Table of Contents for the April Issue of Concussion Litigation Reporter

April 2017, Vol. 5, No. 10

Timely reporting on developments and legal strategies at the intersection of sports and concussions—articles that benefit practicing attorneys who may be pursuing a claim or defending a client.

Articles

New Study Strengthens Calls for Further Investigation into CTE Links with Soccer.

Appeals Court: Use of Oklahoma Drill May Have Been Gross Negligence

Discussion on NCAA and Concussions Steals the Show at Harvard Law School Symposium

Appeals Court: What Coaches Don’t Know About a History of Concussion Cannot Hurt Them

Soccer Goalie Alleges Team Failed to Hold Him out of Practice After Suffering Concussion, Exacerbating Symptoms

BIAPA Executive Talks About Role of Organization and Membership’s Biggest Concerns

Concussion in Sport: Liability of Governing Bodies

Senate Bill 12 – An Analysis

NFLPA Assails Possible Change in Worker’s Comp Law in Illinois

Attorney Weighs in on Change to Workers’ Comp Law for Professional Athletes

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TBI in Emergency Departments a Substantial Economic Burden TBI in Emergency Departments a Substantial Economic Burden

A new study that looked at nearly 134,000 emergency department visits for traumatic brain injury, including concussion, during a one year period in Ontario estimated that those visits had a total cost of $945 million over the lifetimes of those patients.

Medical treatments accounted for $292 million (31 per cent) of the estimated lifetime costs, and lost productivity amounted to $653 million (69 per cent), according to the report, published online in the Canadian Journal of Neurological Science.

Policy makers are increasingly using cost-of-illness studies such as this one to guide resource allocation and identify opportunities for improving health-care sustainability, said Dr. Michael Cusimano, a neurosurgeon at St. Michael’s Hospital and a senior author of the study.

“Traumatic brain injuries are occurring at alarmingly high rates and have the potential for long-term disability, so it’s important to understand how best to prevent them using available resources,” he said. “Determining the patterns, causes, effects, and costs of TBI-related emergency department visits is one way to do that.”

Looking at data from 2009, researchers found there were 133,952 TBI-related visits to Ontario EDs that year. They were also able to break these visits down into demographic groups.

Young children and the elderly had the highest rates of TBI-related ED visits compared with those aged five to 65, according to the authors.

The rate of TBI-related ED visits was higher for men than women across all age groups younger than 65, according to the authors. This gender difference was particularly evident within the 15 to 24 and 25 to 34 age categories, in which men were twice as likely as women to go to an ED with a TBI.

Costs were greater for men than women across nearly all age groups, with men incurring double the costs overall. This finding is consistent with the fact that men suffer a higher rate of fatal injury and earn a higher income on average, compared with women, according to the report. One exception was the over 85 years category, in which costs were 56 per cent higher for females than males. Women live longer than men on average; therefore women are more likely to sustain a TBI because they are overrepresented in the over 85 age range, according to the authors.

Falls were the cause of almost half (47 per cent) of TBIs in the year studied. The highest rate of falls occurred among children under four and the elderly (age 75 years and older), who together were six times more likely to sustain a fall-related TBI compared with other age groups.

Other common causes of TBI were struck by/against injuries, in which TBI was sustained when a person was struck by or struck against another person or an object (37 per cent), motor vehicle crashes (10 per cent) and sports- and bicycle-related accidents (combined 12 per cent).

The highest rates of motor vehicle crash-related TBI occurred among adolescents and young adults. Although they accounted for only 10 per cent of TBIs, they accounted for more than 17 per cent of total costs. This disproportionately large cost reflects the long-term disabilities resulting from the original injury resulting from motor vehicle accidents and the increased likelihood of younger age groups being affected by motor vehicle crashes, resulting in high lifetime medical and lost productivity costs, the authors wrote.

The findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations, said Terence Fu, a medical student at St. Michael’s and an author on the study.

“An emphasis on efforts such as falls prevention among the elderly, motor vehicle accident prevention among young adults, and sports-related TBI prevention among youth, could help decrease the incidence and economic burden of these injuries,” he said.

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NFL Names Dr. Allen Sills Chief Medical Officer

NFL Commissioner Roger Goodell has named Dr. Allen Sills as the NFL’s Chief Medical Officer (CMO), a new full-time position based in New York.

Dr. Sills joins the NFL from Vanderbilt University Medical Center where he serves as Professor of Neurological Surgery, Orthopaedic Surgery and Rehabilitation, and Founder and Co-Director of the Vanderbilt Sports Concussion Center.

Dr. Sills, a neurosurgeon who has specialized in the treatment of athletes, will “strengthen the NFL’s ongoing efforts to advance the health and safety of the sport. He will work closely with team medical staffs across the league, the NFL Players Association and its advisors and the many medical and scientific experts who comprise the NFL’s medical committees” and “guide” the NFL’s health and research efforts.

“There is no higher priority for the NFL than player health and safety and we continually seek to raise our standards and then surpass them,” said Commissioner Goodell. “We sought a highly-credentialed physician and leader with experience as a clinician and researcher, and Dr. Sills’ extensive experience caring for athletes makes him the right choice for this important position.”

“We conducted an intensive international search which included many leading experts in sports medicine,” said Dr. John York, Co-chairman, San Francisco 49ers and Chairman of the NFL Owners’ Health and Safety Advisory Committee.  “Dr. Sills stood out among the highly credentialed and qualified applicants.”

The appointment follows “a rigorous search” conducted by a premier panel of health and medical experts led by Dr. Betsy Nabel, Chief Health and Medical Advisor to the NFL and President of Brigham Health, and including Dr. Rob Heyer, President of the NFL Physicians Society and Team Internist for the Carolina Panthers, Ronnie Barnes, Senior Vice President, Medical Services and Head Athletic Trainer for the New York Giants, Dr. Robert Cantu, Clinical Professor of Neurosurgery and Co-Director, Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, and Peter Foss, GE Healthcare.

The panel worked closely with Dr. John York, and Jeff Miller, NFL Executive Vice President of Health and Safety Initiatives. The NFL consulted with the NFL Players Association, including interviewing the final candidates. Dr. Sills will be reporting to Miller.

“I have been impressed by the talent and experience of the candidates I have met during this process,” said Dr. Betsy Nabel. “Dr. Sills has years of experience on the frontlines of both research and patient care, and I am confident that Dr. Sills will use this platform to continue his work to improve sports health and safety in the NFL and for all athletes.”

“Hiring Dr. Sills is a touchdown for the NFL,” said Dr. Robert Cantu. “He is an international leader for his work on concussions in sports. I look forward to working with him to further advance the NFL’s ongoing commitment to the health and safety of sports.”

Throughout his career, Dr. Sills has worked with numerous professional and collegiate sports programs. In addition to providing care for players on NFL sidelines as an Unaffiliated Neurotrauma Consultant, he has served as a neurological consultant to the NCAA and the International Equestrian Foundation (FEI). He has also worked as consulting neurosurgeon for the NBA’s Memphis Grizzlies, the NHL’s Nashville Predators, the US Equestrian Foundation and all Vanderbilt University, Belmont University and Mississippi State University athletic teams.

“Allen Sills is an exceptional leader who will bring the perspective of a practicing neurosurgeon to this important position,” said Dr. Reid Thompson, Chairman of the Department of Neurological Surgery at Vanderbilt University Medical Center. “He is an avid athlete and gifted surgeon with a passion for the care of elite athletes. With a combination of energy, vision and absolute integrity he is an inspired choice to become the first Chief Medical Officer of the NFL.” 

Dr. Sills is an active researcher who has published more than 150 scientific articles and presentations including more than 40 in the last five years on the topic of sports concussion. He is a member of the Concussion in Sport Group, which publishes international standards regarding concussion in sport. Dr. Sills is also a fellow of the American Board of Neurological Surgery and the American College of Surgeons and currently serves as Section Editor for Sports and Rehabilitation for the journal Neurosurgery.

Previously, Dr. Sills has served as Founder and Executive Director, Memphis Regional Brain Tumor Center; Director of the Neuroscience Institute at Methodist University Hospital, Memphis; Associate Professor, Department of Neurosurgery, College of Medicine at the University of Tennessee, Memphis and the Semmes-Murphey Clinic; and Chief, Division of Neurosurgery at the Memphis Veterans Affairs Medical Center.

Dr. Sills graduated summa cum laude from Mississippi State University with a degree in engineering and received his medical degree from the Johns Hopkins University School of Medicine in Baltimore, Maryland, where he also completed his internship in General Surgery, his residency training in Neurological Surgery and an NIH-funded Neuro-Oncology Fellowship.

Dr. Sills and his wife Shawne live in Tennessee and have four children. He serves on the Board of Directors for Make-A-Wish Foundation of Middle Tennessee, the Heritage Foundation of Franklin and Williamson County Tennessee and has served as a youth baseball coach for more than 20 years.

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