De Caro & Kaplen partner Michael V. Kaplen, a three-term president of the Brain Injury Association of New York State, and professorial lecturer at law, teaching a course in brain injury law at the George Washington University Law School, discusses new breakthroughs/areas of research in diagnosis, classification, and treatment of traumatic brain injuries and concussions.
Click the links below to jump to a video breakdown, along with a short summary.
Blood Tests To Predict Outcome In Severe Brain Injury Cases
Michael Kaplen discusses the findings of a new study, which reports that blood tests taken on the day of a traumatic brain injury (TBI) can accurately predict which patients are likely to die or survive with severe disability, and the clinical and ethical implications of this development.
- Predicting long-term prognosis after severe traumatic brain injury (TBI) is challenging.
- A new study reveals that blood tests taken on the day of TBI can accurately predict patient outcomes, including death or severe disability.
- Researchers measured biomarkers in blood samples from TBI patients on the day of their injury and evaluated their recovery six months later.
- Higher levels of two protein biomarkers in the blood on the day of injury were associated with death and severe disability.
- The study, published in Lancet Neurology (September 2022), suggests that elevated biomarker levels predict outcomes like persistent vegetative state or severe disability requiring daily assistance.
- Those with biomarker levels in the highest fifth were at the greatest risk of death within the first month post-TBI.
- Concerns arise about potential misuse of this information to deny care; study authors emphasize the future use of brain injury biomarkers in patient evaluation and treatment.
- Ethical issues include the risk of influencing decision-making by clinicians and insurance companies based on statistical probability.
- The study’s authors stress the need to avoid using these biomarkers to pressure family members on decisions about care aggressiveness or life-sustaining therapies.
- Past studies have shown conscious awareness in individuals with various levels of unconsciousness, challenging quick judgments on severe traumatic brain injuries.
Report Calls For New System For Classifying Traumatic Brain Injury
Michael Kaplen discusses a new report by the prestigious National Academy of Sciences, which calls for a new system for classifying traumatic brain injury.
National Academy of Sciences Report on Traumatic Brain Injury (TBI):
- Calls for a new system of classifying TBI, acknowledging the absence of a national standard of care.
- Rejects the traditional “mild,” “moderate,” or “severe” classification, deeming it outdated, imprecise, and ineffective.
- Emphasizes that TBI is not a static condition but evolves over an individual’s lifetime, requiring ongoing evaluation and treatment.
- Highlights the lack of access to optimal care and integrated follow-up for many patients and families.
- Cites statistics revealing that 51% of those with a “mild TBI” report persistent symptoms and functional impairment a year after injury.
- Challenges the misconception that TBI has a clear endpoint with good recovery, emphasizing the substantial burden on families, communities, and workplaces.
Recommendations from the Report:
- Calls for the creation and implementation of an updated TBI classification system.
- Advocates for integrated acute and long-term, person- and family-centered TBI management.
- Urges the reduction of unwarranted variability in clinical care to ensure high-quality care for all.
- Emphasizes the need for enhanced awareness and identification of TBI by healthcare providers and the public.
- Recommends the establishment and reinforcement of local and regional integrated care delivery systems for TBI.
- Suggests integrating TBI systems and care into healthcare teaching programs.
- Calls for improvement in the quality and range of TBI studies.
- Proposes the creation and promulgation of a national framework and implementation plan for improving TBI care.
Is This New Test A Game Changer For Concussion Diagnosis?
Michael V. Kaplen discusses a new “rapid” traumatic brain injury blood test from Abbot Labratories. The test, which has received final FDA approval, is able to diagnose a concussion within 15 minutes.
Abbott Laboratories’ Concussion Diagnosis Blood Test:
- Receives final FDA approval for a groundbreaking blood test to diagnose concussions.
- Test aims to detect chemicals released into the bloodstream after nerve cell damage during a concussion.
- Provides results within 15 minutes, offering a faster and more accurate diagnosis than current methods.
- Addresses the lack of a uniform definition for concussions and the high rate of missed diagnoses in emergency rooms.
- Eliminates the need for unnecessary CAT scans in emergency departments.
Importance and Considerations:
- Represents a game-changer in concussion diagnosis, allowing for more accuracy.
- Not a foolproof measure, and a negative blood test doesn’t guarantee the absence of a concussion.
- Caution against relying solely on the blood test for determining a player’s readiness to return to sports.
- Emphasizes the ongoing importance of assessing physical symptoms, cognitive complaints, and emotional difficulties.
- Acknowledges the test as a significant step in concussion diagnosis but warns against media hype influencing safety decisions in sports.
About The Author
Michael V. Kaplen represents victims of vehicle collisions, unsafe buildings and construction sites, and medical malpractice, and is a preferred attorney of The Brain Injury Association of America.
Michael is board certified as a Civil Trial Advocate and board certified in medical malpractice litigation. He is a Professorial Lecturer in Law, The George Washington University Law School, The Legal Aspects of Traumatic Brain Injury.
Michael is past chairman of the American Association for Justice (AAJ) Automobile, Highway and Premise Liability Section, past chairman of the AAJ Traumatic Brain Injury Litigation Group, three term president of the Brain Injury Association of New York State served two terms as chair of the New York State Traumatic Brain Injury Services Coordinating Council and vice-president, New York State Academy of Trial Lawyers.
He was invited by President Obama to participate in the White House Healthy Kids & Safe Sports Concussion Summit.
He is admitted to courts in New York, Florida, and Washington, DC. He has been selected as a New York Super Lawyer and recognized by Best Lawyers of America and U.S. News and World Report in personal injury law.