For legal assistance, contact us toll free at 1 866 272 4652

Coma Information From the Head Injury Lawyers at De Caro & Kaplen LLP

Severe brain damage often results in extended periods of unconsciousness, whether from car accidents, other types of trauma, or after the brain has been deprived of oxygen.

There are three states of unconsciousness known as coma, vegetative state and the minimal conscious state. The recovery from this form of brain damage is variable between persons. Individuals often progress from one state into the next. The medical profession is  trying to understand why some persons with this type of brain injury recover and why others with a similar degree of brain damage do not.

Frequently individuals with severe traumatic brain injuries and disorders of consciousness are misdiagnosed as to their true level of conscious awareness. If you find that you have been mistreated after a harmful brain injury accident, our Head Injury Lawyers will provide the legal assistance you need for adequate compensation

Definition of Coma:

Coma is a state of unconsciousness where the individual’s eyes remain closed and they cannot be aroused even with the use of stimuli. The eyes of the individual remain continuously closed despite the application of noxious stimuli and there are no sleep/wake cycles on EEG examination. A coma typically resolves in one to two weeks following a severe traumatic brain injury.

Vegetative State:

In this condition, an individual’s awareness of themselves and their environment is presumed to be absent and there is an inability to interact with others. The vegetative state frequently follows a coma. The diagnosis is made when there is no evidence of sustained or reproducible, purposeful behavioral responses to visual, auditory, tactile or noxious stimuli and no evidence of language comprehension or expression. Unlike a person in a coma, a person in a vegetative state does open their eyes and may have a sleep/wake cycle.

The chances of recovery dramatically diminish if a person remains in this state for at least three months following a non traumatic brain injury and a least twelve months after a traumatic brain injury.

Minimally Conscious State:

A person in a minimally conscious state has a severely altered level of consciousness but shows evidence of minimal, but definite  signs that they are aware of their environment or themselves. An individual often progresses from the vegetative state into the minimally conscious state as he/she recovers from his/her traumatic brain injury. The diagnosis of the minimally conscious state requires evidence of one or more of the following behaviors: 1) simple command-following, 2) intelligent verbalization, recognizable verbal or gestural “yes/no” response or 4) movements or emotional responses that are triggered by relevant environmental stimuli and cannot be attributed to reflex activity.

Several new brain imaging techniques known as functional MRI (fMRI) and positive emission tomography (PET) are providing the medical profession with assistance in determining what state of consciousness a person suffering from severe brain damage is in.

Retaining an experienced brain injury lawyer is an important step in obtaining adequate compensation for a severe brain injury. The New York personal injury attorneys at De Caro & Kaplen, LLP have frequently been called upon to represent individuals in various stages of consciousness and obtain proper compensation for this devastating brain trauma.

Glasgow Coma Scale

The Glasgow Coma Scale is perhaps the most widely used scale to gauge a person’s initial brain injury. It is frequently used to assess individuals who are unconscious or in a coma. It was developed in Glasgow, Scotland and has gained widespread acceptance. Many studies have shown that the lower the initial score of a person, the poorer their long term prognosis.

Eye Opening Response
  • Spontaneous–open with blinking at baseline (4 points)
  • To verbal stimuli, command, speech (3 points)
  • To pain only (not applied to face) (2 points)
  • No response (1 point)
Verbal Response
  • Oriented (5 points)
  • Confused conversation, but able to answer questions (4 points)
  • Inappropriate words (3 points)
  • Incomprehensible speech (2 points)
  • No response (1 point)
Motor Response
  • Obeys commands for movement (6 points)
  • Purposeful movement to painful stimulus (5 points)
  • Withdraws in response to pain (4 points)
  • Flexion in response to pain (decorticate posturing) (3 points)
  • Extension response in response to pain (decerebrate posturing) (2 points)
  • No response (1 point)

Coma: No eye opening, no ability to follow commands, no word verbalizations (3-8)

Head Injury Classification:
  • Severe Head Injury—-GCS score of 8 or less
  • Moderate Head Injury—-GCS score of 9 to 12
  • Mild Head Injury—-GCS score of 13 to 15
Legal Assistance From our Brain Injury Lawyers:

The brain injury lawyers at the New York based brain injury law firm of De Caro & Kaplen, LLP understand these conditions and the tools for the evaluation of severe traumatic brain injury. If you or your loved one has sustained a traumatic brain injury as a result of an auto accident, bus accident, truck or train accident, construction site accident or fall, our head injury lawyers can provide legal assistance for you.

Our brain injury attorneys co-author the New York Law Journal outside counsel column on the legal aspects of traumatic brain injury; have co-authored the chapter on neurolaw for the Psychiatric Clinics of North America edition on traumatic brain injury and have lectured at the ground rounds of Mt. Sinai Medical Center on brain injury and New York medical malpractice in emergency medicine.

We are based in New York and handle personal injury cases in New York City and throughout New York State including Albany, Long Island, Nassau, Rockland, Syracuse, Suffolk, Westchester and surrounding areas. With national affiliates, we can assist you with your brain injury case throughout the country.

Our lawyers are nationally acclaimed for their skilled representation of traumatic brain injury (TBI) victims. Our founding partner, New York brain injury attorney, Michael Kaplen has lectured extensively though out the United States on effectively representing brain injury survivors. Our partner, Shana De Caro serves as Chair of the national Traumatic Brain Injury Litigation Group of the American Association for Justice. Our attorneys have authored numerous articles on brain injury topics and brain injury legal representation. Our brain injury lawyers work with the Brain Injury Association of New York State and the Brain Injury Association of America to advocate for the rights of brain injury victims.

We will put our experience, skill and resources to work for you.

Preferred Attorneys—Brain Injury Association of America

You’ve come to the right place for help in finding legal representation. The Brain Injury Association of America has recognized the skills and experience of our New York brain injury law firm by listing De Caro & Kaplen, LLP as “Preferred Attorneys”

Attorneys in the Brain Injury Association of America Preferred Lawyer Program “know the carelessness of others changes lives in an instant. They know the physical, cognitive, emotional, and financial tolls a brain injury can inflict on individuals and their families. Firms enrolled in the BIAA Preferred Attorneys Program know the stakes are high and that settling for less has lifelong consequences.”

Our Credentials

Michael Kaplen

Professorial Lecturer in Law
The George Washington University Law School

Past Chair
New York State Traumatic
Brain Injury Coordinating Council

American Academy of Brain Injury Attorneys

Vice President
New York State Academy of Trial Lawyers

3 Term President
Brain Injury Association of
New York State

Past Chair
Traumatic Brain Injury Litigation
Group: American Association
For Justice

Past Chair
Motor Vehicle, Highway, Premises
Liability Section: American Association
For Justice

National Advisory Board
Association of Interstate
Trucking Lawyers of America

Past Co-Chair
Tort Section, New York County
Lawyers Association

Board of Directors
Trial Lawyers for Public Justice

Board of Governors, American Board of Professional Liability Attorneys

Board of Directors
New York Academy of Trial Lawyers

Editorial Board
Neurolaw Letter

Board Certified
Civil Trial Advocate
National Board of Trial Advocacy*

Board Certified
American Board of Professional
Liability Attorneys
Medical Liability*

Sustaining Member:
American Association for Justice
Public Justice Foundation

N.Y.S. Trial Lawyers Association
Florida Academy of Trial Lawyers
Southern Trial Lawyers
North American Brain Injury Association

Graduate of Marquette University, College of Health Sciences, in Neuro Anatomical Dissection of the Human Brain and Spinal Cord

Honors & Awards:

New York Super Lawyer
2006, 2007, 2008, 2009, 2010

Admitted to practice:
New York
District of Columbia

Top 100 New York Trial Lawyers -
American Trial Lawyer Association

Trial Lawyers for Public Justice
Public Achievement Award

Board of Trustees, Melvin M. Belli Society

Shana DeCaro

Traumatic Brain Injury Group: American Association for Justice

1st Vice President
American Academy of Brain Injury Attorneys

Board of Trustees, Secretary
Civil Justice Foundation

Board of Directors
New York State Academy of Trial Lawyers

American Association for Justice

Melvin M. Belli Society

Law Update
New York Academy of Trial Lawyers

Amicus Counsel
New York State Academy of Trial Lawyers

Honors and Awards

Trial Lawyers for Public Justice
Public Achievement Award

President’s Award
New York State Academy of Trial Lawyers

Who’s Who in American Women

Who’s Who in American Law

Top 100 New York Trial Lawyers-American Trial Lawyers Association

Elite Lawyers Of America

Graduate of Marquette University, College of Health Sciences, in Neuro Anatomical Dissection of the Human Brain and Spinal Cord


New York Academy of Trial Lawyers

New York State Trial Lawyers Association

Brain Injury Association New York State

North American Brain Injury Association

Nursing Home Litigation Group
American Assoc. for Justice

Interstate Trucking Litigation Group
American Assoc. for Justice

Brain Trauma Litigation Group
American Assoc. for Justice

Ask The Expert
Contributing Author

Advisory Board, Acquired Brain Injury Program, The George Washington University Graduate School of Education and Human Development, Washington, D.C.

Admitted to Practice:
New York State
United States Court of Appeals, Second Circuit
United States Federal District Courts:
Southern, Eastern and Northern Districts of New York
United States Tax Court
United States Court of International Trade
District of Columbia


* The National Board of Trial Advocacy and the American Board of Professional Liability Attorneys are not affiliated with any government authority. Certification is not a requirement for the practice of law in the State of New York and does not necessarily indicate greater competence than other attorneys experienced in this field of law.