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No Time to Kill (or Get Serious Injuries)

When watching the new Bond film, I found myself wondering whether, as a society, we have any understanding of how vulnerable the human body is. Hollywood certainly doesn’t understand how little force is needed to break a bone. And yes, in case you are wondering, this is a principal reason why I am not a fun person to watch action films with. I will often turn to my fellow audience member after an exhilarating action scene and point out, ‘by the way despite the film pretending the protagonist is fine, they actually have a serious spinal injury and probably a head injury too’. One of my pet peeves is when films treat a knock-out punch as an off-switch, which results in the victim waking up in the next scene with no ill effects, when actually a loss of consciousness following head trauma is indicative of a traumatic brain injury.

Generally speaking humans struggle to accurately assess risks and can underestimate how dangerous common place or everyday activities are. For instance, more people suffer anxiety about flying than driving despite your statistical chance of being in an accident being much higher when travelling in a motor vehicle. I do wonder whether the portrayal of Bond (or other action stars) shrugging off bullet wounds, falling 30 feet plus, or their car flipping over and smashing into walls, adds to how poor our perception is of risk. Do we feel on a subconscious level that if we fell off that ladder, we wouldn’t be too badly hurt? Or in the words of Captain America, that if we died, we would be able to ‘walk it off’.

There is also often a lack of portrayal in most action-heavy films of how traumatising these events would be. Most people who are a victim in an accident or witness an accident are not able to respond with funny quips or puns, but instead find these difficult experiences which take time, and often therapy, to process. Even when films do hint that a character is suffering from PTSD, this is normally disregarded within 20 minutes or so.

Personally I would be keen for films to more realistically portray the consequences of an action scene. I think it would much more exciting to watch a chase scene where if the car crashed into another car, the protagonist would actually be injured rather than just suffering the obligatory limp which is forgotten by the time they cut to the next scene. It would at least save my audience members from me continually pointing out, ‘yeah they just died’.

Click here for The Legal Lounge podcast in which Dawn and I discuss personal injury claims, including those relating to spinal injuries.

For more information or advice, please contact our specialist personal injury team.

Back Behind the Wheel

Driving might not be possible for everyone after a brain injury, but for many it is a realistic target, which can greatly increase independence and quality of life. As a complex and potentially dangerous activity, it is important that everyone approaches driving carefully and follows legal requirements.

There are a couple of questions, which are asked frequently.

How Can Driving Be Affected by Brain Injury?

Driving is a complex activity requiring cognitive and physical skills, as well as the ability to co-ordinate these.

A brain injury can affect these skills, as well as a range of other skills, which are relied on by driving. Some of these are listed below:

  • Poor concentration. You may become distracted or confused when there is a lot going on, or easily lose the sense of what you are doing.
  • Reduced reaction time, due to slower speed of information processing.
  • Difficulty switching or dividing attention.
  • Reduced ability to think ahead or anticipate what may happen.
  • Difficulty interpreting what is seen (‘reading the road’), which increases the time needed to make a decision.
  • Poor memory. You may forget where you are going or how to get there, or what to do in a complex road situation.
  • Poor judgement of novel situations.
  • Perceptual difficulties – e.g. inability to pick out a ‘stop’ sign at a busy junction, or to judge speed or distance.
  • Impulsive behaviour, not thinking through the consequences of actions.
  • Inability to control one’s temper or to cope with the frustrations of traffic delays.

While you may feel able to carry on driving after a brain injury, it is important to remember that it can take time to recover and to fully discover the long-term effects of the injury. It might be difficult to accept that, while you still may have the technical ‘know-how’ for driving, other skills relied on by driving have been affected. Alternatively, relatives may be overanxious to protect you if they think you could still be a competent driver. An objective assessment of your abilities could therefore be helpful for both yourself and your family.

A survivor’s ability to drive may change over time as the effects improve or worsen.

Who Do I Need to Inform about My Brain Injury?

By law, you must tell the licensing authority (DVLA in England, Scotland and Wales, and DVA in Northern Ireland) about your brain injury, as they are responsible for making the decision on whether you are safe to drive or not. You can notify the relevant authority by using the government website. Failure to inform authorities could result in a fine of up to £1,000. It would also mean that your licence is not valid and that you would be uninsured in the event of an accident.

You should also tell your vehicle insurance provider about your brain injury.

It can take over six weeks in some cases to hear back from the licensing authority. In the meantime, you should consult your doctor or neurologist as to whether you can continue driving whilst waiting for a decision.

Following the decision, you may be allowed to continue driving as normal, or there may be conditions such as needing to take an expert driving assessment, having the vehicle adapted to make it more suitable, or having a time-related licence after which you will be re-assessed. Your licence may be withdrawn, but you may have the option to reapply later.

If You Are Allowed to Keep Your Licence

You will no doubt feel very pleased and relieved to be told that you are fit to drive. Some general tips for safer, less stressful, driving should still be kept in mind:

  • When you start driving again after your brain injury, it is advisable to have another adult in the car as a passenger for the first few journeys, and to keep those first journeys short.
  • Alcohol will most likely affect you more than it used to before your injury. NEVER DRINK AND DRIVE.
  • Check with your GP about the possible side effects of any medication you are taking, particularly if this has been started recently or the dose has been altered.
  • You may find that you get more tired than usual. Do not drive when you are fatigued. Plan your journey to take account of your best time of day.
  • Plan your route before you set off, including places to stop for breaks on longer journeys.
  • Use a satellite navigation device and be sure to set your route before you start driving. This removes the need to constantly think about your route while driving.
  • Be prepared to alter your plans if you do not feel well enough or alert enough to drive that day.
  • Check the car for fuel and water levels and tyre tread before your journey, especially if you are planning a long journey.
  • Have adequate breakdown cover, and take a mobile phone with you (with credit, and charged). If you receive the higher rate mobility component of Disability Living Allowance (DLA), or scored eight or more points in the ‘moving around’ area of a Personal Independence Payment (PIP) assessment, you will be entitled to a ‘Blue Badge’ for free parking.
  • Inform your insurance company of any modifications to your vehicle or any changes in your condition which could affect your policy. Remember, if there is anything else which may affect your ability to drive, if you develop any other condition, or if an existing condition gets worse, you MUST inform the licensing authority.

If you would like to speak to a member of our Court of Protection team, please contact us.

Happy, safe, driving!

Whistleblowers Raise Concern about Patient Safety at Essex Maternity Unit

A number of incidents at a maternity unit in Essex are causing concern over serious failings in care. The Care Quality Commission (CQC) visited Basildon Hospital following whistleblowers alerting the CQC of their fears about patient safety. The tip-offs followed a number of serious incidents where six babies were at risk of brain injury after being starved of oxygen at birth.

An article published by BBC noted that the CQC found unsafe staffing levels at the maternity unit at Basildon Hospital during August 2020. This finding follows the maternity unit being rated as inadequate in June 2019. The rating followed the shocking death of a woman in February 2019 where a mother lost six litres of blood after giving birth via emergency caesarean section at Basildon Hospital. The Independent newspaper noted that the coroner concluded that there had been a breakdown in communication, a lack of leadership as well as a lack of co-ordination and team work. The NHS Trust has since apologised for not enacting improvements quickly enough and stated their services were safe to use.

Following the leaked report of the Shrewsbury and Telford NHS Trust maternity scandal detailing the number of deaths of both mothers and babies, it appears that lessons have not been learnt by maternity units in the wider NHS. The findings from the most recent CQC inspection of Basildon Hospital noted a number of concerns including the fact that only four shifts had safe staffing levels in August 2020, expectant mothers at high risk of complications had given birth in the low risk part of the unit and required safety meetings at shift handovers did not occur. The levels of skill and experience of the staff was also found to be concerning.

The NHS Trust responded to the findings by stating they had a robust improvement plan in place and that significant action had been taken since the CQC visit. Only time will tell whether lessons have indeed been learnt from another devastating death within an NHS maternity unit.

The NHS is understandably stretched due to Covid-19 but these findings pre-dated Covid and it is important that as a nation we do not accept falling standards in the care of pregnant mothers and delivery of babies.

The clinical negligence team at Lanyon Bowdler has extensive knowledge and experience in dealing with birth injury cases and handles an extensive caseload of maternity-related cases. If you, or someone you know, has been affected by a birth injury, our friendly team will be happy to discuss the matter with you in confidence. Please contact us.

The Rugby Brain Injury Claims

It was recently reported that a large group of ex-rugby players, some of whom are only relatively recently retired, are bringing claims against rugby governing bodies following the shocking news that they have been diagnosed with a form of early onset dementia and probable chronic traumatic encephalopathy. Those bringing the action claim that their diagnoses have arisen from negligent mismanagement related to repeated head injuries and concussions sustained throughout their careers. A number of current and former players have since publically shared their own concerning experiences, including World Cup winner Kat Merchant, who recently told the BBC that at the age of 35 she suffers ongoing symptoms of concussion and has a lower cognitive capacity than previously.

What Should Be Considered?

These cases will doubtlessly be complex and multi-factorial, but, in order to be successful, the claimants will essentially have to prove that they were owed a duty of care by the defendants before proving that the defendants breached the relevant standard of care that applied throughout their playing careers. They will then have to show that their diagnoses were more than likely caused by such a breach or breaches by the defendants. Another key factor to be considered will be the degree of risk to which a player will have consented to by taking part in a high impact sport such as rugby, whilst any court decision would likely seek to avoid adversely impacting and hindering a desirable activity. Rugby is a sport enjoyed by millions across the world and brings many benefits such as physical fitness, discipline and social interaction and any court judgment will likely, as a matter of public policy, be cautious not to detract from these benefits.

It is unusual to see such high-profile and widespread litigation arising in a sporting context, although the above claims are not without some sort of precedent. In 2011, a class action lawsuit was brought against the NFL by a group of former American football players, leading to the creation of a fund specifically for players with such claims which, to date, has paid out over eight million dollars. The litigation also prompted a raft of changes to improve safety surrounding concussions. It is unclear how the claims brought in the rugby context will progress, but the claimants have already set out a list of “15 commandments” to improve safety surrounding head injuries in the game. Such requests include a limit to contact training and improved education on the issue of concussion.

Which Other Sports Have Been Impacted?

Whilst the progress of the litigation is something that lies in the hands of the relevant parties and potentially the court, it is worth noting the impact that these claims have already had by way of the significant publicity the story has generated and the number of players that have subsequently shared their story. It has also shone a light on other sports. Despite its significantly higher profile, football often appears to be playing catch up in its implementation and application of safety surrounding head injuries, something highlighted by Alan Shearer in his 2017 documentary ‘Dementia, Football and Me’. This was starkly evident when Arsenal defender David Luiz recently played on for 40 minutes after suffering a head injury before eventually being substituted. The impact was so severe it caused a fractured skull to his opponent, Wolves striker Raul Jimenez, requiring emergency surgery.

Whilst the circumstances of the claimants that have ignited the litigation in rugby are tragic, the increased publicity has prompted further debate and put significant pressure on sporting governing bodies to ensure that the sports they govern are as safe as they reasonably can be. This increased awareness of the risks of concussion can also benefit wider society, with the NFL litigation leading to considerable progress in the medical sector’s understanding of chronic traumatic encephalopathy. Such benefits can apply beyond the high-profile sporting sphere and, whilst the priority of most personal injury claimants is to obtain a settlement that seeks to improve their quality of life following their injury, we often see claimants who want to ensure that lessons are learned and that other people don’t suffer in the way they did. Such benefits are often just as important to our clients as the settlement itself and are benefits that can be salvaged from desperately sad situations, such as those the rugby claimants have found themselves in.

Failings in Maternity Care Confirmed by Donna Ockenden Report

This year we have united in pride and admiration for our NHS but today’s report reminds us that we must also accept that in the past not everyone has experienced the standard of care from the NHS that they deserve.

Today’s report from Donna Ockenden highlights shocking examples of failings in maternity care provided at the Shrewsbury and Telford Hospital NHS Trust between 2000 and 2019. The report identifies disappointing and deeply worrying themes, which have jeopardised patient safety and caused harm to babies and mothers for years.

Women at their most vulnerable were not listened to and were denied empathy, appropriate care and the opportunity to deliver their babies safely. A full list of the failings can be found within the report linked here, but the most harrowing findings include:

  • The failure to appropriately risk assess pregnancies. There was little or no discussion with the mothers about options for delivery and the risks involved. Where a mother was to give birth was decided for her, without full disclosure of the risks and options available.

  • There were a significant number of cases where midwives and obstetricians did not demonstrate an appropriate level of competence in particular in relation to knowing when to escalate, the interpretation of foetal wellbeing traces and the use of oxytocin.

  • There is disturbing evidence of a number of repeated attempts at vaginal delivery with forceps, sometimes with excessive force causing significant injury and death.

  • The Trust perceived their low caesarean rates as “good care” when, in reality, this created a dangerous culture where women had little freedom to express any choice on mode of delivery. In some individual cases the report recognises that earlier recourse to a caesarean delivery would have avoided death and injury.

What happens next?

As we at Lanyon Bowdler fight for justice for those families who have been affected, we must also look to the future. This is our local trust. Our staff, friends and family all give birth here and so this is an incredibly personal cause to our team.

Alongside specific recommendations for Shrewsbury and Telford Hospital NHS Trust, the report has identified the following seven essential actions, which must be implemented immediately, across nationwide maternity services:

  • Enhance and strengthen safety by increasing partnerships between trusts and local networks.

  • Ensure women and families are heard.

  • Staff who work together must train together.

  • There must be robust pathways in place for managing women with complex pregnancies.

  • Staff must ensure that women undergo a risk assessment at each contact throughout the pregnancy pathway.

  • All maternity services must appoint a dedicated lead midwife and lead obstetrician both with demonstrated expertise to focus on and champion best practice in foetal monitoring.

  • All trusts must ensure women have ready access to accurate information to enable their informed choice of intended place of birth and mode of birth, including maternal choice for caesarean delivery.

The second part of Ms Ockenden’s report will follow in 2021, however it is expected that the Trust acts upon her recommendations immediately. Improvements must be made to ensure the maternity services at our local trust are safe.

We have profound sympathy for our clients and the families that have suffered indescribable loss. If you would like to discuss a potential claim, please contact us on 0800 294 5915 or via our website for a free consultation.

The Importance of Music in Rehabilitation

For most of us music plays a part in our daily lives; whether listening to the radio during our daily commute, playing an instrument as a hobby or even in our profession. If someone had said ‘music therapy’ to me prior to working at Lanyon Bowdler, I would have probably associated it with listening to different songs depending on a person’s mood. There is, however, far more to it than one might think.

What Is Music Therapy?

The BAMT (British Association for Music Therapy) describes music therapy as ‘an established psychological clinical intervention, which is delivered by… music therapists to help people whose lives have been affected by injury, illness or disability through supporting their psychological, emotional, cognitive, physical, communicative and social needs.’

When asked about the type of therapies a person may require if they have difficulties with their mobility, speech or even their cognition, music is usually unlikely to be one of the common answers. Traditionally, people conclude that the individual may require physiotherapy, or speech and language therapy, and it is unlikely someone would consider music as being able to assist these problems. However, music can be as versatile in how it is used as a therapy tool, as it is diverse in genres. Music therapy can be utilised as a complimentary therapy, standalone therapy or as a precursor to enable fuller engagement in other types of therapies.

How Does Music Therapy Work?

Music therapy can assist both children and adults with an acquired brain injury (ABI), traumatic brain injury (TBI) or other cognitive difficulties. Brain injuries change lives and inevitably have a large impact on the individual and those caring for them. Music therapy can be used to assist individuals suffering with a wide array of difficulties stemming from a brain injury, such as; aphasia, limb movements, gait and balance issues, speech and language, personality changes and much more through varying stages of rehabilitation.

There are many sub-types of music therapies, which enable sessions to target the areas which most impact the client’s daily life. The sessions can be tailored to focus on emotional, social, functional or neuro-rehabilitation goals. They can help develop confidence, awareness, independence and communication skills, which are so important in rehabilitation.

We were extremely fortunate to receive a training session recently from Chroma, a national company providing bespoke music rehabilitation to clients across the country. If you would like more detailed information surrounding music therapy, or their services, please click here.

How Are We Involved?

Our Court of Protection department regularly works alongside a wide range of therapy providers such as music therapists, who provide ad hoc services or are members of multidisciplinary teams for our professional deputyship clients.

As an all-service law firm our professional deputies in our Court of Protection department work closely with our Personal Injury and Clinical Negligence departments to ensure our clients are able to access services and therapies seamlessly throughout their claims, upon settlement and thereafter, as we recognise the importance of rehabilitation. If you would like more information in regards to our professional deputies and how we may be able to help you please call 01743 280280 and ask to speak to a member of our Court of Protection department.

Brain Injury & the Impact of Coronavirus - Finding Support in Challenging Times

From the beginning of the coronavirus pandemic there has been drastic social change at an incredibly fast pace. Everyone, without exception, has faced their own struggles and it is clear that we are all still learning how to adapt to the ‘new normal’. There are certain groups of people however who are experiencing greater hardship than others. Amongst those are individuals with an acquired brain injury.

In response to the government’s guidance on managing the spread of coronavirus, many individuals made the decision to self-isolate and those, who are clinically extremely vulnerable, were advised to shield. Whilst these measures were put in place for the safety of all involved, self-isolation can have a detrimental effect on a person’s mental and physical wellbeing. Being confined to your home for long periods of time can cause feelings of loneliness, anxiety and frustration. In addition, the need to adjust behaviours and adhere to new rules and regulations can be a challenge.

For individuals who rely on practical or social support from carers and friends, the loss of assistance with essential activities such as shopping and cooking, placed them at a greater risk than the remainder of the population. It has been, and continues to be, a time of anxiety for them and their families.

According to a new study published by the charity Headway, more than half of brain injury survivors have lost access to rehabilitation services as a result of lockdown measures. The study showed that 64% of those living with the long-term effects of a brain injury reported a deterioration in their mental health as a result of the measures implemented to control the spread of coronavirus.

Headway UK provides a valuable source of up to date information and advice for individuals with an acquired brain injury and their families. Although a number of Headway groups and branches have had to suspend many of their face-to-face services in accordance with the government’s advice, they are going to great lengths to ensure that help remains available to those who rely on their services.

Headway’s helpline is open to anyone who requires support or information relating to brain injury and can offer reassurance and a friendly voice. These resources can be found online at Headway.org.uk.

Latest News

29 Jul 2020

Brain Injury & the Impact of Coronavirus - Finding Support in Challenging Times

From the beginning of the coronavirus pandemic there has been drastic social change at an incredibly fast pace. Every...

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