Tag Archives: TBI

Investigation reveals abuses at brain rehab institute

Bloomberg’s David Armstrong has assembled an investigation of a huge Florida center for brain injury rehabilitation with a record of serious patient abuse, and the system which has allowed it to keep running for so long.

Armstrong talked with 20 current and former patients and their families, examined criminal and civil cases, and went through “over 2,000 pages of court and medical records, police reports, state investigations and autopsies.”

Patients’ families or state agencies have alleged abuse or care lapses in at least five residents’ deaths since 1998, two of them in the last 18 months. Three former employees face criminal charges of abusing FINR patients – one of whom was allegedly hit repeatedly for two hours in a TV room last September.

But before you get lost deep in the details of Armstrong’s report, take a minute to appreciate his deft aggregation of scores of disparate resources through convenient hyperlinks and attachments. His entire work is truly integrated with the Web in way that, even today, few investigations are. Just as importantly, it’s tied to the bigger picture and what this scandal shows about extended care for Americans with brain injuries.

The complaints underscore the problems that 5.3 million brain-injured Americans are having finding adequate care. Their numbers are growing, according to the U.S. Centers for Disease Control and Prevention, as better emergency medicine and vehicle safety mean that fewer die from traffic accidents, bullet wounds and other causes of traumatic brain injuries.
The long-term ills range from memory loss and physical handicaps to the inability to control violent anger or sexual aggression. Yet because insurance benefits for rehabilitation are scarce, less than half of those who need it receive it, according to the Brain Injury Association of America.

Medical, support network lacking for returning National Guard, reservists

National Guardsmen and reservists returning from duty in Iraq and Afghanistan “have been hastily channeled through a post-deployment process that has been plagued with difficulties, including reliance on self-reporting to identify health problems,” according to an investigation by graduate students in Northwestern University’s Medill School.


Photo by The National Guard via Flickr

Hidden Surge” found members of the National Guard must navigate disparate health care and support providers, made more difficult by the fact that many of them live in rural areas. Three of the stories were published in The Washington Post.

The reporters also found that, in the immediate aftermath of 9/11, most reservists were medically unready to deploy – an assessment made by a private contractor. “More than 2,400 Army Reserve soldiers were held back, at least temporarily, because of inaccurate assessments by the contractor, according to data provided by the Army Reserve Medical Command.”

Meanwhile, some soldiers with behavioral problems that could be aggravated by the stress of deployment and combat were improperly sent overseas.

The project, done by 10 students, was directed by faculty member Josh Meyer, who covered national security for the Los Angeles Times for 20 years. Students used video and interactive graphics to help tell the stories. A “How We Did It” sidebar says the students interviewed more than 150 people, reviewed documents and reports and traveled to nine states to do the reporting.

According to a press release, the Hidden Surge project is part of Medill’s National Security Journalism Initiative, funded by the McCormick Foundation.

GAO evaluates youth concussion databases

In a recent report, the Goverment Accountability Office reviewed national efforts to track concussions in youth sports (highlights). The report evaluates local and national laws designed to keep young athletes safe, but the most immediately useful component may be the identification and evaluation of three incomplete national databases now being maintained.

High School Reporting Information Online database

Provides national estimates of occurrence of concussion, it covers only 20 sports for high schools with certified athletic trainers. It may underestimate occurrence because some athletes may be reluctant to report symptoms of a possible concussion to avoid being removed from a game.

The Consumer Product Safety Commission’s National Electronic Injury Surveillance System

Provides national estimates only on concussions treated in an emergency room.

The National Center for Catastrophic Sports Injury Research database

Provides information only on cases of concussion with serious complications and cannot provide national estimates of the occurrence of all concussions.


Concussion more likely when hit is unexpected

There’s anecdotal evidence that athletes are less likely to get concussions if they were ready for the impact before it arrived, but it’s not an easy premise to test. The primary concerns are ethical ones, of course, as it’s hard to justify enrolling patients in a condition that calls for “sneaking up and, when they’re least expecting it, whacking them in the skull hard enough to deliver a concussion.”


Photo by sphilp1225 via Flickr

Fortunately, researchers for a study published in the June issue of Pediatrics found a clever way to isolate those conditions in a place where they “naturally” occur, namely a youth hockey game.

They started by fitting the young players’ helmets with monitors to measure impact data, then let them play. Researchers then divided the impacts into two categories: Those that occurred along the boards where players expect to be checked, and those that happened mid-ice and were thus more likely to come as a surprise.

Chicago Tribune blogger Julie Deardorff, who alerted us to the study, describes the results:

Of 666 body collisions, 421 took place along the playing boards, and the remaining 245 hits occurred on the open ice. On average, the open-ice collisions were more severe than those occurring along the playing boards, the study authors found.

Deardorff then evaluates youth hockey impacts relative to those in other sports, and ends with the recommendation that youth hockey players “skate through” checks, and keep moving instead of staying put along the boards and absorbing all the kinetic energy of the blow.

House holds hearing on brain injuries in NFL

The House of Representatives is holding a hearing on “Legal Issues Relating to Football Head Injuries” that is being webcast on C-SPAN.org.

The witness list includes NFL commissioner Roger S. Goodell as well as the director of the players association, team executives, doctors, neurologists, retired players, families of former players and safety advocates.


The New York Times: NFL Data Reinforces Dementia Links