Adler Giersch Attorney Richard H. Adler Honored by American College of Sports

Dr. Stan Herring presents award to Richard H. Adler at the ACSM News Conference on May 27, 2009.

SEATTLE, WA – In a surprise move May 27, 2009 at the Annual American College of Sports Medicine convention , Dr. Stan Herring presented Richard Adler with an award for his service and dedication to the Heads Up program and the Lysted legislation. Richard Adler became the first non- ASCM member to receive an award in the organizations history. Richard Adler shared the award with the Lystedt family for their joint dedication and efforts to help prevent devastating injuries to other young athletes were instrumental in getting the ground breaking Lystedt law passed in Washington state.

Richard Adler also spoke to doctors and therapists from all over the country at a news conference for the attendees at the Annual American College of Sports Medicine convention. The focus of the talk was on the Heads Ups program, as well as how to pass a youth sports and concussion law similar to the new Washington State law in other states. Dr. Stanley Herring and the Lystedt family also spoke.

“Delta V”: A Poor Predictor of Spinal Trauma from Motor Vehicle Collisions

By Adler Giersch PS

Whenever an individual claims an injury from a motor vehicle collision with low property damage on visual inspection, insurers routinely assert that the impact is too slight to the cervical spine to cause an injury. The auto insurance companies continue to promote ‘junk science’ testimony of high-gun forensic witnesses claiming that “low Delta V” (ΔV)1 cannot cause injuries. This proposition is not only false, but is often accepted by jurors because the testimony is cloaked under the color of “expert testimony.”

Fortunately, experienced attorneys representing those with traumatic injury are making headway with judges to exclude the testimony of witnesses who claim a lower Delta V means that no injury could have been sustained. Also, there continues to be an ever increasing amount of published research which dispels this Delta V myth. A recent study on this issue was published in the medical journal Patient Safety in Surgery 20092, authored by German trauma and orthopedic surgeons. The authors concluded:

This study provides evidence that, in real-life accidents, cervical spine injuries may occur at low ΔV values, while it is possible to escape unscathed from collisions with high ΔV values. In particular, the correlation between ΔV and the occurrence of WADs [whiplash-associated disorders] was very low for any of the collision types. Therefore it is impossible to make meaningful statements about the existence of WAD based solely on assessment of the [property damage] value. This finding might be of importance for the surgeon’s assessment and patient’s safety after a car accident. Diagnostic and therapeutic management should not be based solely on information related to trauma impact.

The study included data from 57 patients who had been the victims of car collisions. Within 48 hours of the collision, data was collected from the patient and from the patient’s car. Visual Analog Scales (VAS) and Neck Disability Index questionnaires were completed to determine the levels of pain and disability experienced by the subjects.

All of the patients who reported neck pain were evaluated with standard orthopaedic and neurologic clinic examination techniques and had radiological imaging done. If physical exam findings so suggested the need, CT scans were done. The severity of the cervical injures were classified in accordance with values set by the Quebec Task Force (QTF).3

Further, the ΔV for each collision was determined by a qualified engineer from direct assessment of the vehicles involved in the collisions, using accepted engineering analysis techniques.

Accepted statistical analysis formula were used to determine the correlation between the pain score (VAS) and the ΔV, the correlation between the NDI and the ΔV, and the correlation between the QTF classification and the ΔV. Careful study of the data obliged the authors to state:

. . . it can be concluded that ΔV is an irrelevant predictive value for cervical spine injury after an MVA . . . The ΔV value as measured in trauma impact does not represent a conclusive predictor for cervical spine injury in real-life motor vehicle accidents. This could be important for surgeons and patients in their medicolegal assessment of WADs.

1. “Delta V” (ΔV) refers to change of velocity, ie. speed. A car is impacted from behind and it velocity is instantaneously increased from its stopped position (or from its current speed) to a higher velocity.

2. “Deceleration during “real life” motor vehicle collisions – a sensitive predictor for the risk of sustaining a cervical injury?”, Martin Ebel, Michael Kramer, Markus Huber-Lang, Erich Hartwig, and Christoph Dehner.

3. The Québec Task Force (QTF) was a task force sponsored by the Société de l’assurance automobile du Québec, the public auto insurer in Quebec, Canada. The QTF submitted a report on whiplash-associated disorders in 1995, which made specific recommendations on prevention, diagnosis and treatment of WAD (whiplash associated disorders.)

Washington approves law that prohibits sports play after concussion – Experts say: “When in doubt, sit them out”

(L to R) Richard H. Adler, Governor Christine Gregoire, Dr. Stanley Herring, Victor Lystedt, Zackery Lystedt, Mercedes Lystedt, Representive Jay Rodne

OLYMPIA – The Brain Injury Association of Washington (BIAWA) today applauded Gov. Christine Gregoire for signing the nation’s toughest return-to-play law, requiring medical clearance of youth athletes suspected of sustaining a concussion, before sending them back in the game, practice or training.

The new law (House Bill 1824), known as the Zackery Lystedt Law, prohibits youth athletes suspected of sustaining a concussion from returning to play without a licensed health-care provider’s approval. The new law is the most comprehensive return-to-play law in the United States for athletes under 18.

“This is a common-sense law that makes youth sports safer and helps prevent, preventable brain injuries,” said BIAWA President, a Seattle attorney with the Seattle law firm Adler Giersch, ps. His firm, along with attorney Michael Nelson, have been representing Zackery Lystedt, now a 16-year-old Maple Valley boy, who suffered a life-threatening brain injury on Oct. 12, 2006. School coaches returned him to play football after he sustained a concussion, without first obtaining a complete evaluation by a licensed health care professional trained in the evaluation and management of concussions. The young football star underwent emergency life-saving brain surgery at Harborview Medical Center after he collapsed on the field. Zackery remains dependent on a wheel chair and 24/7 supervision for his needs.

More than 3.5 million sports-and-related concussions occur each year in the United States, according to the Center for Disease Control and Prevention.

“Zackery’s injuries could and should have been avoided. This legislation provides the protection he should have received. Well-established return-to-play rules following a concussion must now be communicated by school officials to coaches, student athletes and parents,” Adler said. “It will also protect young athletes from school districts that are lax in educating coaching staff and parents on proper safety standards, preventing them from putting injured children further in harm’s way.”

Key provisions of the new law require:

  • Youth athletes who are suspected of sustaining a concussion or head injury be removed from play. “When in doubt, sit them out”
  • School districts to work with the Washington Interscholastic Activities Association (WIAA) to develop information and policies on educating coaches, youth athletes and parents about the nature and risk of concussion, including the dangers of returning to practice or competition after a concussion or head injury.
  • All student athletes and their parents/guardians sign an information sheet about concussion and head injury prior to the youth athlete’s initiating practice at the start of each season.
  • Youth athletes who have been removed from play receive written medical clearance prior to returning to play from a licensed health-care provider trained in the evaluation and management of concussion.
  • Private, nonprofit youth sports associations wanting to use publicly owned playfields comply with this law.

The new law was sponsored by Rep. Jay Rodne, R-North Bend, with support from BIAWA, Zackery’s parents Victor and Mercedes Lystedt, and a large coalition of supporters that include: The Center for Disease Control, Seattle Seahawks, Washington Interscholastic Activities Association, Washington State Youth Soccer Association, Washington State Athletic Trainers Association, Cannfield & Associates Risk Managers, Harborview Medical Center, University of Washington, Seattle Children’s Hospital.

As a direct result of the “Lystedt Law,” Harborview Medical Center and Seattle Children’s are launching a sports concussion program for children, teen and adult athletes to evaluate, treat and provide medical clearance to return to sports following a concussion. “We are delighted by this announcement,” noted Adler. “This will go a long way to making sports safer and preventing preventable brain injuries in our state.”

Helpful links:
www.biawa.org
www.cdc.gov
www.uwmedicine.org
www.seattlechildrens.org

Harborview/UW Medicine and Seattle Children’s Hospital Launch Sports Concussion Program

PRESS RELEASE

Contacts:
Susan Gregg-Hanson, UW Medicine News & Community Relations, 206-616-6730
Jennifer Seymour, Seattle Children’s, 206-987-5207

Media are invited to join Governor Christine Gregoire, Zackery Lystedt, school athletic coaches and others at the bill signing of HB 1824 to develop guidelines for concussion and head injury risk for Washington youth at 11 a.m. Thursday, May 14:Governor’s Conference Room, Legislative Building – 2nd floor, Olympia.

Seattle—UW Medicine and Seattle Children’s are launching a sports concussion program for children, teen and adult athletes to evaluate, treat and provide medical clearance to return to sports. Beginning this summer, patients will be seen at Harborview Medical Center and Seattle Children’s Hospital.

The UW Medicine/Seattle Children’s Sports Concussion Program will help school and team coaches meet the provisions of a new state law that prohibits young athletes showing signs of a concussion from returning to play without a licensed health-care provider’s approval. The law is named after Zackery Lystedt, a Maple Valley teenager who suffered a traumatic brain injury while playing football in October 2006. After sustaining the injury, Zackery returned to play because no one recognized the signs and symptoms of his serious brain injury.

“Concussions can be a serious health problem and they require immediate recognition and proper management,” said Dr. Stanley Herring, co-medical director of the Sports Concussion Program, medical director of the UW Medicine Spine Center at Harborview and a team physician for the Seattle Seahawks and Seattle Mariners. “With this program, our community is taking an important step forward to protect athletes who play organized sports.”

“We see many children, as well as adults with sports injuries at Seattle Children’s and Harborview Medical Center,” said Dr. Richard G. Ellenbogen, co-medical director of the Sports Concussion Program and professor and chairman of the UW Department of Neurological Surgery. “This collaborative program enhances our ability to diagnose head injuries and provide appropriate treatments to keep young athletes safe and healthy.”

The comprehensive program is composed of health-care providers in Rehabilitation Medicine, Neurological Surgery, Neuropsychology, Sports Medicine and Radiology. In addition, the program will provide education on the prevention and treatment of concussions to parents, trainers, athletes, athletic directors and many others involved in youth sports.

As many as 3.8 million sports-and-recreation-related concussions occur each year in the United States, according to the Centers for Disease Control and Prevention. “Early identification of an athlete with a concussion is critical, as athletes who return to play too soon following initial injury are at risk for brain injuries, some of which can be catastrophic as happened to Zackery Lystedt,” said Richard H. Adler, President of the Brain Injury Association of Washington. “The Sports Concussion Program brings together some of the nation’s top experts on concussions and brain injuries, and will greatly advance the treatment of these injuries to our kids.”

Concussions can happen to any athlete, even without losing consciousness. Prevention and proper treatment are essential. Young athletes should seek medical care immediately if they experience any symptoms after a blow or jolt to the head. For more information, visit: http://www.cdc.gov or http://www.biawa.org

About Harborview Medical Center

Harborview Medical Center is owned by King County, managed by the University of Washington, and part of the UW Medicine system of care. Harborview is the only Level I adult and pediatric trauma center serving Washington, Alaska, Montana and Idaho. The medical center’s mission is to provide exemplary patient care, teaching, research, and community service. For more information, visit: http://www.harborview.org

About Seattle Children’s

Seattle Children’s delivers superior patient care, advances new discoveries and treatments through pediatric research, and serves as the pediatric and adolescent academic medical referral center for the largest landmass of any children’s hospital in the country (Washington, Alaska, Montana and Idaho). Children’s also serves as the primary clinical, research and teaching site for the Department of Pediatrics at the University of Washington School of Medicine. For more information, visit: http://www.seattlechildrens.org