Articles Posted in Long Island

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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.

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According to the research provided in a study released last week, the Army could reduce the chances of a soldier suffering from brain injury simply by having them wear a helmet one size larger and containing slightly thicker padding.

The study in Long Island found that as little as a Enlarge Closen eighth of an inch more cushion could decrease impact force on the skull by up to 24% – a substantial difference when determining whether or not brain trauma is on the menu.

Brain injury is a common occurrence on the battlefield of Afghanistan, and the Army is looking to verify the findings and then to move toward issuing larger helmets with the extra padding. Concussions are common among troops knocked about inside armored vehicles or flung to the ground while on foot patrols.

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A report issued by the Institute of Medicine (IOM) in Long Island now states that if an appropriate dose of nutritional supplements is administered soon after an injury occurs, service members wounded on the battlefield have a much better outlook at recovering from a Traumatic Brain Injury (TBI). Nutrition apparently plays an even bigger role than previously though.

Commissioned by the Department of Defense (DoD), the report urges the military to make infusions, which contain calories and protein, a standard part of care in the immediate aftermath of a brain injury.

Accordingly, these findings also have implications in the civilian sector. “The investment the military makes will cross over into the civilian population for injuries suffered by those in car accidents, in motorbike accidents, by kids on soccer fields,” says the IOM panel chairman, professor emeritus of food science and human nutrition at the University of Illinois.

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At the climax of last year’s fighting season, more than 300 U.S. troops received mild traumatic brain injuriesor concussions every month. Often those injuries resulted from exposure to a blast. Troops not killed or gravely wounded by blasts were often left stunned or even momentarily unconscious.

Concerned that many soldiers were suffering mild traumatic brain injuries or concussions, the military put new treatment procedures in place last year. Regulations now require that any soldier or Marine caught near a blast has to be pulled from active combat for at least 24 hours, and they must be examined for signs of concussion. Those displaying symptoms – such as dizziness, headaches or vomiting – remain on rest duty until the symptoms disappear. This can take up to a week or two.

The concern that led to this change revolved around the thought that troops need time to recover, and that exposure to a second blast before a brain has healed, could cause permanent damage. Manhattan and Long Island doctors remark that it is pivotal that military officials are attempting to provide combat operation manuals that incorporate the wellbeing of soldiers.

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A man working as a janitor for a small private university was performing his usual tasks when he hit the back of his head on a metal pipe that overhung from the low ceiling of the basement of one of the buildings of the university. After hitting the back of his head against the metal pipe, he suddenly felt dizzy and his vision became fuzzy. He dropped to the floor and felt as though the entire left side of his body sagged. He was taken to a hospital immediately and was seen by a doctor’s assistant in the emergency room. He was immediately discharged when the doctor’s assistant noted that his symptoms had abated.

Dissatisfied with the diagnosis, man went to another hospital where he was diagnosed to have a brain injury: the area of his brain nearest the brain stem that leads to the spinal cord was bleeding. He stayed in the hospital for about thirty days. The Manhattan neurologist who treated him at the second hospital he went to gave a report that he believed that the brain injury sustained by the janitor was a direct result of the accident because the bleeding in the brain was in the same site as the area of his head that hit the metal pipe.

He later filed a complaint for damages under the Workmen’s Compensation Board. The doctor who treated him at the second hospital gave an opinion of his medical findings that the brain injury he sustained was a direct result of hitting his head against a metal pipe.

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This is a case where the Manhattan Court reiterated the principle that when a single indivisible injury, such as brain damage, was negligently inflicted upon the plaintiff, defendants can be held jointly and severally liable notwithstanding that the latter neither acted in concert nor concurrently with each other.

A mother, who suffered gestational diabetes during her pregnancy, gave birth to an unusually large baby who is the plaintiff in this case. At the time of the trial, plaintiff was severely and permanently retarded as a result of the brain damage she suffered at birth. The evidence established that the obstetrician who had charge of the ante partum care of plaintiff’s mother and who delivered the plaintiff, failed to ascertain pertinent medical information about the mother, incorrectly estimated the size of the infant, and employed improper surgical procedures during the delivery. It was shown that the defendant, the pediatrician under whose care Josephine came following birth, misdiagnosed and improperly treated the infant’s condition after birth. Based upon this evidence, the jury concluded that the obstetrician committed eight separate acts of medical malpractice, and the defendant pediatrician committed three separate acts of medical malpractice.

During the trial, the plaintiff’s witness concluded that neither he nor anybody else could say with certainty which of the factors caused the brain damage. Although the obstetrician’s negligence contributed to the plaintiff’s brain damage, the medical testimony demonstrated that the defendant’s negligence was also a substantial contributing cause of the injury. No testimony was adduced, however, from which the jury could delineate which aspects of the injury were caused by the respective negligence of the individual doctors.

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The infant plaintiff, then a sixth grader at Intermediate School 292 in Brooklyn (IS 292), was seriously injured when he fell down a flight of stairs on his way to lunch. Because of the resultant traumatic brain injury, plaintiff was unable to remember what caused him to trip and fell down. However, it was plaintiff’s theory at the trial of this action, that he was pushed down the stairs by a group of older students. Plaintiff further presented testimony that it was the written policy of IS 292 to have a teacher escort the sixth graders down to lunch from their second floor classrooms. Plaintiff claims that his teacher’s negligent failure to do so proximately caused his injury.

Plaintiff testified that, he had been in math class on the second floor right before lunch and that the teacher for the class was Mrs. Thomas. According to plaintiff, Mrs. Thomas never escorted her class to the lunchroom and that day was no exception. Plaintiff stated that at the sound of the bell, he and his friend Nathaniel headed to one stairwell, while the rest of the class went to the stairwell at the other side of the hall. The Manhattan Plaintiff testified that he suddenly heard footsteps which sounded like they were coming from a herd of buffalo and the next thing he remembered was waking up in the school nurse’s office with a tissue on his forehead and blood stains on his shirt. Plaintiff was taken by ambulance to Brookdale Hospital where he spent time in the Intensive Care Unit.

A Lawyer said that, at trial, plaintiff detailed the “excruciating” pain he suffered immediately following his accident and for the six days he spent in the hospital. Plaintiff described this pain as being in his head, neck, and lower back. Additionally, his arms and leg were swollen and sore and he was in a neck brace. After his release from the hospital, plaintiff received outpatient physical and occupational therapy there. The purpose of the physical therapy was to improve his balance and mobility skills and the occupational therapists sought to improve plaintiff’s hand/eye coordination and to build strength in his arms. Plaintiff stopped attending therapy but had to use a cane for balance for about three years.

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The current conflicts in Iraq and Afghanistan have led to a great many more serious injuries to United States service members. One of the most prevalent and dangerous is explosive blast traumatic brain injury (TBI). Doctors have been studying the rising trend.

There have been a number of military medical treatments for blast TBI which have been a success in the war theater, such as decompressive craniectomy, cerebral angiography, transcranial Doppler, hypertonic resuscitation fluids, and others. There has been similar progress stateside in neurosurgery, neuro-critical care, and rehabilitation for patients suffering injuries caused by blast TBI.

As they continue to treat these injuries, military physicians in Brooklyn and Long Island have been able to clinically categorize many types of blast TBI, according to studies. One of these important discoveries is the development of psuedoaneurysms and vasospasm in severe blast TBI victims, which can cause delayed decompensation. Another is that mild blast TBI often has very similar clinical features to post-traumatic stress disorder (PTSD). Some physicians have conclude that the injuries explosive trauma causes to the nervous system might be more complex than might appear at first examination.

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Physicians currently do not have many distinctions between explosive blast traumatic brain injury (bTBI), closed head traumatic brain injury (cTBI) and penetrative traumatic brain injury (pTBI), according to doctors. The military also uses the same criteria to assess such injuries as civilians.

A 1993 definition from the Mild Traumatic Brain Injury Committee of the American Congress of Rehabilitation Medicine of TBI apples to bTBI when an explosive blast causes loss of consciousness, amnesia, or loss of focus. The severity is determined by how long the altered mental state lasts. Less than 5 minutes is mild, though it can lead into difficulties like headaches, confusion, and amnesia, as well as a difficulty to concentrate, altered mood, problems sleeping, and general anxiety. These symptoms usually go within a few hours or days.

Studies in Manhattan and Long island have discovered that even these mild cases could result in post-concussive syndrome which could happen days later. Government agencies are currently developing guidelines to manage this condition, which seems to respond to simple reassurance and specific treatments like non-narcotic analgesics, anti-migraine medication to treat headaches, and anti-depressants. Just as with civilian cTBI, the problem might last only a few weeks, but it might well last a year or more in some cases.

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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.

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