Articles Posted in Manhattan

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A Manhattan contractor who owned a home improvement company obtained a contract to renovate a couple’s home. The man worked on the couple’s home: he was up on the roof supervising the repair of the roof when he slipped and fell. He hit his head and sustained a brain injury.

He filed a personal injury complaint against Workmen’s Compensation, against his own company and against the couple who owned the house he was renovating. In that personal injury case, trial was held to determine if the brain injury sustained by the contractor qualifies as a grave injury under the Workmen’s Compensation Law.

During the trial, the contractor adduced proof regarding the extent and nature of his brain injury. His medical experts testified that the contractor had cognitive dysfunction which permanently disabled him from doing any work. The insurance company provided its own expert who conducted a neuropsychological evaluation of the contractor. The expert of the insurance company found that the contractor’s brain injury was severe and traumatic such that he has lost the ability to make decisions required in daily life.

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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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U.S. service members injured in the line of duty have long been eligible to receive the Purple Heart Medal. This has held true for the signature wounds of the current wars, including mild traumatic brain injuries and concussions.

Recently, the criterion for awarding the medal was refined. “More clarity now exists for how medical criteria for the award are applied,” Defense Department officials reported.

“The criteria for the Purple Heart award state that the injury must have been caused by enemy action or in action against the enemy and has to be of a degree requiring treatment by a medical officer.”

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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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The Facts:

On 9 September 2000, infant plaintiff was in an infant walker. Thereafter, infant plaintiff fell down a stairway leading to the second floor apartment in Bronx County.

As a result, a personal injury action has been instituted. Infant plaintiff allegedly sustained the following personal injuries: traumatic brain injury; developmental delays including speech; impaired motor and sensory processing skills; blunt face and head trauma; abrasions, tenderness and swelling to nasal area.

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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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State Representative Dewayne Bunch, also a Whitley County High School teacher, is improving. According to the public relations and marketing director for Shepherd Center in Atlanta, Georgia, the 49-year-old who sustained a head injury while trying to break-up a fight between two students in the school’s cafeteria, in April, is recovering nicely.

The teacher was transported to Baptist Regional Medical Center and then transferred to the University of Kentucky Medical Center. Two weeks after that, he was moved to the intensive care unit at Shepherd Center, a hospital specializing in the treatment of brain and spinal cord injuries.

The State Representative’s traumatic brain injury (TBI) has improved enough that he has now even been moved to the hospital’s rehabilitation unit.

His wife was quoted as giving thanks to the public. “I appreciate the outpouring of support and kindness we’ve received from the community. Please continue to keep [my husband] in your prayers as he continues his journey to recovery.”

More extensive details on his recovery and prognosis are not available at this time. Realizing how varied brain injuries can be, an Attorney, has said that his brain could be recovering from a minor hurt, or it could be trying to reconnect neurons after a serious injury left him with a damaged portion of his brain. While it is unclear what the extent of the TBI is, the fact that the teacher is going to rehabilitation is a good sign. The first periods immediately after a TBI are extremely important and rehab helps tremendously.

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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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