Too many cases of mild traumatic brain injury are not initially diagnosed.  The reasons are many and diverse, including but not limited to: 

• The patient presents in the emergency room with trauma that requires immediate orthopedic, medical-surgical or burn treatment to stabilize or save the life of the patient. 
• Pharmacological intervention with narcotics which mask the neuro-cognitive impairments during acute care, and sometimes for weeks or even months after injury.
• Periods of hospital and home convalescence following injury, during which cognitive and functional demands are limited.
• Incomplete testing of persons who display no obvious injury to the head. 
• Failure to seek treatment immediately after injury or during the weeks that follow, during which symptoms of cognitive impairments manifest and become problematic.
• Inability of diagnostic equipment typically utilized in emergency departments (CT, MRI, EEG) to detect the presence of mild brain damage. 
• Misunderstandings among even some medical providers that brain damage can exist even where there has been no impact or direct trauma to the head. 
• Timing of arrival of paramedics to the scene of an accident or timing following an accident in seeking initial medical care.  If the joint medical assessment (paramedic or emergency room physician) is delayed, initial assessments and Glasgow Coma Score determination may be different than immediately after the injury. 
• There are many, many factors that affect whether a Traumatic Brain Injury is initially diagnosed.

Any or some combination of these factors can result in an undiagnosed and therefore, untreated, mild traumatic brain injury.  This is the silent epidemic-the large numbers of people who are left to suffer impaired abilities to succeed at work, or to work at all, and engage in social and family relationships at the levels they did before they were injured.  Widely accepted symptoms of mild traumatic brain injury, even if only noticed weeks after initial injury include:

• Impaired attention/concentration
• Impaired memory
• Slowed information processing                 
• Difficulty in word finding
• Impaired executive function-planning, thinking   
• Headache
• Easily fatigued                           
• Slurred Speech
• Problems with vision                         
• Easily frustrated
• Emotional swings (anger/sadness/euphoric)      
• Sleep Disturbance
• Fine motor impairments                   
• Tinnitus
• Anxiety                                 
• Depressed mood

All brain injuries are serious.  Traumatic brain injury survivors suffer emotional and psychological issues and loss of self-esteem and self worth.  Often, it is a downward spiral in which dysfunctional coping responses lead to more dysfunction, alienation from co-workers, friends and family, and depression.  They and their family are lost and bewildered.  The lack of diagnosis and treatment for the mild traumatic brain injury leave them rudderless and without hope.  This downward spiral can result in serious depression, loss of relationships and loss of self.  The longer it is unaddressed and untreated, the more difficult it becomes to treat.  Layers of psycho-emotional dysfunction are laid on, and can result in a destroyed life.

There is help.  There is hope.  The first step is to recognize that help is needed.

If the injury was caused by the fault of another person-whether an auto accident, boating accident, explosion, burn injury with anoxia or inhalation injury, or injury at work, it is important to locate and retain legal help with an attorney who understands the dynamics of mild traumatic brain damage and is experienced and well studied in how to successfully prove the existence and impact of this “silent” but devastating injury.  In choosing an attorney, it is important to consider whether the attorney will support, and be a part of, the treatment team.  The attorney then must understand not only the goals of the treatment modalities (psychological, neuropsychological, psychiatry, occupational therapy, neurological, social work, etc) but must support and facilitate the client’s compliance with and consistent participation in, the treatment regimes and plan. 

An invaluable resource is the family physician.  Our experience has seen these dedicated and caring physicians serve as the gateway to verification of diagnosis and treatment weeks and months after injury onset.  The family physician can initiate referrals to neuropsychological testing, psychiatry, and/or neurological care.  Where necessary, the attorney can assist in facilitating referrals for help if the traumatic brain injury survivor is without a family physician or primary health care provider.

Even where weeks or months have elapsed since the initial injury, it is not too late to seek help.  The good news is that there is hope and help available.  The recovery process can be long and the extent of recovery will vary case by case.  But, it is a road that must be traveled.  There are many caring and dedicated people who understand the struggles endured by the traumatic brain injury survivor and his/her family.  The enemy of the traumatic brain injury survivor is inaction.  Frequently, it is the family, friend or co-worker who must provide the initial energy to intervene and take the first step to seek help.  Most often, it is a step that can save quality of a life.

The prohibition is the latest in a series of actions taken by the U.S. government to combat distracted driving.  In September 2009, the Secretary of Transportation convened a national summit on this serious driving issue and has set up a website dedicated to resolving the problem.   www.distraction.gov  

In his opening remarks at the Distracted Driving Summit, U.S. Transportation Secretary Ray LaHood said, “Every single time you take your eyes off the road or talk on the phone while you’re driving – even for just a few seconds – you put your life in danger. And you put others in danger too. This kind of behavior is irresponsible – and the consequences are devastating.”

In announcing the ban, the Secretary said “We want the drivers of big rigs and buses and those who share the roads with them to be safe. This is an important safety step and we will be taking more to eliminate the threat of distracted driving.” 

According to the National Safety Council, drivers who are texting cause an estimated 200,000 crashes on U.S. roads.  Drivers of commercial trucks and buses who text while driving may now be subject to civil or criminal penalties of up to $2,750.

Research from the Federal Motor Carrier Safety Administration shows that drivers who take their eyes off the road while sending and reading text messages are significantly more at risk for being involved in an accident than those drivers who do not text while driving.  Research demonstrated that texting drivers take their eyes off the road for an average of 4.6 seconds out of every 6 seconds.  At 55 miles per hour, this means that a texting driver travels the length of a football field, including the end zones, without looking at the road.  Those drivers are more than 20 times more likely to get in an accident than non-distracted drivers.  

Because of the significant safety risks associated with the use of electronic devices while driving, the FMCSA is also working on additional regulatory measures that will be announced in the coming months.

On October 28, 2009, a van was pulling a utility trailer in Cannon Township.  The trailer came loose and hit an oncoming car’s windshield, killing the driver and severely injuring her passenger. 

 Police said it appeared the steel pin holding the ball mount to the van’s hitch came loose, allowing the trailer that was hauling salvage metal to break free from the van. No safety chains were being used by the driver of the van.  After the trailer was inspected by the Sheriff Department, it was found to not be road worthy.  The law firm of Halpert, Weston, Wuori and Sawusch P.C. has handled numerous civil cases involving vehicles hauling trailers.  The law firm investigates all levels of the mechanical, safety and legal issues for each and every case.  

It is important that drivers hauling trailers not only have the knowledge of how to properly hookup and use the trailer, but also know the dangers of what could happen without the proper hookup and lack of safety precautions.

 There are several types of trailer hookups to vehicles.  In the matter mentioned above, the driver was using a ball mount hitch hookup.  The driver not only failed to take safety precautions by using chains to secure the trailer to the vehicle in the event the hitch came loose, the driver also failed to make sure the pin that holds the ball mount to the van’s hitch was safely secured. 

Michigan law requires that a trailer towed or drawn by a vehicle must be attached to the vehicle with forms of coupling devices so that the movement of the towed or drawn trailer does not deviate more than 3 inches to either side of the path of the towing vehicle. The trailer must also be connected to the towing vehicle by suitable safety chains or devices, 1 on each side of the coupling and at the extreme outer edge of the vehicle. Each safety chain or device and connection must be of sufficient strength to haul the trailer when fully loaded.

 Safety chains should be crossed-over on each side of the trailer to the hookup on the vehicle.  The left side chain on the trailer should be hooked to the right side of the vehicle and the right side chain on the trailer should be hooked to the left side of the vehicle.

The law firm of Halpert, Weston, Wuori & Sawusch P.C. has successfully litigated cases involving vehicle-trailer collisions.  In 2009, the law firm obtained a 1.05 million dollar settlement in a case involving a pickup truck that was hauling a trailer full of salvaged steel.  The poorly secured and overloaded trailer unhitched from the truck, and the trailer crushed the passenger side of a vehicle, trapping the victims inside and causing very serious injuries. 

CO can be caused by a faulty heat exchanger in a furnace, by incomplete combustion, and/or by faulty venting.  Improper maintenance can be a major factor in CO productions. For example, below is a photograph of a heating system where a previously rusted-out vent created toxic levels of CO at a hotel, causing it to be shut down but not before injuries were suffered.

As in many circumstances, just because  the injuries may not appear to be “life-threatening” does not mean that there can be no residual, long-term or permanent damage. What is critical is for an accurate and reliable blood draw to be done to evaluate the carboxyhemoglobin levels, taking into account exposure times, levels of CO recorded (and when and where and how), when the victim was removed from the toxic area, and whether and when the victim was given oxygen (non rebreather mask with oxygen for example). The half-life of carbon monoxide in the body differs depending on these factors. And the levels of CO recorded in the area in comparison to the  injured person’s carboxyhemoglobin levels can be important, but are not dispositive or controlling in evaluating what happened, why, and any long-term complications from the exposure. 

Symptoms of CO poisoning can range from nausea and headaches to mental confusion and dizziness.  “Flu-like” symptoms may be indicative of  CO poisoning.  Victims of CO poisoning have been thought to be “drunk” when in fact they were exposed to high levels of CO (707 ppm). Typically, a safe level of CO in a building is between 0 and 9 ppm.

Brain damage can result from CO poisoning, and the damage is not dependent on the person’s carboxyhemoglobin levels or the severity of the poisoning.  There are circumstances in which a substantial CO exposure or persons with high COHb levels can make substantial recoveries.  However, many do not.  Those with ostensibly “minimal poisoning” (or low or nearly normal COHb levels) can suffer substantial damages.  Loss of consciousness is not a requirement for neurological damage to have been suffered.

Exposure to CO, whether chronic or acute and depending on many factors, can lead to neurological changes and damage along with other physiological damage. Immediate treatment in a hyperbaric oxygen chamber has been utilized in some cases. Simply because a person may be discharged with appropriate levels of carboxyhemoglobin after treatment does not mean that there is no damage. Sometimes, brain damage and other neurological deficits do not appear until later.  Often times, the victim of CO poisoning does not equate the CO exposure with their symptoms of tiredness or difficulties in processing and organization. There are specialists who are knowledgeable and experienced in this highly specialized area. Specialized neuropsychology battery of tests have been developed and are geared towards those who have been exposed to CO and may be experiencing problems.   

The law firm of Halpert Weston Wuori & Sawusch, P.C. has handled CO poisoning cases in the past and is currently involved in a major CO poisoning case in which two people were exposed to significant levels of CO. In such cases there are many issues that should be addressed, ranging from preservation and documentation of the scene, the cause (before repairs are made and equipment thrown away), and other testing. Experts familiar with CO poisoning can be helpful early on in assisting in treatment and diagnosis, all of which requires skill in the coordination of how best to handle the many issues that may confront a victim of CO poisoning.  Issues ranging from medical bills and expenses, preservation of the evidence and cause, and legal recourse. Halpert Weston Wuori & Sawusch, P.C. investigates and handles CO poisoning cases and stays abreast of the mechanical, medical, and legal issues surrounding these types of cases.

Our law firm is a strong proponent of CO and gas detectors–in homes and environments where this deadly gas may escape purely by accident or due to someone’s negligence.

Public education is critical not only to understand the dangers presented by CO exposure, but also about prevention and treatment.  Public perceptions about the dangers and causes of CO show that there is not a sufficient understanding of the risks and from where the risks come (i.e. not just a furnace, but also from automobiles, recreational boats, radiant heaters, and so on).  The risks are underestimated; the use of CO detectors is small (not unlike the utilization of smoke detectors years ago).

CO poisoning is a substantial risk and may lead to unanticipated and unexpected damages. Carbon monoxide lawyers with an established record of state-wide experience and knowledge in protecting your rights and obtaining maximum justice should be contacted immediately before critical evidence is lost.

If you have any questions regarding CO poisoning, go to www.leadersinlaw.com or call 800.400.9115.

Too many cases of mild traumatic brain injury are not initially diagnosed.  The reasons are many and diverse, including but not limited to: 

• The patient presents in the emergency room with trauma that requires immediate orthopedic, medical-surgical or burn treatment to stabilize or save the life of the patient. 
• Pharmacological intervention with narcotics which mask the neuro-cognitive impairments during acute care, and sometimes for weeks or even months after injury.
• Periods of hospital and home convalescence following injury, during which cognitive and functional demands are limited.
• Incomplete testing of persons who display no obvious injury to the head. 
• Failure to seek treatment immediately after injury or during the weeks that follow, during which symptoms of cognitive impairments manifest and become problematic.
• Inability of diagnostic equipment typically utilized in emergency departments (CT, MRI, EEG) to detect the presence of mild brain damage. 
• Misunderstandings among even some medical providers that brain damage can exist even where there has been no impact or direct trauma to the head. 
• Timing of arrival of paramedics to the scene of an accident or timing following an accident in seeking initial medical care.  If the joint medical assessment (paramedic or emergency room physician) is delayed, initial assessments and Glasgow Coma Score determination may be different than immediately after the injury. 
• There are many, many factors that affect whether a Traumatic Brain Injury is initially diagnosed.

Any or some combination of these factors can result in an undiagnosed and therefore, untreated, mild traumatic brain injury.  This is the silent epidemic-the large numbers of people who are left to suffer impaired abilities to succeed at work, or to work at all, and engage in social and family relationships at the levels they did before they were injured.  Widely accepted symptoms of mild traumatic brain injury, even if only noticed weeks after initial injury include:

• Impaired attention/concentration
• Impaired memory
• Slowed information processing                 
• Difficulty in word finding
• Impaired executive function-planning, thinking   
• Headache
• Easily fatigued                           
• Slurred Speech
• Problems with vision                         
• Easily frustrated
• Emotional swings (anger/sadness/euphoric)      
• Sleep Disturbance
• Fine motor impairments                   
• Tinnitus
• Anxiety                                 
• Depressed mood

All brain injuries are serious.  Traumatic brain injury survivors suffer emotional and psychological issues and loss of self-esteem and self worth.  Often, it is a downward spiral in which dysfunctional coping responses lead to more dysfunction, alienation from co-workers, friends and family, and depression.  They and their family are lost and bewildered.  The lack of diagnosis and treatment for the mild traumatic brain injury leave them rudderless and without hope.  This downward spiral can result in serious depression, loss of relationships and loss of self.  The longer it is unaddressed and untreated, the more difficult it becomes to treat.  Layers of psycho-emotional dysfunction are laid on, and can result in a destroyed life.

There is help.  There is hope.  The first step is to recognize that help is needed.

If the injury was caused by the fault of another person-whether an auto accident, boating accident, explosion, burn injury with anoxia or inhalation injury, or injury at work, it is important to locate and retain legal help with an attorney who understands the dynamics of mild traumatic brain damage and is experienced and well studied in how to successfully prove the existence and impact of this “silent” but devastating injury.  In choosing an attorney, it is important to consider whether the attorney will support, and be a part of, the treatment team.  The attorney then must understand not only the goals of the treatment modalities (psychological, neuropsychological, physiatry, occupational therapy, neurologic, social work, etc) but must support and facilitate the client’s compliance with and consistent participation in, the treatment regimes and plan. 

An invaluable resource is the family physician.  Our experience has seen these dedicated and caring physicians serve as the gateway to verification of diagnosis and treatment weeks and months after injury onset.  The family physician can initiate referrals to neuropsychological testing, physiatry, and/or neurologic care.  Where necessary, the attorney can assist in facilitating referrals for help if the traumatic brain injury survivor is without a family physician or primary health care provider.

Even where weeks or months have elapsed since the initial injury, it is not too late to seek help.  The good news is that there is hope and help available.  The recovery process can be long and the extent of recovery will vary case by case.  But, it is a road that must be traveled.  There are many caring and dedicated people who understand the struggles endured by the traumatic brain injury survivor and his/her family.  The enemy of the traumatic brain injury survivor is inaction.  Frequently, it is the family, friend or co-worker who must provide the initial energy to intervene and take the first step to seek help.  Most often, it is a step that can save quality of a life.

For thousands of years, dogs have been referred to as “Man’s Best Friend.”  Why?  It’s simple—because dogs are well known for their ability to be loyal, loving, playful, and a great source of companionship for both the young and the old.  Dogs even serve some of the most important roles for humans such as being the eyes for the blind and drug and human trackers for police. There is no denying the fact that dogs bring a lot of joy to many and because of the deep bond that is established with humans, they are often considered and treated like part of the family.   

Unfortunately, the staggering number of dog attacks every year tells us that it is not always safe or wise to trust Man’s Best Friend.  The statistics reported by the Center for Disease Control and Prevention tell us that the number of dog attacks each year are in the millions, that medical attention is necessary for one out of every six attacks, and that dog attacks are in the top five reasons that children are sent to the hospital each year.  These are facts that should not and cannot be ignored.  Although cute, cuddly and furry, dogs of all types can be very dangerous causing severe injuries up to and including death.  Granted, not every dog is prone to or has a reputation for biting or attacking, but the statistical data speaks for itself—Man’s Best Friend has been the root cause of many horrendous and life altering injuries for a lot of innocent people. 

This law firm has represented many victims of dog attacks that have resulted in significant injuries requiring prolonged hospitalization and surgery for skin grafting and/or reconstructive surgery.  Below is a sample of some of the types of injuries that can result from being bitten or attacked by a dog:

The lawyers at Halpert, Weston, Wuori & Sawusch, P.C., know excellent plastic surgeons and other specialists and work with them to understand the injuries and help obtain compensation to pay for future surgeries and other needs.  In some cases, the injuries are such that the scarring can be reduced and improved, but not eliminated.  A dog bite can be very traumatic and result in not only long-term or permanent physical injuries, but also emotional and psychological issues that must also be addressed medically.  This law firm has successfully handled dog bite cases in which a neighborhood dog has attacked a child that caused puncture wounds requiring stitches to more catastrophic cases in which a woman was savagely attacked by three escaped dogs causing hundreds of puncture wounds that required multiple skin grafting surgeries due to the depth and severity of the wounds. 

Thankfully, Michigan law is harsh on dog owners forcing them to be responsible pet owners and responsible to the victim of a dog attack.  The dog bite statute in Michigan imposes strict liability (absolute or complete responsibility) against the dog owner(s) where it is shown that (1) there was a dog bite or attack of a person, (2) there was no provocation (i.e., taunting, hitting, or other action that might cause an ordinary dog to react by biting), and (3) the dog bite victim was lawfully at the location where the bite occurred.  MCL 287.351.   The key to establishing strict liability is developing the factual evidence to show an absence of provocation on the part of the victim.  Even if provocation is involved, however, there are other theories of liability for which a claim can be brought against the owner or keeper of a dog responsible for the attack that results in injury.    

The owner of a dog may also face criminal charges if the dog is determined to be a “dangerous animal” that has caused serious injury or death to a person.  Depending on the factual circumstances of the dog bite or attack, the owner can be fined, ordered to perform community service, and/or sentenced to jail time.  Generally, after a dog bite or attack is reported, the dog is required to be quarantined either at the owner’s home or the local Animal Control Department.  Under Michigan law, however, many dogs have to be put down to avoid future harm to others.   MCL 287.321. 

 The lawyers at Halpert, Weston, Wuori & Sawusch, P.C., have been successfully representing dog bite victims for many years.  This law firm has obtained hundreds of thousands of dollars in compensation on a single case and millions in total over the years.  We believe strongly that just like all the other types of personal injury claims we handle, a skilled and experienced trial lawyer is crucial to obtaining the best possible recovery to take care of medical bills incurred, future medical bills and treatments, therapy as well as compensation for pain and suffering, disfigurement, and any other long-term or permanent implications a person is forced to live with as a result of being bitten or attacked by a dog.  

Seriously now, I have been thinking very hard about how I could put into words the way my husband and I feel about Bonnie Sawusch.  It is almost the seventh anniversary of my husband’s auto accident.  After being airlifted to U of M in Ann Arbor, Michigan.  I was given a brochure on the rights and benefits entitled to me by an auto insurance company.  It was a few days before I called the number on the pamphlet.  I was then put in touch with Bonnie.  

My days at this time were a blur as my husband was in a coma and not expected to make it.  Over the next few long weeks angels seemed to just come out of the woodwork.  There were people to hold me, listen to me, help me walk and sometimes let me rest on their shoulder and get a few minutes of much needed sleep.  I didn’t know that my angel Bonnie was already hard at work to help me through, not just days or weeks or months, but years of very trying and happy days. 

Bonnie and her assistant, Suzanne, were voices that I looked forward to hearing.  They told me that I could call them anytime whether it was for legal help or just to talk and boy did I!  I was facing battles that I had no idea how to prepare for or how to fight but they stood by me and helped me win not only the legal battle but more importantly the life changing battles that I faced then and now on a daily basis. 

Bonnie took what I thought at the time a very special interest in my case but as I have come to know her in the past years, it is just the person that she is.  She handled our case with legal knowledge that she was trained and educated for, but also with care and compassion for a person who was in emotional turmoil and knew nothing of what to do other than putting one foot in front of the other.

As I sit and write this, there are tears rolling down my cheeks There is so much that I have to be thankful for and I count my blessings every day.  We all will face sadness in our lives but ours was catastrophic and I am so very thankful for the aide and help and of course the love that I was and am still being shown by Bonnie.  

My husband made a miraculous recovery and he enjoys calling and talking to Bonnie about almost anything and she takes time out of her busy day to listen.

I find new angels in my path each day and in one way, shape or form they help me through.  Sometimes I just don’t know what I ever did to deserve them but I sure am glad they are here and helping me to be strong.   On the days that my life gets overwhelming I know that if I needed to call on Bonnie she would be right there for me only if it was just to hear her voice and know that she was smiling and concerned for me.  I am proud to tell people about my lawyer Bonnie and how blessed I am to be able to call her my friend. 

Victoria Parrish

White Lake,  MI