The “Other” Type of Fatal Brain Injury

A recent article in CNN calls attention to a pair of elite athletes who never met, but who had a lot in common – Catlin, a champion US cyclist, and Ellie, an up-and-coming British snowboarder. Catlin was 23 and Ellie was 18, both were young women, and both suffered serious head injuries during their short careers. They also both, tragically, took their own lives.

Now, CNN is looking at a report from the Orthopaedic Journal of Sports Medicine that states women are more susceptible to sports-related concussions and experience worse outcomes than men. And, as CNN points out, “women remain significantly underrepresented within sport and exercise science research. This, leading experts warn, means they often do not get the treatment or aftercare they need following a head injury.”

They both suffered serious concussions

Catlin was doing a practice run in 2019 when she took a hard fall. She was later diagnosed with a concussion after suffering a painful and severe headache at an event in Berlin – a telltale sign of a traumatic brain injury (TBI). However, her father tells CNN that although a return-to-play protocol was advised, her coach never implemented it, saying, “There wasn’t any follow-up from Colorado after this. I believe they assumed she would seek care at Stanford.” (As of this writing, Stanford and USA Cycling in Colorado had not responded to CNN’s request for comment.)

Catlin took her life later that year.

Ellie’s father Tony told CNN she experienced seven concussions in five years of snowboarding. He told CNN, “With every concussion, with the exception of a few minor knocks, Ellie saw a doctor in person. I was always told that she was young enough to bounce back to full health after each case and therefore never consulted with the doctors that I met, about any previous concussions.”

Ellie took her own life in 2018, a few months after her last concussion.

CNN also brings up the death of Jacinda Barclay, an Australian athlete who took her own life back in 2020. Scientists found she had cerebral degradation unusual for a woman her age, which points toward white matter damage similar to a person with dementia. Michael Buckland, founder and Executive Director of the Australian Sports Brain Bank, told CNN, “For someone her age, you would expect to see lovely pristine white matter, and hers looked like she was an old woman in that it was basically degraded.”

Is there a connection between TBI and suicide?

A 2018 study from JAMA Neurology asks the question, “Is concussion and/or mild traumatic brain injury (TBI) associated with a higher risk of suicide?” Long story short? Yes.

Researchers found a twofold increase in suicides, suicide attempts, and suicidal ideations among over 700,000 patients diagnosed with concussion and/or mild TBI, compared to 6.2 million who hadn’t been diagnosed.

Dr. Robert Cantu, clinical professor of neurology at the Center for the Study of Traumatic Encephalopathy at Boston University School of Medicine, explained to CNN why TBIs might cause depression and suicidal feelings:

One theory, he explained, is that those suffering from persistent post-concussion symptoms may have structural or functional brain damage and could be experiencing “behavioral dysregulation: short fuse, irritability, [and] can’t suppress impulses the way you normally could.”

With these emotional problems, “they would be more prone to perhaps do something impulsive, like commit suicide.”

Dr. Cantu also notes that brain injuries and post-concussion syndrome can also cause these types of side effects.

The complex issue of liability and suicide in Virginia

Under Virginia law:

Any person who knowingly and intentionally, with the purpose of assisting another person to commit or attempt to commit suicide, (i) provides the physical means by which another person commits or attempts to commit suicide or (ii) participates in a physical act by which another person commits or attempts to commit suicide shall be liable for damages as provided in this section and may be enjoined from such acts.

In other words, if a loved one commits suicide and has help doing it, you could file a civil lawsuit against the party or parties who assisted in the action. But what happened with these two athletes – indeed, with most people – is not that cut and dry.

The issue hinges on what is a “reasonable action” to take to prevent a suicide. If a person reports suicidal thoughts or self-harming behavior to a doctor, for example, then that doctor may bear some liability if:

• He or she fails to address/treat the symptoms, or
• He or she fails to admit the patient to a hospital.

Schools also owe this duty of care. Virginia law states that educators (and other personnel) “who, in the scope of his employment, has reason to believe, as a result of direct communication from a student, that such student is at imminent risk of suicide, shall, as soon as practicable, contact at least one of such student’s parents.”

If a person does not self-report, however, then the options are much more narrow. Would it be reasonable to assume that a person with multiple concussions could be suffering from suicidal ideation? Perhaps – but legally, there is no precedent for it.

A potential exception to the rule

If a person sustains brain trauma as a result of someone else’s negligence and attempts suicide as a result of this injury, it may be possible to seek damages as part of a personal injury lawsuit. The medical care associated with the life-saving attempts (and any further treatment) as well as a person’s pain and suffering are compensable under Virginia law.

After a concussion or head injury

As you can see from these tragic stories, it’s crucial to get immediate medical attention after any type of TBI – no matter how mild you may think it may be. Ensure that you, your child, and your child’s coaches follow through on your physician’s concussion protocol to the letter, and read more about traumatic brain injuries in our other blogs:

• Breakthrough Test for Brain Injury Receives FDA Clearance
• Traumatic Brain Injury Can Affect Students’ Learning

If you’re thinking about suicide, are worried about a friend or loved one, or need emotional support, the 988 Lifeline is available 24/7 across the United States. It is available for everyone, free, and confidential. Call or Text 988 or visit 988Lifeline.org.

If you or a loved one have experienced a concussion or other traumatic brain injury, the lawyers at Phelan Petty want to help. We can protect your rights to financial compensation and handle the legal process on your behalf while you take the time you need to rest and recover. Although our law firm is based in Richmond, we serve injured clients throughout the state of Virginia. To schedule a free initial case evaluation at our firm, call us or complete our contact form today.