District Court for the Middle District of Pennsylvania rules on coach and school’s liability for student athlete’s traumatic brain injury (Mann v. Palmerton Area School District)

The Policy

What it does

Determines that the constitutional rights of a student who suffered a traumatic brain injury during football practice were not so clearly established by law that the coach or the school district could be held liable.

Synopsis

This decision found that a student athlete could not hold his high school football coach or school district liable for a concussion he suffered during football practice.

First, this decision held that the coach was immune to liability because, at the time of the injury, the athlete’s right was not so clearly established by law that any reasonable coach would know that he was violating that right. This is a powerful legal doctrine known as “qualified immunity.” 

However, this decision suggested that if the athlete’s right not to suffer a brain injury during practice was more clearly established, then the facts would have overcome the coach’s immunity. The court acknowledged that based on the facts, a hypothetical jury could reasonably find that the coach was responsible for creating a danger of injury to the student athlete. Specifically, the court discussed how the coach had received traumatic brain injury (TBI) training and, therefore, should have recognized a concussion symptom in the Plaintiff, known as a “stinger” (so-called in sports because of a stinging or burning sensation), rather than ordering him to continue practicing and subjecting him to a second hit. The court made it clear that if only there were any previous cases holding a school official liable for an athlete’s brain injury, then it would have taken the question of the coach’s liability to a jury.

Second, the decision held that based on the facts presented, the school district could not be found liable for the student’s injuries under the stringent test of municipal liability. There was no evidence to suggest that the district was deliberately indifferent to the coach’s training or had a custom or practice of ignoring head injuries. The district’s athletic handbook included comprehensive policies for handling injured athletes. Although the policies proved inadequate and ultimately may have contributed to the injury, they were not the ‘moving force’ behind the student’s injury. The ‘moving force’ was the coach. In addition, the court found that plaintiffs could not establish a direct causation link between any inadequate policy (or lack thereof) and the harm suffered by the student – given that they did not provide evidence that the coach believed the student had actually suffered a concussion.     

This decision makes a strong statement that the coach and the school district could have done more to prevent a football player’s TBI. It suggests that a student athlete may have a tenuous Constitutional right to not face a state-created danger of TBI in the context of a school sports program. The decision portends that if such a right becomes more clearly established, then certain facts surrounding a student athlete’s injury might be able to overcome a coach’s qualified immunity and expose the coach to liability.

Context

The Science

Science Synopsis

A traumatic brain injury (TBI) is an injury caused by a bump, blow, or jolt to the head that disrupts the brain’s normal functioning. A concussion is the mildest and most common form of TBI; other types, such as contusions or penetrations of the skull, can be more severe. TBI can lead to temporary or permanent disability including, but not limited to, impaired thinking, problems of memory and perception, emotional and personality changes, seizures, and/or death. Symptoms of TBI vary widely and can include headache, difficulty thinking clearly, disorientation, dizziness, nausea, etc.

TBI is considered a major public health risk that contributes to up to 30% of annual injury-related deaths in the US. Infants, young adults, military service members, and the elderly have increased risk of TBI. TBI is also particularly common among student athletes and there are a number of initiatives to increase TBI awareness in sports settings. 

The severity of TBI is typically calculated according to the Glasgow Coma Scale (GSC). The brain takes time to heal depending on the severity, and people who have suffered one concussion are at greater risk of suffering future concussions.  Although rare, there is some research about “second impact syndrome” or recurrent TBI, and how multiple head injuries may exacerbate TBI symptoms. This was a key concern in the plaintiff’s argument in this decision.

Relevant Experts

Dale Bass, PhD, is an Associate Research Professor of Duke University’s Department of Biomedical Engineering, Director of the Injury and Orthopaedic Biomechanics Laboratory, and a faculty member of the Duke Institute for Brain Sciences.

Carrie R. Muh, MD, is a Pediatric Neurosurgeon and an Assistant Professor of Neurosurgery at Duke University Hospital who treats children with a wide range of neurosurgical disorders.

Barry S. Myers, MD, PhD, is a Professor of Duke University’s Department of Biomedical Engineering. He focuses on the biomechanics of head and neck injury with the goal of injury prevention.

Carolyn Pizoli, MD, PhD, is an Assistant Professor of Pediatrics – Neurology at Duke University School of Medicine who focuses on neural network changes after an acquired brain injury.


The Debate