Army's New Brain Injury Test: "Breakthrough" or Bomb?

April 28, 2011

Army's New Brain Injury Test: "Breakthrough" or Bomb?

Can one simple blood test diagnose a brain injury before symptoms of the brain injury show themselves to medical practitioners? Last fall, the Army touted its new brain injury test as a quick answer to a medical diagnosis that traditionally has been difficult for doctors to make in the early days following head trauma.

Not only that, but the Army doctors that headed up the study on brain injury diagnosis claim that the test will save lives and keep soldiers with traumatic brain injuries from undergoing operations where they could sustain more head trauma. The same physicians note that the new brain injury test could have far-reaching effects on brain injury diagnosis beyond the theatre of combat -- even going so far as to call it a "benefit for mankind."

The brain injury test evaluates a blood sample from the head trauma victim for the presence of two blood proteins. These blood proteins only appear after an injury -- researchers speculate that sudden head trauma that results in coup and contra-coup injuries to the brain will result in the two blood proteins being released into the victim's blood stream.

Soldiers injured in the wars in Iraq and Afghanistan have suffered numerous brain injuries ranging from TBIs to mild concussions. In fact, brain injury is the so-called "signature wound" of these armed conflicts. While many more troops have survived traumatic injuries in these modern conflicts than in earlier wars, many of these same troops have returned home as the walking wounded with diagnosed and undiagnosed concussions, mild brain injuries, traumatic brain injuries and other undiagnosed cognitive injuries.

But critics are already lining up to take shots at the research and study methodology behind the Army's brain injury test. First, other medical experts urge caution because the brain injury test was developed after research on less than three dozen soldiers with previously diagnosed concussions. Others suggest that previous military attempts at "instant" diagnosis have resulted in more false positives than the Army's current brain injury screening protocols, which rely on presence of neurological symptoms that can be difficult to recognize and also rely on patients to report, such as headaches or difficulty speaking.

Nearly a Quarter Million Pennsylvanians Live with Brain Injury

According to statistics gathered by the Brain Injury Association of Pennsylvania, nearly a quarter million Pennsylvania residents live with brain injury, whether from trauma, stroke or other causes. Almost 50,000 brain-injury patients are treated at Pennsylvania emergency rooms each year. Of those, over 2,000 will die annually. Over 8,000 will be hospitalized and may seek rehabilitation at brain injury rehabilitation centers such as Philadelphia's Moss Rehab -- one of 14 facilities designated nationally as a Traumatic Brain Injury Model System of Care. Pennsylvania brain injury victims stand a lot to gain if the Army's brain injury test can be proven to work in hospitals across the globe.

One recent Pennsylvania medical malpractice case involves a 24-year-old Pennsylvanian who was admitted to the hospital after complaining of severe headaches. In this tragic case, the patient was diagnosed with an aggressive brain tumor, but died in the hospital's neurological unit a few days after he was admitted. Medical staff attending to him failed to act on symptoms that ultimately led to brain herniation and death.

His family sued the doctor and nurse who attended to him, as well as the hospital where he was treated, for failing to properly train the nurse on escalation protocols when an attending physician fails to respond promptly to information indicating a patient is in critical condition and needs immediate medical treatment.

Here, the nurse in the neurological unit attended to the patient overnight and noted his left pupil was fixed and dilated -- a sign of pressure on the brain. As brain pressure builds, the risk of brain herniation -- a potentially fatal condition -- increases. The nurse called the treating doctor at home, but the doctor and nurse dispute what was communicated during that conversation. The doctor did not come to the hospital immediately, and the nurse did not resort to a call that reported the patient's critical condition to other physicians in the hospital. As a consequence, the brain injury victim rapidly deteriorated and was on life support by the time the doctor reported for the neurological surgery that early that morning.

Two emergency operations on the patient's brain failed to relieve the pressure, and he died within the day. His family members won wrongful death damages because of the "breakdown in communication" during the course of the victim's treatment.

While the Army's new brain injury test probably would not have helped this brain injury victim, this case shows how quickly brain injury victims can move from walking, talking and reporting symptoms of pain and confusion, to becoming victims of fatal brain trauma. If you or a loved one experiences medical malpractice, medical negligence, misdiagnosis or failure to diagnose a brain injury, whether by the VA or military health care system, private or public hospital, or doctor or other medical professional, you should consult an experienced Pennsylvania medical malpractice lawyer.

Article provided by Ronald J. Bua & Associates
Visit us at www.ronaldbua.com