Youth Sports and Head Injuries:

The statistics on head injuries that our children sustain while

participating in sports and athletic activities are alarming. According to

the Centers for Disease Control and Prevention (CDC), more than 2.6

million U.S. children are treated in emergency departments for sports-

and recreation-related activities every year, and an average of 6.5%

of these emergency room visits are for traumatic brain injuries, such

as concussions. A more distressing fact, however, is that the number

of annual emergency room visits for concussions in children aged

8-19 doubled from 1997 to 2007 even though participation in youth

sports has declined. It is estimated that between 2005 and 2008,

approximately 400,000 high school athletes suffered from concussions.

The majority of concussions in the U.S. are sustained by football

players, but other sports such as soccer, basketball, and baseball also

see a high frequency of brain injuries. Tragically, in 2010 and 2011, 120

children died of their various sports-related injuries, and many of those

deaths were almost certainly preventable.

“Second-impact syndrome” (SIS) is a rare but preventable condition

with catastrophic effects, including rapid swelling of the brain that can

lead to death within 2-5 minutes of impact. SIS occurs when an athlete

sustains an impact to the head, chest, or neck too soon after enduring

a first concussion. Because the brain is already damaged after one

concussion, a second minimal impact can disrupt the body’s ability

to regulate pressure in the skull, which compounds the damage from

the initial concussion and can quickly cause cranial pressure buildup

and severe brain swelling. While most individual concussions do not

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What can you do when your child’s coach fails to protect them?

A White Paper by the Personal Injury Attorneys at Romanucci & Blandin, LLC

cause any lasting damage, the American Association of Neurological

Surgeons warns: “A second concussion soon after the first one,

however, does not have to be very strong for its effects to be deadly or

permanently disabling.”

In light of the risk of severe consequences from SIS, the American

Academy of Neurology (AAN) has issued return-to-play guidelines

that coaches, parents, and athletes should follow to allow the youth’s

brain to recover properly before going back to the game. Additionally,

concussion experts from around the world updated another set

of guidelines for returning to play in 2004 at the 2nd International

Symposium on Concussion in Sport in Prague. Both of these

guidelines require a coach or athletic trainer to immediately assess the

player’s symptoms, and they recommend a specific amount of time to

wait before the athlete can return to the game safely. Noncompliance

with these guidelines puts the adolescent at a risk of prematurely

sustaining a second injury that is too often permanently disabling or

fatal.

Even though there are differences between the guidelines on the exact

amount of time an athlete should sit out, it is crucial that concussion

symptoms should not be ignored or downplayed. Contrary to what

many believe, a concussion does not necessarily involve a loss of

consciousness. A recent study found that only 5% of high school

athletes reported losing consciousness as a result of a concussion.

Far more common symptoms include headache, dizziness, difficulty

concentrating, and confusion. Training and information on these

symptoms are readily available to youth sports coaches through the

CDC, the AAN, and other organizations. Most concussions do not

cause permanent damage if symptoms are recognized early and

athletes are allowed sufficient time to heal. Studies have shown,

however, that enduring just one concussion increases the risk of

additional concussions by 3-6 times for football players and 4-6 times

for soccer players.

Despite the clear warnings about SIS and the dangers of sustaining

multiple concussions, many coaches ignore symptoms and return

players to the game too quickly. A recent study found that as many

as 40% of injured athletes failed to follow the AAN guidelines, and

likewise 15% completely ignored the Prague guidelines. Perhaps even

more startling is the coaches’ lack of education on their players’ head

injuries: 42% incorrectly believe that a concussion occurs only when

there is a loss of consciousness, and 25% would allow an athlete

to return to the game even if the player is showing signs of having a

concussion. Since 58% of high school athletes do not have on-site

access to sports medicine professionals, coaches are often making

return-to-play decisions based on their own drastically incorrect beliefs.

Studies have also revealed that more than 15% of high school football

players’ coaches blatantly ignore the warnings and allow their player

to return to the field on the same day that he or she experiences a

concussion involving a loss of consciousness.

Beginning with the 2010-2011 school year, the National Federation

of State High School Associations implemented a rule that requires

coaches to remove any player demonstrating signs of a concussion

from the game immediately. The rule also mandates that players will

not be allowed to play until cleared by a licensed physician or a certified

athletic trainer working with a physician. The Illinois High School

Association (IHSA) further requires schools to adopt policies regarding

concussion management and to educate their coaches and athletes

about head injuries. Illinois law requires school boards to comply with

the IHSA, and a number of other states have also passed laws similar

to Illinois’. Although the IHSA and related state laws do not necessarily

apply to non-school sports teams, individual organizations may also

promulgate their own standards and policies that their coaches are

expected to comply with.

While these rules, laws, and policies are a step in the right direction,

standing alone they will not solve the problem. They rely entirely

on individual schools and organizations to develop and implement

concussion management policies, and they presume that coaches

and other personnel will follow the rules. When the rules are bent (or

completely ignored) to allow a concussed player to return prematurely

to the field, however, the consequences can be serious. Those

responsible for the athlete’s resulting injuries must be held liable, even if

the athlete begged his or her coach to be put back in the competition.

It is the coach’s decision, not the player’s, to allow team members to

play in a game or participate in practice.

Sports injury cases of this nature, admittedly, can be difficult to win.

Defenses such as assumption of risk and comparative fault may be

fatal to a claim if the correct arguments are not raised in response. For

example, the school could argue that the athlete voluntarily re-joined

the game, but this assertion completely ignores the duties that coaches

owe to protect our children from preventable harm. If the organization

responsible is a public school, an even tougher barrier to success

will be the state’s sovereign immunity statutes, which can severely

limit or totally prohibit claims against state actors depending on the

circumstances. Depending on the facts, however, there might be ways

to get around sovereign immunity statutes or to argue that they do not

apply to specific cases. Even if the claim is not against a public school,

some state laws provide immunity from lawsuits to some individuals

who take certain steps after they suspect an athlete has sustained

a concussion. Careful legal research will be needed to uncover the

specific rules and laws that apply to each unique case.

Gathering evidence to prepare a child’s sports injury case for trial is

also challenging. The judge and/or jury needs to understand what

happened, when and where it happened, and who was involved. This

requires victims to locate witnesses, interview them thoroughly, and

have them testify in court. Photos, videos, and other documentation

must be gathered to give the court as much information as possible

regarding the circumstances of the incident. The injured athlete also

has to prove that he or she sustained an injury and, more importantly,

that the school, organization, coach, or other staff personnel caused

that injury. Evidence of the injury itself may include lengthy medical

records, doctors’ testimony, school forms documenting the injury,

and the results of various medical tests. Proof of causation requires

uncovering all of the intricate details of the incident (especially in cases

involving multiple concussions) to understand the nature and extent of

the injury caused by each collision, fall, tackle, etc. To do this, various

medical experts may need to be consulted, deposed, and brought to

court to testify. Depending on the incident and the extent of the injuries,

other miscellaneous evidence such as neurological exam results, school

board policies, safety equipment that was worn, and the testimony of

other coaches or athletes may be required. Additionally, it might be

possible to bring multiple claims against multiple parties together in one

lawsuit, and each claim would involve its own unique issues and would

require its own separate proof.

Of course, each claim is unique, and it is impossible to list here what

specific pieces of evidence any one case will require. One thing is

certain, though: sports injury and concussion mismanagement cases

are incredibly intricate. Because of this complexity, it is imperative

that injured children and their parents seek the assistance of a law

firm equipped to handle their case. The attorneys at Romanucci &

Blandin, LLC, have decades of experience in personal injury litigation

and are very sensitive to the numerous issues surrounding children’s

still-developing bodies and minds. Their attorneys will relentlessly fight

to ensure that injured children are fully compensated for carelessly

being put in harm’s way by negligent coaches, schools, doctors, and

athletic organizations. No concussion or childhood injury should ever be

taken lightly, and when athletes are needlessly hurt because they were

expected to simply “take one for the team,” those children deserve

only the best and most well-prepared attorneys fighting on their behalf.

Romanucci & Blandin, LLC, is ready to take on any battle, in or out

of court, in order to make sure our injured children get the justice and

compensation that they are entitled to.

With the assistance of Angela Kurtz Law Clerk, Candidate Juris Doctor, 2013

28 September 2012

“Sports Injuries: The Reality.” Centers for Disease Control and

Prevention. 12 April 2012. Web. 27 Sept 2012.

“Nonfatal Traumatic Brain Injuries Related to Sports and Recreation

Activities Among Persons Aged < 19 years – United States, 2001-

2009.” Centers for Disease Control and Prevention. 7 Oct 2011. Web.

26 Sept 2012.

Bakhos, Lisa, et al. “Emergency Department Visits for Concussion in

Young Child Athletes.” Pediatrics, 1 Sept 2010; 126(3): e550-e556.

Web. 26 Sept 2012.

Comstock, Dawn and Yard, Ellen. “Compliance with return to play

guidelines following concussion in US high school athletes, 2005-08.”

Brain Injury, Oct 2009; 23(11): 888-898. Web. 27 Sept 2012.

Ziegler, Terry. “Alliance for Youth Sports Safety: A call to action.”

SportsMD. 20 March 2011. Web. 25 Sept 2012.

Bey, Tareg and Ostick, Brian. “Second Impact Syndrome.” Western

Journal of Emergency Medicine, Feb 2009; 10(1): 6–10. Web. 25 Sept

2012.

Ziegler, Terry. “Second Impact Syndrome.” Sports MD. 2 Jan 2012.

Web. 25 Sept 2012.

“Concussion.” American Association of Neurological Surgeons. Dec

2011. Web. 26 Sept 2012.

Brey, Robin. “Concussion is Serious: No one should be asked to ‘Take

one for the team.’” Neurology Now, Feb/March 2011; 7(1): 5. Web. 26

Sept 2012

“New National Study Examines Concussion Management in High

School Sports.” Nationwide Children’s Hospital. 1 Dec 2010. Web. 25

Sept 2012.

Bachur, Richard and Meehan III, William. “Sport-Related Concussion.”

Pediatrics, 1 Jan 2009; 123(1):114-123. Web. 26 Sept 2012.

“Return to Play Policy.” Illinois High School Association.

“Concussion Management: School Resources.” Illinois High School

Association. Web. 27 Sept 2012.

105 ILCS 5/10-20.54 (West 2012)

See e.g. Ind. Code Ann. § 20-34-7-4 (West 2012); Wis. Stat. Ann. §

118.293 (West 2012); Mo. Rev. Stat. Ann. § 167.765 (West 2012)

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Toll Free 888-458-1145 | Phone 312-458-1000 | Fax 312-458-1004 | Email Info@rblaw.net