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(What follows is a short excerpt from the March 2015 issue of Concussion Litigation Reporter)

Athletic trainers (AT) are increasingly being relied upon to provide insight and feedback into proposed concussion litigation.

Witness the presence of the New York State Athletic Trainers’ Association (NYSATA), whose representatives were recently invited to attend and provide expert testimony at the Youth Concussion and Sports Safety Hearing in New York City, where two introductory bills regarding youth sports safety for New York State were being considered.

Among the questions being addressed on that day were:

  • “Is it reasonable – and appropriate – to require appropriate medical coverage at youth football practices and games, and possible to do so without causing impossible financial burden on these programs?
  • “What other youth sports might be at high risk for concern and could also need similar safety provisions?”

These bills, if passed,  would mandate that a certified AT would be present at all youth football contact practices and a physician, likely alongside the AT, be present at all games, as well as set up a task force to investigate safety and injury concerns in all youth sports.

The aforementioned hearing was held jointly by the Committee on Health and the Committee on Education. Joining a long list of various medical professionals, researchers, school officials, and athletic personnel, NYSATA President, Aimee Brunelle, MS, ATC and NYSATA Region 1-Long Island Representative, James Pierre-Glaude, DPT, ATC, CSCS traveled to New York City to provide expert testimony about the qualifications of ATs, concussion management, and sports safety issues, including injury prevention and injury rates in contact sports. A NYSATA focus group also prepared a detailed written testimony to provide to the Committee members, which included some recommendations on how to improve the proposed legislation.

Based on NYSATA’s examination of the bills, Brunelle said that NYSATA is “pleased to see the interest demonstrated in … creating a safety task force to collect information and then make recommendations.”

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State chapters of the National Athletic Trainers’ Association (NATA) aren’t the only ones taking a proactive stance with regard to concussion laws. …

(Editor’s Note: For the rest of the story, subscribe to Concussion Litigation Reporter)

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(Editor’s note: The following synopsis is from a case summary that will appear in the December issue of Concussion Litigation Reporter)

A state supreme court has affirmed the ruling of a district court, which dismissed the claim of a college athlete, who alleged that the school was negligent when it allowed him to continue to compete after he suffered a concussion.

Central to the court’s ruling was its conclusion that the lower court did not abuse its discretion when it struck expert affidavits of the plaintiff.

The plaintiff in the case was a student athlete, who, each year as an active member of the team, signed liability waivers releasing his school from any claims for damages or injuries sustained while participating in athletics.

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By Michael J. Perrotti, Ph.D., Inc.

Recently, the NFL settled over 4,000 lawsuits by the players. It was reported that the NFL would make enough profits in the first week of the regular season to pay for the settlement! It was also reported that an initial lump sum was to be paid over three years and the balance paid in 17 years. It is doubtful that this can ever address the diminished quality of life of the players secondary to effects of brain injury. In fact, as this article was going to press, the court rejected the NFL settlement as not providing enough money to pay the players. In response,the NFL elected to remove the cap on the settlement amount.

As noted by Henry & De Beaumont (2011), the prevailing attitude in sport culture minimizes concussions. The recovery process is elongated with athletes with multiple concussions. Collins et.al. (2002) found that 9.4% of players with no history of TBI were found to have prolonged post-injury mental status. Chargers as opposed to 31.6% (3.36 odds ratio) of players with multiple concussions. Mounting evidence suggest that within the acute phase, athletes who sustained multiple concussions demonstrate increased symptomology. Junior Sean was reported to have told a friend who played soccer that he experienced headaches for years.

Animal studies demonstrate the existence of a temporal window of metabolic brain vulnerability to second in TBI that had unsubstantial adverse effects in mitochondrial related metabolism, Vagnozzi et.al. (2007).

Measurement

Moser & Schatz (2002) and Moser, Schatz, & Jordan (2005) found that high school athletes who had had two or more concussions had performance decrements on neuropsychological testing similar to athletes in the post-concussion phase. Neuropsychological deficits were found to increase concurrently with the number of concussions in soccer players Wall et.al. (2006) reported have significant neuropsychological deficits on younger athletes with Jockeys. High School football players who sustained a previous concussion resulting in loss of consciousness were four times more likely to sustain a grade 3 injury according to American Academy of neurology (AHN) Guidelines (Gerberich et al., 1983)

Imaging and Repeated Concussions

A large scale study looked at over 300 active amateur boxers. CT scans revealed the presence of a cavum septum pallucidum as a potential marker of Brain atrophy and also revealed that it is progressive in nature.

Long Term Effects

DeBeaumuat et.al (2009) found that former hockey and football players, 30 years post-concussion found decreased performance in neurocognitive measures compared to an age matched control group of former athletes. Guskiewicz et.al. (2005) identified that mild cognitive impairment (MCI) rates (converts to a 10 – 20% annual rate into dementia of Alzheimer’s Type) increased as a function of a number of concussions in former NFL players. Players who had three or more concussions had five times the probability of being diagnosed with MCI and three times more likely to manifest marked memory impairments than retired players with no history of concussion. This same study found an earlier onset of Alzheimer’s in concussed retirees than in the general U.S. population. Moreover, former NFL players with a history of multiple concussions were three times more likely to be diagnosed with depression.

Signs of Traumatic Brain Injury (TBI) can involve deficits in the areas of attention, memory, and executive function. Freeman, et.al. (2005) relate substantial preparations of subjects with Traumatic Brain Injury manifest agitation and anger 15 years post-injury. This writer has observed many patients in his practice with substantial clinical problems post TBI.

For his conclusions and his recommendations, visit the latest issue of Concussion Litigation Reporter.

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