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The possibility of a concussion is one of the most important concerns surrounding participation in contact sports. The concern is legitimate – the Brain Injury Research Institute estimates that anywhere from 1.6 million to 3.8 million sports- and recreation-related concussions occur every year in the US. The unanimous consensus is that combat sports cause the most concussions of any type of sport. Nevertheless, other common sports also generate numerous concussions.

What Is a Concussion?

A concussion is a mild form of traumatic brain injury (TBI) that is caused by a bump, blow, or similar impact that causes rapid movement of the brain inside the skull. In many cases, the blow will cause the brain to bump against the inside of the skull. A concussion typically results in an altered mental state (“seeing stars”, for example) and sometimes losing consciousness.

Symptoms of a Concussion

Concussions cannot be seen on X-rays or CT scans. Nevertheless, some of the most common symptoms of a concussion include:

• Headaches;
• Blackouts;
• Confusion;
• Amnesia during the time that the concussion occurred;
• Dizziness;
• Ringing ears;
• Nausea and vomiting;
• Slurred speech;
• Fatigue;
• Problems with concentration and memory;
• “Dazed” appearance;
• Personality changes (such as irritability);
• Changes in sleeping patterns;
• Depression;
• Problems with smell and taste; and
• Sensitivity to light and noise.

Some of these symptoms may not emerge until hours, days, or even months after impact.

Post-concussion Syndrome

Most of the time, concussion symptoms dissipate within three months after the injury that caused them. People with post-concussion syndrome, however, continue to experience symptoms for several months or even a year or more after the initial injury. The symptoms of post-concussion syndrome are similar to the concussion symptoms listed above. Headaches and dizziness are especially common.

Second Impact Syndrome

Lack of knowledge about how to identify and respond to a concussion creates a potentially fatal danger to student-athletes. A 2007 study, for example, indicated that over 40% of amateur coaches believe that a concussion only occurs when an athlete loses consciousness. Ominously, a quarter of all coaches surveyed said that they would authorize an athlete to return to play or practice even while he or she was experiencing symptoms of a concussion. This can cause second impact syndrome.

Second impact syndrome occurs when someone suffers a second concussion before fully recovering from an earlier concussion. Second impact syndrome causes rapid and severe brain swelling, and it is life-threatening. The consequences are almost immediate, and they include the following symptoms:

• Dilated pupils;
• Loss of eye movement;
• Respiratory failure;
• Unconsciousness; and

Concussions during Practice vs. Concussions during Actual Games

In just about every sport, concussions are more frequent in actual games than during practice. One consistent exception, however, is cheerleading, where concussions occur more frequently in practice than during games.

Combat Sports: In a Class by Themselves

Common sense will tell you that boxing and other combat sports cause the most concussions of any type of sport, since the object of the game is to cause your opponent a concussion. Never forget that although a knockout is caused by a concussion, you can suffer a concussion without losing consciousness. One study published in the Saudi Journal of Sports Medicine found that about 30 percent of 54 boxers studied reported suffering a concussion in any given year.

The American Medical Association describes combat sports as “barbaric” and has called for them to be banned. Given their enduring popularity, however, the banning of combat sports seems unlikely in the foreseeable future. Even a blanket legal ban would likely result in “underground” matches that would lack even the most basic safety precautions.

Other Contact Sports

In terms of the risk of suffering a concussion, the most dangerous contact sports (other than combat sports) are listed below in order of relative risk:

Adult Athletes (19 and older)

Concussion rates during actual games/matches:

1. Men’s rugby
2. Men’s football
3. Women’s ice hockey
4. Men’s Ice hockey
5. Women’s soccer
6. Men’s soccer

Concussions during practice:

1. Men’s rugby
2. Women’s ice hockey
3. Men’s football
4. Women’s soccer
5. Men’s ice hockey
6. Men’s soccer

Young Athletes (under 19)

Concussions during games/matches and practices combined, for both genders:

1. Rugby
2. Ice hockey
3. Football
4. Lacrosse
5. Soccer
6. Wrestling
7. Basketball
8. Softball
9. Field Hockey
10. Baseball
11. Cheerleading
12. Volleyball

Safety Precautions: How the Law Is Responding

All 50 states have enacted some form of sports-related concussion legislation that includes return-to-play restrictions for student-athletes who have suffered concussions.

Connecticut Sports Concussion Legislation

Connecticut sports-related concussion law now requires medical clearance before an athlete may return to play after suffering a concussion. This clearance can only be issued by a specified health care professional – a doctor, a physician assistant, an advanced practice registered nurse (APRN), or an athletic trainer, all of whom must have undergone training in the evaluation and treatment of concussions.  

More specifically, Connecticut law requires the following steps to be taken when an athlete exhibits symptoms of a concussion:

1. An athlete may not under any circumstances return to play on the same day that a head injury or a concussion occurs.
2. If the athlete loses consciousness or suffers vomiting or seizures, he or she must be immediately transferred to a hospital.
3. Monitoring of an injured athlete must continue after a concussion or head injury. The athlete must not be left alone.
4. An athlete with symptoms of a concussion must be evaluated by a specified health care professional who has been trained in the evaluation and treatment of concussions.
5. After an initial clearance of a specified health care professional, the injured athlete must enter a step-by-step program before a return to practice or play will be allowed. The athlete must stop any activity allowed under the program if concussion symptoms return.
6. The athlete may not return to unrestricted practice or play until final medical clearance is issued by a specified health care professional.

Civil Liability (Monetary Compensation)

When an athlete suffers an unnecessary injury, the potential defendants in a civil (or criminal) proceeding are coaches, schools, and health care professionals (primarily doctors). In order to win a lawsuit over a head injury, you must prove:

• The defendant owed a duty of care to the injured student-athlete. This is not normally difficult to establish. Coaches and schools are subject to a duty to protect the safety of student-athletes who participate in school-sponsored programs, while doctors are held to a professional level of care with respect to their patients.
• The defendant breached his duty of care. This might refer to a coach who sent an injured athlete back to play after a concussion, for example, or a doctor who improperly issued medical clearance authorizing the athlete to return to play. Breach of a duty of care is known as negligence.
• The defendant’s negligence caused the athlete’s injuries. Suppose, for example, that a coach returned an athlete to the second half of a game after the athlete suffered a head injury in the first half. He suffered no further impacts during the game but later complained of lingering dizziness. Since he suffered no further impact, it might be difficult to prove that the coach’s decision to return him to play actually caused his symptoms.
• The injured athlete suffered a tangible physical injury as a result of the defendant’s negligence. Although concussions generally do not show up on CT scans, symptoms alone can be enough to prove the fact of the injury.

Negligence per se

Negligence per se is a rule in Connecticut jurisprudence that gives the plaintiff (the person filing the lawsuit) a shortcut to proving that the defendant was negligent by allowing him to introduce evidence that the defendant violated the law and argue that the defendant was thereby negligent.

In a concussion case, this might mean that the plaintiff introduces evidence that the coach returned the athlete to play without medical clearance in violation of Connecticut sports-related concussion law. This violation could be used to prove that the coach was negligent. Proving negligence, without more, will not automatically win your claim for you, but it will get you most of the way there.

Please note that if a school coach is found negligent, since a coach is normally an employee of the school he works for (rather than an independent contractor), the school can also be held liable. This is important if the amount of the judgment is too high for a coach to pay.

Wrongful Death

Imagine that a high school football player is tragically killed when he suffers second-impact syndrome when the coach improperly allowed him to play after suffering a concussion earlier in the game. While a personal injury lawsuit is normally filed in the name of the injured player himself, a deceased person cannot file a lawsuit.

The solution in this case is to file a lawsuit under Connecticut’s wrongful death statute. The plaintiff in this case would be the probate estate of the deceased victim. The personal representative of the probate estate, appointed by a court, would be the person to actually file the lawsuit. Compensation would go to the probate estate to be distributed to the beneficiaries of the estate (generally, immediate family members).

Trends

The passage of sports-related concussion laws in all 50 states is bearing fruit, and there is reason for optimism. Concussion rates have generally declined across the board, especially the rate of successive concussions (in other words, second and third concussions are less common). The only bad news is that concussion rates increased in football games.

Contact Berkowitz Hanna Today

The experienced Connecticut personal injury lawyers at Berkowitz Hanna enjoy decades of combined experience, and we won multi-million dollar verdicts and settlements on a number of occasions.

If you have suffered an injury that you believe may have been caused by someone else’s misconduct, call Berkowitz Hanna today  or contact us online for a free initial consultation. We serve clients throughout the state of Connecticut from our offices in Stamford, Bridgeport, Danbury, and Shelton.