SPINAL CORD & TRAUMATIC BRAIN INJURY

WATCH > Documentary: Understanding Traumatic Brain Injury

“Understanding Traumatic Brain Injury” is a 29-minute program, introduced by General Colin L. Powell, USA (Ret.). It offers an introduction to traumatic brain injury, a health issue affecting at least 1.4 million Americans each year. It features the recovery journeys of several service personnel and their families.

Paraplegia and Quadriplegia

Representing clients who suffer from paraplegia or quadriplegia presents the most challenging yet rewarding damages case a lawyer can undertake. The spinal cord injured client has lifetime care needs that will cost in the millions of dollars. The reward to the lawyer of knowing that he or she has fulfilled those needs in a skillful, dedicated and compassionate manner results in the highest degree of career satisfaction. Such a case also represents an opportunity for the lawyer to do good for a human being in dire need. Such a case deserves the very best representation a lawyer can deliver. Years of experience are required to effectively handle these cases.

E. Marcus Davis has spent 30 years developing the medical knowledge and expertise necessary to expertly and professionally represent clients who have sustained catastrophic spinal cord injuries.

The most challenging and daunting task is to educate insurance companies for settlement and juries in trial about the myriad complications and conditions that are associated with spinal cord injuries.

Actor Christopher Reeves’ plight following a horse jumping accident, which left him a ventilator dependent quadriplegic, has heightened public awareness and interest in spinal cord injuries. Unlike Mr. Reeves however, many potential clients cannot afford the sort of care that their injuries require, when they obtain full and adequate compensation against a negligent party who caused their injuries. Many clients suffered paralysis through no fault of their own and should be compensated for their life altering injuries so that they can afford excellent care.

As the spinal cord injury patient soon learns, being paraplegic or quadriplegic does not simply mean that a person experiences an inability to move extremities, nor does it mean that you can no longer act as a functioning member of society. What these injuries do mean is that a client will require expensive medical care, therapies, and assistive devices, in order to become accustomed to living with a spinal cord injury, as well as carrying out day to day activities or return to work or functioning as a parent or spouse in meaningful productive activities.

We have learned over many years of representation of catastrophically injured clients that spinal cord injuries cause both physical injuries, pain and suffering and emotional and mental harm.

The issues which must be taught to the jury in a trial or insurance company adjuster in a mediation, are that paraplegics and quadriplegics experience a break down of bodily tissue due to a lack of movement in and pressure on their extremities. Decubitus ulcers, known as pressure sores are common. 60% of quadriplegics develop these sores. In order to avoid the formation of these ulcers, the client must be constantly moved and readjusted by caregivers.

Such infections are serious and sometimes life threatening. They must be treated aggressively and sometimes at great expense.

Spinal cord injured patients develop deep vein thrombosis (DVT) which can result in pulmonary embolism. A number of methods must be used to prevent DVT including Heparin, Warfarin, external pneumatic compression, Greenfield filters and TED hoses. Because blood clots that result in pulmonary embolism normally originate in the calf muscle, both the paraplegics and quadriplegics are at risk. Quadriplegics are also at risk for pulmonary complications including; pulmonary atelectasis and bronchio-pulmonary infection and pneumonia.

Although some paraplegics retain normal bladder function, most paraplegics, and all quadriplegics need a system of mechanical intervention in order to avoid urinary tract infections from a neurogenic bladder. Urinary tract infections are common and must be prevented if possible and treated aggressively if they occur. Worse case complication is renal failure and death. Further renal problems include tubular necrosis as well as platelet dysfunction and disruption of bone and mineral metabolism.

A quadriplegic or paraplegic person can develop osteoporosis because of the lack of muscle activity and weight bearing that normally results from physical activity, thus increasing the likelihood of bone fractures.

Spinal injury sufferers also frequently have a condition known as a neurogenic bowel, in which fecal matter builds up until it causes an impaction, unless relieved. Many patients require a stoma or hole into the large intestine to avoid feces.

Muscle spasticity, the sometimes violent, rapid flexing of muscles, sometimes occurs. Heterotrophic Ossification, or abnormal bone build up, can cause diminish range of movement of major joints.

Gastrointestinal complications are common as well, such as illeus, paralysis of the intestines, and GERD (gastroesophigial reflex disease).

Perhaps the most threatening complication of paralysis below the sixth thoracic vertebra is autonomic dysreflexia, a symptom that occurs in 85% of tetraplegics. The complications of this syndrome includes stroke and death. Pain stimulus below the level of injury activates the sympathetic nervous system, causing blood pressure to rise to potentially dangerous levels.

It is a myth that spinal cord injured patients feel no pain below the level of injury. Frequently they experience pain akin to that experienced by amputees-phantom pain.

The psychological trauma associated with spinal cord injury may be the worst aspect of the injury. Client’s lives are altered in a devastating and lasting way. Depression is a common response. Traumatic deterioration of self-image ensues. The client and his or her family feel like the patient/client is no longer the same person in a very profound way. Many paralyzed people cannot get out of bed, feed oneself, scratch an itch, or use the bathroom without assistance. All of these complications of injury lead to embarrassment, frustration and loss of self-esteem. As a result of spinal cord injury, most victims have to leave work, causing problems of financial dependency and loss of the ability to support themselves and their family as well as the ability to have a meaningful function and purpose in life.

To children who suffer spinal cord injuries, the effects can be devastating. While other children can run and play at will, the severely injured client becomes a spectator to life, rather than a happy, active participant.

Romantic relationships, including sexual function, become more difficult for those who suffer a spinal cord injury. Procreation becomes problematic. Many paraplegics and quadriplegics fear that they will never find a mate or will lose the mate that they have.

As a result of all the negatively impacted aspects of life, most people suffer at least an initial period of depression requiring therapy.

For the attorney to properly represent the spinal cord injured client, he or she must plan for the injured client’s future and obtain a "life care plan" which will provide for all of the itemized expenses involved in such an injury including medical treatment, caregivers, special housing needs, special adaptive devices and the like.

We as trial lawyers have a vital and important role to play in society in helping spinal cord injured clients to obtain full compensation for their losses and enough money to pay for all their specialized medical, caregiver, housing and transportation needs.

Spinal cord injured clients deserve the very best representation a lawyer can provide.

TRAUMATIC BRAIN INJURY

Mr. Davis has prosecuted over one hundred traumatic brain injury cases ranging from mild to catastrophic for brain injury survivors. His knowledge about brain injuries allowed him to help clients whose cases might not have been considered by other less informed lawyers. Using his expertise in this area, he published "Mild to Moderate Brain Injury - A Silent Epidemic Needing to be Heard" in the magazine of the Georgia Trial Lawyers Association, The Verdict, published "Mild to Moderate Brain Injury" in the magazine of the Association of Trial Lawyers of America, Trial Magazine, and has co-chaired numerous seminars on the subject of brain injuries for lawyers. In 2000, he was co-chairman in the annual fundraising campaign for the Brain Injury Association of Georgia. The article and seminar instructed attorneys in the field on the emergence of new diagnostic tools being used by neurologists and neuropsychologists and the importance of previously ignored symptoms of brain injury.

An experienced trial lawyer should recognize a mild to moderate brain injury case even when the client arrives undiagnosed. Often, the client may experience dizziness, overwhelming fatigue, vision problems, concentration problems, memory problems, mood swings, and even depression. Recognizing some of the signs and symptoms of traumatic brain injury and making sure that the client's treating physician refers the brain injured person for proper diagnostic evaluation is part of the obligation of the trial lawyer in this field. A good personal injury lawyer should concern himself with obtaining appropriate specialized medical help for his clients while also fulfilling the more traditional lawyer's role of helping clients obtain full and fair compensation for of their injuries, physical, mental and emotional. After all, a lawyer should serve his client not only in the court room, but also as an advisor to the client who has just experienced tragedy and needs the appropriate medical care in order to recover as quickly as possible.

To maintain his expertise in traumatic brain injury cases, Mr. Davis attends seminars across the country on brain injury, and, over the years, has attended many traumatic brain injury support groups. He also belongs to and donates to the Brain Injury Association of Georgia and served as co-fundraising chairman in 2000. Through many cases, Mr. Davis has acquired a wealth of brain injury textbooks, articles, and demonstrative exhibits that he uses to keep his knowledge in this field fresh as well as to educate clients, judges, and juries in this complicated area of medicine.

For a more exhaustive review on the subject, please refer to: "Mild to Moderate Brain Injury: A Silent Epidemic," Trial Magazine, 1990.

• American Academy of Neurology
  http://www.aan.com
  Review of neurological conditions and neurology related links.
  
  
• American Association of Neuroscience Nurses
  http://www.aann.org
  Organizational information and links to other neurological sites.
  
  
• Brain Injury Association of America
  http://www.biausa.org/
  Provides education, advocacy and support for those affected by brain injury.
  
  
• Brain Injury Association of Georgia
  http://www.braininjuryga.org
  Provides education, advocacy and support for those affected by brain injury.
  
  
• Brain Injury Association of Georgia Info & Resources
  http://www.braininjuryga.org/info_resources-frame.html
  FAQs and a directory of brain injury services and resources in Georgia
  
  
• Brain & Spinal Injury Trust Fund Commission
  http://www.ciclt.net/bsitf/
  The Brain and Spinal Injury Trust Fund Commission enhances the lives of Georgians with traumatic brain and sponal cord injuries by administering the central registry, distributing resources through the trust fund, and advocating for improvements in statewide services.
  
  
• Brain Injury Research Foundation
  http://www.birf.info/
  Where people affected by brain injury find answers to questions, resources, and a caring community.


• Centers for Disease Control (CDC)
  http://www.cdc.gov
  
  
• Defense and Veterans Brain Injury Center
  http://www.dvbic.org/
  The mission of the Defense and Veterans Brain Injury Center (DVBIC) is to serve active duty military, their dependents and veterans with traumatic brain injury (TBI) through state-of-the-art medical care, innovative clinical research initiatives and educational programs.
  
  
• Cerebral Palsy Directory
  http://www.ecerebralpalsy.com
  Compendium of Cerebral Palsy related resources.
  
  
• Georgia Advocacy Center
  http://www.thegao.org/
  The Georgia Advocacy Office (GAO) works with and for oppressed and vulnerable individuals in Georgia who are labeled as disabled or mentally ill to secure their protection and advocacy.
  
  
• Global Brain Stem '97
  http://www.anatomy.wisc.edu/bs/text/bs/bs.htm
  University of Wisconsin Medical School's online textbook.
  
  
• Hydrocephalus Association
  http://www.hydroassoc.org/
  Organizational information and newsletter articles.
  
  
• Institute of Neurotoxicology and Neurological Disorders
  http://www.innd.org
  Consumer health resources for neurological disorders.
  
  
• Journal of Neuroscience Online
  http://www.neuroscience.org
  Searchable database with full text on abstracts.
  
  
• Malignant Brain Tumors and Neuro-oncology Resources
  http://neurosurgery.mgh.harvard.edu/nonc-hp.htm
  Massachusetts General Hospital Harvard Medical School site with information and links to other neurological resource sites.
  
  
• Medical Matrix - Neurology
  http://www.medmatrix.org/
  Neurological news, articles, abstracts, diseases, patient education and more.
  
  
• Ntl. Assoc. of State Head Injury Administrators
  http://www.nashia.org/
  Assisting state government in promoting partnerships and building systems to meet the needs of individuals with brain injury and their families.
  
  
• The National Institute of Neurological Disorders and Stroke
  http://www.ninds.nih.gov
  A searchable site with information on selected neurological disorders.
  
  
• Neurosciences on the Internet
  http://www.neuroguide.com/
  Searchable database and links to resources.
  
  
• Neuro Trauma Law Nexus
  http://www.neurolaw.com/
  Resource for understanding the legal system's involvement in brain and spinal cord injury cases.
  
  
• Society for Neuroscience
  http://www.sfn.org/
  Publications of the Neuroscience Society.
  
  
• The Virtual Hospital: The Human Brain
  http://vh.radiology.uiowa.edu/Providers/Textbooks/BrainAnatomy/
  7BrainAnatomy.html
  Online textbook with images of dissections of the real brain.
  
  
• Whole Brain Atlas
  http://www.med.harvard.edu/AANLIB/home.html
  Searchable site with images of various medical conditions and a neuro-imaging primer.

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