{"id":1752,"date":"2015-06-23T11:00:47","date_gmt":"2015-06-23T16:00:47","guid":{"rendered":"http:\/\/nflconcussionlitigation.com\/?p=1752"},"modified":"2015-06-23T11:00:47","modified_gmt":"2015-06-23T16:00:47","slug":"the-latest-wave","status":"publish","type":"post","link":"http:\/\/nflconcussionlitigation.com\/?p=1752","title":{"rendered":"The Latest Wave"},"content":{"rendered":"<p>The following is an excerpt of an article I presented at a recent CLE in Kansas City.<\/p>\n<p>On April 22, 2015, the Honorable Judge Anita B. Brody of the Eastern District of Pennsylvania granted final approval to the NFL Concussion Settlement.<a href=\"#_ftn1\" name=\"_ftnref1\">[1]<\/a> What has been hailed by some as a \u201chistoric settlement\u201d and a \u201chuge victory\u201d for the retired players is, in reality, a tremendous deal for the National Football League (\u201cNFL\u201d) and Class Counsel.<a href=\"#_ftn2\" name=\"_ftnref2\">[2]<\/a>\u00a0But a lousy one for the overwhelming majority of players and their families.<\/p>\n<p>The NFL has all-but eliminated any future threat of concussion litigation,<a href=\"#_ftn3\" name=\"_ftnref3\">[3]<\/a> saved itself from potentially damaging discovery and turned a PR nightmare into a salvageable message of philanthropy. Class counsel, too, will get to share in more than $112.5 million in class attorneys\u2019 fees, for essentially promoting a slick advertising campaign in which they convinced 99% of the class members to \u201caccept\u201d the settlement\u2014by not opting out.<\/p>\n<p>On the other hand, the \u201coverwhelming majority,\u201d of class members, according to Class Counsel\u2019s own actuarial data, \u201care not compensated because they never contract a compensable disease.\u201d<a href=\"#_ftn4\" name=\"_ftnref4\">[4]<\/a> Stated differently, the overwhelming majority of class members will receive nothing because the most prominent disease affecting retired players\u2014CTE\u2014is not compensable under the settlement.<\/p>\n<p>While the merits of the NFL Concussion Settlement will be debated\u2014and potentially litigated\u2014for the next sixty-five years (i.e., the life of the settlement), one thing is certain: the NFL Concussion Litigation has triggered a new wave of litigation \u2013 concussion litigation.<\/p>\n<p><strong style=\"line-height: 1.5;\">THE GENESIS OF THE NFL CONCUSSION LITIGATION<\/strong><\/p>\n<p>In 2011, the first concussion-related lawsuit was filed against the NFL. The lawsuit asserted that the NFL knew or should have known since 1928 that football caused brain damage. But instead of warning the players about these dangers and seeking to make the game safer, the NFL engaged in a campaign of denial, deception and brain-rattling glamour, profiting and sensationalizing the big hits through NFL Films.<\/p>\n<p><strong>A. The NFL Takes a Page Out of Industry\u2019s Playbook: Manufacture Doubt<\/strong><\/p>\n<p><em>Doubt is our product since it is the best means of competing with the \u2018body of fact\u2019 that exists in the minds of the general public. It is also the means of establishing a controversy. <\/em>\u2013 <em>Tobacco Executive<a href=\"#_ftn5\" name=\"_ftnref5\"><strong>[5]<\/strong><\/a><\/em><\/p>\n<p>Like Big Tobacco, Big Pharma et al., the NFL knew that it was much easier to debate the science than to debate the logic.<a href=\"#_ftn6\" name=\"_ftnref6\">[6]<\/a> Of course hitting your head repeatedly is not a good thing. But a finely-orchestrated \u201cscientific\u201d controversy could easily derail that logic. The NFL knew that if the message \u2013 FOOTBALL CAUSES BRAIN DAMAGE \u2013 was crystallized, its lifeblood \u2013 the moms of football-playing adolescents \u2013 could be in jeopardy. Enter the manufacture of doubt.<a href=\"#_ftn7\" name=\"_ftnref7\">[7]<\/a><\/p>\n<p>Although the medical science defining the link between repeated blows to the head and neurological diseases has been established for more than eight decades,<a href=\"#_ftn8\" name=\"_ftnref8\">[8]<\/a> the dangers of concussions and sub-concussive blows have been, at best, marginalized. Some would argue that this is because the brain is a highly complex organ for which the study of neurological disease is still in its infancy, (true), whereas others will argue that this \u201clast-frontier\u201d discovery is the result of the NFL\u2019s campaign of denial and cover up, (also true).<a href=\"#_ftn9\" name=\"_ftnref9\">[9]<\/a><\/p>\n<p>There can be no doubt that the NFL did in fact create junk science in order to obfuscate the truth. In 1994, then-Commissioner Paul Tagliabue formed the Mild Traumatic Brain Injury Committee with the specific task of \u201cstudying\u201d concussions in professional football. The Committee was led by Dr. Elliot Pellman, a rheumatologist; Dr. David Viano, a biomechanical engineer; and Dr. Ira Casson, a neurologist.<\/p>\n<p>Over the next 15 years, the Committee created a series of several controversial studies that refuted the link between concussions and neurodegenerative diseases (e.g. dementia, Alzheimer\u2019s, ALS, CTE). In the Committee\u2019s most controversial summary study,<a href=\"#_ftn10\" name=\"_ftnref10\">[10]<\/a> published in Neurosurgery, the authors made four conclusions that would eventually cost the NFL approximately a billion dollars in the NFL Concussion Litigation.<\/p>\n<p>First, \u201cit can be concluded that mild TBIs in professional football are not serious injuries.\u201d<a href=\"#_ftn11\" name=\"_ftnref11\">[11]<\/a><\/p>\n<p>Second, in regard to the often-times deadly second-impact syndrome the Committee found that \u201c[i]t is possible that this syndrome does not truly exist in this population of athletes.\u201d<a href=\"#_ftn12\" name=\"_ftnref12\">[12]<\/a><\/p>\n<p>Third, in dismissing the various grades of concussions and the necessity to hold concussed players out until they are asymptomatic, the authors found that their study \u201csupports the suggestion that such arbitrary return-to-play guidelines may be too conservative for professional football.\u201d<a href=\"#_ftn13\" name=\"_ftnref13\">[13]<\/a><\/p>\n<p>Fourth, \u201c[t]he results of this study indicate that many NFL players can be safely allowed to return to play on the day of the injury after sustaining a mild TBI.\u201d<a href=\"#_ftn14\" name=\"_ftnref14\">[14]<\/a><\/p>\n<p>The final kicker, on an interview which aired in 2007 on HBO Real Sports, Dr. Casson boldly stated the following in response to questioning:<\/p>\n<p>Q. Is there any evidence, as far as you are concerned, that links multiple head injuries among pro football players with depression?<\/p>\n<p>A. No.<\/p>\n<p>Q. With dementia?<\/p>\n<p>A. No.<\/p>\n<p>Q. With early-onset of Alzheimer\u2019s?<\/p>\n<p>A. No.<\/p>\n<p>Q. Is there any evidence as of today that links multiple head injuries with any long-term problem like that?<\/p>\n<p>A. In NFL players?<\/p>\n<p>Q. Yeah.<\/p>\n<p>A. No.<\/p>\n<p>Two years later, the NFL was forced to implicitly acknowledge that the studies were flawed when it \u201caccepted\u201d the resignations of the principal authors of the studies: Drs. Casson and Viano.<a href=\"#_ftn15\" name=\"_ftnref15\">[15]<\/a> But the damage was done and the lawsuits were being drafted.<\/p>\n<p><strong style=\"line-height: 1.5;\">B<\/strong><span style=\"line-height: 1.5;\">. <\/span><strong style=\"line-height: 1.5;\">The Settlement That Freezes Science.<\/strong><\/p>\n<p><em>The study of CTE is nascent, and the symptoms of the disease, if any, are unknown.<\/em> <em> \u2013 Judge Anita B. Brody.<\/em><\/p>\n<p>The NFL Concussion Litigation was initially framed as a CTE lawsuit, but as negotiations progressed it was transformed into a cognitive-disorder settlement, all-but eviscerating future awards of CTE. CTE has been described as the \u201cindustrial disease of football.\u201d Some objectors analogized the failure to compensate CTE in this case to an asbestos settlement excluding compensation for mesothelioma.<\/p>\n<p>The settlement provides compensation for individuals who have been diagnosed with ALS, Alzheimer\u2019s, early-to-severe dementia, or Parkinson\u2019s. The settlement also carves out a period in which certain CTE claims (\u201cDeath with CTE\u201d) will be paid. Retired players who died and were diagnosed with CTE at anytime between January 1, 2006, and the date of final approval (i.e., April 22, 2015) will receive an award.<a href=\"#_ftn16\" name=\"_ftnref16\">[16]<\/a> To be fair, the settlement will pay relatively generous awards to <em>some<\/em> individuals:<\/p>\n<p>However, it forecloses any future awards for CTE. So, for example, if a retired player died today, and he was subsequently diagnosed post-mortem with CTE, his family would receive <em>zilch<\/em> under the settlement. Moreover, the settlement fails to compensate for the classic, clinical symptoms relating to CTE, including mood and behavioral disorders, depression, irritability, explosivity, suicidality, etc. CTE is described in the medical literature as manifesting in four stages; it is not until the final stages that cognitive disorders\/dementia manifest.<a href=\"#_ftn17\" name=\"_ftnref17\">[17]<\/a><\/p>\n<p>While it is true, at present, CTE can only be definitively diagnosed post-mortem, Dr. Robert Stern, among others, believe that an <em>in-vivo<\/em> CTE diagnosis will be forthcoming within the next five years.<a href=\"#_ftn18\" name=\"_ftnref18\">[18]<\/a> Despite this, the settlement states that it will <em>never<\/em> pay an award for an <em>in-vivo<\/em> CTE diagnosis without the player manifesting \u201cactual cognitive impairment.\u201d<a href=\"#_ftn19\" name=\"_ftnref19\">[19]<\/a> Thus, if a retired, living player is diagnosed with CTE at anytime in the next 65 years, he will not receive compensation under the settlement <em>unless<\/em> he is cognitively impaired. But that is not CTE. That is CTE + dementia.<\/p>\n<p>This exclusion creates the potential to derail the science relating to CTE and cast further doubt upon the causality of CTE. The latter has already been emphasized by the commissioner of the National Hockey League. Gary Bettman recently stated, \u201cFrom a medical and science standpoint, there is no evidence yet that one necessarily leads to the other.\u201d<a href=\"#_ftn20\" name=\"_ftnref20\">[20]<\/a> His support? The NFL Concussion Settlement. When pressed, Bettman said, his \u201cviews echoed those of the federal court judge who approved a settlement between the N.F.L. and thousands of retired players.\u201d<a href=\"#_ftn21\" name=\"_ftnref21\">[21]<\/a><\/p>\n<p>More troubling, the memorandum granting final approval reads like a <em>Daubert<\/em> analysis.\u00a0<em>See e.g., <\/em>Final Approval Memorandum, at *82 (\u201cBecause of these [studies\u2019] limitations, researches do not know the symptoms someone with abnormal tau protein in his brain will suffer from during life. No diagnostic or clinical profile for CTE exists.\u201d); <em>Id. <\/em>at *83 (\u201cNo definitive clinical profile yet exists for CTE, however, and the idea that CTE progresses in defined stages\u2014or even that it is associated with symptoms listed\u2014has not been sufficiently tested in living subjects.\u201d). Federal courts faced with future<em> Daubert<\/em> challenges relating to CTE may rely upon this decision to reject the introduction of expert CTE evidence because it is too \u201cunreliable\u201d or lacks \u201crigorous testing.\u201d<\/p>\n<p>The former\u2014that the settlement may impede scientific advancements relating to CTE\u2014may occur like this. Before the settlement was reached, families had an incentive\u2014both financially and in a search for answers\u2014to go through the grueling and emotional process of having a loved one\u2019s brain examined for CTE. The financial incentive is no longer present since future CTE claims will not be paid. This in turn could reduce the \u201cbrain donations\u201d that clinical researchers rely upon in order to study CTE.<\/p>\n<p>The settlement also mandates that the parties confer at least once every ten years to determine whether adjustments to the qualifying diagnoses need to be made due to the advancements in science. But since CTE is not one which will be modified, the study of CTE may fall by the wayside. Without the NFL\u2019s clout and other interested parties pushing for the advancement of the medical science relating to CTE, it may be difficult to generate funding to complete future studies.<\/p>\n<p>Despite the many shortfalls, the settlement obviously avoids the cost and uncertainty of this complex litigation and ensures that certain individuals are compensated. But in the same stroke, it also delivers a hollow award to the overwhelming majority. The settlement must still survive an arduous appeals process. More than ten separate notice of appeals have been filed. The thrust of the appeals focuses on the exclusion of CTE from the settlement. Time will tell if this exclusion can withstand the Third Circuit\u2019s scrutiny.<\/p>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\">[1]<\/a> <em>In re Nat&#8217;l Football League Players&#8217; Concussion Injury Litig.<\/em>, 2015 WL 1822254 (E.D.Pa.)(April 22, 2015)(final order approving settlement)<\/p>\n<p><a href=\"#_ftnref2\" name=\"_ftn2\">[2]<\/a> NFL Concussion Settlement Press Release, Mediator Judge Layn Phillips<\/p>\n<p><a href=\"#_ftnref3\" name=\"_ftn3\">[3]<\/a> <em>But see<\/em> <em>Green v. Arizona Cardinals Football Club LLC<\/em>, 21 F. Supp. 3d 1020 (E.D. Mo. 2014)(granting remand; only case in the country to get out of the MDL and proceed to discovery)<\/p>\n<p><a href=\"#_ftnref4\" name=\"_ftn4\">[4]<\/a> <em>See<\/em> NFL Concussion Liability Forecast, prepared at the direction of Class Counsel, (Feb. 10, 2014) <a href=\"http:\/\/nflconcussionlitigation.com\/wp-content\/uploads\/2014\/09\/6167-Special-Master-Report.pdf\">http:\/\/nflconcussionlitigation.com\/wp-content\/uploads\/2014\/09\/6167-Special-Master-Report.pdf<\/a><\/p>\n<p><a href=\"#_ftnref5\" name=\"_ftn5\">[5]<\/a> <em>See <\/em>David Michaels, <span style=\"text-decoration: underline;\">Doubt is Their Product: How Industry\u2019s Assault on Science Threatens Your Health<\/span> (Oxford University Press, 2008)<\/p>\n<p><a href=\"#_ftnref6\" name=\"_ftn6\">[6]<\/a> <em>See id.<\/em><\/p>\n<p><a href=\"#_ftnref7\" name=\"_ftn7\">[7]<\/a> <em>See <\/em>Professor Daniel Goldberg, <span style=\"text-decoration: underline;\">Mild Traumatic Brain Injury, the National Football League, and the Manufacture of Doubt: An Ethical, Legal, and Historical Analysis<\/span>, The Journal of Legal Medicine, Vol 34, Issue 2 (June 19, 2013)<\/p>\n<p><a href=\"#_ftnref8\" name=\"_ftn8\">[8]<\/a> <em>See<\/em> Martland HS: Punch drunk. JAMA 91:1103-1107, 1928<\/p>\n<p><a href=\"#_ftnref9\" name=\"_ftn9\">[9]<\/a> <em>See<\/em> Mark Fainaru-Wada and Steve Fainaru, <span style=\"text-decoration: underline;\">League of Denial<\/span> (Crown Archetype, 2013)<\/p>\n<p><a href=\"#_ftnref10\" name=\"_ftn10\">[10]<\/a> Pellman, Elliott, et al. Concussion in professional football. Neurosurg. Focus 21 (4):E12, 2006<\/p>\n<p><a href=\"#_ftnref11\" name=\"_ftn11\">[11]<\/a> <em>Id.<\/em><\/p>\n<p><a href=\"#_ftnref12\" name=\"_ftn12\">[12]<\/a> <em>Id.<\/em><\/p>\n<p><a href=\"#_ftnref13\" name=\"_ftn13\">[13]<\/a> <em>Id. <\/em><\/p>\n<p><a href=\"#_ftnref14\" name=\"_ftn14\">[14]<\/a> <em>Id. <\/em><\/p>\n<p><a href=\"#_ftnref15\" name=\"_ftn15\">[15]<\/a> Alan Schwarz, \u201cN.F.L. Head Injury Study Leaders Quit,\u201d The New York Times (Nov. 24, 2009). <a href=\"http:\/\/www.nytimes.com\/2009\/11\/25\/sports\/football\/25concussion.html\">http:\/\/www.nytimes.com\/2009\/11\/25\/sports\/football\/25concussion.html<\/a><\/p>\n<p><a href=\"#_ftnref16\" name=\"_ftn16\">[16]<\/a> The settlement provides a grace period of 270 days to receive a diagnosis if a player dies before the final approval date.<\/p>\n<p><a href=\"#_ftnref17\" name=\"_ftn17\">[17]<\/a> <em>See<\/em> Ann McKee, et al., <em>The Spectrum of Disease in Chronic Traumatic Encephalopathy<\/em>, 136 Brain 43 (2013)<\/p>\n<p><a href=\"#_ftnref18\" name=\"_ftn18\">[18]<\/a> Declaration of Robert A. Stern, PH.D. (Oct. 6, 2014); <em>see also <\/em>Barrio JR, et al., <em>In vivo characterization of CTE using [F-18]FDDNP PET brain imaging<\/em>. Proc. Natl. Acad. Sci. USA. (April 21, 2015)<\/p>\n<p><a href=\"#_ftnref19\" name=\"_ftn19\">[19]<\/a> Section 6.6 of the Settlement Agreement provides for modifications to qualifying diseases based on the advancements of science. However it expressly rules out <em>in-vivo<\/em> CTE diagnoses: \u201cFor the avoidance of any doubt, the identification of a condition\u2014for example, through a blood test, genetic test, imaging technique, or otherwise\u2014that has not yet resulted in actual cognitive impairment and\/or actual neuromuscular impairment experienced by the Retired NFL Football Player does not qualify as a Qualifying Diagnosis.\u201d Section 6.6(b)<\/p>\n<p><a href=\"#_ftnref20\" name=\"_ftn20\">[20]<\/a> Pat Iverson, \u201cGary Bettman says \u2018no evidence yet\u2019 that playing hockey causes brain damage\u201d SB Nation (May 21, 2015) <a href=\"http:\/\/www.sbnation.com\/nhl\/2015\/5\/21\/8641783\/gary-bettman-says-no-evidence-yet-that-playing-hockey-causes-brain\">http:\/\/www.sbnation.com\/nhl\/2015\/5\/21\/8641783\/gary-bettman-says-no-evidence-yet-that-playing-hockey-causes-brain<\/a><\/p>\n<p><a href=\"#_ftnref21\" name=\"_ftn21\">[21]<\/a> Ken Belson, \u201cGary Bettman Denies Brain Disease Link.\u201d The New York Times (June 3, 2015) <a href=\"http:\/\/www.nytimes.com\/2015\/06\/04\/sports\/hockey\/gary-bettman-denies-brain-disease-link.html?_r=0\">http:\/\/www.nytimes.com\/2015\/06\/04\/sports\/hockey\/gary-bettman-denies-brain-disease-link.html?_r=0<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The following is an excerpt of an article I presented at a recent CLE in Kansas City. On April 22, 2015, the Honorable Judge Anita B. Brody of the Eastern District of Pennsylvania granted final approval to the NFL Concussion Settlement.[1] What has been hailed by some as a \u201chistoric settlement\u201d and a \u201chuge victory\u201d [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0},"categories":[1],"tags":[466,98,29,16,465,467,23,13,4,291],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"","_links":{"self":[{"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts\/1752"}],"collection":[{"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1752"}],"version-history":[{"count":2,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts\/1752\/revisions"}],"predecessor-version":[{"id":1754,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts\/1752\/revisions\/1754"}],"wp:attachment":[{"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1752"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1752"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1752"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}