Can a neuropsychiatrist critique the report of a neuropsychologist for a person who has suffered TBI?
Yes. Neuropsychiatrists and neuropsychologists specialize in critiquing each other. What you need to keep in mind is the distinction between the two professions.
A neuropsychiatrist is a Medical Doctor (M.D.) who specializes in psychiatry for people with neurological dysfunction. The neuropsychiatrist is knowledgeable about human anatomy (e.g., the physical make-up of the brain) and human behavior. He/she conducts brief counseling or interview sessions with the patient, makes use of medical information on the patient’s condition, and dispenses medication to treat his/her patients.
A neuropsychologist is a Doctor of Philosophy (Ph.D.), a specialized psychologist who evaluates and treats people with neurological dysfunction. Neuropsychologists do not dispense medication, but instead conduct extensive testing and counseling. Neuropsychologists look at how brain injury affects a person’s behavior through the use of written tests, "performance" tests, and interview/discussion sessions.
The neuropsychiatrist offers a medical background, while the neuropsychologist offers testing, assessment, and counseling expertise. In the best of all words, these two professionals compliment each other, healing humanity together.
Pat, help! I need an expert witness to reconstruct my car accident -- someone who can testify that someone who does not hit his/her head can still have a brain injury. What leading experts do you know?
Pat knows everyone who is anyone. In fact, if you are not a close personal friend of Pat’s, then it’s time to take a good look at your social circle. To find someone to provide "expert testimony" in your case, you must begin by hiring an attorney who is experienced handling brain injury cases. Such an attorney will know which professionals to call as expert witnesses in your case. For example, your attorney should know and be prepared to call a neuropsychologist who is experienced in treating people with mild brain injuries. This expert witness will have credibility in court and be able to explain how someone could sustain a brain injury without hitting his/her head on the windshield. If you need an attorney referral, contact your state Brain Injury Association, Bar Association, attorney referral service, or the "Directory of Experts" on the National Resource Center for TBI.
I have a question regarding my rights as an employee with epilepsy. I have myoclonic and complex/partial seizures. Every once in a while I have problems which keep me home from work. With my previous boss, I had an agreement for making up the time when I was out due to seizures. Now I have a new boss, so I discussed my situation with him to see if the same arrangement could be a possibility. He said he would think it over and a few weeks later called me into his office. The new boss said he had taken my question to senior management. I thought our original conversation had been confidential and I never gave him permission to discuss my situation with anyone else. Now senior management wants documentation from my neurologist. What are my rights and were any violated?
You have several options, but the first thing you must do is establish what exactly went wrong. You "thought" your conversation was confidential, but did you ever specifically state to your boss that you preferred it be? Have you been denied a reasonable accommodation for your disability? If so, you may have a legitimate complaint.
Another critical first step is to collect any evidence to help prove your point (i.e., written information, letters, memos -- even your own dated, written account of events is useful).
Next, if your company has an internal grievance procedure, pursue that. The personnel department should be able to advise you.
You can contact your state's disability advocacy organization. Look in the telephone book government pages for something like: "Disability Rights Protection." Contact that agency and ask for information and advice.
The U.S. Department of Justice investigates claims of disability discrimination under the Americans with Disabilities Act (ADA). Write: Department of Justice, Civil Rights Division, Disability Rights Section, P.O. Box 66738, Washington, D.C. 20035-6738. Telephone: 1-800- 514-0301 ADA Homepage: http://www.usdoj.gov/crt/ada/adahom1.htm
The Dept. of Justice does a thorough investigation of complaints so it's worth a try if you feel you have a good case of denial of disability rights (e.g., access to public services, fairness in employment, etc). However, if you can work with your employer to resolve the situation, that is much better for both of you in the long run. Harmony can be preserved.
I am an avid reader of your articles since my brother became a survivor 7 months ago. He had water around his heart (pericardial sac) that was misdiagnosed as pneumonia. He went into cardiac arrest at the hospital and the residents did open heart massage for 20 minutes. He is now totally dependent on his wife who also cares for their two small children. I am there daily and on the Internet nightly, looking for all information. My question is - Where can I look for similar cases as ours to sue the hospital and doctors? The expenses are enormous to keep him at home. This is our only recourse, we are involved with the Mayo Clinic now. That is a blessing, but now my family is considering bankruptcy. My brother is 51 years old. We celebrated his birthday in ICU while he was on life support. Life’s not always fair, but we need to find out if others had this happen and what is our legal recourse. I did go to an attorney who is waiting for records from the hospital. I had to give him $5,000 just to review the case, non-refundable. I have learned that what needs to be done, I must look into myself. Where can I go to review other lawsuits?
I’m very sorry for this tragedy in your family. Your story shows how brain injury and illness affect entire families, not just the patient. As my readers know, cardiac arrest can result in brain damage from lack of oxygen to the brain – and this sounds like the case with your brother.
As for your question about malpractice – it’s hard to comment on the specifics of your situation. Pat is not a lawyer or a cardiac or respiratory specialist. I do know that fluid in the pericardial sac is often the result of viral or bacterial infections such as pneumonia. Pat isn’t qualified to assess whether your brother’s treatment conformed to standards of practice or if the physicians failed to identify the pericardial fluid when they should have… Consultation with a specialist in cardiac or respiratory illness may provide some answers for you.
There are some other resources on the Internet that you have probably located with your Internet savvy! There are many legal and medical websites that may better address your malpractice questions. I am concerned that you gave an attorney $5000 of non-refundable money just to "review" the case. Many attorneys offer free initial consultations and free legal aid is available for people who do not have the ability to pay attorneys’ fees. It is important to find out if you have a good case before you spend large amounts of money – especially if your family is having financial problems. It is important to weigh the financial risks of bringing a lawsuit against the potential benefits of a settlement or successful suit. I hope that you will find justice and that your family will successfully adjust to this terrible tragedy.
My husband was in a car accident over 4 years ago and sustained a minor brain injury. Two months after the accident he started getting involved in criminal activity and drugs. He is not violent, but has continued to get into trouble. He has been in jail over 8 times in the last year. He is a very successful manager of a car dealership and makes over $180,000 dollars a year income. There is no reason for his criminal doings. It baffles everyone that knows him. He is now in jail and is non-bondable. His behavior changed after the accident and he is very impulsive. He says he cannot control his criminal activity. Is this possibly caused by the brain injury? I s there any evidence relating to this kind of behavior.
His brain injury could be contributing to his current behavior. Brain injuries often result in people having difficulty with impulse control, trouble delaying gratification (waiting for what they want), and thinking about the consequences of their actions. In other words, a person’s personality can change dramatically after a brain injury. It is a little surprising that such a dramatic change would occur after a "minor" injury, but Pat has seen cases where people have long-term effects from a concussion or other "mild" injuries. Drug and alcohol abuse after a brain injury are also common problems. Sometimes pre-injury substance abuse contributed to the injury, but in other cases, people who feel badly after an injury may attempt to "self medicate" through using alcohol or illicit drugs.
If your husband is not already working with his physicians to control his behavior, he should be. A comprehensive neuropsychological examination, and/or brain imaging (like the MRI) may help to determine if he sustained a brain injury that is contributing to his behavior. Working with his physicians and a psychologist may help to find medications as well as behavior management and coping strategies to help control his behavior (even if the brain injury did not cause his behavior).
Having a brain injury does not give someone an excuse to commit criminal acts. Only he can make the choice to get help and to work to gain better control of his behavior. Certainly you can encourage and support your husband. Just remember the old saying – "You can lead a horse to water, but you can’t make him drink."
After a person has been injured in a car accident and suffers a traumatic brain injury, who determines they are "of sound mind" to sign any kind of legal papers? To ask for a divorce? When is that determined? At what point is it discussed? I'm referring to my brother who suffered a closed head TBI nine months ago. He has been home from the hospital for five months and his wife treats him with zero respect. She constantly talks down to him and I'm afraid of how she treats him when I'm not around. He begs me to take him away from her. I don't know what to do. I think he is "of sound mind" now. Thank you for your excellent work. I don't know how I would have survived without you during these last few months.
You need a sound mind to get divorced? You sure don't need one to get married! Actually, you are asking a legal question. You should consult an attorney for more specific information and I can only make general comments. Decisions about someone's competence for making legal decisions (like divorce) would likely be made by a judge, although judges often decide to follow the guidance of a medical or mental health professional who may do an evaluation. Competency is usually task specific. That means that you are neither "competent" nor "incompetent." Instead, you may be competent to do some things, but not others. For example, a person could have the capacity to decide his or her medical care, but not to make financial decisions. It sounds weird, but people could have a deficit in a specific area (like math or reading) that would affect their ability to make some kinds of decisions but not others. In most cases, the individual determining "competence" will attempt to determine if the person understands the issues and alternatives in making a decision for that specific issue (in your brother's case, divorce).
Probably the place to start is simply for you or your brother to make a phone call to a divorce attorney. He or she will be able to guide you through the laws and procedures of initiating divorce in your state. It may be that competency will not even be an issue if either your brother's wife agrees to the divorce, or if your brother is capable of making an informed decision.
A final note. If you believe that "zero respect" crosses the line into verbal or physical abuse, there are other avenues to pursue. Spousal abuse is against the law regardless of gender. Contact an attorney or social services for more assistance.