Concussion after an accident: when a head injury has more serious consequences

For example, if someone falls from height at work and sustains a brain injury, the circumstances may need to be investigated to establish whether the work was properly planned, the risks were appropriately assessed and suitable safety measures were provided. 

Similarly, following an accident in a public place, questions may arise about who was responsible for the premises, how the accident happened and whether reasonable steps should have been taken to prevent it. 

Importantly, the seriousness of a claim is not determined by the diagnosis someone receives immediately after the accident. If the longer-term consequences prove much greater than initially expected, the claim should reflect the actual effect the injury has had on that person's life and future. 

How Simpson Millar can help when a brain injury has lasting consequences 

Where a head injury results in significant or long-term difficulties, the legal claim can become much more complex. 

Our Serious Injury Solicitors look beyond the original diagnosis to understand how the injury affects the person's everyday life, independence and future. This can involve obtaining evidence from specialists in neurology, neuropsychology, rehabilitation, care, accommodation and other relevant areas. 

Where appropriate, we may also seek interim payments before the claim has concluded. These can help someone access rehabilitation, treatment, professional care or suitable accommodation at a time when that support can make a practical difference. 

Compensation in a claim can broadly include general damages and special damages. 

General damages compensate for the pain, suffering and loss of amenity caused by the injury. This considers the physical and psychological impact of the brain injury and the effect it has had on the person's ability to enjoy and participate in everyday life. 

Special damages compensate for the financial losses and expenses caused by the injury, which can include both losses already incurred and future needs. Depending on the circumstances, these may include:

• Past and future loss of earnings
• Loss of pension
• Rehabilitation and treatment
• Professional care and support
• Case management
• Adapted or alternative accommodation
• Specialist equipment and assistive technology
• Travel and other expenses resulting from the injury
• Additional education or vocational support
• Future care and assistance 

For someone facing the long-term effects of a brain injury, compensation can provide the financial security needed to put appropriate support in place and help maximise independence and quality of life. 

What if the medical care after the concussion was inadequate? 

When someone attends hospital following a head injury, the healthcare professionals treating them owe a duty to provide an appropriate standard of care. This includes properly assessing their symptoms and the circumstances of the injury, considering whether there are signs of a clinically important traumatic brain injury, and arranging further investigation, observation or treatment where this is clinically required. 

NICE guidance sets out specific factors that healthcare professionals should consider when deciding whether a CT scan is needed. These can include reduced consciousness, suspected skull fracture, seizures, neurological symptoms, repeated vomiting and, in some circumstances, factors such as age, bleeding or clotting disorders and the mechanism of the injury. 

Where someone does not require admission, appropriate discharge is also an important part of their care. NICE recommends that people discharged following a head injury are given verbal and written information explaining the nature of their injury, warning signs that should prompt a return to hospital, the possibility of delayed or persistent symptoms, and advice about returning to everyday activities. A suitable person should also normally be available to supervise them during the first 24 hours following the injury. 

Hospitals are also expected to communicate with the person's GP following an emergency department attendance for a head injury, and specialist referral may be considered where problems persist. 

Not every person attending hospital with concussion will require a CT scan, admission or specialist treatment. A poor outcome or missed diagnosis does not therefore automatically mean medical negligence occurred. 

However, there may be grounds to investigate where the care provided fell below a reasonable standard and this caused additional avoidable harm. For example, concerns may arise where:

• recognised signs of a more serious traumatic brain injury were not appropriately assessed
• CT imaging or other investigations were not arranged despite relevant clinical indications
• deterioration or neurological symptoms were not acted upon
• someone was discharged when further observation or treatment should reasonably have been considered
• appropriate discharge or safety-netting advice was not provided
• persistent symptoms were not appropriately reviewed or referred for specialist assessment 

Medical negligence claims usually require independent expert evidence to establish both that the care provided fell below the appropriate standard and that this made the person's eventual outcome worse than it otherwise would have been.