By Steven J. Anglés, Attorney at Law
Ever since the first air bags became standard in passenger vehicles during the 1990s, there has been consistent debate over the amount of physical injury an airbag can cause versus the amount of physical injury it can prevent during a motor vehicle collision. There is little doubt that airbags can serve as one of the most potentially life-saving safety features in motor vehicle engineering by preventing drivers and passengers from impacting their steering wheels, windshields, or side windows, possibly reducing the severity of injuries to the brain and musculoskeletal system. However, there are also studies that show that airbags cause serious injuries in their own right. These range from visible injuries including friction burns, chemical burns, and bruising, to less immediately apparent trauma such as temporomandibular joint injury, orbital fractures, rib fractures, and spinal injuries. A 2014 study published in the Canadian Journal of Cardiology looks closely at the more difficult to detect injuries that stem from air bag trauma, such as cardiovascular trauma and complications from concussion. Keep in mind that any injury, from a superficial burn to a concussion, can result from body-to-airbag impact, regardless of the speed of the crash. 
Researchers participating in the study utilized information spanning from 1970 to January 2013, and compared outcomes as a result of motor vehicle collisions including clinical /functional response, left ventricular remodeling, hospitalizations, and mortality. These researchers determined that initially unsuspected cardiaovascular damage due to non-penetrating chest trauma or thoracic trauma was a common occurrence with airbag deployment. The primary forms of cardiovascular injuries following airbag deployment were aortic transection, tricuspid-valve injury, right atrial rupture, cardiac contusion, myocardial infarction, aortic-valve avulsion, cardiac tamponade, and hemopericardium. Unfortunately, due to the polytrauma that a patient can often experience as result of a vehicle collision significant enough to result in airbag deployment, it can be difficult to detect cardiac trauma early. The absence of chest pain or visible wounds can also lead to a missed or delayed diagnosis of cardiac irregularities. The researchers point to the right ventricle as particularly susceptible to injury due to its location directly behind the sternum, which can often bear the full force of a deploying airbag against the anterior chest wall. The right atrium was also found to be at significant risk as one of the thinnest vascular structures in the thorax.
The researchers also noted that lower-speed collisions when patients were positioned closer to the airbag at the time of deployment, particularly with shorter adults and those riding without seatbelts fastened, were more likely to produce cardiac injury from airbags.
Additional studies have also indicated that cardiac injury as a result of nonpenetrating chest or thoracic trauma may not manifest within the initial 48 hours post-trauma.  Arrhythmias such as ventricular tachycardias as a result of cardiac contusion caused by the heart itself moving, or surrounding organs and structures swinging to strike the heart have been known to develop up to one week following the initial trauma, and in some cases, up to one month later. During this time period, the heart may experience necrosis, inflammation, or fibrotic changes as the heart muscles attempt to heal.
Patients diagnosed with cardiovascular injuries as a result of a motor vehicle collision may face challenges in presenting a claim for these injuries, particularly when there were no immediate symptoms recorded.
The attorneys at Adler Giersch ps can assist patients seeking guidance through a broad range of these medical-legal-insurance claims, such as the one highlighted in this article, and remain available for complimentary consultations. Please visit our website at http://www.adlergiersch.com, or contact us at 206-682-0300 for more information.
 L A Wallis, I Greaves; Injuries associated with airbag deployment; Emerg Med J 2002;19:490-493 doi:10.1136/emj.19.6.490.
 Khouzam RN, Al-Mawed S, Farah V, et al. Next-generation airbags and the possibility of negative outcomes due to thoracic injury. Can J Cardiol 2014; DOI:10.1016/j.cjca.2014.01.002.
 An accumulation of blood in the pericardial cavity
 Hamilton W.J. Textbook of human anatomy. 2nd ed. CV Mosby Co; 1976. p. 225.