New York City

Published on: December 11, 2012

Baby Receives Brain Injury

by Stephen Bilkis

When a baby suffers from a brain injury at birth, it is a devastating event for the entire family. The family is stricken with the knowledge that the happy healthy baby that they were expecting has received a birth injury that will render that child disabled for the rest of their lives. In cases of this nature where medical malpractice is involved, it is especially devastating for the parents. Many problems can affect the medical malpractice lawsuit in these cases. There are generally more than one doctor present at deliveries in hospitals these days. When there is more than one doctor, it can be difficult to determine which doctor deviated from acceptable medical practice of the day.

One case that involved a child who was delivered by an obstetrician in New York City, left this question unanswered. One of the doctors who attended the birth admits that he was negligent, but claims that the obstetrician who was responsible for the delivery of the child was responsible for the larger portion of blame. He contends that he was not involved in the actual delivery or prenatal care of the mother. He contends that the vast majority of brain damage occurred during that time of the delivery and not after the delivery when he became involved in the case. The doctor stated that he was responsible for caring for the newborn infant when the baby born. He stated that the primary injury to the child occurred when the obstetrician who delivered the child failed to administer oxygen to the mother when the child compressed the umbilical cord during labor. The obstetrician failed to notice that the child was not getting enough blood or oxygen through the umbilical cord until the child had been hypoxic for some time.

Following the delivery of the baby, the obstetrician handed the infant off to the Long Island pediatrician who was standing by. He contends that he was negligent because when he observed the child’s blood tests, he noticed that there was a very high bilirubin count. A high bilirubin count is indicative that the child has had a traumatic birth and that the baby may have suffered from a brain injury. He states that he was also negligent in that the child also had a high hematocrit level which would also tend to indicate that the baby had suffered brain damage during birth. If he had acted immediately with appropriate oxygen therapy, there is a chance that the child would not have suffered as severe a brain injury as he did. However, the pediatrician failed to act and some undetermined time after the child was born, it was discovered that the infant was severely brain damaged.

Published on: October 31, 2012

In 1960, a man was found dead by his own hand

by Stephen Bilkis

In 1960, a Nassau man was found dead by his own hand. He left behind a suicide note that stated that he could not stand the pain of his injuries any longer. This man had suffered from a back injury on his job that left him in constant pain and unable to function as he had before he was injured. His wife filed a wrongful death suit against the Workmen’s Compensation Board. Her contention is that her husband suffered from two debilitating industrial accidents. One of the work related accidents that he suffered occurred in 1945. He was working for a theatre as an usher when he attempted to break up a fight in the men’s room. His head was slammed against the marble wall of the men’s room and he suffered from a brain injuryas a result. Following this injury, the man was plagued by headaches, blackouts, and incidents of blindness. His wife stated that he would have moments of blindness that would last a few seconds at least once or twice each day. These incidents were followed by excruciating headaches. She stated that following the second injury, it was too much for him to handle. She proposes that there was a direct causal link between her husband’s industrial accidents and his suicide.

New York law states that where the symptoms of an injury that occurs on the job continue until the suicide of that person, a direct causal relationship may be inferred. That means that death benefits are awarded if the injury results naturally in disease and the disease is the cause of death. The courts have ruled that if the injury causes insanity and the insanity cause the suicide, it is the proximate cause of the death. However, if the insanity is not a result of the injury, but rather from some other cause such as melancholy or discouragement, then the injury is not considered to be the proximate cause of death.

The Worker’s Compensation Board contends that the brain injury was not the proximate cause of the decedent committing suicide. They contend that the decedent had a long history of mental illness dating back to early childhood. They produced evidence that he had committed himself to a mental institution before his first injury. His complaint at that time was severe anxiety and headaches accompanied with bouts of blindness. They stated that following this incident and only one year before his death, he checked himself into the hospital for renal colic and was in treatment for one month. They brought forth evidence of the decedent’s many medical issues and even ventured into his relationship with his mother. His mother was crippled at an early age. She was raped and the result of the rape was the decedent. He grew up in foster care. The Worker’s Compensation Board contends that the decedent had numerous health and psychiatric problems his entire life and that it was these problems and not his back injury that caused him to take his own life.

Published on: October 14, 2012

A man sustained severe personal injuries during the course of his employment

by Stephen Bilkis

A man sustained severe personal injuries during the course of his employment when he fell from a ladder in a warehouse owned by the accused warehouse corporation. He commenced an action alleging negligence and violations of Labor Law. The warehouse corporation brought a third-party action against the Dollar Store in Westchester which is the man’s employer to seek common-law and contractual indemnification. In two separate motions, the employer moved for summary judgment to dismiss the third-party complaint. Supreme Court denied both motions, finding issues of fact as to whether, under the Workers’ Compensation Law the man sustained a grave brain injuryand whether the employer had contractually agreed to indemnify the warehouse corporation.

Workers’ Compensation Law permits an owner to bring a third-party claim against an injured worker’s employer in only two circumstances: when the injured worker has suffered a grave brain injury or the employer has entered into a written contract to indemnify the owner. The employer asserts that the warehouse corporation failed to raise an issue of fact as to the applicability of either exception to the prohibition against third-party claims against the employers.

A grave injury is defined, in relevant part, as an acquired brain injury caused by an external physical force resulting in permanent total disability. Although the statute does not define permanent total disability, the Court of Appeals has determined that a brain injury results in permanent total disability under the Workers’ Compensation Law when the evidence establishes that the injured worker is no longer employable in any capacity. Even the employer sustained its initial burden of establishing as a matter of law that the man did not sustain a grave injury, the evidence submitted in opposition to the motion was sufficient to raise a triable question of fact.

Published on: September 20, 2012

U.S. Representative Giffords’ Office Closing Gap in TBI Care

by Stephen Bilkis

Staff members in the employ of Rep. Gabrielle Giffords (D-Ariz.) have become key advocates in the campaign to ensure health-care guarantees for Americans who suffer traumatic brain injuries (TBI). They are advocating that other citizens should be entitled to the same high quality care that the congresswoman is receiving in her recovery from a January shooting.

Last month, Giffords’ chief of staff released a letter urging Health and Human Services to prioritize defining the minimum package of “essential benefits” in the new health-care law that will be required of insurance plans for individuals and small businesses. This new law is expected to be operational by 2014.

Giffords’ Staff members are also planning to join encourage the Defense Secretary to expand the range of “cognitive rehabilitative therapies” that Tricare, the military’s insurance program for active-duty and retired service members, covers in cases of brain injury.

Published on: September 17, 2012

30% of Brain Injury Victims Suffer from Depression

by Stephen Bilkis

A study reports that almost one-third of all cases of TBI (Traumatic Brain Injury) eventually lead the sufferer to a depression experience. A Vanderbilt University Medical Center team spent a considerable amount of time analyzing existing research on such brain injury-inducing incidents as: blunt force trauma to the head from traffic accidents, falls, sports and assaults.

Attorneys have long seen the correlation between the two events, but it is always welcome when an expert in the field corroborates the evidence. “Any patient who has a traumatic brain injury is at a real risk for developing depression, short and long term,” the study’s co-author said in a medical center news release.

“It doesn’t matter where on the timeline that you check the patient population — six months, 12 months, two years, five years — the prevalence is always around 30 percent across the board.” Compare this to the rate of depression in the general population which is about 9 to 10 percent, and the issue is apparent.

Published on: July 19, 2012

The way surgeons deal with shrapnel or bone fragments in the brain has changed

by Stephen Bilkis

The way surgeons deal with shrapnel or bone fragments in the brain has changed since the days of Korea or Vietnam, doctors tell sources. It was once the standard to remove every last fragment of bone or any other foreign body, so the brain would have a lower risk of infection and there would be less chance of developing post-traumatic epilepsy. Studies in Westchester County of Vietnam War patients has shown that removal of all fragments is not actually necessary, though objects that cause gross contamination should still be removed.

Closure of the scalp and replacement of the dura are absolutely vital to prevent, or at least reduce the chance of, CSF leakage and meningitis. A soldier who seems to have good neurological status, with only small fragments in the brain may be able to be treated locally to prevent leakage. One with a more extensive injury will have to undergo a large decompressive creniectomy and removal of the fragments.

Another source of head injury from an explosive blast can result from being bodily thrown by the explosion. The soldier’s head could strike some other object, causing tertiary blast injury. This can cause injuries in a number of places in the patient’s skull. There is also the risk of infection in cases such as these, often from bacteria that are drug-resistant. A number of dangerous injuries can result from such trauma, New York City doctors know. It can be very important to repair such injuries as facial fractures quickly.

Published on: July 16, 2012

Blast TBI (traumatic brain injury) happens to many combatants, according to New York Brain Injury Lawyers

by Stephen Bilkis

Blast TBI (traumatic brain injury) happens to many combatants, according to doctors. It can rightfully be considered a new class of TBI. While it might share a lot of features with standard TBI, it has some unique aspects that are all its own.

The milder forms of TBI can be very similar to PTSD (post-traumatic stress disorder), but it also has distinct aspects of its own. The military currently uses civilian standards of care for TBI when it comes to bTBI (explosive blast TBI), but they are constantly revising their standards to better provide for those injured on the field, according to experts. The theater of war requires different standards of medical practice.

It is apparent that there need to be more studies done on the precise effects of bTBI, both scientifically and clinically. The research will have to be focused upon how explosive blasts can lead to TBI. It is also important to learn how prevalent this disease is, and the exact causes. Once the research reaches a certain level, it will become much easier to diagnose and treat bTBI. A clinical definition of bTBI should quickly create the means to treat bTBI.

Published on: July 2, 2012

Brain injury can be very tricky to find and properly assess and treat

by Stephen Bilkis

Brain injury can be very tricky to find and properly assess and treat, doctors have learned. Very often, the location of the actual injury is not at the point of impact. When an impact does not have the force to breach the skull, but is significant enough to cause injury, the force can be transferred to thinner bones found in other places, such as the base of the skull.

Physicians in New York and Westchester County sometimes use the term ‘countrecoup’ to describe head injuries that result from an impact on the other side of the head. Contrecoup injuries are caused by rapid and localized pressure changes on the surface of the brain due to force transmitted by a sudden impact. These injuries can also be caused by the brain actually moving inside the skull and sustaining injury from striking the bony surfaces.

The location of the head injury is also important, studies have learned. As far back as 200 years ago, physicians have been noting that injuries to the frontal portion of the brain tend to be less severe than injuries taken to other parts of the brain. Research has shown this to be the case time and again, both from experiments and from collecting medical data. There are, however, studies that suggest that the nature of head injuries may be far more complex than that, depending upon the location of the injury. The very complexity of the brain itself makes it difficult for physicians and other medical experts to establish a clear pattern when it comes to head injuries.

Published on: June 22, 2012

Stepfather Convicted of Causing Grievous Bodily Harm to Toddler

by Stephen Bilkis

After seven hours of deliberation, a District Court jury delivered a majority, or 11 jurors to one, verdict in the case of a 22-year-old stepdad. The man was found guilty on the charge of causing grievous bodily harm with intent.

The stepfather had always denied the charge that he caused a head injury that left a 2-year-old child with little more than 50% of his brain function. He stood passively in the dock as he was remanded to custody for a July sentencing. As he was escorted from the court, a supporter mouthed “I’m sorry.”

The Judge thanked the jury and told them, based on the evidence, their decision was the only one open to them.

Published on: May 26, 2012

Coalition Developed to Explore TBI Treatment on the Scene of Accidents

by Stephen Bilkis

Approximately 1.4 million Americans will suffer a brain injurythis year. An unprecedented collaboration of Emergency Medical Services (EMS) first responders, state health officials and university researchers will hopefully help save Arizona residents who are among that number who could suffer brain injury in the coming year.

Groundbreaking studies and life-saving developments are melding into a series of pre-hospital treatments for traumatic brain injury (TBI). These treatments, as studies suggest, are to be administered immediately at the scene of the accident.

Arizona Department of Health Services, Arizona fire departments, ambulance companies, Arizona Emergency Medicine Research Center and the University of Medicine, announced their collaboration during an extraction demonstration by Glendale Fire Department.