How Do I Get My Doctor To Help Me Document The Full Extent Of My Child’s Head Injury?

The head is the most common body region injured in motor vehicle crashes for children age birth to seven years and head injury outcome in children can be worse than similar injuries sustained by adults.

Children who suffer traumatic brain injuries (TBIs) can experience lasting or late-appearing neuropsychological problems. For this reason, head injuries should be of particular concern to parents of children injured in motor vehicle traffic crashes. Proper diagnosis and treatment is critical. So is marshalling the legal evidence necessary to prove the link between the crash or other trauma and your child’s deficits. Proving future deficits is one of the most vexing issues that arise in child head injury cases.

In children, some neurological deficits after head trauma may not manifest for many years. Consider that frontal lobe functions develop relatively late in a child’s growth, so that injury to the frontal lobes may not become apparent until the child reaches adolescence when higher level reasoning develops. Since the frontal lobes control social interactions and interpersonal skills, early childhood brain damage may not manifest until such frontal lobe skills are called into play later in development. Likewise, injury to reading and writing centers in the brain may not become apparent until the child reaches school age and shows signs of delayed reading and writing skills.

How can you obtain compensation now for deficits that may not show up until many years later? How can you prove now what may happen later? Head injury legal claims are challenging precisely because of these kinds of considerations.

The standard for admitting evidence on considerations of this nature is “a reasonable degree of medical certainty.” Your child’s doctor must be willing to testify to a “reasonable degree of medical certainty” that the trauma sustained by your child caused or will cause the future deficits. What does this phrase “a reasonable degree of medical certainty” mean?

It’s been observed that the phrase is almost an oxymoron. Normally the word “certainty” means certain. But the adjective “reasonable” negates the absolute connotation of the word “certainty.” But if you push past the awkwardness of the phrase to how it is employed in the courtroom it makes more sense. In actual trial practice the evidentiary standard is “more likely than not” or “more probable than not.” This is a lower standard of proof than certainty and also lower than the “beyond a reasonable doubt” standard (which is the standard used to convict a defendant in criminal cases). Essentially the standard is whether your doctor can say that it is “more likely than not” that the trauma will cause your child to suffer a particular deficit in the future.

Many medical doctors don’t understand what I said in the last paragraph. They don’t want to get involved with a legal claim unless there is overwhelming proof that the trauma caused a deficit. They in effect think there must be enough evidence to prove it “beyond a reasonable doubt.” They are not aware of the correct legal standard. This is unfortunate as it results in many families not getting enough compensation to provide for the future care of their injured child.

I talk with my client’s doctors before they give any testimony and educate them on the correct standard of proof. I ask them to tell the truth, no matter what that may be. I request that they review their treatment of the child with an eye toward helping the family prove all related deficits that have or may flow from the trauma. I encourage them to understand that the law only allows the family “one bite of the apple”, one chance to get justice, and that when the legal claims ends they can never reopen the case even if it turns out their child has far more profound deficits than we proved.

If your child has suffered a head injury, you are dealing with one of the most complex and challenging of all claims. You would benefit greatly from talking to an attorney. There are many related issues that arise in the context of child TBI claims that are not for the uninitiated. Please call me if, due to the fault of another, your child has sustained a brain injury. The call is free, you are under no obligation to hire me, and I will do my best to point you in the right direction.

Sources: http://www-nrd.nhtsa.dot.gov/Pubs/811325.pdf

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Attorney Pete Pearson practices law in Atlanta, Georgia and has a special interest in helping families with injured children. He is a father to seven and lives with his wife and children near Atlanta, Georgia. He can be reached directly at Six-Seven-Eight 358-2564 or through his main site, www.petepearsonlaw.com.

 

Child Sports Injuries in Georgia – Second Impact Syndrome

Concussions are a common sports injury among children. In recent years there has been growing consensus that policies are needed for “concussion management” and “return to play” guidelines – to protect our children. In 2013 Georgia became the 44th State to enact a law that requires schools to create a policy on how to respond to head impacts during sports and other recreational activities.

The Georgia law, The Return to Play Act of 2013, mandates that all public and private schools must adopt and implement a concussion management and return to play policy. The rationale behind the law is that school officials are in the best position to prevent children and teens from returning to play after a blow to the head. Continuing to play with a concussion or symptoms of head injury leaves a child vulnerable to severe injuries like post-concussive syndrome and chronic traumatic encephalopathy (CTE), or death.

Under the new law each local Board of Education and the governing board of every non-public elementary school, middle school, and high school must:

  • Provide written warnings to coaches, students and parents that educate and inform of the risks of concussion and head injury to children who participate in athletic activities (this notice must be provided prior to the start of each athletic season and all pre-season practices)
  • Require each coach to complete an annual concussion recognition course and be certified in recognition of concussions in student athletes
  • Require coaches and school officials to comply with a uniform return to play protocol in the event of an injury or suspected injury to a child

What if your child was injured and school officials failed to follow the law and even greater harm happened to your child? How can the school be held accountable?

The answer to this question is unfortunately complex. Georgia law does not treat all students equally. If your child is injured while attending public schools your rights are fewer than if the injury happens at a private school. For a full treatment of how the law works in this area, read my post on Public School Injury Law In Georgia. If you don’t have time to read the full version, the law in Georgia is basically this:

In the State of Georgia the rule is that you can not sue a governmental employee (which includes school teachers, coaches, and school administrators) unless the governmental entity that employs them has waived Sovereign Immunity.

Sovereign Immunity is a shield that stops cold most injury claims against school districts and public school teachers/coaches, etc . . . Sovereign Immunity means that you can not sue the government without it’s consent. And as you might imagine, the government is not often inclined to give that consent.

Thankfully, there are exceptions to the rule. One exception is that under Georgia law, a suit against a public officer acting in his or her official capacity will NOT be barred by official immunity if the public officer negligently performed a ministerial duty. Suit IS barred, however, if the public officer negligently performed a discretionary duty. In other words, public officials are immune from damages that result from their performance of discretionary functions (GENERALLY, there is an exception that has to do with when those functions were undertaken with malice or intent to cause injury, read my full blog post on Public School Liability in Georgia if you want to learn more about that.)

What does all this mean? A ministerial duty is one that is commonly simple, absolute, and definite, arising under conditions admitted or proved to exist, and requiring merely the execution of a specific duty. A discretionary duty is one that calls for the exercise of personal deliberation and judgment, which in turn entails examining the facts, reaching reasoned conclusions, and acting on them in a way not specifically directed.

So the question is whether the Courts will interpret the new duties created by Georgia’s Return To Play Act as ministerial (no immunity – you can sue for negligence) or discretionary (immunity – you generally can’t sue.) Over the last decade or so the Georgia Court of Appeals has shown a tendency to interpret duties as discretionary (thereby barring suit). It is unknown how the Courts will interpret this new law.

I believe the Courts should interpret the duties under the new law as ministerial. The duties concern matters that are simple, absolute and definite – a blow to the head occurs and a duty arises at that point in time to act on the duty created by this new law. No discretion is needed – the coach or school official needs to remove the child from play and not allow return to play until the appropriate health provider has examined the child and cleared them to return. Failure to follow this simple protocol would be a violation of a ministerial duty. Similarly, a school district who fails to provide the required warning notices or required training for coaches would be in violation of a ministerial duty.

That’s my take on the proper interpretation of the new law. What the Courts will do is in the future. If your child has been injured at school, please call me. Navigating these waters alone is treacherous. Public school officials are well aware of the law of sovereign immunity. Private school officials already have lawyers working to defend them. Shouldn’t you too?

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Attorney Pete Pearson practices Child Injury and Wrongful Death Law in the State of Georgia. Located in the Greater Atlanta Metro Area, he is available to help families all over the State of Georgia. He can be contacted directly at Six-Seven-Eight 358-2564 or by Email.

Homeowner’s Insurance – What If My Child Is Hurt At Another Family’s Home?

If your child sustains an injury while at another family’s house and there is a homeowner’s insurance policy in effect, your child’s injury claim will almost certainly be covered. Don’t delay in reporting the injury, however, because all policies have a provision that says if timely notice is not given to the insurance company they can deny coverage.

After making sure the injury is reported to the insurance company (preferably in writing), take time to assess what type of insurance claim will be appropriate. There are two types.

The first type of claim under homeowner’s insurance. Many homeowner’s insurance policies contain “Med Pay” or “Medical Payments” coverage. “Med Pay” is no-fault coverage, which means it is available to help compensate you for medical expenses related to your child’s injury no matter how the injury took place. In other words, there is no requirement that you show that anyone was negligent. If you can show that your child was injured on the other family’s property, you can recover under the “Med Pay” coverage.

“Med Pay” is sold in increments and a family may have $1,000, $2,000, $5,000, $10,000, $25,000, $50,000, or more coverage in place. The way this type of coverage works is that you submit your child’s medical bills to the homeowner’s insurance company as you receive them. Some medical providers will even handle the submissions for you. Or, if you prefer, you can have the insurance company mail you (or your attorney) a check for the cost of your child’s medical treatment. I recommend the latter approach because it allows you (or your attorney) to negotiate with your medical providers. Often providers will offer a discount to settle your child’s bill if you ask. You can save money that way and use what you save to pay for your client’s future medical care or other injury related expenses.

The second type of claim under homeowner’s insurance. The second type of coverage is bodily injury liability coverage. This pays only when the owner or someone in the owner’s family is found to be at fault. You have to be able to (usually with the assistance of an attorney) prove that the owner or representative of the owner did something (or failed to do something) that constitutes negligence and that negligence led to your child’s injury.

Even if the homeowner has admitted fault, keep in mind that is is very common for stories to change after a little time goes by. Do your child a favor and document everything. If the homeowner admits fault, get that on a recording or in writing. Get them to admit the specifics of what they did wrong. This will protect you in the event they later change their story (and you would be amazed at how often stories change.)

A bodily injury liability claim allows you to recover more damages than in a “Med Pay” claim. “Med Pay” pays only for your child’s medical expenses. A liability claim pays you for medical expenses, any related lost wages, human losses (pain and suffering), and any damages that flow from your child’s injury.

One question that you may have is whether your child can be held responsible for causing their own injury? This issue arises if your child was doing something that perhaps was a little foolish at the time they were hurt. The answer is: it depends. It depends on the age of your child.

In the Georgia common law there is a legal creature known as the “tender years doctrine.” This doctrine holds that children under a certain age can not be charged with contributory negligence (fault) or assumption of the risk. The younger the child, the less likely they can be found to have contributed to their own harm.

For example, there is a case that holds that a 4 year old child is presumed incapable of negligence. But there is also a case that holds that a child that is 5 years, 10 months old does not get that same presumption. Exactly when a child becomes capable of contributory negligence is not clear in the case law. It seems safe to say that if a child is older than 6 years they might be charged with contributory negligence. But the issue is one for a jury to decide and is very fact specific.

So essentially, with very young children (4 and under) it is clear that they can’t be blamed for hurting themselves. With children older than 6, it is less clear. It will come down to what the courts have called a “subjective, individual standard of care for children.” In other words, the court or jury will have to examine the capacity of the child in question and their behavior and make a judgment call about whether they were capable of preventing the harm to themselves or if the adult in the situation should be charged with full or partial responsibility.

An example from a recent case I handled may help clarify how the doctrine of tender years works in practice.

My client, a 5 year old girl, was dropped off at the home of the Defendant. The Defendant had agreed to babysit my client.

The previous Sunday was Easter Sunday and my client’s mother had pressed out the child’s hair for the occasion. When the mother dropped her daughter off at the Defendant’s house, her hair was up in a ponytail. 

On the evening of the loss, the Defendant loosed the pony tail and let the girl’s hair out and shortly after gave her a lit candle to take into the house (the Defendant was outside talking to a friend on the phone). My client went inside the house unsupervised and while inside her hair caught on fire.

What happened next shocks the conscience. After this 5 year old child was burned, the Defendant told no one, called for no medical attention, and hid the fact from her own husband (by putting panty hose on the girl’s head to conceal the burns). The Defendant put the child to bed and kept her quiet during the night (while she fussed) by giving her Motrin.

All that night, the following morning, and throughout the next day, the Defendant again told no one and called for no medical attention. She did not inform the child’s mother. It was not until nearly 24 hours later, when the child’s mother returned, that her mother discovered the burns. Immediately she called 911 for an ambulance.

In that case, the insurance company didn’t even bring up the tender years doctrine. But, had my client been 7 or 8 or older, the insurance company might have.

One final piece of information. Because “Med Pay” claims are no-fault generally you do not need an attorney if that is the only type of claim you plan to bring. Generally the homeowner’s insurance company will pay the bills up to the limits of coverage without much of a fight. There are exceptions but generally you should be able to handle that without the expense of an attorney. If, however, you believe there was fault, it would be worth your while to consult with an attorney. Keep in mind that the attorney fee on a bodily injury liability claim is paid from the settlement, not from you or your child, and that if there is no recovery there is no attorney fee. So it is a risk free call to the attorney.

If your child has been injured by the negligence of another and you believe there may be grounds for a bodily injury liability claim, please call me. I have been representing families for over 17 years right here in Georgia and would be honored to talk with you. 

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Attorney Pete Pearson practices Child Injury and Wrongful Death Law in the State of Georgia. Located in the Greater Atlanta Metro Area, he is available to help families all over the State of Georgia. He can be contacted directly at Six-Seven-Eight 358-2564 or by Email.

Traumatic Head Injuries in Infants, Young Children, and Teenagers Significantly Underdiagnosed

Brain injuries often go undetected following a trauma such as an automobile accident, bike accident, or fall. Detection is crucial because an injury to the brain early in life can have long-term effects, including impairments to a child’s ability to control their emotions and inhibit inappropriate behavior. Children who have suffered traumatic brain injuries also can have trouble responding to subtle social cues and planning difficult tasks.

Traumatic brain injuries (often referred to as TBI or sometimes as Acquired Brain Injury) often go undetected because in many cases there is no visible wound and unless a brain bleed or other visible abnormality is seen on an MRI or CT scan, the injury may go unnoticed. TBIs in very young (0-4) children are commonly overlooked by doctors even though very young children are at a greater risk for head injuries than the general population. This may have to do with the difficulties inherent in gathering information about cognitive and emotional functioning from children so young.

Warning signs that your child may have suffered a traumatic brain injury include:

  • any loss of consciousness immediately after the head injury
  • a change in behavior immediately after the head injury, such as becoming angry/irritable, lethargic/sleepy, not remembering the injury or other things, or suffering from poor balance, etc.
  • vomiting after the head injury, especially if your child develops persistent vomiting, which is usually defined as vomiting more than three or four times
  • a seizure immediately after the injury or later that day
  • can not open eyes fully after the head injury
  • develops other symptoms after the head injury, such as a severe or worsening headache, stiff neck, or photophobia (sensitivity to light), etc.
  • personality changes

Many of the warning signs of a pediatric brain injury are subtle and may only be noticed by family and close friends of the child with whom the child spent significant time prior to the injury.

If you suspect that your child may have suffered a traumatic brain injury, ask your doctors to refer you to a pediatric neuropsychologist – they are the doctors best equipped to diagnose head injuries in children.

Also, consider hiring an attorney to gather the evidence you need in order to prove your child’s brain injury was caused by the trauma they suffered. Insurance companies routinely deny that these difficult to detect injuries were caused by the accident in question. You need a lawyer on your side if you want the insurance company to pay for past medical bills and the future costs of care for your injured child.

“Baby Strep” Infection After Birth – Brain Injury

Group B Streptococcus (also known as GBS or “B Strep”) is a type of bacteria that can be passed from mother to baby during delivery and if not detected and treated early enough can lead to an infection that causes a brain injury. The brain injury can lead to a host of medical issues, including cerebral palsy, spastic quadriplegia, seizure disorders, an inability to swallow, communications deficits, incontinence and permanent pain. Other complications of Group B Strep (“Baby Strep”) infections are sepsis, pneumonia, meningitis, and death (Group B Strep is the most common cause of sepsis and meningitis in the United States during a newborn’s first week of life).

Group B Strep can easily be prevented. It is customary for doctors to run a battery of diagnostic tests prior to delivery, including a test for Group B  Strep. If the bacteria is detected neonatal antibiotics can be prescribed to eliminate it. The cost of the testing is minimal.

If the diagnostic test is not ordered (more common with premature births – this test is typically undergone in last month prior to delivery), there are well settled protocols for observing the infant after delivery to detect Group B Strep infection. The doctors and nurses taking care of your baby are responsible to follow these protocols so they can detect the infection and administer antibiotics immediately. Delay in starting antibiotics can result in catastrophic injuries to a newborn, including severe and permanent brain injuries.

If you feel that the doctors involved with the delivery and post-delivery care of your child negligently failed to recognize and act upon risk factors and signs indicating Group B Strep infection and caused your baby injuries by failing to administer antibiotics – please call me.

The life time costs of caring for a child with a brain injury is daunting. In one recent case the family of a brain injured child was awarded over $29 million in damages for past and future losses and expenses.

Here is one mom’s story of how doctors failed to order the proper diagnostic tests prior to delivery and her baby contracted Group B Strep (GBS) –

And here is a nicely done video that covers the basics of Group B Strep detection and prevention –