Mild Traumatic Brain Injury (MTBI) can be difficult to diagnose after car accident. The Insurance Corporation of BC generally refuses to accept the existence of a MTBI and will fight these claims to the end. In this case ICBC hired Dr. Rehan Dost, Neurology. Dr. Dost was eager to assist the court in assessing the credibility of the claimant and he was combative in his critique of the other expert opinions. The judge disavowed herself of the offending portions of the report and conclusions reached (Mayer v. Umabao,2016 BCSC 506) finding that the claimant had indeed suffered a brain injury, albeit rather mild.
This car accident occurred when the claimant was exiting a parking lot in Richmond, British Columbia on the south side of Cook Road. He pulled up to the sidewalk and stopped momentarily for pedestrians and then started to turn left. The other vehicle slammed into the front wheel area of the driver side of the claimant’s vehicle. The statement the claimant gave to ICBC after the motor vehicle accident made no reference whatsoever to hitting his head or dizziness or imbalance. When asked about this and whether there was something missing from the statement he said “I believe there was something missing from the statement”.
There is little debate in the medical community about the definition of MTBI and the term concussion. The American Congress of Rehabilitation Medicine (“ACRM”) is the tool used by many doctors and this definition says a patient with MTBI is a person who has had a traumatically induced physiological disruption of brain function as manifested by at least one of the following:
a) Any period of loss of consciousness;
b) Any loss of memory for events immediately before or after the accident;
c) Any alteration in mental state at the time of the accident (e.g., feeling dazed, disoriented, or confused); and or
d) Focal neurological deficits that may or may not be transient; but where the severity of the injury does not exceed the following: (i) loss of consciousness of approximately 30 minutes or less; (ii)after 30 minutes, an initial GCS of 13 to 15; and (iii) post‑traumatic amnesia (“PTA”) not greater than 24 hrs.
Dr. Dost referred to several different definitions in his report and in his evidence. Dr. Dost said that all of the definitions agree on the first three criteria:
a) There has to be a transmission force neurological dysfunction or in other words there has to be a force significant enough to cause a neurochemical change in the brain;
b) There has to be neurological impairment at the time of trauma; and
c) The neurological impairment cannot be explained by some other cause, for example stroke, drug or alcohol impairment, psychological disorder etc.
Ultimately, the judge found that the claimant did suffer from a MTBI. However she considered this to be “quite mild and only affected higher level speech and executive functioning or the ability to multitask”. The irritability, personality changes and memory loss were not related to the brain injury but more likely caused by the long term effects of pain, sleeplessness, anxiety and somatoform disorder.
The Supreme Court Judge awarded over $400,000.00 summarized as follows:
|Pain and Suffering||$175,000|
|Future loss of earning capacity||$250,000|
|Future cost of care||$12,140|
|Out of Pocket Expenses||$5,980.16|
Watch our short video featuring Neurosurgeon Dr. R.O. Holness to learn more about brain injury with normal MRI findings:
Posted by Personal Injury Lawyer Mr. Renn A. Holness, B.A. LL.B.– Serving Richmond and all of British Columbia.