Traumatic Brain Injury

 

Traumatic Brain Injury

Traumatic-Brain-Injuries-full-screen-bkgrndAccording to the National Institute of Neurological Disorders and Stroke, a Traumatic Brain Injury is a form of acquired brain injury occurring when a sudden trauma causes damage to the brain. Cite/ Link: www.ninds.nih.gov/disorders/tbi/tbi/htm Brain injury can occur whether the person whose head has been struck remains conscious or not. A TBI can be caused by a bump, blow or jolt to the head. Not all such events cause a TBI. Most, in fact, do not. As we discover more about the brain, however, we have consistently learned that the threshold for causing a serious brain injury is less than previously believed.

Causes of Brain Injuries:

  • FALLS: 40% of all TBI’s in the united States occurred as a result of falls. More than half of TBI’s among children 0 to 14 were caused by falls and more than two thirds of TBI’s in adults aged 65 and older are caused by falls. Cite: Centers for Disease Control and Prevention. Traumatic Brain Injury in the United States: Fact Sheet (internet). CDC.gov. Atlanta (GA): CDC; (updated 2015 Jan 12). Available from: www.cdc.gov/traumaticbraininjury/get_the_facts.html
  • UNINTENTIONAL BLUNT TRAUMA: Being hit by an object is the second leading cause of TBI’s in America. About one quarter of all TBI’s in children were caused by blunt trauma. Id.
  • MOTOR VEHICLE COLLISIONS: Among all age groups, car crashes are the third leading cause of TBI’s, and the second leading cause of TBI-related deaths (26%). Id.

Symptoms of Brain Injuries:

Symptoms of more mild TBI’s include:

  • Headache;
  • Confusion;
  • Lightheadedness;
  • Dizziness;
  • Blurred vision or tired eyes;
  • Ringing in the ears;
  • Bad taste in the mouth;
  • Fatigue or lethargy;
  • A change in sleep patterns;
  • Behavioral or mood changes
  • Trouble with memory, concentration, attention or thinking.

Symptoms of a more serious brain injury can include the above but also:

  • Headache that gets worse or does not go away;
  • Repeated vomiting or nausea;
  • Convulsions or seizures;
  • Inability to awaken from sleep;
  • Dilation of one or both pupils of the eyes;
  • Slurred speech;
  • Weakness or numbness in the extremities;
  • Loss of coordination;
  • Increased confusion, relentlessness or agitation

Immediate Medical Care:

Whether the symptoms are those that initially indicate a mild or a serious brain injury, the injured person should seek out medical treatment immediately.

In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and this isa very serious condition that can result in death if not properly treated. The signs of having a “Brain bleed” include:

  • Headache that is either not going away or getting worse
  • Weakness, numbness or decreased coordination
  • Repeated vomiting or nausea
  • Slurred speech

If any of these signs are present it is prudent to proceed immediately to the emergency room.

Additional concerning symptoms that should result in the immediate obtaining of emergency medical care include:

  • Extreme drowsiness or even a brief loss of consciousness
  • Having one pupil that is larger than the other
  • Inability to recognize people or places
  • Confusion / agitation that is on going or getting worse
  • Any type of seizure or convulsion

Danger Signs In Children:

Children should be taken to the emergency room if they have suffered a blow or jolt to the head and they have any of the signs discussed above, but, also, because they have limitations on their ability to self-report symptoms, greater concern should be shown if they are crying continuously and not able to be consoled or they show other signs of feeling badly such as not wanting to ear / nurse.

Data for this section of the site was obtained from the CDC : Centers for Disease Control and Prevention. Traumatic Brain Injury in the United States: Fact Sheet (internet). CDC.gov. Atlanta (GA): CDC; (updated 2015 Jan 12). Available from: www.cdc.gov/traumatic brain injury/get the facts.html

Types of Care and Recovery:

Most concussions resolve well and fairly quickly with few on-going symptoms.   If symptoms do not abate, however, then medical intervention is important.

Medical professionals agree on some general guidelines for patients suffering from symptoms as discussed above and concerned about whether they have incurred a TBI:

  • Get plenty of sleep and rest;
  • Avoid physically demanding activities;
  • Avoid activities that could result in more jolting or impacts with the head (I.e. don’t go on a roller coaster);
  • Have discussions with your health care professional about what things you should or shouldn’t be doing – driving / working certain jobs / riding a bike, etc.
  • Do not take medication / drugs / alcohol if you suspect a brain injury;
  • Ask for help from those around you and implement systems to keep track of your abilities – write things down – have family members check your work , important decisions.

FOR CHILDREN:

  • All of the above but also keeping track of the types of behaviors they are showing and the type of play they are participating in – try to avoid sports / bike riding / anything that could result in a further holt or blow to the head until the symptoms have cleared and you’ve talked with the child’s doctor for medical clearance. 

Data for this section of the site was obtained from the CDC : Centers for Disease Control and Prevention. Traumatic Brain Injury in the United States: Fact Sheet (internet). CDC.gov. Atlanta (GA): CDC; (updated 2015 Jan 12). Available from:www.cdc.gov/traumatic brain injury/get the facts.html

Accommodations:

Getting back into life after a TBI can be difficult and the patient should consider asking for accommodations that will help them with this segue. Returning to work or school may need to be accompanied by more rest breaks, shorter work days, more time to complete certain tasks, help from others to both insure that tasks are done properly and to allow for more time to focus and concentrate with less pressure.   If you are concerned about obtaining accommodations, you should discuss this with your doctor. Schools and employers are generally respectful or what a physician indicates is needed in order for the patient to re-integrate into the education or profession.

In sports, the threshold is going to be higher for returning a student athlete to the field because of the danger of underestimating the degree of injury in the short time frame provided during a game and the danger of a subsequent injurious event.   All 50 states now have laws implementing standards surround returning to play that schools and leagues must follow in order to keep children safe while participating in sports.

Conclusion:

Wiener & Lambka, PS takes special pride in representing those persons who are least able to do so for themselves and we take great care with our cases involving traumatic brain injury and any case involving an injury to a child.

Brain Injuries: How the Right Lawyer Can Help You Pay for Treatment

Wiener & Lambka, PS takes great care and pride in working with clients who have suffered traumatic brain injuries. We have the knowledge, experience and compassion to handle these important cases. If you need a Seattle area attorney experienced in brain injury cases, please consider contacting us for a free consultation. https://www.wienerandlambka.com/contact-us/

What is a Traumatic Brain Injury?

The Center for Disease Control defines a traumatic brain injury (TBI) as a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury.

Each year, traumatic brain injuries contribute to a substantial number of deaths and cases of permanent disability. In 2010 2.5 million TBIs occurred either as an isolated injury or along with other injuries.

What Are the Symptoms of Traumatic Brain Injury?

Initial symptoms range from “mild” with a brief change in mental status or consciousness to “severe” with an extended period of unconsciousness or amnesia.

The most common form of a TBI is a concussion.

Concussions occur from motorcycle or car accidents, falls or contact sports. Over the past decade, TBIs have begun to receive more media attention. More and more studies point to the fact that we are only beginning to understand the nature of these injuries. Doctors used to believe, and some still do, that a loss of consciousness is a prerequisite for a traumatic brain injury. It is now widely agreed that serious injuries can occur even without a loss of consciousness.

While football players and service members who suffered blast injuries or repeatedly fired loud weaponry near their head have made headlines and received a great amount of attention, these are also rather obvious ways of obtaining a head injury. The reality is that just suffering a good whiplash-type injury is more than sufficient to also cause a traumatic brain injury. These injuries are difficult to diagnose because the doctor is generally not looking for it at the time of initial treatment following a car accident or sports injury. The focus is often on the spine, and for good reason. Most car accident victims have a feeling like they had their “bell rung” a little bit. The vast majority of these symptoms fade away in the days after the motor vehicle accident. When the symptoms don’t fade away, however, medical intervention is both crucial, and sometimes difficult to obtain, because the medical providers generally take a wait and see approach to these injuries. While the majority of people will be symptom free within a week, the ones that still have symptoms will also typically see a reduction back to baseline over the course of a couple of months. At this point, however, is where medical intervention becomes important because any lingering symptomology past the 60-90 day mark is an indicator of a more serious problem. The good news is that appropriate interventions, in the form of speech therapy, brain injury specific therapy and other interventions can help the injured person to handle the effects of their TBI and either re-learn certain helpful behavior and thought patterns or eliminate the issues altogether. Either way, however, medical intervention is important for lingering symptoms.

What makes traumatic brain injuries all the more difficult is that often the injured person is not fully aware of the symptoms. It is impossible to get out of your own skin and so if you aren’t remembering things clearly, for example, you may not notice a difference in your abilities – but close friends and family members might see that you are no longer functioning at the same level that you were prior to the injury. If you are having trouble finding the right words, for example, is that because of a TBI or maybe because you just didn’t get a good night’s sleep – or for no reason at all. Because of these ambiguities, it can be difficult for people to know that they need medical care.

The CDC discusses TBI Symptoms as follows: https://www.cdc.gov/traumaticbraininjury/symptoms.html

What are the Signs and Symptoms of Concussion?

Most people with a concussion recover well from symptoms experienced at the time of the injury. But for some people, symptoms can last for days, weeks, or longer. In general, recovery may be slower among older adults, young children, and teens. Those who have had a concussion in the past are also at risk of having another one. Some people may also find that it takes longer to recover if they have another concussion.

Symptoms of concussion usually fall into four categories:

Thinking/Remembering Physical Emotional/Mood Sleep
Difficulty thinking clearly Headache

Fuzzy or blurry vision

Irritability Sleeping more than usual
Feeling slowed down Nausea or vomiting (early on) Dizziness Sadness Sleep less than usual
Difficulty concentrating Sensitivity to noise or light balance problems More emotional Trouble falling asleep
Difficulty remembering new information Feeling tired, having no energy Nervousness or anxiety

Some of these symptoms may appear right away. Others may not be noticed for days or months after the injury, or until the person resumes their everyday life. Sometimes, people do not recognize or admit that they are having problems. Others may not understand their problems and how the symptoms they are experiencing impact their daily activities.

The signs and symptoms of a concussion can be difficult to sort out. Early on, problems may be overlooked by the person with the concussion, family members, or doctors. People may look fine even though they are acting or feeling differently.

When to Seek Immediate Medical Attention

Danger Signs in Adults

In rare cases, a person with a concussion may form a dangerous blood clot that crowds the brain against the skull. Contact your health care professional or emergency department right away if you experience these danger signs after a bump, blow, or jolt to your head or body:

  • Headache that gets worse and does not go away.
  • Weakness, numbness or decreased coordination.
  • Repeated vomiting or nausea.
  • Slurred speech.

The people checking on you should take you to an emergency department right away if you:

  • Look very drowsy or cannot wake up.
  • Have one pupil (the black part in the middle of the eye) larger than the other.
  • Have convulsions or seizures.
  • Cannot recognize people or places.
  • Are getting more and more confused, restless, or agitated.
  • Have unusual behavior.
  • Lose consciousness.

Danger Signs in Children

Take your child to the emergency department right away if they received a bump, blow, or jolt to the head or body, and:

  • Have any of the danger signs for adults listed above.
  • Will not stop crying and are inconsolable.
  • Will not nurse or eat.

Traumatic Brain Injury (TBI) Statistics

  • In general, total combined rates for traumatic brain injury (TBI)-related emergency department (ED) visits, hospitalizations and deaths have increased over the past decade. Total combined rates of TBI-related hospitalizations, ED visits, and deaths climbed slowly from a rate of 521.0 per 100,000 in 2001 to 615.7 per 100,000 in 2005. The rates then dipped to 595.1 per 100,000 in 2006 and 566.7 per 100,000 in 2007. The rates then spiked sharply in 2008 and continued to climb through 2010 to a rate of 823.7 per 100,000.
  • Total combined rates of TBI-related hospitalizations, ED visits, and deaths are driven in large part by the relatively high number of TBI-related ED visits. In comparison to ED visits, the overall rates of TBI-related hospitalizations remained relatively stable changing from 82.7 per 100,000 in 2001 to 91.7 per 100,000 in 2010. TBI-related deaths also decreased slightly over time from 18.5 per 100,000 in 2001 to 17.1 per 100,000 in 2010. Note that the axis scale for TBI-related deaths appears to the right of the chart and differs from TBI-related hospitalizations and ED visits.

    SOURCE: https://www.cdc.gov/traumaticbraininjury/data/rates.html

Up to Date Medical Information on TBI Studies

Because of our commitment to helping clients who have suffered traumatic brain injuries, Wiener & Lambka, PS tries to keep abreast of the latest developments relating to this intricate field of medicine.   When a new study of importance is published, we try to cover the information in our blog. Please check out our blog posts on the subject of Traumatic Brain Injuries, which are compiled here: https://www.wienerandlambka.com/category/brain-injuries/

Traumatic Brain Injuries in Legal Cases

TBI’s are often very difficult injuries to handle in the legal context. It is not uncommon for insurance companies to have adjusters who may rely on bad information or earlier understandings about brain injuries in seeking to deny a personal injury claim.

Because Traumatic brain injuries are often difficult to diagnose and do not show up on xrays or other diagnostic imaging, it is easier for insurance companies to present defenses about the existence of the injury or the severity of the injury. Additionally, the issue of whether or not the traumatic brain injury was caused by the fall or car accident or whatever negligence act or omission is at issue is a likely target for their defense efforts. There are even doctors who will knowingly rely upon outdated information to provide opinions about the non-existence or the alternative causation of a brain injury. These cases, often because of the high value of the matter to the injured party, are met with an expensive and comprehensive defense. They are hard fought and difficult. Many people with TBI’s have also suffered psychological injuries as well that make standing up to the rigors of a personal injury lawsuit difficult and sometimes impossible. At Wiener & Lambka, PS, we are on our client’s side, every step of the way through this difficult process.

How is compensation provided for a brain injury?

If you have been injured as a result of someone else’s failure to exercise reasonable care, then you may have legal rights to be compensated for your injuries. Not all situations where one person’s actions or inactions result in a legal claim. There three main questions that need to be answered in order to have a legal claim for personal injury.

First, did the person who caused the injury breach a legal duty to you?

This means that the person had to have acted in a negligent manner, but in the context of having a legal duty. Sometimes people can act negligently, but because they have no duty under the law, there is no ability to compensate the injured party.

The second question is whether or not the person who had a legal duty acted in a unreasonable manner.

This question is at the heart of many personal injury cases. A clear example of a breach of a duty is when a driver fails to stop at a red light and causes a collision with another car. There are statutes governing how we are required to act when driving, including stopping at red lights. When someone makes a mistake and fails to do so, they will be deemed negligent. Negligence can be a more difficult question in other contexts. For example, in order to find a doctor negligent, a jury must determine whether or not the doctor acted in a manner that was below the expectations of a reasonable doctor in the same specialty, acting under the same circumstances. This is described as the ‘standard of care.” This is a much more subjective standard and subject to much more debate than someone who fails to drive their car consistent with traffic laws.

The third question is whether or not the negligent actor caused the suing party harm.

Harm is typically pretty well understood. Car repair, physical injury, monetary losses, pain, inconvenience, deprivation of the pursuit of happiness. Damages and harm are the same thing. It is just as important in an injury case to have a showing of negligence and a showing that the negligence caused the harm complained of. Alone neither is adequate for the purposes of having a right to compensation.

For example, if you are driving home and someone runs a red light and you have to stop suddenly, but they drive by and no collision occurs and nothing else happens, then you do not have a lawsuit, even though the other driver was clearly negligent.

What is lacking is harm. You were inconvenienced, certainly, and likely scared. But these things do not amount to damages that would be recognized as meaningful enough to warrant compensation. In personal injury cases, the issue of causation is typically hotly contested.

Even though causation may seem clear to the injured party, the defense attorneys will hire their own doctors who will try to cast a shadow on the causation of the injuries. They will attribute them to prior incidents, psychological causation, or at least indicate that the injuries are not nearly as bad as the hurt person claims. This is done because the law requires the party bringing the suit to prove that the care they received was “reasonable and necessary” care that was directly caused by the incident. Because these things are subject to opinion, the defendant can bring in a doctor of their choosing to argue that the care someone received is not reasonable care or is not directly related to the incident itself.

Types of Personal Injury cases causing brain injury

While a traumatic brain injury can occur through any number of different scenarios, we typically see these case stemming from the following types of cases:

Automobile accidents

Slip and fall incidents

Sports-related injuries

Activities involving children

What should you do if you believe you may have suffered a traumatic brain injury?

The most import thing to do is to seek medical care. Write down all of the symptoms that you are having to discuss with the doctor.  Provide examples if possible. Distinguish the differences in your symptoms / feelings/ behaviors from how things were before your incurred the injury.

Second, once you have taken care of yourself medically, please consult with an experienced personal injury attorney. Most firms provide a free consultation. Wiener & Lambka PS provides a free consultation with experienced TBI attorneys.  Please feel free to contact us:

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There is no reason why you would be expected to suddenly understand all that needs to be learned about insurance, the legal system and the medicine that is involved with your injury. In fact, many personal injury attorneys don’t fully understand each of these areas of law.

Your case will be unique, no matter how commonplace a component of it might be. For example, you might have a straight-forward automobile accident where someone struck you from behind. While this part of your case may well be simple, there are always, in every case, unique facts that need to be analyzed and handled properly.

The earlier you contact an attorney, the earlier you can learn how to properly handle your case. Even if you learn nothing special, you will at least be re-assured then of how to do things the right way and not have regrets later.

Otherwise, depending upon what area of law your case involves, you can find our basic advice on what to do for the following situations here:

Automobile Accidents

Injuries to Children

Property Damage

Medical Negligence

Dog Bites

What is the Statute of Limitations for a brain injury case in Washington?

Most personal injury cases in Washington have a three year statute of limitations. The statute of limitations is a date by which you must either resole or properly file and serve your lawsuit against the negligent party. Failure to do so will result in the loss of your legal rights to compensation. Other statues can also apply to cases that might otherwise also be considered to be personal injury suits. Assault, for example, has a two year statute of limitations. Consult an attorney immediately if you think that you have a case.

Because the statute of limitations is a statute that can cut off your legal rights, it is important to take action in front of the deadline. Moreover, lawsuits can be complicated. Finding the right party to sue can sometimes be difficult. We have even had clients come to us who did not obtain the name of the driver who negligently caused a collision with them. Without basic facts, it is impossible to preserve your legal rights. Even with them, the insurance companies defending the cases that we see will take every opportunity to try to have a case dismissed if not properly field and served.

While the statute of limitations provides three years to take action, we advise doing so much earlier. Moreover, this should not be considered a deadline as much as it is something to be aware of. Contacting an attorney immediately when you have a personal injury matter is the most important thing you can do.

How to find and hire a brain injury personal injury lawyer in Seattle?

It is important that you find an attorney that you trust. At the end of your case you will either settle the matter or go to court and have a jury or judge give an award. Either way, you will depend to some degree on your attorney for advice. We tell all of our clients that it is our job to provide you with important information and risk analysis so that they can make a good decision about their case.  We do not make big decisions for our clients. How much to ask for, whether or not to sue, and whether or not to settle or go to trial are all questions resolved by the client.

What does a brain injury settlement look like?

Most settlements are made as a compromise between the parties. This means that seldom does either side get exactly what they want when settling their case. Settlements, on both sides, are a product of risk reduction. The injured party was to obtain sufficient compensation such that their bills are paid and they can obtain monetary compensation for their pain and inconvenience and loss of enjoyment of life related to the injuries. If injuries have healed and are thing of the past, then it is easier for the injured party to reach a settlement.  If, on the other hand, injuries are on-going, then it is much more difficult because money must be paid that represents this person’s now uncertain medical future. Insurance companies don’t like to provide money for the hypothetical future, especially if they also believe that they injuries should have healed or that the injured party either did something or failed to do something that resulted in those injuries not healing.

The insurance company will typically only offer smaller amounts of money early on in negotiations. They want to see if the injured party will accept the smaller amount before becoming more reasonable. Once past this stage, insurance companies will often make offers that are designed to have a value to them that parts with money now in an effort to eliminate the possibility of paying more later. This is a subjective determination on some level regarding the evaluation of a case’s value. Value is often very hard to determine because each case is unique. In the end, both sides must try to accurately determine what is the amount that they would be willing to accept or pay in exchange for giving up the opportunity of getting more, or eliminate the opportunity of the other side doing better.

All cases are unique but potential types of damages that can be compensated in brain injury cases are as follows:

* Wage loss;

* Impairment of future earning capacity;

* Household services;

* Loss of consortium – the loss of love and affection of a spouse or other family member due to death or serious injury;

* Past and future medical bills;

* Past and future pain and suffering, loss of enjoyment of life.

Brain injury cases are unique in that the degree of the injury may have serious adverse effects on the future ability of the injured person to work and earn income. Moreover, because the nature of these cases is that the person who has suffered the injury has also likely suffered personality changes and other important psychological harms, obtaining compensation for these serious damages can be difficult but also is very important.

How long does it take to settle a personal injury case in Seattle?

Most cases follow a similar time table.First, the client gets to a point where they no longer require medical care. Ideally, if a client can completely resolve their injuries, then that places them into a position where their case is ripe for settlement. Until an injured party physically recovers, they are not in a good position to resolve their claim because the future is still too unknown. Settlement occurs only once, and the injured person has to release the other party from any further requests for damages when accepting their settlement monies. Accordingly, we wait to pursue negotiations in cases until our clients are in a position to know the most about the future.

Once a client has completed their treatment, we then obtain their medical records and put together a settlement package for the insurance company. Obtaining medical records usually takes about 8 weeks. While many providers respond promptly to requests for records and bills, there is almost always a provider who does not. Moreover, the records have to be reviewed in order to ascertain whether or not they are complete. These things take time and expertise and often result in the discovery of the need for additional records that then need to be obtained.

>Once all records are obtained, it typically takes a few weeks for a case to be thoroughly reviewed and a demand package put together. This package then needs to be sent to the insurance company and then time is needed for it to also review the matter. Once all of this is done, some negotiations can be completed with a week, others take weeks or even months. If resolution cannot be had agreeably, then a lawsuit needs to be filed and this process, of course, does not move rapidly either, but makes the settlement process seem speedy by comparison.

How can I obtain a free consultation for my brain injury case?

At Wiener & Lambka, PS, we are happy to provide a free consultation to potential clients.

This can be done via email or telephone. Either way, we’re happy to take some time and talk with you about whether or not your case warrants an attorney getting involved. Many cases do not, and we’re also happy to re-assure potential clients in these circumstances.

If we both agree that legal representation is something that will benefit you, then we will come to you to meet in person and talk in more detail so that you are fully informed about your case and what representation entails. While you are more than welcome to come to our offices, we believe that injured persons have enough to worry about without also traveling to meet their attorney. We usually seek to meet at a coffee shop nearby your home or place of employment – whatever works for our clients also works for us. We don’t force our injured clients to travel to us in order to have a consultation.

Click Here to Contact Wiener & Lambka

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