Little Was Known About The Medical Consequences Of Head Injury

One of the most difficult problems facing athletic trainers and team physicians is the recognition and treatment of sport-related concussion. Cerebral concussion involves a violent jarring or shaking of the brain caused by a sudden change in the momentum of the head. More than 300000 sport-related traumatic brain or head injuries occur annually in the United States.1 Moderate to high incidences of concussion have been reported in football, basketball, softball, soccer, baseball, boxing, rugby, and ice hockey.1 Repeated head injury can result in permanent brain disability or death.1 Providing medical clearance for sports participation and treatment of athletic injuries involves legal as well as medical issues. The threat of lawsuits exists for the sports medicine professional whether the athlete is allowed to play or not. Athletic trainers and team physicians have been sued for prematurely clearing athletes, and surprisingly, have also been sued for not permitting athletes to play. 2–5 Until recently, little was known about the medical consequences of head injury. This dearth of medical information has contributed to a lack of legal precedent, as only a few cases establish precedent when dealing with sport-related concussion. More cases dealing with negligence or medical malpractice involve a physician and an athlete; the medical condition generating the most media attention involves death as a result of a cardiac condition. The published cases involving severe head injuries are nearly all related to boxing, and most of those cases have been settled on issues unrelated to the actual diagnosis or treatment of the athlete. In general, established medical malpractice principles govern claims by athletes for injury or death caused by improper treatment by health care providers.6 In this paper, I provide an overview of the general legal principles of negligence for sports medicine professionals and apply these principles to situations involving athletes with head injury. Recommendations are made for athletic trainers and team physicians to protect themselves from liability