What happens when an attorney without Traumatic Brain Injury (TBI) expertise handles a Traumatic Brain Injury (TBI) case?


My firm took over a case from a prior firm. At the time of my taking over the case, the case was 1 month away from a final trial date. Upon review of the file, I realized that the prior firm failed to prepare the case in order to prove that the client suffered a mild Traumatic Brain Injury (mTBI). What was more alarming was that the prior firm did not even understand the medical and diagnostic tests that the client had undergone.

In reviewing the case file, I realized that the prior attorney failed to follow up with the Diffusion Tensor Imaging (DTI) study which indicated a nonspecific finding and recommendation of quantitative analysis (QA) of the Diffusion Tensor Imaging (DTI) study. The Diffusion Tensor Imaging (DTI) study was done almost a year before the client came to me to take over the case. 

Nonspecific findings mean that there's no way to differentiate the potential causes of the white matter abnormality or diffuse axonal injury (DAI) as well as whether it is within the norm. It is well accepted that white matter abnormality or diffuse axonal injury (DAI) can be within a normal population. It is the degree of the abnormality away from the standard norm that is critical to determine if the white matter abnormality is within the normal population or truly abnormal consistent with some type of disease- outside the norm. The diseases that can cause structural damage and changes to the axons can be cerebral vascular diseases (Diabetes, stroke, hypertension) as well as Traumatic Brain Injury (TBI). 

The reason a Quantitative Analysis (QA) was necessary and critical is that it determines the degree of deviation from the norm. The more deviation, the more likely the white matter injury was caused by a cerebral vascular disease or TBI. Note that TBI is a disease but I differentiate here due to common misconception that diseases are of long standing or genetic pathology whereas TBI is obviously traumatic in pathology. (There's a long standing joke where a self proclaimed expert in TBI starts his article stating that the leading cause of TBI is trauma).

The next step is to rule out the any other causes of white matter injury leading to the only remaining pathology of Traumatic Brain Injury (TBI). This what I had done when I commissioned a radiological forensic analysis in addition to having the Quantitative Analsis (QA) performed to determine whether or not there was a significant deviation of the client's white matter brain structure from the normal brain. 

It is essential to have a multi-disciplinary investigation to rule out other causes.

The prior attorney failed to have one of the more important tests performed: a neuro-psychological evaluation (NPE).

An effective Traumatic Brain Injury (TBI) investigation always involves multi-disciplinary study. Beyond radiological/ neuro-imaging studies, you need a neuro-psychological evaluation (NPE). The neuro-psychological evaluation (NPE) is critical to determine and measure cognitive deficits. In fact, it is the only universally accepted study and should only be done by a trained neuro-psychologist. A neuro-psychological evaluation (NPE) would provide quantitative data about a person who has suffered Traumatic Brain Injury (TBI). 

A neuro-psychological evaluation (NPE) would provide important data about a person's mental functioning such as IQ, memory and ability to analyze information.

Despite recommendations from the treating psychiatrist to have the client undergo a neuro-psychological evaluation (NPE), the prior attorney failed to have one performed. 

I had client undergo a neuro-psychological evaluation (NPE).

At the time I took over the case, there was no more than $250,000.00 offered. Within 2 years after I took over the case, I was able to secure a $5,000,000.00 Million offer- twenty (20x) times what the prior attorney could secure at the time he had the case.

There are attorneys who handle personal injury cases involving common orthopedic injuries. They may not be the type of attorneys you want to handle a Traumatic Brain Injury (TBI). In fact, unless they have expertise with Traumatic Brain Injury (TBI), they may do irreparable harm to your case.

NGUYEN LEFTT P.C. – Traumatic Brain Injury Attorneys / Lawyers
675 Third Avenue, 25th Floor, New York, NY 10017
tel: 212-256-1755   •   fax: 212-256-1756 

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