Concussion and Court: The Role Litigation Plays in Time to Recovery

Abstract

ObjectiveTo evaluate whether there is a difference in time to recovery (TTR) between concussion patients who have and have not pursued litigation post injury, and determine what factors might influence someone’s decision to litigate.BackgroundAn investigation on how litigation influenced TTR in all types of recovery.Design/MethodsA retrospective study of 851 adult and pediatric patients, ages 1–78 (333men and 518 women) in a concussion clinic. Injuries included, motor vehicle accidents MVA (n = 181), falls (n = 140), assaults (n = 36), sporting injuries (n = 378) and other (n = 116). Full and matched samples were studied by symptom endorsement, (headache, dizziness, sleep disturbance, attention/concentration dysfunction and moodiness), litigation/non-litigation and TTR (survival-curve). Secondary analysis reviewed abuse/depression, mechanism-of-injury and symptom type as it related to litigation/non-litigation.Results1) The odds ratio (OR) in the logistic regression model for the unmatched sample shows increasing age, fewer total symptoms (<3 symptoms vs. ≥3), history of abuse/depression, and mechanism-of-injury as significant predictors of litigation status. MVA, compared to sports/other injuries, showed the greatest rates of litigation (OR = 98.121). Higher total symptoms showed increased litigation (OR = 0.238), where abuse/depression patients are less likely to pursue litigation (OR = 0.063/OR = 0.214). 2) A survival analysis of unmatched patients suggested that patients engaging in litigation have a longer TTR (Litigation TTR M = 293 days vs. non-litigation TTR M = 130 days). However, a matched analysis, which grouped patients by age, #of symptoms, abuse/depression history, and mechanism-of-injury, showed no significant difference in survival time between patients based on litigation status. (Litigation TTR M = 269 days vs. non-litigation TTR M = 223 days).ConclusionsWhile litigation patients are often stereotyped to malinger and exaggerate symptoms, this data showed that with appropriate matched analysis, there was no difference between litigation/non-litigation patients with TTR. The desire to pursue litigation may be influenced by several factors; athletes were less likely to litigate. These findings are important for physicians and attorneys to consider when tasked with focusing on recovery time in litigation cases.