New York Personal Injury Lawyer Blog

Earlier this month, 12 former NFL players who played in the late 1990’s and early 2000’s instituted a class action lawsuit in the U.S. District Court of New Jersey, contending that the league failed to inform players of the risks and side effects of the pain killer (and blood thinner) Toradol. Ex-players including Joe Horn, Matt Joyce and Scott Dragos would be given injections of Toradol to numb the pain from injuries suffered during games in order to get them back on the field quickly. The suit indicates that Toradol would mask traumatic brain injuries with long term effects, including concussions, which have led these ex-players to suffer from numerous health problems since their retirement from the league.

When a player suffers a “stinger”, (Concussion in NFL lingo), trainers often conduct a cursory examination including a quick memory test, check of reflexes and coordination, and examine pupil size. If this short examination appears normal, the player is cleared to return to action.
The side effects of a concussion, which is a traumatic brain injury caused by various types of collisions, include:

An altered state of consciousness, such as drowsiness;
Confusion and loss of concentration;
Severe headaches of long term or short term variety;
Mood changes;
Amnesia;
Nausea and vomiting;
Changes in alertness;
Muscle weakness on one or both sides of the body;
Difficulty walking and with balance and coordination.

Nate Jackson, one of the plaintiffs, described in an editorial in the New York Times that when he played for the Denver Broncos, Toradol was often administered to the players prior to a game. The evening before game day, a line of 10-20 players formed to receive their injections. They were told that other than a small risk of internal bleeding, Toradol was safe. It is easy to visualize Jackson’s description of the pressure that he felt from team personnel, including trainers and doctors, to get back on the field as soon as possible or risk being replaced by “spare parts”, as Jackson referred to them. Jackson’s description is compelling: "There was no hesitation, no trepidation, no point at which I felt that taking Toradol was a risk. I trusted our team doctors…they wouldn't suggest a drug if it was dangerous.”

In the lawsuit, the players accuse the NFL of negligence, fraud, fraudulent concealment, misrepresentation and conspiracy. The 2nd, 3rd and 4th of these charges care essentially the same: that the NFL knew of the specific risks of Toradol, yet chose to not divulge these risks to the players to benefit teams by doing whatever was necessary to keep players off of the disabled list.

The NFL denies that it deceived players and argues that they now make safety a priority, with severe penalties and suspensions for helmet to helmet collisions, for example. Presently, there are numerous lawsuits against the NFL after two dozen players have died from the effects of chronic traumatic encephalopathy (CTE), which is a condition caused by multiple blows to the brain (it used to be known as dementia pugilistica as many boxers suffered from the condition). With CTE, a substance known as “tau” forms on the brain and interferes with cognitive functioning. Former star safety Dave Duerson of the Super Bowl champion Bears and New York Giants was so convinced that he was suffering from CTE that in committing suicide, he purposely shot himself in the chest and requested that the coroner examine his unharmed brain, which examination confirmed the CTE diagnosis.

One of the main reasons that these former players have commenced the Toradol lawsuit, and the other lawsuits claiming undiagnosed CTE, is that the NFL’s health insurance does not cover collision related injuries, so that the ex-players are now left with serious medical problems compounded by major financial difficulties when they have significant medical expenses and can no longer work. Hopefully, this problem will be addressed by the NFL in the near future, as players are faster and bigger than ever and the collisions are likely to lead to an increase in the CTE diagnosis in the future.

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Ridge Barden, a 16 year old Phoenix, New York high school football player, died on October 14, 2011 after suffering a concussion and traumatic brain injury (TBI) during a game for Homer High School. Barden was a defensive tackle for the team, and died a few hours after falling to the turf in the 3rd quarter of the game following a blow to the head. The coroner determined the cause of death to be subdural hematoma, and massive swelling of the brain.

A subdural hematoma occurs when blood vessels rupture between the brain and the outermost of three membranes that cover the brain, (the dura) resulting in a collection of blood. Subdural hematomas can occur acutely, from a severe blow to the head, subacutely, in which the signs and symptoms can occur days or weeks later, or chronically, in which the precipitating cause might not even be known or remembered by the person suffering the condition. (Additionally, the elderly, people taking aspirin daily, or alcohol abusers can also suffer a subdural hematoma).

Coaches and school administrators watched a video of the game to determine if they noted a particularly violent collision which caused the fatal injury to Barden. Also under scrutiny was the helmet that Ridge was wearing, known as a Riddell “Revolution”. There are lawsuits pending by former NFL players against the league and Riddell Sports, Inc., the manufacturer of football helmets, alleging that former players now suffer from severe injuries from repeated collisions and concussions, including dementia, and CTE, meaning chronic traumatic encephalopathy. Chronic traumatic encephalopathy is a progressive debilitating disease suffered by people who have had multiple concussions or other head injuries. The brain tissue deteriorates from the blows and a protein called “tau” accumulates on the brain. CTE is also known as “dementia pugilistica”, since until recently the huge majority of these cases were diagnosed in boxers.

Teenagers are considered to be more at risk for concussions and traumatic brain injuries as the brain tissue is not completely developed. The National Center for Catastrophic Sports Injury Research notes that Ridge Barden was the 13th high school football player to die from a brain injury since 2005 and the third in 2011. An additional 5 college football players have suffered fatal brain injuries during a game in that same 6 year span. In Ridge Barden’s case, there was apparently no prior history of head trauma or concussion, and the autopsy did not reveal any previous brain injury.

During a recent Senate Commerce Committee Hearing, the topic being addressed was whether manufacturers of sports equipment made misleading statements and claims about their products. Several neurosurgeons and sports concussion experts testified who specialize in traumatic brain injury and sports concussions. Dr. Kevin Guskiewicz, the chairman of the department of Exercise and Sports Science at the University of North Carolina testified that Ridge Barden’s life could only have been saved if he had undergone an immediate operation to relieve the pressure on his brain as a result of the subdural hematoma. However, the problem is that in order to diagnose the issue, a CAT Scan must be ordered, and Barden’s condition deteriorated to quickly allow him to undergo a CAT Scan.

Dr. Robert Cantu, a neurosurgeon at Boston University and well known expert in the field of sports related head trauma and injuries, explained that when a person is conscious immediately after a trauma, and then deteriorates quickly as in Ridge Barden’s case, the cause of death is not the subdural hematoma, but massive brain swelling. Frequently, the fatal injury is due to a previous trauma to the brain compounded by a second impact in close proximity in time to the first. Dr. Cantu calls this “second impact syndrome” in association with subdural hematoma.

After a House Judiciary Committee hearing in October of 2009 in which NFL Commissioner Roger Goodell was pounded with questions about the NFL’s concussion policies, the NFL changed its rules to require that a player diagnosed with a concussion would not be permitted to return to that same game even if he was not experiencing any symptoms.

In the wake of the truly tragic death of Ridge Barden, numerous other high school and college football players like him, and the continuing litigation by former NFL players against the league and Riddell, changes must be contemplated and hopefully implemented. One possibility would be to terminate the three point stance for linemen, (with one hand on the ground as well as two feet), and go to a two point stance, in the expectation that this would limit helmet to helmet contact and result in more blocking with arms and hands. Another possibility would be to eliminate the purposeful helmet hit whereby running backs lower their heads into a defender to garner some additional yardage, and defenders respond by lowering their heads as well. Something else to consider would be fewer full contact drills, which undoubtedly contribute to the long term problem—after all, there are no referees blowing a whistle for helmet on helmet contact, and it is certainly unlikely that a head coach or assistant coach at any level would lecture a player for being too aggressive with an opposing teammate in practice.

Continue reading "Fatal Brain Injury In H.S. Football Game" »