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Shaken baby syndrome (SBS), also known as abusive head trauma (AHT), refers to a combination of injuries that occur when an infant or young child is violently shaken. When a baby or young child is shaken violently, its head snaps back and forth or from side to side. Children’s brains are softer than adults’ brains, their neck ligaments are weak and not fully developed, and their heads are large and heavy in proportion to the rest of their bodies. In SBS, the infant’s brain is first pushed against one side of the skull, and then against the other. The bumping action can cause brain tissue to tear, blood vessels to break, and bruises to the brain, causing pressure and swelling of the brain. The large veins along the outside of the brain may tear, leading to further bleeding, swelling, and increased pressure, which can easily cause permanent brain damage or even death. Serious damage can be done in only five seconds of vigorous shaking of the child. SBS can occur if the child receives as few as three rapid shakes. Head impact is not necessary to develop brain swelling and trauma, but often the child is thrown onto a crib mattress or even into a wall.
Crying is by far and away the most common cause of shaken baby syndrome. It is a fact of nature that an infant spends at least two to three hours a day crying. But the caretaker, who may be frustrated in other areas of his or her life, takes out his or her anger by violently shaking the infant. Normal play, such as bouncing a child on one’s knee or gently tossing the child in the air do not cause SBS. The perpetrator is most often a male in his early twenties who is married to the mother or is the mother’s boyfriend. Women who injure babies are more likely to be a babysitter or childcare provider than the child’s mother. The child’s mother accounts for approximately 10 percent of SBS cases.
A baby’s head makes up as much as 25 percent of the baby’s weight, and the baby’s neck muscles are not sufficiently developed to support a disproportionately large head. An infant’s brain is softer than the brain of an adult, and the protective tissue that surrounds the brain only begins to form at birth, making the blood vessels more fragile and easily ruptured.
Shaking or throwing a child or slamming the child against an object causes uncontrollable forward, backward, and twisting head movement. Brain tissue, blood vessels, and nerves tear. The child’s brain can hit the skull with force, causing brain tissue to bleed and swell. The violent shaking can also cause injury to the cervical cord resulting in paralysis, bleeding in the eyes, and even death.
The injuries associated with SBS may not show up immediately. The infant may have nonspecific complaints, such as lethargy, breathing difficulties, irritability, and vomiting, which can be attributed to sources other than the shaking.
Shaken baby syndrome can occur in infants as young as a few days to children as old as five years. The majority of cases involve infants from three to eight months old. 25 percent of all children diagnosed with SBS die from their injuries. An infant or young child that has been violently shaken often requires emergency medical treatment, including life-sustaining measures such as breathing support and surgery to stop internal bleeding and bleeding in the brain.
Many cases of SBS or AHT are brought in for medical care as “silent injuries.” The parents or caregivers don’t admit to the doctor that they had violently shaken the infant or threw the infant head-first against an object. Because of this lack of information, the doctor doesn’t know to look for subtle or physical signs. This can sometimes result in children having injuries that aren’t identified in the medical system and the child’s being returned to the person who violently shook him or her. Unfortunately, in mild cases in which the infant seems lethargic, fussy, or perhaps isn’t feeding well, the doctor will misdiagnose the infant’s condition as a viral illness or colic. Without a diagnosis of child abuse and any resulting intervention with the parents or caregivers, these children may be shaken again, worsening any brain injury or damage from previous shakings.
Without the parents’ or caregiver’s disclosure of how the injuries really happened, shaken baby syndrome can be difficult for the pediatrician or emergency room doctor to diagnose, as there may be no visible symptoms in the baby even when there is extensive damage to the baby’s brain, and the parents or caregiver who inflicted the injury is not going to admit shaking the baby. As the brain swells and presses against the skull, damage to nerves and other areas of the brain may occur. Some of the more serious injuries that may result include blindness, hearing loss, paralysis, speech impairment, mental retardation, learning disabilities, and even death.
Some of the symptoms of SBS are vomiting, seizures, loss of consciousness, bleeding in the eyes, difficulty breathing, convulsions, decreased feeding, difficulty sucking or swallowing, no smiling or making sounds (“vocalization”), rigidity, pale or bluish skin, the head or forehead appears larger or the soft spot on the head appears to be bulging, inability to lift the head, and inability of the eyes to focus or track movement or unequal sizes of the pupils. Children who have been shaken violently may also sustain broken ribs, arms, legs, and neck.
If SBS is suspected, the doctor may look for:
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Bleeding in the retinas of both eyes
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Skull fractures
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Swelling of the brain
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Subdural hematomas (collections of blood pressing on the surface of the brain
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Fractures of the ribs or “long bones” (the arms and legs)
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Bruises around the head, neck, or chest
If the doctor suspects SBS, in addition to a thorough physical examination of the child, he or she may order a computed tomography (CT) scan or a magnetic resonance imaging (MRI) of the child’s head to check for swelling of and bleeding in the brain.
About one out of every four babies who has been violently shaken or thrown against an object, such as a crib mattress or a wall dies from his or her injuries. Survivors suffer permanent damage in the form of developmental problems, such as seizures, muscle stiffness, mental retardation, blindness or trouble seeing, physical or emotional growth delays, and learning or behavioral problems that may not appear until the child starts school.
Infants who have suffered SBS require emergency care, often including respiratory support and surgery. It is frequently necessary to drain the blood around the brain to decrease the ongoing brain injuries associated with brain swelling. Additional treatment may be required, including obtaining ophthalmologist and neurological examinations.
The prognosis for a baby that has been violently shaken is poor. Up to one in four victims of SBS die of their injuries. Those that survive may suffer from complete or partial blindness, mental retardation, loss of motor (muscular) control, cerebral palsy, neck and spinal cord injuries, learning and physical disabilities, hearing and speech disabilities, seizures, behavior disorders, and cognitive disorders.
A doctor, social worker, therapist or certain other professionals who suspect child abuse—such as violently shaking a baby—is under a legal obligation to report his or her suspicions to Child Protective Services.
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A fairly common injury resulting from an automobile accident, a fall, or a blow to the face is a broken (fractured) jaw. There are two bones that may be broken. One is the “mandible,” the lower jawbone. The other is the bone that makes up the upper jaw, the “maxilla.” The term jaw fracture generally refers to a break in the mandible, while a break of the maxilla is considered a facial injury. (When the maxilla is broken, there are usually other bones of the face that are broken as well. Breaks to the maxilla may cause double vision, numbness in the skin below the eye, or an irregularity of the cheekbone.)
A broken jawbone is a common facial injury; only the nose is broken more frequently. The most common cause of a broken jaw is injury to the face. This may be due to a motor vehicle accident, a physical assault, an industrial accident, or a recreational or sports injury. An impact with a dashboard during an automobile accident can fracture any part of the jaw. The force of the impact can dislodge teeth and cause fragments of the broken jaw to pierce the gum or damage nearby blood vessels and nerves. A broken or dislocated jaw requires immediate medical attention. Emergency situations include difficulty breathing or heavy bleeding.
The jawbone (mandible) is a long bone that includes the chin and angles up toward the ears on both sides of the face. On each side, the end of the jawbone is rounded like a ball. This ball (a “condyle”) is the part of the jaw joint right in front of your ear that lets you open and close your mouth. The jaw joint is called the temporomandibular joint, or TMJ.
Symptoms and complications of a broken jaw can include:
Pain in the face or jaw, located in front of the ear on the affected side, and gets worse with movement
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Bruising, swelling, and tenderness along your jaw or below your ear
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Bleeding from the mouth
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Airway blockage
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Breathing blood or food into the lungs
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Jaw joint (TMJ) pain and other problems
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Your jaw is deformed, crooked, or shifted out of its normal midline position
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You have a painful lump in your jaw or below your ear
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Jaw tenderness or pain, especially when chewing or biting
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The feeling that your teeth don’t fit together properly or that your bite is “off” (“malocclusion”)
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Improperly aligned teeth
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Missing or loose teeth
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Difficulty opening your mouth widely
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Numbness in your lower lip or chin resulting from nerve damage
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Very limited movement of the jaw (with a severe fracture)
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Drooling because of the inability to close the mouth
If you have been injured in an automobile accident or other accident, or suffered a blow to the jaw the results in severe pain, it is important that you seek immediate medical treatment. To diagnose a jaw fracture, the doctor will conduct a physical examination of the area and take standard X-rays of your jaw. Sometimes the doctor will order a special dental panoramic X-ray (Panorex), and in some cases, especially for fractures near the TMJ, a CT scan may be ordered. A potential but very serious consequence of jaw fractures is a problem breathing due to loss of support to the tongue. If you have any signs of breathing problems, you should get immediate medical attention by dialing 911 to summon the paramedics.
In more than half the cases of jaw fracture, the jaw breaks in two places: a “direct” fracture where the jaw was hit, and an “indirect” fracture somewhere else along the opposite side of the jaw. This second fracture is usually near one of the ends of the jawbone, close to the jaw joint (TMJ). The second fracture occurs when the force of impact travels upward along the jaw and snaps the relatively thin part of the jawbone just below the ear.
If you have been subject to that degree of trauma that was forceful enough to break your jaw, you must also be evaluated by the medical doctors to determine whether you have suffered any injuries to your spine in the neck area (your “cervical vertebrae”) or whether you suffered a concussion or have bleeding within the skull. X-rays should be taken of your upper spine to diagnose whether or not you have suffered a fracture of a cervical vertebra. Sometimes a fracture goes through a tooth or its socket (an “open fracture”) creating an opening into the mouth, which requires immediate treatment with antibiotics to prevent it from becoming infected with oral bacterial.
The specific treatment for a broken jaw depends on how badly broken the bone is. If you have only a minor fracture, you may only need pain medications and to follow a soft or liquid diet for a while. Surgery is often needed for moderate to severe fractures. To stabilize the broken lower jaw, it may be wired to the upper jaw. This may last six to eight weeks, depending on the rate the person heals. During this time, the broken-jaw victim is only able to drink liquids through a straw. Small rubber bands are used to hold the teeth together for a few weeks, at which time they are removed to allow some motion and reduce joint stiffness.
Alternatively, depending on the nature and extent of the fracture, the doctor may surgically repair the broken jaw with a metal plate that is screwed into the bone on each side of the fracture. If a metal plate is used, the jaw is immobilized for only a few days, after which the victim should eat only soft food for several weeks. If fragments of bone have pierced the skin or if teeth were lost or loosened, the doctor will probably prescribe an antibiotic to reduce the risk of infection.
A person whose jaw has been wired shut should have metal cutters readily available to cut the wire in the event of vomiting or choking. If the wires must be cut, you should consult your doctor promptly so they can be replaced. You should call your doctor if you develop a high temperature, experience a severe headache, lose feeling in your face, have severe pain that will not go away despite the use of painkillers, or if the wires or splints become loose. You should seek immediate emergency health care if you have difficulty breathing.
If you have suffered a broken jaw, with proper and prompt medical care the jaw should heal in about two months. However, where there are several fractures or the person heals poorly, long-term complications can include facial deformity, long-lasting facial pain, or pain or limitation of the movement at the jaw joint and a bad bite.
A dislocated jaw means the lower jawbone (the mandible) has moved out of its normal position at one or both joints where the jawbone connects to the skull (the TMJ). When a person presents with a dislocated jaw, the doctor may be able to place it back to the correct position using the thumbs. Numbing medications (anesthetics) may be required to relax the strong jaw muscles. The jaw may need to be stabilized. This usually involves bandaging the jaw to keep the mouth from opening widely. In some cases, surgery may be needed to repair a dislocated jaw, particularly where the person suffers from repeated jaw dislocations occur.
If you have been injured in an accident and suffered a broken jaw, you should contact an experienced personal injury law firm as soon as possible. It is also important to contact an experienced personal injury law firm promptly, as the law firm may want to send its own investigators to the scene of the accident to inspect and take pictures of the vehicles, the accident site, and any dangerous condition that caused or contributed to the accident, especially before there is a change in the condition of the area or vehicle. The attorney or his or her investigator will also want to talk to any witnesses to the accident as soon as possible while the facts are still fresh in their minds.
An experienced personal injury law firm can also help with seeing to it that you obtain appropriate and thorough medical care for your physical, emotional, and psychological injuries suffered as a result of the accident. The attorneys in the firm can also do everything possible to ensure that you obtain full compensation for your medical expenses, pain and suffering, mental anguish, property damage, lost wages, and all of your other injuries and damages.
Our Law Firm has experience in diligently representing clients who have been in accidents resulting in a broken jaw. We understand the physical, financial, and emotional toll a broken jaw can take on the injured victim and his or her family. We will work our hardest on your behalf to get you the maximum recovery possible.
Call now for a free consultation of your case: 858.909.9090
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Quadriplegia (now becoming more commonly known in medical jargon as “tetraplegia,” tetra meaning four in Greek, plegia coming from the Greek word for paralysis) is the most serious of all the spinal cord injuries and one of the most devastating injuries a person can sustain. Quadriplegia results from the fracture, dislocation, or compression of one or more of the seven cervical vertebrae that make up the top of the spine, causing severance of, compression of, or tears to the spinal cord itself.
The exact extent of a victim’s injury depends on how high up on the cervical vertebrae the fracture is. If the break is at the first (top), second, or third cervical vertebrae (“C-1,” “C-2,” or “C-3”), the injured victim will lose the ability to breathe on his or her own and will have to rely on artificial respiration to survive for the rest of his or her life. A person with a spinal cord injury at or above the C-3 level usually has no control over or feeling in any of his or her four limbs.
If the break is to the C-4 through C-6 vertebrae, in addition to being able to breathe without artificial help, the victim generally has varying degrees of use of his or her shoulders, biceps, and wrist, but no hand function. A fracture at the lowest of the cervical vertebrae (C-7) generally means that the injured victim will have some use of his or her arms, hands, and fingers, and trunk. Injury to the spinal cord at or below the C-7 level generally gives the injured victim functional independence akin to a paraplegic.
The damages in terms of financial costs for treating a quadriplegic are extensive, running into the millions of dollars. There are tremendous “economic damages,” including medical expenses, rehabilitation and physical therapy costs, the cost of around-the-clock caregivers, lost wages due the inability to return to a career or job, the loss of earning potential, the costs of education and retraining if the quadriplegic victim is able to do some work, modifying the house to accommodate a wheelchair, purchasing a special van or other vehicle to transport the quadriplegic, etc. Damages for so-called “non-economic damages” such as pain and suffering and “loss of enjoyment of life” are substantial.
The life span of a person who has been rendered quadriplegic is often shortened due to an impaired immunity system that leaves the quadriplegic victim more susceptible to infections and diseases. For instance, pneumonia is a leading cause of death among quadriplegic persons. Infections from bedsores (“decubitus ulcers”) are common in quadriplegics, explaining why it is so important that the quadriplegic victim be carefully monitored by his or her caregiver and turned frequently to prevent the development of bedsores. Untreated bedsores can result in deadly infections.
Besides the serious physical injuries, a person who suddenly and unexpectedly gets into an accident or otherwise is harmed by another person’s careless conduct that causes him or her to become a quadriplegic, the mental and emotional side of the injury must also be considered. The victim may go into despair and grieve for the life lost. The victim may become depressed, withdrawn, hopeless, even suicidal. The mental health aspects of becoming a quadriplegic are serious and require appropriate psychotherapy and even psychoactive medications.
Slaughter & Slaughter has experience in diligently representing clients who have been rendered quadriplegic due to the careless conduct (“negligence”) of another person, a company, or a defective product. We understand the physical, financial, and emotional toll quadriplegia takes on the injured victim and his or her family. We will work hard on your behalf to get you the maximum recovery possible to help you to adjust to your new living requirements.
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Have you been involved in an accident in San Diego? Call now and talk to an experienced and aggressive San Diego Personal Injury Attorney for free.
Before you talk to anybody about your accident case, it is critical that you know what your legal rights are. The insurance company wants nothing more than to settle your case quick and cheap before you get a lawyer. Do not give any statements or sign any papers. Protect yourself and let us fight for you. Contact us today for a free legal consultation.
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Alicia A. Slaughter is a personal injury attorney in San Diego, California with over 20 years experience in the field. Visit her San Diego injury website today for more information on her practice as well as her experience.
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