The Metropolitan Transportation Authority has announced that beginning in the fall of 2015, buses in New York City will be equipped with “collision avoidance devices”, which will alert bus drivers to the location of pedestrians, bicyclists and motor vehicles which are in the operator’s blind spots. The system will utilize radar and sensors with speakers mounted on the exteriors of the buses, and will sound warnings to pedestrians and others as the bus is turning, to stay clear of the direct area.

Transit authorities in Los Angeles, Baltimore and Portland have either adopted the program or tested it, with the two main providers being ProTran from Newtown, New Jersey, and Clever Devices, with headquarters located in Long Island. In 2010, the Cleveland Regional Transit Authority installed the devices on 400 buses after averaging six pedestrian deaths a year. Since 2010, there have apparently been no pedestrian fatalities reported in Cleveland.

Ironically, the bus collision rate in NYC has dropped significantly (46%) from 92 collisions per million miles travelled in 1988, to 50 per million miles travelled in 2014. Nonetheless, there were 55 pedestrians and 7 bicyclists killed in bus collisions (including buses operated by private companies) in the City since 2010. Further, 131 pedestrians died in all types of traffic accidents in NYC in 2014, which is the lowest number of fatalities reported since 1910 (when record keeping of fatalities began), but still an unacceptably high number.

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For the last several years, several European countries, including Sweden, the Netherlands, and Norway, and some states in the U.S., have adopted a program known as “Vision Zero” in an all-out effort to reduce traffic fatalities and serious injuries. The program includes better traffic signs and roadway design, and a reduction of speed limits on local roads and highways. Research has determined that the human tolerance for a collision with a well-designed motor vehicle is approximately 19 miles per hour. When Mayor Bill de Blasio entered office last year, he announced that New York City was going to adopt the Vision Zero program to emphasize an effort to make New York City streets safer for pedestrians and bicyclists. This was after a personal plea by more than 4,500 letters from members of Families for Safe Streets, an organization that was created by family members of those killed or seriously injured in pedestrian, bicycle or car crashes in New York City.

The Vision Zero program involves improving traffic signage and reducing speed limits. In New York annually, approximately 4,000 people are seriously injured and there are more than 250 fatalities in traffic crashes. For children under the age of 14, being hit by a car is the leading cause of injury-related death, and is the second leading cause of death due to injury of seniors. On average, vehicles seriously injure or kill a New Yorker every two hours. Interestingly, although Mayor de Blasio has placed a major impetus on implementing the Vision Zero program, traffic fatalities in New York City have been steadily decreasing from 701 in 1990, 381 in 2000, to 249 in 2011. Obviously, any traffic fatalities are a problem when it comes to the huge volume of pedestrians in the City of New York.

Vision Zero has also been implemented in major cities across the U.S., including Boston, where in March of 2014, personal injury attorney John Sheehan initiated the “Vision Zero Auto Accident Prevention Scholarship” to encourage young adults to recognize the benefits of safer driving, and San Francisco, where district supervisors introduced the Vision Zero plan after 25 pedestrian and bicyclist fatalities in 2013 alone.

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On December 1, 2013, an otherwise ordinary early Sunday morning after the Thanksgiving holiday, a southbound Metro North train bound for Grand Central Station from Poughkeepsie derailed just north of the Spuyten Duyvil station in the Bronx. The train engineer, William Rockefeller, who had been employed by Metro North for fifteen years, fell asleep at the controls, (or fell into a trance sometimes called “highway hypnosis), allowing the train to hurtle along the tracks at 82 miles per hour in an area where the speed limit is 30 m.p.h. The derailment was investigated by the National Transportation Safety Board (NTSB), the MTA Police, the NYPD and the Bronx District Attorney’s Office to determine if a crime was committed, but none of these agencies found any basis for criminal charges. The brakes on the train were in working order and a check of Mr. Rockefeller’s phone revealed that he was not texting or using his cell phone prior to the crash. Rockefeller awoke just prior to the derailment and attempted to slow the out of control train to no avail as the train went flying off the tracks. Of the more than 100 passengers on the early morning train, four were killed and more than 80 injured. Mr. Rockefeller’s shift had been switched two weeks earlier from a night to the early morning run starting in Poughkeepsie at 5:04 AM. He was diagnosed with sleep apnea, which certainly contributed significantly to the tragic incident. No drugs or alcohol were found in his system. Continue reading

Walk down any block in cities large or small, and you will inevitably see people walking across the street, into crosswalks, onto roadways, through parking lots with moving traffic, and along sidewalks, never looking up from their cell phones while they busily send a text or email. Worse, there have been ample examples on You tube of people walking into telephone poles, falling into Lake Michigan, falling onto train tracks, tripping on uneven areas of the sidewalk or into holes, into other pedestrians on the sidewalk, or in one heavily viewed video, a woman walks into the wall of a fountain in a mall, falling directly into the water while passersby look on.

At the University of Ohio in 2010, researcher Jack Nasar conducted a study of 1,500 pedestrians who suffered injuries while using their cell phones and who were treated at emergency rooms. The study showed that there were six times more injuries suffered by texting pedestrians than five years earlier. Nasar’s study included a teenager who fell into a ditch after he walked off of a bridge, and a 23 year old man who was hit by a car and suffered hip injuries when he walked into the street without paying attention.

Safe Kids Worldwide performed a survey this past October, noting that 40% of the 1,000 teens they interviewed admitted they had been struck by, or almost hit by a car while walking. Of those interviewed, 85% indicated that they were listening to music, texting, or on their cell phones when they were struck or almost hit. Dr. Barry Smith, director of the emergency medicine department at St. John’s Medical Center in Yonkers, noted that he sees many patients with orthopedic injuries suffered when they were walking and trip on the sidewalk, striking their heads or fracturing a limb. Obviously, the problems is greatly exacerbated when the pedestrian is focused on the music they are listening to, sending or reading a text or email, and not looking at what is in front of them.

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Knee replacement surgery has become more and more prevalent over the last fifteen years.  However, two recent studies from researchers at Virginia Commonwealth University in Richmond, after reviewing the records of 200 patients, suggest that in many cases, the surgery may not be appropriate or warranted.  The studies concluded that knee replacement should be performed only for those people who are suffering from advanced arthritis in the knee joint.  This is defined as encompassing severe pain, and impaired range of motion and function which hampers the person from getting out of a chair and walking without assistance.

According to data from the American Academy of Orthopedic Surgeons, knee replacements in people ages 45-64 skyrocketed 205% between 2000 and 2012.  For those aged 65 and older, the increase was a still substantial 95%.  The Virginia Commonwealth researchers indicate that surgical replacements are more indicated for patients over age 65 because the implanted materials last approximately 20 years.  Thus, if a 45 year old patient has the replacement, they will likely need another one during his or her lifetime. The researchers determined that about one third of the subjects were probably not good candidates for knee replacement surgery, because their arthritis was not substantial, and they had only slight pain and physical impairment.

Conversely, those whose arthritis was advanced benefited tremendously from knee replacement, with much improved function, and significantly less knee pain in the two years after the procedure.  Additionally, their knee function scores improved about 2o points.  In contrast, those whose knees didn’t justify the surgery had only a 2 point improvement in function scores.

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Melissa Rivers, the only daughter of the late Joan Rivers, the 81 year old comedian who died on September 4, 2014, has announced her intention to file a multimillion dollar medical malpractice and wrongful death lawsuit against the Yorkville Endoscopy Clinic in New York City. The facts are that Ms. Rivers was seen at the clinic on August 28, 2014 for a voluntary procedure to examine her upper gastrointestinal tract and vocal chords. She was under sedation with Propofol, (ironically the same drug that was responsible for the death of the pop performer Michael Jackson in June of 2009).  Rivers went into cardiac arrest during the procedure, and the allegations include the charge that Yorkville did not properly monitor her intake of Propofol, which was administered prior to the operation. Ms. Rivers was rushed to Mount Sinai Hospital from Yorkville Endoscopy, and died of low blood oxygen to her brain for an extended time, resulting in irreversible brain damage.

Melissa Rivers is the sole heir to the Rivers estate (her father, Edgar Rosenberg, committed suicide in August of 1987), and the estate has been valued as high as $100-150 million. She claims that the lawsuit is not to seek compensation, but rather to “fully determine the facts and circumstances surrounding [Joan Rivers] death.” The official cause of death was “anoxic encephalopathy due to hypoxic arrest during laryngoscopy and upper gastrointestinal endoscopy with Propofol sedation for evaluation of voice changes and gastroesophageal disease.”

Ms. Rivers was in a coma from the throat procedure on August 28, 2014 through her death on September 4, 2014. Thus, with regard to the medical malpractice allegations, which would require that her attorneys prove “conscious pain and suffering”, this will be difficult to establish unless there is some evidence that Rivers had some conscious awareness of her condition.

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This week, ten former NFL players filed objections to the NFL Concussion Lawsuit settlement due to concerns that the settlement does not adequately compensate the victims of chronic traumatic encephalopathy, or CTE. CTE is a brain injury of progressive neurological deterioration caused by repeated blows to the head. It was previously known as “dementia pugilistica”, as the condition was frequently observed in boxers. CTE has symptoms including memory loss, behavioral and mood disorders, personality changes, speech and gait abnormalities, impulsive actions and rage. 

The settlement covers approximately 20,000 players, and the great majority of those players or their families for those who are deceased are accepting the terms of the settlement. But Robert Stern, a Boston University professor of neurology and leasing expert on CTE, has declared that players “who suffer from many of the most disturbing and disabling symptoms of CTE will not be compensated under the settlement.” 

Since CTE cannot be diagnosed in living players, the 76 cases of the diagnosis in football players were all discovered during autopsies, which is part of the reason that the CTE diagnosis was not given the same weight as other conditions when determining the compensation provided to ex-players in the settlement. For example, conditions including Alzheimer’s disease, Parkinson’s disease, ALS, (Amyotrophic Lateral Sclerosis, also known as Lou Gehrig’s Disease), and dementia do not have the same restrictions as does CTE, ostensibly because each of these diagnoses can be determined while the player is alive. As presently constituted and approved by federal justice Anita Brody of the 3rd District in Philadelphia, all caps as to total compensation were removed. However, former NFL players who were diagnosed with CTE prior to January 1, 2006, or after July 7 of this year, are not covered by the settlement.

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On September 18th, Jill Tarlov, 59, a married mother of two and former employee of WINS News, was crossing West Drive near West 63rd Street when she was struck by a bicyclist, 31 year old Jason Marshall.  Apparently, Marshall was travelling in excess of the 25 mph speed limit in Central Park, and swerved to avoid a group of pedestrians when he collided with Ms. Tarlov.  Marshall allegedly screamed “Get out of the way!” a couple of times before the tragic collision.  It is unclear who had the traffic light, but according to the New York Times, Marshall admitted during questioning that he was in the car lane, not the bike lane, when he struck Ms. Tarlov.  She struck her head on the roadway and suffered severe head injuries.

Ms. Tarlov was taken to New York Presbyterian Hospital/Cornell Medical Center and shortly thereafter, declared brain dead.  This past Monday, September 22, Ms. Tarlov died of her injuries.  The issue here is whether Central Park is safe for pedestrians in light of the large volume of pedestrians, runners, horse drawn carriages, cars, in-line skaters, and leisurely bikers who share the roadway with racing cyclists, who frequently violate the rules of the road with regard to speeding and disregarding traffic control devices. According to the Times, the police have issued 468 moving violations (speeding tickets, unsafe lane change, failing to yield to pedestrians, disregarding a stop sign or red light) to bicyclists so far in 2014.  Last year, by this date, there were only 151 summonses handed out by police for these infractions.

The fatal crash this month is only 45 days after another similar tragedy on August 3rd of this year.  On that date, 75 year old Irving Schacter, who was training for the 2014 New York City Marathon and was an avid cyclist himself, was struck by a 17 year old cyclist while he was jogging on the east park loop near East 72nd Street.  Mr. Schacter was taken to New York Presbyterian Hospital with head trauma and died two days later.

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In a stunning and sudden change of position, the National Football League now acknowledges that 1 in 3 former players are likely to develop some long term brain damage from repeated head trauma and TBI suffered during their playing careers. The data was compiled by actuaries retained by the NFL and provided to United States District Court Justice Anita B. Brody of Philadelphia, who has been supervising the settlement of approximately 5,000 former players’ claims against the league that the NFL knew that repeated concussions led to long term permanent injuries and diagnoses but intentionally withheld this information.

Specifically, the ex-players contended in their lawsuit that the NFL was well aware for many years that repeated head trauma would cause Alzheimer’s Disease, Parkinson’s Disease, ALS, (Amyotrophic Lateral Sclerosis, also known as Lou Gehrig’s Disease), dementia, depression, mood disorders, and chronic traumatic encephalopathy, (CTE) which is not possible to diagnose until an autopsy is performed. Last fall, a $675 million settlement was entered into between the players’ lawyers and the NFL. However, Justice Brody rejected the settlement amount, considering the proceeds to be inadequate to fairly compensate all potential claimants over the 65 year life of the settlement. Justice Brody directed counsel for both sides to submit a more substantial total settlement package.

To address the concerns of Justice Brody, the NFL agreed in June of 2014 to pay an unlimited amount in awards for brain injuries suffered by former players who filed claims under the settlement agreement. Some former players, or their families, (as in the case of Junior Seau, the all-star linebacker for the San Diego Chargers who killed himself and requested that his brain be studied for brain injury), “opted out” of the settlement and will sue the NFL individually.

A significant percentage of the payouts to ex-players will be for those diagnosed with Alzheimer’s disease or advanced dementia. They will receive approximately 800 million dollars. The NFL and players’ attorneys believe that the largest payouts will go to players suffering from Parkinson’s Disease, ALS or CTE. Estimates by lawyers for the players are that approximately 28% of players (5,900) will develop injuries for which they are entitled to compensation. About 60 percent of these players are expected to file claims which would comprise about $950 million.

The actuarial reports are magnifying one of the main concerns of the players who have joined the class action, as well as those who have not—namely, that players with less severe brain injuries due to repeated concussions will not receive any compensation or minimal compensation at best. Seven retired players submitted papers to a federal appeals court requesting that the Court review the issue of compensation for less severely affected ex-players, but the appeals Court declined to do so.

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Over the last three years, 4,500 former NFL players filed lawsuits against the league alleging that for many year, the NFL deceived them as to the risks of repeated concussions and traumatic brain injury (tbi), resulting in numerous long term neurological conditions and the long term effects of these conditions, including dementia, Alzheimer’s Disease, chronic traumatic encephalopathy (CTE), Parkinson’s Disease and ALS (amyotrophic lateral sclerosis), also known as “Lou Gehrig’s Disease.” The lawsuits were consolidated into once class action and filed in the U. S. District Court in Philadelphia before Justice Anita Brody.

Several months ago, attorneys for the NFL and attorney’s for the players worked out a tentative settlement of the lawsuits, which included the following: A cap of $675 million for financial awards to ex-players for pain and suffering arising out of their medical conditions, (without the requirement to prove that the conditions were caused by the repeated concussions); $75 million for baseline neurologic and neuropsychological testing for any legible retired players; and $10 million from the league for programs to promote safety and the prevention of head injuries. However, Justice Brody balked at approving the settlement last fall, contending that the $675 million cap on payments to former players was inadequate and needed to be bolstered. Certainly, the NFL’s annual estimated revenue of $10 billion reflects the fact that the $675 million over the 65 year life of the agreement would not even make a dent in the league’s finances. Further, it is expected that the number of players who will make claims for brain injuries incurred during their playing careers will continue to escalate as awareness of the damage from repeated concussions increases.

The revised agreement presented to Justice Brody removes the cap of $675 million for claims by ex-players. Former players will be notified of the terms of the settlement and provided with an opportunity to accept the terms or “opt out”, allowing the individual players to file their own lawsuits. Justice Brody will conduct a hearing this fall to determine whether the settlement is now in the best interests of the former players and is fair and adequate. The settlement as presently constituted provides awards of $3.5 million for Parkinson’s disease; $4 million for a diagnosis after a player’s death of CTE; and $5 million for ALS. Additionally, the settlement would encompass payouts for early dementia and “severe decline in cognitive function”, although it is unclear how those terms are defined or what the amount awarded for those diagnoses would be.

We will follow the evolution of the settlement between the NFL and the players’ attorneys and report further after the notification period to the ex-NFL players.

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