quality legal representation
quality legal representation
… all of 'em, the whole firm, they became, I don't know, they were almost like, they were more like family than they were like attorneys. — PM & GM
… [Dugan, Babij, Tolley, and Kohler] did an outstanding job of getting the facts and detailing the case. I would definitely recommend them for medical malpractice. … — RH
… [Alison Kohler] built this case from just an idle conversation into a complete legal case. — RH
Bruce was so patient, kind, and sensitive, you know, and he was so passionate about what he did and what he brought to the table and he made me comfortable in the process. — FB & EB
Jury Verdict & Total Recovery — Birth Injury
Jury Verdict — Traumatic Birth Injurya
Recovery — Traumatic Birth Injury
… all of 'em, the whole firm, they became, I don't know, they were almost like, they were more like family than they were like attorneys.
“ We dealt mostly with Bruce, and with Henry quite a bit as well. But all of 'em, the whole firm, they became, I don't know, they were almost like, they were more like family than they were like attorneys. They were a very, very professional, very, very, good group. From the attorneys all the way down to the receptionist. It was a, uh, they are good group. ”
— PM & GM
A study recently published in Obstetrics and Gynecology International has found a correlation between the size of the cranium (the baby’s head circumference) of infants born at full term and the incidence of cerebral white matter damage (WMD), a condition known to be related to developmental delay and cerebral palsy in childhood. The study indicates the possible need for a change in the observation and management of seemingly asymptomatic newborns who have suffered head trauma during delivery resulting in excessive molding and depression of the baby’s skull. In such cases, fetal cephalopelvic disproportion may be present leading to the compression of the fetal skull and brain during vaginal delivery. In the deliveries of babies with a large head circumference, it is posited that the functional capacity of the maternal pelvis may be inadequate to allow for the unobstructed passage of the fetus during labor. This may be evidenced by prolonged or obstructed labor. The study suggests that cranial ultrasound or magnetic resonance imaging can be used after birth to asses for these intracranial white matter injuries even in seemingly healthy full-term infants with large head circumferences in cases of prolonged or obstructed labor. These imaging techniques can be used to detect and screen for white matter damage after birth, potentially providing the opportunity to administer timely therapeutic interventions. Recent developments point to eventual treatments for WMD which may be only successful if administered within one week after the injury is sustained.
Cerebral white matter consists of the fibrous tracts of the brain that serve an important role in brain development and neuromuscular control. Recent studies have identified a relationship between damage to the white matter of preterm infants and cerebral palsy or other neuromuscular disorders. However, this study confirms the WMD can also occur in term infants. Research at Children’s National Hospital points to a possible treatment for white matter injuries (WMI) in neonates but the treatment must be administered within a short time frame, less than 1 week, after the injury is sustained. Therefore, the timely diagnosis of WMD would need to occur prior to the manifestation of easily recognizable clinical or developmental symptoms of the injury. Clearly recognizable symptoms of a brain injury during birth can often take over a year to manifest.
Diagnosis of white matter injuries can be performed using magnetic resonance imaging after birth. However, screening MRI’s are not routinely performed on asymptomatic newborns and therefore many cases of white matter damage may go unrecognized until later in life and after any chance of administering a potential treatment has passed. Determining pre-natal conditions that might cause or indicate the possibility of WMD in term babies could lead to better screening and diagnosis which in turn could lead to treatments designed to reduce the onset and severity of cerebral palsy and other neurological disorders later in life.
Most of the research into WMD has focused on pre-term babies where the condition was first observed. However, since WMD can and does occur in full term babies, this study sought to determine what predictors might statically correlate with the incidence of WMD in full term infants. By performing cranial ultrasounds on a large number (4,725) of newborns the researchers discovered a statistically significant correlation between large head circumference and the incidence of WMD. They posit that this increased risk of WMD in full-term newborns with large head circumferences may be due to the mechanical complications during vaginal delivery resulting in excessive compression, molding and depression of the fetal skull. The study also identifies additional areas of future research to help narrow down possible intrapartum complications associated with the development of WMD in term newborns. If found, these associations may become helpful in developing new guidelines for the use of MRI after birth to screen for, diagnose and more effectively treat white matter damage. The hope is that an early assessment of WMD in the at-risk tern newborn may lead to a reduction of the incidence and severity of cerebral palsy and other childhood neurological disorders linked to WMD.
In our practice, we often evaluate cases involving term newborns who have sustained significant cranial molding and compression during labor and vaginal delivery leading to a neonatal assessment of cerebral white matter damage. As is indicated in this study, white matter damage of the term newborn might not always be associated with the classic signs, symptoms and laboratory findings consistent with systemic fetal hypoxia. As is referenced in this study, it is understood that the mechanical forces of obstructed or prolonged labor, leading to excessive compression and molding of the fetal cranium, can alone be potentially injurious leading to cerebral white matter damage. This risk is accentuated in those term babies with a large head circumference as is emphasized by this study.
In every one of our motor vehicle accident cases one of the fundamental questions that must be answered is, “Who was at fault?” Usually, any case accident analysis would typically point to one of the operators of the vehicles involved in the accident. That paradigm has now changed. The recent involvement of both Tesla and Uber self-driving cars in fatal accidents have stimulated open debate about the safety and long term viability of autonomous vehicles. An obvious question to ask is how well do self-driving vehicles compare to those operated by humans? Are the present generation of self-driving vehicles really “safer” to operate than conventional operated motor vehicles? Is this the right question to ask?
First some context. The Insurance Institution for Highway Safety reported that 37,461 people died in motor vehicle accidents in 2016. That is a 5 percent increase in the overall per capita death rate when compared to the rate in 2015.
The facts are clear, driving a motor vehicle is dangerous. People are poorly designed for the unusual combination of skills safe motor vehicle operation now requires: continuous focus on an ever-increasing number of audio and visual inputs to which a driver is now subjected to and close attention to detail combined with repetitive, prolonged and often boring limited physical activity. The result is a growing number of motor vehicle accidents caused by distracted, inattentive or impaired driving. Driving a motor vehicle is unlike many of the activities that we have now become used to and too often take for granted- - continually browsing the internet or using a cell phone. These activities are now being performed by the operators of motor vehicles leading too often to horrific accidents. It’s no wonder many dream of a day when we can sit back and relax and let the computer take over. Or do we?
Self-driving cars now present a different set of problems. While human drivers have short attention spans, slow reaction times and, sometimes, good situational awareness; artificial intelligence (AI) computers have infinite attention spans, fast reaction times and poor situational awareness. The Uber crash footage depicts these presumed “advantages” both graphically and tragically.
So, is there a middle ground? Are there technology solutions on the horizon that can improve the safety of human drivers without the dangers of the current generation of autonomous vehicles? Currently, there are a number of solutions that are designed to assist humans with the task of driving a car. Among the many solutions are autonomous emergency braking and steering (AEB/AES) and camera-based driver monitoring systems. These and similar technologies are designed to assist drivers and reduce the likelihood of common human errors. These technologies are also significantly less expensive than the cost of completely autonomous vehicles.
We have already entered the next wave of automotive innovation. The safety of motor vehicles has increased steadily over the last 40 years with the rate of crash deaths per 100,000 people in 2016 being about half what it was in 1975 and number of crash deaths per 100 million miles traveled declining from 3.35 to 1.18. These improvements in safety have largely been due to the improvements in motor vehicle design. Unfortunately, with ever more technologically complex vehicles being operated on our highways, the abilities and behavior of motor vehicle operators has not correspondingly improved.
The next wave of innovation will be a revolution in the use of technology designed to assist motor vehicle operators. Many driver assist and warning solutions are already on the market with implementation and use growing particularly in commercial vehicles and luxury cars. Soon we will see this new wave of driver assistance technology become common place throughout the automotive industry.
Along with these innovations will come a whole new set of legal and social questions and issues. With assisted and automated driving on the rise who will be to blame when accidents occur? How will motor vehicle accidents be investigated? By the police or by a computer geek? Who will be to blame if the cause of an accident is found to be a software bug or hardware hiccup? The car manufacturer, the software company or the vehicle dealership that failed to update the software? Won’t every at fault operator of an autonomously driven motor vehicle now blame some glitch in the “driverless” operation of vehicle as causing the accident? When and under what circumstances will the operator of an autonomously driven motor vehicle be expected to reassume direct control and operation of the vehicle? These are just a few of the questions that will arise in the legal evaluation of every motor vehicle accident case involving vehicles with driver assist technologies.