Bruce Stern in Tennessee: All Brain Injury is Serious

On Monday, September 26, 2016, I had the pleasure of giving a presentation entitled “Dispelling the Myths of a Mild Traumatic Brain Injury: All Traumatic Brain Injury is Serious.”

My presentation addressed 10 myths surrounding Mild Traumatic Brain Injury, such as concussions are not serious, everyone recovers from mild TBI, mild TBI is not permanently disabling, one does not need to lose consciousness, and conventional neuroimaging is sensitive to mild TBI. The three day event in Nashville brought together some of the country’s leading trial attorneys and medical experts who presented on a myriad of medical and legal issues surrounding the preparation of a TBI case.

The symposium was sponsored by the Brain Injury Association of Tennessee and the Tennessee Trial Lawyers Association.

North America Brain Injury Society holds its 28th Medical Legal Seminar in Tampa

The North America Brain Injury Society (NABIS) held its 29th Medical Legal Traumatic Brain Injury Seminar to educate attorneys and assist them in better representing their clients. Medical and legal experts from around the United States presented at this three day conference held in Tampa, Florida.

As one of the programs co-chairs, along with Ken Kolpan, Stewart Casper, and Simon Forgette, we put together what many considered to be the premier medical legal traumatic brain injury conference in the United States. I had the pleasure of presenting on the topic of the admissibility of diffusion tensor imaging, which is a sophistic neuroimaging technique that can detect traumatic brain injury where conventional MRI and CT cannot.

I look forward to seeing everyone next year (March 29-April 1, 2017) in New Orleans when NABIS will be hosting the 30th Medical Legal Traumatic Brain Injury Seminar in conjunction with the International Brain Injury Association’s 12th World Congress that will be held at the same time.

Stern Delivers Two TBI Presentations

This past week, I attended the American Association for Justice’s mid-winter convention in Palm Desert, California.  Besides my duties and responsibilities as Parliamentarian of AAJ, I was pleased to be invited to give a presentation at the Specialized Track: Concussion Crisis-Litigating Sports Injuries and TBI CLE program where I spoke on the topic of “Proving the Invisible:  Arguing a Sports-Related Concussion Case without Neuroimaging.”

On returning to New Jersey this past Saturday, I co-chaired the New Jersey Association for Justice (NJAJ) Traumatic Brain Injury program.  Besides co-chairing the event, I gave a presentation entitled “Identifying and Handling the Traumatic Brain Injury Case.”

Stern Gives Seminars on Both Coasts and Canada

It has been a very busy past two and a half weeks as I have given presentations on both coasts of the United States as well as Nova Scotia, Canada.  In late October,  I was invited by the Workers Injury Law and Advocacy Group to speak at their yearly convention in Santa Barbara, California.  There, along with my colleague Gordon Johnson, we gave a mock demonstration of a direct examination of a neurologist in a traumatic brain injury. A week later, I flew back to California to give a presentation entitled “Admissibility of Diffusion Tensor Imaging (DTI)” for the Brain Injury Association of California.

Back in New Jersey, I co-chaired a program entitled “Cross Examination College” at the New Jersey Association for Justice’s mid‑year convention at the Meadowlands in East Rutherford, New Jersey.  Besides co-chairing the college, I also gave a presentation on cross examination of the expert in a traumatic brain injury case. Finally, I was invited to speak at the Atlantic Province Trial Lawyers Association’s seminar in Halifax, Nova Scotia, Canada.  There, I gave two presentations , one entitled “The Effect of Disability on Earning Capacity for Canadians”  as well as a presentation on “The Use of Demonstrative Evidence.

While travelling can be quite tiring and travelling back and forth to the west coast is exhausting, I believe it is important to help educate other trial attorneys so they can better be able to represent their clients who sustained injury as a result of the fault of others.

New York Court Upholds Use of Diffusion Tensor Imaging in Litigation

I was recently sent two Orders from the State of New York in which defendant’s motion to bar the introduction of diffusion tensor imaging was denied.  Here is a discussion of the first case with the second to follow.

In the matter of Girgs v. Snapple Distribution Corp., Civil Court of the City of New York, County of Queens Part 30 the defendant moved to preclude the testimony of plaintiff’s medical expert, Michael Lipton, M.D., Ph.D. regarding his assessment of a traumatic brain injury based upon his analysis.  The basis of the motion was due to the plaintiff’s “alleged failure to comply with prior discovery orders wherein defendant sought to obtain various records, data, and information relied upon to reach the results in his report.  Defendant asserted that Dr. Lipton was unavailable and would always be unavailable to turnover his data as it is based on a comparison to individuals who did not waive their privilege under HIPAA.  Plaintiff asserted that discovery had been turned over.

According to the Order, Dr. Lipton performed an MRI of the plaintiff’s brain with results which were interpreted as being “unremarkable.”  Dr. Lipton also reviewed the plaintiff’s MRI with diffusion tensor imaging at which time he performed a quantitative analysis of the fractional anisotropy (“FA”) images from the DTI portion of the examination.  Dr. Lipton opined that this analysis revealed that plaintiff had multiple abnormalities consistent with axonal injury due to traumatic brain injury.

In response, defendant demanded discovery of all data, films, and information on which Dr. Lipton based his findings.  Defendant filed a motion to compel such discovery which was granted to the extent plaintiff was to provide all FA images using DTI, and any and all control values, including but not limited to films and images of the control group relied upon by Dr. Lipton and any other DTI imaging and films.  According to that Order, if plaintiff did not provide the requested information, plaintiff would be precluded from offering trial evidence and testimony from Dr. Lipton regarding the items not produced.

That early order was modified to the extent that defendant was given leave to subpoena the “computer programs and foundational data bases from Montefiore Medical Center and Albert Einstein College of Medicine.”  That early order was again modified to the extent that defendant was to serve a subpoena on Montefiore Medical Center requesting the data/information used for the comparative analysis by Dr. Lipton.

In response to that order, plaintiff turned over to defendant the DTI demographical data and quantitative analysis compiled by Dr. Lipton.  This information contained a number of participants in the control group, age, gender, and FA numbers.

In this most recent decision, the Court found that “since the images comprising the normal data base contained personal identifying information, as well as protected HIPAA information of parties not part of the lawsuit, who had not given consent, there is no legal basis to turnover this information.”  Furthermore, in that defendant’s “expert” Dr. Panasci, M.D. did not allege that he had any expertise in the quantitative analysis of DTI, the Court found that this information was not necessary for his analysis.  Accordingly, defendant’s motion to preclude the testimony of Dr. Lipton was denied.

Defendant then asserted that Dr. Lipton’s testimony should be precluded on the basis that the determinations in his report were not based on the “generally accepted standard” as set forth under Frye. The Court rejected this argument as well finding that the “data and methods relied upon by Dr. Lipton to quantitatively analyze plaintiff’s DTI images had been peer review endorsed by scientific publications including Radiology, Journal of Neuro Trauma, PLOS ONE, and Brain Imaging and Behavior. 

The Court stated: Moreover, to follow the defendant’s argument to its logical conclusion, would lead to an illogical result.  If the Court adopted defendant’s argument, there would not be any introduction of a great deal of generally accepted medical research since this privilege HIPAA information can never be turned over without consent.  Limitations of this type would be a waste of helpful resources and counterproductive to the administration of justice. Thus, defendant’s motion to preclude the testimony of Dr. Lipton based on Frye was denied.

2014 World Congress on Brain Injury, March 19 – 22, 2014 in San Fransisco

The World Congress is held biennially, and sponsored by the International Brain Injury Association. The IBIA World Congress is the largest gathering of international professionals working in the field of brain injury. Delegates are comprised of physicians, psychologists and neuropsychologists, therapists, social workers, nurses, case managers, legal professionals, advocates, and all others working in the field of brain injury. In 2012, over fourteen multi disciplinary professionals attended the Ninth World Congress held in Edinburg, Scotland.

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