Articles Posted in New York City

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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.

The parents of the child filed a personal injury lawsuit to recover damages from the medical malpractice that existed in that delivery room. The parents won the lawsuit and were awarded over two million dollars in damages. The pediatrician filed a motion that would prevent the family from recovering more than $450,000 from him personally as a result of the injury to the baby. He contends that he was not the person who caused the greatest amount of damage to the baby and that he should not have to share equally with the cost of damages that the obstetrician caused. The court evaluated the decision of the trial court and determined that the jury was not wrong in awarding damages to the parents and that the sum that was awarded was not extreme. They also contend that the testimony that was given at trial did not provide any type of identifiable manner in which the percentage of guilt could be divided between the two doctors. For that reason, the appeals court determined that the prior order of the court was accurate and that the responsibility would be shared equally between the two doctors.
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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.

The wife disagreed and presented the case to the courts. The courts examined the injuries, reports, and contentions associated with this case. The trial court at first determined that there was no causal link between his injury and his death. The wife appealed this decision to the Supreme Court. The Supreme Court ruled that based on the suicide note claiming that the injury caused his suicide, and the devastating effects that the back injury had on his life, there was reason to believe that the suicide was the result of the injury at least in part. There is little doubt that this man dealt with depression in his life circumstances, but the court determined that there was a causal link between his suicide and his injury.
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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.

The medical evidence reveals that, as a result of the fall, the man suffered a traumatic brain injury which included, among other things, a posterior temporal contusion and a left frontal epidural hematoma. The psychiatrist, who performed an independent medical examination to the man, reported that as a result of the brain injury that the man suffers from an inability to concentrate for long periods, significant loss of short-term memory, fatigue and psychomotor slowing, as well as depression symptoms directly resulting from the catastrophic injuries sustained in the accident. The physician that the man has been treating since the accident similarly averred that the man continues to suffer from cognitive difficulties, such as poor concentration and memory deficits, as a consequence of his brain injury. Both experts agreed that, given that the man’s cognitive deficits persist more than four years after the accident, the symptoms will not improve with time or rehabilitation and, therefore, are permanent in nature. They also unequivocally opined that the symptoms and residual effects caused by the brain injuries suffered as a result of the accident, particularly the man’s poor cognitive functioning, render him permanently and totally disabled and unable to maintain any type of gainful employment either on a full or part time basis. The evidence, coupled with the fact that the man has been awarded with Social Security disability benefits, is sufficient to raise a material question of fact.

When a tenant remains in possession upon the expiration of a lease, it is a holdover and, pursuant to common law, there is implied a continuance of the tenancy on the same terms and subject to the same covenants as those contained in the original instrument. The Workers’ Compensation Law in NYC permits a third-party indemnification claim against the employer only when such claim is based upon a provision in a written contract entered into prior to the accident or occurrence by which the employer had expressly agreed to indemnification of the claimant or person asserting the cause of action for the type of loss suffered. There is clearly no such written agreement between the employer and the warehouse corporation whereby the employer expressly agreed to indemnify the warehouse corporation. Rather, the only express agreement to indemnify is contained in a long expired lease between the warehouse corporation and the owner of the Dollar Store. Whether an assignment of the expired lease could be presumed as a consequence of its possession of the premises and payment of rent is simply irrelevant to our analysis under Workers’ Compensation Law.

Thus, inasmuch as there is no writing whereby the employer Dollar Store expressly agreed to indemnify the warehouse corporation, summary judgment dismissing the warehouse corporation’s contractual indemnification claim should have been awarded.
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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.

The disparity in coverage of brain injury cases is alarming. It is not uncommon for patients with bare-bones insurance coverage to be discharged after only a week or two in the hospital. As a result, significant medical complications will probably arise. Muscles might begin to contract, or seizures may occur.

Even Americans in Staten Island with more substantial insurance often get shortchanged, which reduces their likelihood of returning to work or even making a complete recovery.

An interested based in New York shares what he recently learned from the president of the Brain Injury Association of America. He says “a person with a moderate to severe injury would likely need at least a month of continuous therapy at a rehabilitative hospital. Exercises would focus on restoring muscular and other physical functions, speech, psycho-social capacity and cognitive functions, such as forming memory and maintaining attention. Next, a patient might spend six to eight weeks at a transitional rehabilitation unit, regaining life skills such as bathing and cooking. Finally, once home he might need rehabilitative therapy three times a week for at least another month.

Such comprehensive rehabilitative care is expensive – at least $8,000 per day for hospital-based “acute rehabilitation,” up to $2,500 for “post-acute residential care” and as much as $1,000 per day for other treatment programs. But still these costs are still a bargain when comparing them to the cost of long-term care for someone who doesn’t receive proper care and ends up permanently disabled.
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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.

Each year, U.S. hospital emergency departments treat 1.2 million cases of traumatic brain injury. At 30%, these findings suggest that at least 360,000 of those patients will suffer depression sometime after their head injury. Whether it is immediately after or in weeks, months, or years – the study doesn’t pinpoint when each victim will experience it, it just highlights that is should be a serious consideration for loved ones of TBI sufferers to consider.
The authors of the study said their findings are important because it is still being debated whether antidepressants are a safe and effective treatment for the brain-injured. Brain Injury doctors based in New York agree that there is currently a lack of research in the area.

The co-director of the Vanderbilt Evidence-based Practice Center said, in a news release that, “It’s unacceptable, with so many people sustaining TBIs — both in combat and civilian life — that we know so little about treating depression in this population.”

With more research into the area, advancements will be made in the area. At the very least, figuring out whether brain-injury patients in NYC or Westchester should have their depression treated differently than patients without TBI is of utmost importance.
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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.

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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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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.

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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.

During the five-day trial, the jury heard that the small boy had been found face down and unconscious on his bedroom floor in May of 2009. He was then taken to Southland Hospital, in Westchester where an urgent CT scan revealed a collection of blood on his brain. He was transferred to another facility to undergo a lifesaving brain surgery, and then sent to Auckland’s Starship children’s hospital.

At the time of the injury, the defendant was in a relationship with the boy’s mother. The mother told the jury that the toddler was sent to time out on May 31 because he had stood too close to the television after being repeatedly told not to. She said the 22-year-old had walked the boy to his bedroom and was only gone long enough to place him in the room and then leave. She said that a few minutes later he checked on the toddler, but again quickly returned.
The mother reported that he again checked on the child. This time, he returned carrying Harry, who was floppy and acting like a ragdoll with blood coming out of his mouth.

The prosecuting attorney pointed to something being ‘amiss’ in the household because the little boy was subjected to repeatedly lengthy time-outs. She also posited that the injury happened because the defendant was angry and slammed the little boy’s head into the floor. Apparently 11 of the 12 jurors in New York City agreed with her.
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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.

Glendale’s Fire Department demonstrated a “mock” car crash extrication to illustrate the time-sensitive process involved with a traumatic brain injury. During the demonstration, firefighters engaged in an extrication of a patient from a vehicle, treated the patient and then transported them using helicopter HALO-151.

Firefighters used “jaws of life” to quickly and safely remove the mock victim from the vehicle and demonstrate how the patient is transported from the crash site to the hospital in the quickest and safest way possible.

Under a grant recently received from the National Institutes of Health, Arizona will activate guidelines that have been heavily researched across the country, and the coalition will record the impact of this approach to patient care. New York City and Staten Island will do the same. The Arizona Emergency Medicine Research Center will be conducting the tracking. The research center, part of the University of Arizona’s College of Medicine, will be able to determine the program’s effectiveness and identify the number of lives saved.

“We are going to save lives and improve the quality of life for those who suffer traumatic brain injury with the standards developed through this project,” said the medical director of the Bureau of Emergency Medical Services and Trauma System for the Arizona Department of Health Services.

Half of all TBI fatalities occur within two hours of initially suffering the brain injury. A doctor says, “In fact, there’s very strong evidence that the care provided in the first few minutes has a profound impact on survival.”
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