There are a multitude of cases where CT scans of the head are ordered to rule out a brain bleed. Stringent criteria have to be met before this imaging is ordered. Basically there has to at least be a concussion.

But many doctors who order head CTs do not diagnose concussion. Instead, they offer the anemic diagnosis: “MVC.”

Seriously. They diagnose “Motor Vehicle Collision.” I think that’s such an incredible disservice to the patient. It doesn’t provide guidance for future care. And what it does is it provide a basis for the defense to harp on the fact that the doctors who saw the plaintiff first didn’t diagnose a concussion.

This exact issue came up in an arbitration last week. And, in a new case that arrived last week, I saw this issue in the ER records where the doctor diagnosed cervical strain/sprain while noting vomiting, light-sensitivity, dizziness and giving concussion protocols (all without diagnosing concussion).

I don’t know whether there’s an extra layer of work for ER doctors if they diagnose concussion or if they think they’re doing the patient some kind of favor. The motivation is entirely unclear. But what is abundantly clear is that for whatever reason, their reluctance to write “diagnosis: concussion” is creating a huge burden for their patents who were injured because of someone else’s negligence.

The term "non-economic damages" describes the loss of quality of life.There are a lot of studies about concussions being missed in the ER.

Everyone was floored when Dr. Powell’s article came out in 2008. Entitled Accuracy of mild traumatic brain injury diagnosis, it provided empirical evidence that doctors in the ER at Harborview missed 50 percent of concussion diagnoses.

The defense complex tried to pass it off as an outlier. And then as a historical relic.

But similar results were found in 2020 in two different articles: Challenges in the acute identification of mild traumatic brain injuries: Results from an emergency department surveillance study and Concussion care in the emergency department: A prospective observational brief report.

Statistically missing diagnoses is a big issue. But I find an equally big problem is ER doctors’ bizarre reluctance to actually write: “Diagnosis: Concussion.”

Doctors in the ER go through all sorts of gyrations to avoid writing the words.