Landau Injury Law

The American College of Physicians (”ACP”) recommends that you see a doctor IF:

1. Pain runs down the leg below the knee
2. The leg, foot, groin or rectal area feels numb
3. Fever, nausea or vomiting, stomachache, weakness, or sweating occurs
4. Bowel or bladder control is lost
5. Pain was caused by an injury
6 Pain is so bad you cannot move around
7. Pain does not seem to be getting better after 2-3 weeks.

The ACP and the American Pain Society published guidelines on the diagnosis and treatment of low back pain in December, 2007.  For a “Summary for Patients” of these guidelines, go to www.annals.org/cgi/reprint/147/7/

Many people have low back pain at some time in their lives. It can become chronic, meaning that it comes and goes over months to years.

In the “ANNALS OF INTERNAL MEDICINE” it is suggested that

IF YOU HAVE LOW BACK PAIN:
*Do not lift heavy things or do strenuous work
*Try to keep doing everyday activities an walking, even if it hurts
*Do not stay in bed longer than 1-2 days, because it can make your recovery slower

These recommendations, published by the American College of Physicians (”ACP”) in the May 6, 2008 volume, also contain this advice:

TO HELP YOU FEEL BETTER, TRY SOME OF THESE THINGS AT HOME:
*Medicines from the drug store to reduce pain, (acetaminophen, ibruprofen - read the labels !)
*Heating Pads or hot showers
*Massage

See tomorrow’s post for suggestions from the ACP as to when you should see a doctor. For more information, in English and Spanish. try the American Academy of Family Physicians (http://familydoctor.org/online/famdoces/home/common/pain/treatment/117.html)

I have been very fortunate throughout my legal career.  I have been able to work with, and learn from, some of the greatest lawyers in the country.  My first job in the legal profession was before I had even applied to law school.  After graduate school in Applied Anatomy and Physiology, I worked as a “gofer” for Aaron Levine, who had been voted “D. C. Trial Lawyer of the Year” and was a preeminant medical and drug product liability lawyer.  I learned enormously from this brilliant and creative genius.  And I have been fortunate to have co-counseled and tried catastrophic injury cases for him in the decades since, including an arm amputation (and re-attachment “medical miracle”) in Fredericksburg; a second generation D.E.S. drug product case in the District of Columbia; and, the first Phen-Fen Diet Drug case in the Circuit Court of Alexandria.

Other highly regarded trial lawyers also worked with Aaron Levine, including top Maryland medical negligence lawyer Andrew Greenwald, shown here with me at the wedding of Bernie Cohen’s son in Spotsylvania, Virginia.  Greenwald (www.jgllaw.com), of the Greenbelt law firm Joseph, Greenwald & Laake, also was a law clerk of the Levine Law Office in the District of Columbia.  We have shared “war stories” about our brilliant former boss, and we both agree that Aaron is one of the most unique and successful trial lawyers in the country.  I and others at ABRAMS LANDAU have referred clients to both the Law Offices of Aaron Levine and Joseph, Greenwald & Laake, because they are outstanding, ethical, and I have seen both Aaron and Andrew “in action.”  Come see us “in action.”  Call ABRAMS LANDAU today so that you can watch Doug Landau try a case in a court room near you.

The Associated Press reported on 5/22/08 that Medtronic will be settling the Justice Department’s fraud case against it for $75 million. The case stems from allegations that spinal catheter maker Kyphon fraudulently caused hospitals to file inflated reimbursement claims with Medicare for back surgery known as kyphoplasty. Kyphon was acquired in November of 2007 by Medtronic.

Kyphoplasty is a minimally invasive spinal surgery procedure used to treat vertebral compression fractures (VCFs). A VCF is a fracture in the body of a vertebra, which causes it to collapse. Kyphoplasty involves the use of a device called a balloon tamp to restore the height and shape of the vertebral body, which is the bone that comprises the back and spinal column. This is followed by insertion of bone cement to strengthen the vertebra. The operation on the injured person’s back and spine is performed (more…)

This important concept explains both short and long term neurologic deficits in patients whose trauma did not produce either contusions, hemorrhages or lacerations sufficient to account for the deficits. Frequently, the latter lesions are minimal but the deficit is severe. Sometimes, notes Herndon Reston brain injury lawyer Doug Landau, there is a minimal laceration (cut) or not cut at all, but the neurological damage is significant. This is often harder on the innocent crash victim because they have no “Red Badge of Courage” to display to friends, family or their physicians to buttress their claims of disability, deficit and suffering. This, in turn can cause anxiety, depression and fear, especially in cases in the long and trying litigation process adds Landau.

How does Diffuse Axonal Injury occur ? What has happened is that rotational and other movements of the brain during trauma has resulted in injury to numerous axons in both cerebrum and brain stem. Brain injury trial attorney Doug Landau explains that this can happen as the result of a sharp, fast back-and-forth movement of the skull, or a rapid twisting of the head from an impact, or a high-velocity combination of (more…)

When an injured victim of a crash is brought into an emergency room, x-rays are often ordered. However, Herndon Reston area brain injury lawyer Doug Landau notes that while such diagnostic testing, while good for showing broken bones and fractures, does not show many kinds of brain injury. For example, a cyclist or motorist injured in a crash may have a subdural hematoma (sometimes spelled, “haematoma”) which may not show up in the Hospital immediately on a post-accident x-ray.
A Subdural Hematoma is a collection of blood that pools under the dura. Because x-rays do not “see” blood as easily as hard, boney structures, Doug Landau advises that these are sometimes missed. The dura is a relatively tough connective tissue (collagenous) membrane, about the thickness of parchment paper. It is firmly attached to the under surface of the skull, and in the spinal canal, it is separated from the bony structure (more…)

In the previous posting, brain injury lawyer Doug Landau listed Direct Effects of head trauma and brain injuries.  In addition to those sometimes permanently disabling effects of an impact or blow involving the skull and brain, the Herndon Reston trial attorney notes that there are “Secondary Effect” which can also be quite devastating to the innocent victim of a bike or car crash.  Listed below are Secondary Effects of brain injury and head trauma:

B. SECONDARY EFFECTS OF BRAIN INJURY AND HEAD TRAUMA:

1. Cerebral edema or swelling

2. Herniations of brain tissue

3. Infection

4. As a result of traumatic brain damage, there may be permanent localizing neurologic defects or post-traumatic epilepsy.

See, www.pathology.vcu.edu/trauma.html

Brain injury lawyer Doug Landau studied neurology and neurophysiology before attending law school. He recognized that it was important to understand how his clients’ bodies functioned. This Virginia trial lawyer also realized that he needed to have more than just a passing understanding of the medical terminology used in his clients’ records and experts’ reports.

Landau (shown here teaching in Richmond on the topic of medical care and equipment for disabled workers on a government program) is fond of pointing out that the human body is a miraculous machine. It is resilient, and often able to recover from horrific and traumatic injury. The ABRAMS LANDAU trial team has seen a number of clients heal from terrible injuries and bounce back from enormous impact. This is especially true of our younger clients. Children, even those who sustain fractured skulls and subdural hematoma, seem to make better recoveries than their adult counterparts.

Part of the resiliency of the human body is found in the flexibility and elasticity of many of its parts. Tendons, ligaments, muscles and other connective tissues are often able to withstand and absorb significant impact and blows. There may be bruising and pain, but (more…)

General Principles

A blow to the head, or any other severe physical force, can deform, displace, and tear the tissues covering the brain and the brain itself.  According to brain injury lawyer Doug Landau of the Herndon law firm ABRAMS LANDAU, Ltd., the injury and disability from this type of “inside” injury can be more devastating than a fractured skull.   Tears in the “soft tissues” or “connective tissues” covering and protecting the brain may produce loss of function, necrosis, and hemorrhages.

Head injuries can be classified as:

(a) Closed: when a blunt object damages the brain and its coverings without actually perforating the skull or dura.  The closed type of injury constitutes the majority of civilian injuries. Extensive intracranial damage may result from an injury to the head which produces little damage to the outside.  Instead, the force may be communicated through a rigid, bony vault (calvarium) to the soft tissue within.

(b) Penetrating: when the skull and brain are directly lacerated by an object, such as a bullet or a knife.  Brain injury lawyer Doug Landau notes that when the skull is pierced by a penetrating object that needs to be surgically removed, it is sometimes called “Excaliber Syndrome.”  While working at Columbia Presbyterian Neurological Institute in the 1970s, Landau witnessed just such an extraction, as well as “penetrating” head injuries sustained by New York City Police and Law Enforcement Officers.  Even when the injury to the brain was not readily apparent, the object (in one case, a metal pipe) was easily observed on the x-rays.

Herndon Reston brain injury lawyer Doug Landau notes that there does not have to be a fractured skull, broken bones or even visible bleeding for there to be a severe and debilitating brain injury after an accident or car crash.  One reason is that the brain can be injured by striking the INSIDE of the skull.  Landau points out that this can be from what is called a “Contra Coup Injury.”  Contra Coup injuries occur when there is an injury to the opposite side of the head from the impact site. Contra coup injuries are generally thought to be an indicator of a moving head hitting a stationary, unyielding force or object.  Abrams Landau trial attorney Doug Landau points out that there does not have to be a fracture, bleeding, external head swelling or even discoloration for there to be an internal injury, such as results from Contra Coup.

See: http://www.neuroskills.com/swfcoup.html  for an excellent movie demonstrating this form of interior brain injury.