excused by the law.

My many years as a Chicago personal injury attorney has taught me that juries will give a doctor every benefit of the doubt before finding their conduct negligent and awarding a patient money damages. During the selection process prospective jurors are asked if both the plaintiff and defendant start out on equal footing before the case begins. No matter what a juror may say the doctor has a clear edge over the plaintiff. The physician is typically placed on a pedestal representing the pinnacle of all professions. This attitude is exacerbated by the medical lobby and their insurance companies flooding the media with the “cry” that, “there are too many lawsuits brought against doctors”, that “doctors are being chased out of their state” and “there will be no one available to deliver babies”. Jurors are therefore brainwashed to believe these untruths.

Given the foregoing prevailing attitudes, I submit that unless a plaintiff’s personal injury attorney can get a jury “mad” or upset at the doctor over their conduct in the case on trial the plaintiff will lose. This is true no matter how technically correct the plaintiff’s position may be. Young, inexperienced plaintiffs’ medical malpractice attorneys forget who they are trying their case in front of and fall into the trap of asserting a technical position in an effort to win the case. If they use this tactic their case is doomed. Jurors’ already brainwashed, lack the knowledge, patience and desire to absorb technical medical jargon. Defense attorneys’ spoon feed as much of this information as they can to confuse jurors into a verdict for the defendant doctor.

The “Big Picture” is the only solution. Each side presents expert witnesses as required by applicable law. The witnesses offset each other’s testimony, so who is the jury to believe? The plaintiff’s attorney must shift the argument away from both witnesses labeling them a legal necessity and win the case upon common sense, lay facts that can always be found in the medical records or non medical testimony. Jurors can easily absorb this type of evidence, forget (as they will anyway) the technical medical testimony and side with the plaintiff. Examples of this technique include showing the jury that the doctor was too lazy or pompous to make a telephone call to the patient, hospital resident or even a nurse; that the doctor did not visit the patient in the hospital or went off on vacation; that the patient was left in the hands of an inexperienced intern or resident physician or the physician may have left the operating room prior to the completion of a surgical procedure.

Physicians often know that they have committed malpractice at a moment in time. Their typical reflex reaction is to write a detailed “cover your ass” entry in the patients chart in an effort to absolve themselves of the mistake. This may be followed with yet another writing called a “post entry” note. The trial attorney must use these physicians “progress notes” to show the jury that the physician knew that he or she made the mistake and went to painstaking lengths to cover it up. What the physician actually wrote in the chart is of little import since they have shown a guilty state of mind. Discrediting their conduct is the goal. Get the jury mad at the doctor!

Inexperienced attorneys having watched too many television legal dramas will do everything possible to catch the doctor in an outright lie. Although this is certainly a desirable goal, a failed effort will inflame the jury against the plaintiff. A better technique is to let the physician or their expert witness make incredible claims which are preposterous even to a lay person. Said another way, the doctors testimony on many critical issues may make perfect sense to a jury causing the plaintiffs’ case to suffer. If left alone at this stage the plaintiffs case may be lost. Yet, my 35 years of medical malpractice experience has shown me that physicians do not know when to stop. After effectively hurting the plaintiffs’ case they come forward with a single self serving statement or opinion that is “over the top”. Once made, the physician has taken away all of the good will established with the jury and brought all of their testimony into question. The plaintiffs’ attorney must then argue this fact to the jury during closing argument, effectively taking that witness out of the case. Even though the doctor did not admit fault he might as well have done so.

Once the plaintiffs’ medical practice attorney abandons the “he said / she said” technique and masters the art of selling the “Big Picture,” they will be on their way to successfully winning medical malpractice cases.

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Attorney ethics, juries softened by years of insurance company “education”, and the escalating complexity of litigating brain-damaged baby cases show the importance of investigating, working up and establishing liability and causation proofs before filing suit. Recent empirical studies and emerging technologies have made causation the focal point of birth injury litigation.

Investigating Before Filing Suit.

A subspecialty-birth injury cases-is emerging within the legal specialization of medical negligence. For this and other reasons, the claimant’s lawyer should already have a general knowledge of medicine, especially obstetrics and gynecology.

The client interview comes first. Besides the usual data collecting and document signing typical of most client interviews, lawyers must -

–Obtain facts from the parents, including physical evidence (baby books, etc.) the complete medical history of mother, father and siblings; and a factual history of the physician-patient relationship. Lawyers should always have the parents screened for possible genetic and environmental exposures-foreseeable defenses-and have the parents’ and child’s teeth, fingerprints, eye placement in relation to nose and forehead, and forehead deformities, etc. looked at to screen for all possible genetic defects.

–See the child. Too often, the parents of a severely injured child attend the first attorney-client meeting without the child. Lawyers should always try to arrange for the child to be at the first meeting or at least be sure to see the child before filing suit. Lawyers should view he child with an eye not only toward damages, but also toward liability.

–Obtain complete medical records, including mother’s primary and prenatal care records; mother’s labor and delivery records ((e.g., uterine-contraction and fetal-monitoring strips, ultrasound reports and films, slides, incident reports, billings, and in-hospital records and post-discharge follow-up consultation and treating physician reports; and serial photographs of the child from the date of birth to the present.

–Identify potential defendants (always screen for drug or other product causes that would support a products liability action). If anything about the parents, their histories, or the child’s looks or medical records suggests genetic causation, a genetic workup for purposes of excluding this as causation may be indicating before filing suit. If possible, lawyers should have a nurse specialist organize and review the records (labor and delivery, etc.) before submitting them to a physician specialist. A timeline of significant medical and factual events should be prepared. Lawyers should forward the timeline, the organized records, and a letter of suggested areas of inquiry to each potential expert.

Because many defense lawyers believe obstetricians are competent to comment only on the obstetrical standard of care or deviations from it, not on causation, plaintiffs’ lawyers should have brain-damaged baby cases reviewed by both an obstetrician and a pediatric neurologist or neonatologist.

Lawyers should select experts they will use at trial before the complaint is filed and should not rely on a “reviewing expert” who is unwilling to testify at trial. Many lawsuits have been started on the word of such experts who, when the time comes to find an expert to give a deposition and testimony at trial, cannot be found.

Lawyers must ensure that both deviations from accepted standards of care and a causative link between those deviations and the injury can be established. They should also secure statements from follow-up treating physicians, especially neonatologists and pediatric neurologists, before suit is filed. If they do not, control over these key witnesses falls to the defense.

Severe Diffuse Brain Injury.

Criteria used to identify children with severe diffuse brain injury-especially children whose injuries were caused by obstetrical malpractice-are controversial. Yet, there are signs and symptoms that typify the newborn with severe brain injury:

–difficulty in breathing

–difficulty in sucking and swallowing

–difficulty in maintaining temperature (persists over 24 hours)

–alterations in levels of consciousness (i.e., extreme irritability to coma)

–hypotonia-abnormal decrease in strength-floppiness

–normal head circumference (abnormal head circumference may suggest an alternative causative factor. Macro or micro head sizee may suggest a congenital or intrauterine growth retardation.)

–signs of increased intracranial pressure after several days (e.g., an intense bulging fontanel)

–high pitched, shrill cry

–projectile vomiting

–pupil/iris appearing as if it is setting into lower part of eye-setting sun sign

–apnea (may be a manifestation of intercranial pressure).

Some signs of an infant at risk for acute brain injury include-

–maternal illness during pregnancy (infection, trauma, preeclampsia, etc.)

–maternal exposure to drugs or environmental exposure to teratogens

–cord or placental accidents

–meconium staining of the amniotic fluid

–a low Apgar score at birth that does not promptly rise significantly with vigorous resuscitative efforts

–epileptic seizures

–septicemia in a sick infant

–hypoglycemia

–white or ashen skin tone

–facial abnormalities.

In a given case, these signs and symptoms may appear alone or in combination. Concerning liability and causation questions, lawyers must determine the existence of the sign or symptom, the cause of the sign or symptom, what response the physician made or should have made, and whether any response would have changed the outcome.

Neonatal Brain Damage.

Causes of neonatal brain damage, alone or in combination, include hypoxia (low oxygen asphyxia); ischemia (low blood pressure and flow); hemorrhages, spontaneous or traumatic; apnea; cessation of breathing; hypoglycemia (low blood sugar); kernicterus (excessive bilirubin); infection (e.g., meningitis); seizures (which complicate and exacerbate other pathologic processes); and hydrocephalus.

Not all neonatal brain damage is the result of obstetrical error. If a physician deviates from accepted standards of care, causes the signs or symptoms above, or fails to respond to them and an injury results, that may constitute obstetrical malpractice.

Asphyxial brain damage, sometimes described as cerebral palsy, is a subject in itself.

Drafting the Complaint.

Competent lawyers in the same and different jurisdictions debate whether general or specific complaints are indicated. Regardless, the complaint sets the framework of the suit and determines the scope of discovery. It should be drafted to meet the legal requirements of the jurisdiction and anticipated testimony of plaintiff’s experts.

As discovery proceeds, the complaint should be amended to reflect newly discovered facts or deviations from accepted standards of care. As the case approaches trial, the complaint should be amended to conform to the trial proofs; charges that cannot be proved by the close of discovery should be dropped. Discovery should be viewed as an ongoing process that involves thinking, rethinking,communicating, negotiating, and sometimes, fighting. It begins with the lawyer’s general obstetrical knowledge, which can be supplemented by reading.

Discovery costs money. How the patient’s lawyer spends money on discovery telegraphs to the opposing counsel what the lawyer knows about litigating birth injury cases.

There is no single right way to conduct discovery. The facts of each case should determine what discovery steps will be taken, and in what order. Indeed, before lawyers begin discovery, the legal theories to be proved and the crucial medical facts to be established on deviation from standard of care and causation must be understood so that discovery can be tailored to produce the necessary proofs. Although there is no cookbook order of discovery, the typical order includes:

1. The investigation before the complaint is filed.

2. Interrogatories to defendants covering nonsubstantive material. Substantive material should be discovered in depositions in jurisdictions that allow them. Interrogatories may be used to discovery substantive material in smaller damage cases as a form of cost control.

3. Interrogatories to the plaintiff, which are typically accompanied by “defense authorization forms”. If the patient is to sign authorization forms, they should be drafted by the patient’s lawyer and should clearly state that they authorize the disclosure of records only. The forms should expressly state that discussions with nondefendant treating doctors or other health care providers are not permitted.

4. Discovery about the defendant’s lawyer-reputation, substantive knowledge, integrity, etc.

5. Deposition of the plaintiff. If the defense lawyer does not move to take the plaintiff’s deposition, this may signal a problem. It may be that the defense lawyer is following the plaintiff’s declining health through Medicaid billings or other sources and is waiting for the plaintiff to die. If the plaintiff is at risk of dying, a videotape of the plaintiff if he is old enough to give testimony should be taken to preserve the testimony. Otherwise, a day-in-the-life video should be prepared as a hedge against the child’s untimely death.

6. Collection of defendants’ and experts’ writings and speeches.

7. Deposition of the defendant doctor, preferably in the doctor’s office. Sometimes it is important to take the depositions of nurses and other operating or delivery room personnel before taking the defendant doctor’s deposition. Such witness may lock in the doctor’s testimony.

8. Depositions of fact witnesses, e.g., nurses, respiratory therapists, and hospital administrators.

9. Depositions of plaintiff’s experts. If the defense does not move to take these depositions, the lawyer should try to find out why. The answer to this question may reveal a defect in plaintiff’s case or a weakness in plaintiff’s expert. It may be that the plaintiff has inadvertently selected an expert who is well known to the defense, has a fatal flaw, or has been well-deposed in other actions.

10. Deposition of defendant’s experts.

11. Follow-up interrogatories.

12. Requests for admissions.

13. Investigation of client’s damages. Because damages often increase or appear over time, the patient’s attorney must monitor the child’s health throughout the litigation. In cases involving newborns, it may be wise to delay filing the complaint as the cognitive damages may not be measurable until the child is about five.

Conducting Depositions.

Before deposing the defendant doctor or the defendant’s experts, the lawyer should have completed the case workup. The lawyer should list key questions to be asked, including those based on answers gleaned from medical texts, articles, or materials the defendant or the defendant’s expert have prepared so that questions eliciting contrary responses can be noted, preserving the discrepancies for use at trial. Where possible, depositions should take place in the doctor’s office so educational plaques, licenses, and other factors can be noted and possibly used for deposition questions.

When deposing the defendant doctor and defendant’s expert, the lawyer should do the following:

1. Review the files of the doctor or expert and have them marked as exhibits, checking the underlinings, sidebar comments, or other markings that may serve as a basis for questioning.

2. Have an outlined set of questions that will cover all aspects of defendant’s knowledge about the matters in question. Ask the witness to define key terms, explain normative ranges for tests, etc. This helps set a baseline against which the answers that follow can be measured.

3. Ask questions in a random manner unless the deposition is intended for use as testimony at trial. This method, sometimes called the “hit/skip” method, limits the witness’s ability to anticipate the next question and denies the witness the opportunity to prepare a set answer.

4. Obtain an unequivocal answer to each question. Too often, thinking about the next question prevents the lawyer from listening carefully to the witness’s answer. Listening to answers is as important as, if not more important than, asking questions. Often, a witness’s answer will suggest unplanned questions.

5. Be flexible enough to leave prepared questions, venture into unplanned areas, and then return to the prepared questions.

6. Be nonconfrontational. Relaxed questions may elicit less guarded responses than more hostile, aggressive questions.

7. Try not to telegraph positions or theories to opposing counsel during the deposition.

8. Use everyday language.

9. Test the witness’s knowledge of basic medicine and the medicine involved in the case. Such questions can unsettle an unprepared physician witness, just as questions about the rule against perpetuities might unsettle a lawyer witness.

The two events most dangerous to the plaintiff’s case are the depositions of the plaintiff and of the plaintiff’s experts. Although plaintiffs can rarely help their cases with their testimony other than in the area of damages, they can do a lot to hurt their cases. (The baby’s mother should be prepared for questions about prenatal infections, traumas, Agent Orange exposures, and other prenatal events that may give rise to substantive alternative causation defenses.)

The plaintiff’s experts should be prepared to report the number of times they have testified at depositions and at trials; the medical legal reviews they have performed; whether these services were performed for the plaintiff or the defense; and, if for both, what percentages were provided to each. Experts must know all the relevant facts and understand that opinions should be stated in terms of “probabilities” instead of mere “possibilities”, as the latter are usually not admissible. Experts should be prepared to confront anything they have written that might contradict their current opinions.

As the depositions proceed, follow-up interrogatories and, ultimately, requests for admission may be helpful. Well-drafted requests for admission, especially when based on the depositions of the defendant or the defendant’s expert, can be devastating weapons. Requests for admission can also force defendant’s counsel and carrier to confront admitted facts that they might otherwise forget or successfully ignore.

Foreseeable Causation Defenses.

New technology, such as magnetic resonance imaging, and the emergence of studies whose statistical findings favor alternative causations in brain-damaged baby cases must be considered and rebutted. Credible explanations to adverse test findings must be found before the depositions of the plaintiff’s experts.

Alcohol, cigarettes, lawn sprays, chemical contraceptives, household solvents, medications, and X-rays are capable of producing brain-injured children. LSD and other street drugs are also capable of producing anomalies. LSD and other street drug use has an emotional impact on jurors and is the most negative of all alternative causation obstacles.

Infectious processes, especially viral, are insidious defenses to rebut. The presence of these viruses is rarely noted on prenatal records and may be noted for the first time at the mother’s deposition when she reports having had a severe cold or respiratory infection during the prenatal period. Understanding how and when various organs develop in the fetus may help rule out such prenatal exposures as causes of the baby’s injury if the dates of exposure do not correspond with the dates of the organ’s development.

Maternal traumas, such as falls or car accidents during the prenatal period, may also be significant causative factors. The timing of such events and any corresponding signs and symptoms must be noted and evaluated.

An emerging causative defense is generically referred to as “maternal stress”. Nervous mothers-mothers who make nonsubstantive calls to the obstetrician, are in psychological counseling, or have endured family stresses like unemployment or divorce-serve as grist for defense experts who point to these factors as prenatal causes of the baby’s brain injury.

Family histories of seizures, genetic anomalies, or other problems must be scrutinized. The plaintiff’s lawyer should anticipate defense use of these factors and be prepared to rebut them before deposing the plaintiff’s expert.

It is useful to have the defendant obstetrician give opinions about each of these potential causation defenses. Sometime, the honest defendant will say that there was no evidence of maternal trauma, prenatal infectious processes, environmental exposures, or genetic defects.

Prematurity carries its own risks of morbidity and mortality. The more premature the baby, the less likely the baby’s brain injury was caused at the time of labor and delivery. This axiom, although rebuttable, has sufficient support in the medical literature to be a formidable defense on the issue of causation, especially where the birth weight of the infant is below 1,500 grams.

Settlement or Trial?

Some factors that determine whether or not a brain-injured baby case will ultimately settle or go to trial include the following:

1. The strength of the plaintiff and the plaintiff’s case.

2. The weaknesses of the defendant and the defendant’s case.

3. The extent of special damages such as medical and hospital bills; loss of earning capacity; and other expenses, including future custodial or medical expenses.

4. The scope of the plaintiff’s injuries, e.g., permanent disability and cosmetic or deformity problems.

5. The number and quality of collateral claims, such as those of the mother, father, and siblings.

6. The scope of defendant’s insurance coverage.

7. The insurance companies involved and the contract language of the policies.

8. The power and credibility of the various experts.

9. The complexity of causation.

10. The liberalism or conservatism of the jurisdiction where the case is to be tried.

11. The experience of the attorneys.

12. The presence or absence of animosity between the plaintiff and defense attorneys.

With the emergence of studies supporting the alternative causation defenses, caps on pain and suffering, abolition of the collateral source rule, the dwindling supply of credible plaintiff obstetrical and pediatric neurologic experts, and more aggressive insurance defenses, more brain-injured baby cases are going to trial than ever before. The cases tend to involve shopworn plaintiff experts, viable alternative causation defenses, and inexperienced plaintiff’s counsel, or else these cases involve instances where the plaintiff’s demand for settlement transcends the risks of trial perceived by the defendant and insurer.

Because case selection determine so many of these variables, the specialized plaintiff’s lawyer can predict fairly well which cases will go to trial and which will not.

When a case goes to trial, several concerns are worth noting:

1. Skillful use of motions in limine and other pretrial motions to keep out red-herring alternative causations.

2. Avoidance of bifurcation. Federal courts in particular and some state courts are bifurcating liability and damages in these cases. Because liability proofs are often intertwined with damage proofs, bifurcation can be fatal to the strongest plaintiff’s case.

3. Whether plaintiff’s experts can appear at trial or can only appear by deposition. Because it is foreseeable that many local defense experts will appear, it is incumbent on plaintiffs to present witnesses in court where possible.

4. Availability of models and anatomical drawings. The use of models, especially in the hands of expert witnesses demonstrating the defects in the delivery process, may be effective teaching tools, especially with male jurors.

5. Use of the defendant or defendant’s expert to rule out alternative causations that may be offered as “smoke” by defendant’s counsel in closing argument. Anticipatory motions in limine and the absence of alternative causation proofs may prevent the defendant’s counsel from employing obfuscating alternative causation arguments.

6. Avoidance of overreaching in damage claims. Because of the severity of the plaintiff’s injuries in these cases, each dollar figure presented should have some rational basis, and the total demand for recovery should adequately compensate the plaintiff, yet avoid the appearance of overreaching. Discussions with the plaintiff’s economic expert should anticipate the problem of overreaching and facilitate an empirical/data-based claim for damages. In some cases, mock trials may be very useful.

7. The credibility of the plaintiff and of the plaintiff’s experts-especially when it is contrasted to that of the defendant and of the defendant’s experts.

Responsibility Required.

The techniques of trying a brain-damaged baby case and the trial considerations involved are similar to the concerns in any malpractice or personal injury case. Concerns common to all personal injury litigations are not specifically addressed here, as volumes have been written on these subjects.

Litigating the brain-damaged baby case, especially in the screening and discovery phases, is a unique subspecialty within the field of medical negligence litigation. Professional ethics, parental vulnerabilities, physicians’ rights to fair treatment, and the public’s intense scrutiny of birth injury litigation require knowledge, skill and responsibility from both plaintiff’s and defense lawyers.

J. Douglas Peters
Charfoos & Christensen, P.C.
5510 Woodward Ave.
Detroit, MI 48202
313.875.8080
http://www.c2law.com

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Brain injuries are suffered at a rate of approximately one million cases per year, through trauma alone. These are injuries suffered as the result of birth trauma, vehicular collisions, sports injuries, construction site accidents and over means. There are also non-traumatic brain injuries suffered through such means as carbon monoxide poisoning or lead poisoning. Professional lawyer handles many of the above described cases involving brain damage to children and adults. Here are some questions he is frequently asked in the course of his practice.

1. What are some less known symptoms of brain injury?

Head injuries resulting in concussion, mental retardation and amnesia are mostly commonly known results of an injury. However Professional lawyers know that there are many less known, but just as dangerous symptoms that come from traumatic brain injury, and realizing what they are can be very important to getting early intervention and treatment. These include:

a. Visual disturbances

b. Hearing loss

c. Changes in smell and taste

d. Hormonal dysfunction

e. Cranial diabetes

2. How is brain injury caused during birth?

Typically improperly managed labor and delivery is the main cause of traumatic injury in newborns. Obstetrician in charge of delivering the child is charged with closely watching the fetus for any sign of fetal distress. It is vital for the fetus to receive adequate supply of oxygen for his brain to function properly. If problems arise, such as irregular heartbeat or umbilical cord compression on the neck, and they are not caught in time, the failure to monitor may result in brain damage to the infant. Injury lawsuit arising out of trauma to the infant caused during birth needs to prove that the damages to the infant did not arise from unrelated causes such as premature birth or mother’s diabetes, but came directly as the result of the doctor’s negligence.

3. Why is it so difficult to determine brain injury in a child?

Statistics show that children are more likely to sustain permanent brain damage than adults when equal force is involved or impact is similar. However, it is more difficult to measure the extent of the damage in a child, in case of mild to moderate injury since adults can be tested via I.Q. tests or other psychological criteria, while the children due to their young age may not be as easily tested by objective tests and methods. Furthermore, in children some neurological disability may not show up for many years and is difficult to detect until their frontal lobe function, such as social interaction, or reading and writing skills affected by other parts of the brain, come into play.

An Expert lawyer will explain applicable statutes of limitation for starting a medical malpractice lawsuit against a negligent doctor that caused the injury. Typically, children enjoy a tolling of this statute, meaning that the brain injury lawsuit may be started later than for adult. This of course takes into the account the difficulty in diagnosing an injury in a child and the legislature has taken appropriate steps to make sure the interests of the child are not lost due to severe time limitations.

If you or someone you know has been the victim of brain injury, it is in your best interest to call a qualified New York malpractice lawyer right away. At Duffy and Duffy – brain injury attorney, our brain injury lawyers have the experience to help families whose child has been the victim of brain injury.

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Hiring a lawyer may be the single most important decision for brain injury survivors and their families. When a person becomes brain injured, the entire family suffers with injuries which can be financially, medically and emotionally draining. professional lawyers handle a wide variety of head injury matters and can help you determine if your case is meritorious:

1. Improperly Managed labor

Obstetricians delivering babies are charged with taking appropriate care to make sure that fetal distress is timely noted, analyzed and responded to. Failure to perform a timely C-section, may lead to a child sustaining brain damage and result in hypoxia or cerebral palsy, which are caused by oxygen deprivation during labor. Experts in obstetrics and perinatology working closely with a brain injury attorney can estimate in terms of time, when the C-section was indicated, and testify as to how the prolonged delay resulting in the head injury to the child.

2. Car Accidents

Pedestrians, bicyclists and motorcyclists are often the most seriously injured victims of automobile accidents, because there is nothing to protect them from impact by several tons of metal barreling at them. The impact can cause the victim to fall to the ground, causing bleeding inside the brain and increased pressure, which can lead to permanent brain damage. This leads to lifelong necessity for medical care, loss of income, loss of enjoyment of life and loss of services and consortium by a spouse of the victim. Brain injury lawyers who litigate brain injury cases resulting from car accidents understand that any settlement offers have to take into the account the costs of care for the victim for years to come. Therefore, they will often hire economists to calculate monetary damages they’ll seek to recover.

3. Construction accidents

Brain injury at construction work sites take place when employers fail to take necessary safety precautions to protect their workers. These cases arise from workers not wearing proper equipment, such as hard hats, or operating heavy machinery without sufficient training or instruction, Construction sites can also cause serious injury to innocent bystanders, as in cases of scaffolding collapse or over unsecured equipment falling from certain heights. In these cases a brain injury lawsuit on behalf of the worker can only be brought if a third party is at fault, since the employer is insulated from suit under the workers compensation coverage (employee will only be able to collect for lost wages, disability and medical bills).

4. Carbon monoxide poisoning

Daily exposure to carbon monoxide may result in cognitive impairment and brain injury. In residential buildings the landlord is supposed to inspect, maintain and repair gas-fired equipment, such as a heater. Some states also require that a carbon monoxide detector be installed in every rented apartment and checked regularly. However, some landlord fails to live up to their duties and bring the apartment up to code. Continuously emitted CO may lead to headaches, dizziness and vomiting, and chronic exposure can result in irreversible brain damage. Expert lawyers working with victims of carbon monoxide poisoning on the premises will demand that defendant produce all record of inspection, repair and maintenance to determine if they can be held liable for client’s injury.

Over a million people sustain brain injury caused by trauma each year. The injury can be suffered as a result of an accident, such as a car collision, medical malpractice or intentional tort, such as assault. In those cases where others are at fault in causing brain injuries, it is critically important the family retain effective legal representation. Choosing the wrong legal strategy can have a significant adverse effect. Your choice as your attorney is one of the most important decisions in your case. Choosing someone who knows how to properly assess a legal case and give an opinion as to your options is the brain injury lawyer you should hire to represent you.

Medical Malpractice Law Firm Duffy & Duffy a wide range of personal injury and medical malpractice matters, which include brain injury litigation. A brain injury lawyers with our firm is experienced in handling a variety of such cases, where brain injury can be caused in either traumatic or non-traumatic fashion.

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those ones. The effects can be traumatic for the victim and their loved ones. Most people do not think about what they would do if they or a loved one suffered a brain injury.

Most injuries result from a blow to the head as the result of vehicle and motorcycle accidents, slips and falls, sports injuries, and assault. Those injuries can also be acquired through near drowning, aneurisms, seizures and strokes. The effects vary and can include: the inability to walk or talk, paralysis, loss of voluntary and involuntary motor functions, loss of memory, inability to process information, loss of sight, hearing or speech, anxiety, depression, and post traumatic stress disorder, as well as the inability to perform simple daily tasks. These injuries can leave people unable to take care of themselves. In many cases, the symptoms may take days or weeks to appear.

When one suffers that from an accident, malpractice, product defect, or other negligent means, it is essential to seek advice from a personal injury lawyer experienced in this topic. In a paraplegic injury claim, the issues can be complicated. Personal injury lawyers who specialize in those cases will do more than just represent you in court. They will seek damages for current and future medical costs, current and future earnings, pain and suffering, and punitive damages.

A personal injury lawyer specializing will have an understanding of the causes, symptoms, and effects of traumatic injuries. The lawsuits often involve a lot of research, medical expert testimony, and medical evidence presentation. An attorney that is experienced and knowledgeable in those cases will alleviate the stress of the case so their clients can focus on rehabilitation. Some injury law firms will even help with arranging medical and rehabilitation treatment during the case.

Recovering from this injury can be a slow process. Rehabilitation can include treatments in such areas as physiotherapy, occupational therapy, neurology, neuropsychology, psychiatry, behavioral medicine, orthopedics, physical therapy, vocational rehabilitation, speech and hearing therapy, occupational therapy, education therapy, social work, and much more. Over a lifetime, treatment costs could be devastating for a victim and their families. A personal injury lawyer will seek recovery compensation from those deemed responsible for the injury so the victim will be able to participate in the necessary rehabilitation and support programs.

Having to cope with a loved one who has experienced is difficult for any family. Traumatic brain injuries cases involve gathering critical information regarding the circumstances of the injury, the first symptoms of the injury, details of the emergency care, and details of the medical treatment. Personal injury lawyers such as. The Law Firm of McWhirter, Bellinger & Associates in South Carolina who specialize in the theme cases will have the experience and knowledge to protect your present interests as well as your future interests.

Because the statute of limitations regarding personal injury cases varies from state to state, it is important to obtain a personal injury attorney soon after receiving a trauma. Victims and their families will not only need present support but future support as well. To ensure peace of mind for you and your family, choose your personal injury firm carefully. You will rest easy knowing that you are being protected.

Find a Personal injury lawyer Toronto that will help your case with honesty and integrity. Whether it’s a motor vehicle accident, Paraplegic and Brain Injury or a Slip & Fall Injury, our Law Firm can help you.

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