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Bay’s Concussion May Signal Need for Change in Mets’ Protocol
By DAVID WALDSTEIN
Published: August 15, 2010
When Mets outfielder Jason Bay ran full speed into the padded outfield wall at Dodger Stadium last month after catching a long fly ball, then crumpled to the ground, it appeared he had hit his head, face first, against the blue padding.
Bay lay motionless for an instant on the warning track. After he slowly got up, he said he told the Mets’ athletic trainer, Ray Ramirez, that he had injured his back and knee, but had not hit his head on the wall.
Based on that, Ramirez and the Mets’ medical staff did not give Bay a complete neurological examination to determine if he had sustained a concussion. They allowed him to remain in the game, and play the next two games.
It turned out that Bay did sustain a concussion, which a specialist in New York determined only after he returned home. It was not from the impact of his head hitting a wall, the doctor concluded, but from the trauma caused by his head snapping backward, causing whiplash.
In essence, his brain slammed against his skull, and the symptoms did not surface until two days later on the flight home.
Bay has not played in three weeks, and although he is improving and expected to recover, a concussion from whiplash can be severe enough to end a career. It did for Corey Koskie, a former Twins, Blue Jays and Brewers third baseman who retired after he sustained a similar injury in 2006.
“It was two and a half years of my own personal hell,” said Koskie, who eventually recovered from the symptoms, but by then was 36 and had been out of baseball too long to get back in.
As Bay waits at home for the symptoms to subside, the Mets appear to have learned a lesson from the episode and are expected to expand the conditions under which trainers will regularly check for neurological damage.
“We are looking into that,” the assistant general manager John Ricco said. “I think we will probably change the protocol so that if there is a serious impact, even if the head doesn’t hit something directly, it will be checked out.”
While Bay’s injury went undetected, he might have exacerbated it, according to Dr. David Hovda, the director of the U.C.L.A. Brain Injury Research Center, by continuing to play after it happened in the second inning of the Mets’ game against the Dodgers on July 23.
In the immediate aftermath of a concussion, the brain is particularly vulnerable to further injury, including from relatively minor events like quickly rotating the head.
“By playing again, he could have exposed the brain to a secondary injury, and that can make it worse,” Hovda said.
But according to Hovda, Ramirez was not remiss in declining to order a neurological exam given the information he received from the 31-year-old Bay at the time. The Mets do not allow their medical staff to speak to reporters, but Hovda assumes Ramirez followed the Mets’ standard procedure, and strongly agrees with Ricco that it should quickly change to allow for the possibility of a concussion from whiplash.
He said it would have taken a particularly diligent trainer to consider the possibility of a concussion even when the player said he did not hit his head, but he thought all teams should include that in their protocol.
“It’s almost inexcusable if it’s not already based on data we have had since 2000,” he said. “But it’s really unfair for the trainer to be responsible if they are told by the player that he didn’t hit his head, and he is following the S.O.P. In hindsight, yes, of course they should have checked him out. But at the time, there was no indication from the player that something happened.
“If I was the owner of a team, and I had a lot of money invested in this player, I would not take a chance. I would order a full neurological examination just to make sure.”
Two years ago, the Mets were criticized for their handling of outfielder Ryan Church’s concussion. Church was allowed to fly and play in Denver before the symptoms were gone, and they became worse. But Hovda said, referring to Bay, that there was no evidence cabin pressure from a flight had any effect on the severity of concussions.
He also noted that if Bay was still feeling the effects of the concussion three weeks on — including headaches, dizziness, nausea — he might continue to do so for another month, which would effectively end his season. Hovda said some of those symptoms could also be the result of a neck injury associated with the whiplash. Such an injury can affect the inner ear, causing vertigo, dizziness and vomiting.
That is what Koskie said he thought happened to him. On July 5, 2006, Koskie fell while chasing a pop-up. He hit his head slightly and stayed in the game, but was later removed. It was determined that it was not so much the impact of his head hitting the ground, but the whiplash that caused the concussion.
“It was awful,” he said. “I could barely move. I couldn’t be in the sun, I couldn’t get my heart rate over 110. Everything seemed strange. It was like I was watching my life through the lens of a video camera.”
Now the owner of two health club franchises in Minneapolis, Koskie said it was not just the concussion that caused his enduring symptoms, but also the neck injury. When he finally saw a specialist who did osteopathic manipulations of his neck, everything changed.
“I would wake up sometimes and I couldn’t feel one side of my body,” Koskie said. “I was told I had an anxiety disorder. You would feel pretty anxious, too, if you couldn’t feel one side of your body. People say brain, brain, brain. Yes, it’s that, but I think the neck and the upper cervical column was just as critical. I don’t have any medical evidence, but once they fixed that, I was fine.”
Arizona Little Leaguer Killed When Pitch Hits Chest
First Posted: 06/ 3/11 11:42 PM ET Updated: 06/ 4/11 09:56 PM ET
Amanda Lee Myers, Associated Press
PHOENIX -- A 13-year-old Arizona boy was killed in a freak accident after a baseball hit him over the heart as he tried to bunt, officials in his Little League said Friday.
Hayden Walton went for the bunt during a game Tuesday night in the close-knit northern Arizona city of Winslow, said Jamey Jones, a Winslow Little League official.
"He took an inside pitch right in the chest," Jones said. "After that he took two steps to first base and collapsed."
He died the next morning at a local hospital.
The boy's parents, who were at the game, are heartbroken, shocked and unable to speak to members of the media, league president and family spokesman Dale Thomas said.
"It's a hard thing to handle for everyone," Thomas said. "When you're touched by something of this magnitude, it sends shock waves throughout the community."
Thomas said he grew up around the boy's family and described Hayden as "the epitome of what every little boy ought to be." Besides participating in Little League, Hayden was a Boy Scout, loved to work on cars and helped neighborhood widows by mowing their lawns and doing odd jobs for them, Thomas said.
He said Hayden had a younger sister.
The league suspended games until Friday and has counselors available for players or parents who need them.
Stephen Keener, president and CEO of Little League Baseball and Softball, said in a statement that "the loss of a child is incomprehensible."
"Words cannot adequately express our sorrow on the passing of Hayden," he said. "Our thoughts and prayers go out to Hayden's family, all the players and volunteers of the Winslow Little League, his classmates, and his friends, at this difficult time."
Youth Baseball Player Dies in Arizona
By Vincent Iannelli, M.D.June 4, 2011, About.com Guide  
There are a lot of sayings, some old, some new, that go along with playing baseball.
"There's no crying in baseball!" has been popular since the movie A League of Their Own.
That's likely going to be hard for the family and friends of a 13-year-old baseball player in Arizona who died the other day after getting hit in the chest with a pitch while attempting to lay down a bunt.
He took a few steps towards first base and collapsed. He died the next day at a local hospital.
I'd like to say there's no dying in baseball, especially as we head out to our own baseball games today, but unfortunately that's not true. Any kind of blunt, non-penetrating chest blow, such as a thrown baseball, can cause sudden death in some athletes. There is even a name for it - commotio cordis.
This type of sudden death isn't limited to baseball though, and it can also occur in, but isn't limited to softball, hockey, football, soccer, and competitive lacrosse players. It even occurs in players wearing chest protectors, but fortunately, these are all very rare events. When the ball or puck hits the child's chest, even when it is an innocent-appearing blow to the chest, it can trigger ventricular fibrillation and sudden cardiac death in a child, who on average is about 14 years old.
Although still considered rare, commotio cordis is the second leading cause of sudden cardiac death in young athletes. The leading cause of sudden death in young athletes is hypertrophic cardiomyopathy and congenital coronary-artery anomalies. The National Commotio Cordis Registry has recorded 224 cases of commotio cordis, in the past 15 years, 80 of which have been in kids and teens playing baseball.
About 25% of the cases of commotio cordis occur in kids who were playing a non-organized recreational sport at home or on the playground, etc.. Many cases, another 25%, are unrelated to sports, and have occurred, for example, when a playground swing hits a child in the chest.
Unfortunately, commotio cordis is usually fatal. For one thing, because the blow to the chest doesn't seem that serious, many bystanders don't think things are that serious when a child with commotio cordis collapses, which can delay the start of CPR. Also, few fields have a automatic external defibrillators (AEDs), which can help restore the heart to a normal rhythm.
These events are always tragic. If you see a child get hit in the chest with a baseball and collapse, don't assume he got the wind knocked out of him. Call 911. And then rush over and see if you need to start CPR. If you don't know how, take a CPR class and learn.
Parents and coaches should also likely push for wider access to AEDs at organized athletic events. It may be too expensive to have a defibrillator at each and every youth baseball field or game, but larger fields, especially those that host a lot of tournaments, should certainly consider having an AED readily available.
 
Brandon Patch - Who was to Blame?
Brandon Patch was a young pitcher who was seriously injured during a game on July 23 2003, and sadly died later the same day from his injuries. The trial has taken a long time in coming to court. This is no ordinary trial in that there isn't an individual being charged; the defendant is the company who manufactured the aluminium bat which struck the ball which hit Brandon Patch in the head.
Brandon Patch's death was a tragedy, no one's arguing that, but was the design of the bat to blame? Brandon Patch's family say the bat is to blame for his death as it made the ball go faster and harder than normal. Brandon was on the mound and couldn't get out of the way in time, and was hit by a baseball travelling at 99.8 mph.
His team mates all testified that everything just happened way too fast for anyone to react. Was this the bat at fault, or just the nature of the sport? Baseball is dangerous, most sports are. There archives of newspapers are littered with tragic kids like Brandon patch, who were in the wrong place at the wrong time and paid the ultimate price.
News that Brandon Patchs' family have received £850,000 in compensation has triggered a nationwide debate. Many have long believed aluminium bats to be dangerous and are now hoping they will be outlawed. Others think it's just a tragedy that has resulted in yet another compensation claim. You don't get the same velocity from a wooden bat, and a nationwide campaign has been started to revert to them.
It's a little known fact that between 1991 and 2001, 27 people died in the US from being hit by batted balls. All types of bats are involved in these deaths, not just aluminium. If anyone should have been sued it should surely have been the league for allowing these bats to be used in the first place.
Either way, whatever they decide, and whichever material they decide to make future bats from, it isn't going to bring Brandon Patch back.
 
Aluminum Bats Update
August 2, 2010 10:14 AM
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By Steve Kallas
Many of you who have listened to Rick Wolff’s “The Sports Edge” (Sunday mornings from 8-9 on WFAN) over the last few years are familiar with the cases of Steven Domalewski in New Jersey and Brandon Patch in Montana. Domalewski was severely injured by a ball hit off an aluminum bat in 2006; Brandon Patch died a few hours after being struck with a ball hit off an aluminum bat on July 25, 2003. The following is an update on where these two cases stand in the legal system.
THE STEVEN DOMALEWSKI CASE
Steven Domalewski was a 12-year-old pitching in a youth baseball game in Wayne, New Jersey, on June 6, 2006, when he was struck in the chest by a ball hit off an aluminum bat. His heart stopped and he couldn’t breathe for approximately 10-15 minutes. The commotion cordis condition caused brain damage to the point where he could not walk or talk and needed 24/7 care.
In May of 2008, The Domalewski family, by their attorney, Ernie Fronzuto of the New Jersey law firm of Wellinghorst & Fronzuto, filed a five-count lawsuit against, among others, Louisville Slugger (the maker of the bat), The Sports Authority (the seller of the bat) and Little League, Inc. (the organization that approved the bat for play). The suit seeks unspecified compensatory damages and punitive damages.
Attorney Fronzuto spoke exclusively with WFAN.com this past week. When asked about Steven’s present-day condition, he said: “Steven has made some progress but has not improved significantly. He has taken some aided steps, but he still can’t talk or walk or feed himself. He continues to battle and, of course, has the full support of his family.”
When asked about the status of the case, which was filed over two years ago, Mr. Fronzuto stated: “We are proceeding with discovery. We have taken the deposition of five representatives of Hillerich & Bradsby [Louisville Slugger], and have started taking depositions of Little League, including that of Stephen Keener of Little League International. There is a conference this week in state court in New Jersey.”
When asked about the possible time of a trial, Mr. Fronzuto could only guestimate that it would be sometime at the end of 2011.
While one can only imagine what Steven and his family have gone through and are going through today and everyday, one can only hope that a resolution in this matter could take place prior to over five years after he was hit and three-and-a-half years after the lawsuit was filed. But the wheels of justice turn slowly. Hopefully, Steven Domalewski can improve with time. (For a more detailed view of the complaint, see Kallas Remarks, 5/25/08).
THE BRANDON PATCH CASE
Many of you know that 18-year-old pitcher Brandon Patch was hit in the head by a ball off an aluminum bat during a youth baseball game in Miles City, Montana, on July 25, 2003. After seemingly gathering himself on the mound after being hit, Patch collapsed and died a few hours later at the hospital.
After failing to get a bill passed in Montana banning aluminum bats from youth baseball, the Patch family decided to file a lawsuit against Louisville Slugger, the maker of the aluminum bat used to hit the ball that killed Brandon Patch. In October of 2009, a state court jury in Helena, Montana found against Louisville Slugger and awarded $850,000 to the Patch family and the estate of Brandon Patch.
Louisville Slugger, which in 2002 lost a $150,000 federal lawsuit brought by pitcher Jeremy Brett and paid the verdict rather than appeal, has decided to appeal the jury verdict in the Patch case. One of the Patch family lawyers, Joe White, Jr., who was the trial attorney in the Brett case and one of the trial attorneys in the Patch case, spoke exclusively with WFAN.com to update the Patch appeal.
Mr. White stated: “The defendant [Louisville Slugger] had filed a motion for a new trial but that was denied. Now the defendant has filed its appellate brief before the Montana Supreme Court. We will file our response to their brief and then they will file a reply to our brief. Once all of the briefs have been served and filed, it usually takes somewhere in the vicinity of a year for the appeal to be heard. That should take us to the summer or fall of 2011.” (For more on the jury verdict, see Kallas Remarks, 10/28/09.)
It would be unusual for any court to overturn a jury verdict. The Patch family didn’t even want to file a lawsuit in this matter. They had tried to have a bill passed as law but, apparently, when push came to shove, the legislature would only pass a “resolution” suggesting that youth leagues in Montana use wood rather than the more dangerous metal. At this point, and with the public reaction to this across Montana and across the country, it would be hard to see a scenario where this jury verdict is overturned.
Having said that, you never know what will happen on appeal but the Patch family has made millions of parents aware of the issues, which have had reactions from New York City (banning metal bats from high school games) all the way to Marin County, California (where a similar ban is being proposed after 16-year-old Gunnar Sandberg was hit in the head earlier this year with a ball off an aluminum bat and put into a three-week coma after part of his skull was removed to save his life).
With awareness being spread nation-wide, hopefully the movement to ban these dangerous bats will spread across the country, making baseball (and softball) a safer sport to play on the baseball diamonds of America.
Steve Kallas is a New York City attorney who writes on sports and the law, youth sports and sports in general. More of his columns can be read at www.stevekallas.com.
 
WAYNE, N.J. - She wraps her arms around her son, gently raising the spindly 14-year-old boy off a couch to his feet. She hugs him and rubs his back, whispering "I love you'' over and over.
Steven Domalewski moves his head to kiss his mother, but all he can manage are slurping sounds in front of her lips. His head flops onto her shoulder, spent from the effort.
Less than two years ago, Domalewski was a happy, healthy star pitcher on a youth baseball team coached by his father. He loved martial arts, climbed every tree on the block and zoomed down his street on inline skates. He once shot an arrow into the wall of his basement rec room.
Now Domalewski is severely disabled, left with brain damage after being struck in the chest by a line drive that stopped his heart while he was playing in a youth baseball game.
His family plans to file a lawsuit Monday against the maker of the metal bat that was used in the game, against Little League Baseball and a sporting goods chain that sold the bat. The family contends metal baseball bats are inherently unsafe for youth games because the ball comes off them much faster than from wooden bats.
There has been a string of injuries the past two decades involving metal bats launching balls that have killed or maimed young players across the country. The Domalewskis' lawyer claims bat manufacturers put speed ahead of safety; one even advertised a bat so powerful it is capable of "beaning the third baseman'' with a line drive.
Attorney Ernest Fronzuto says Domalewski will needs millions of dollars worth of medical care for the rest of his life.
Other than the word "Yeah,'' which he repeats over and over, or "Dadada'' which he sometimes utters when he sees his father, Steven cannot speak. He also can't walk or stand on his own, and needs help with everything from using the bathroom to eating.
"My son is serving a sentence, and the only thing he did was pitch to an aluminum bat,'' said his father, Joseph Domalewski.
'It was just so fast'
Steven Domalewski's life changed forever on June 6, 2006, an overcast evening in which his Tomascovic Chargers were playing the Gensinger Motors team on the Wayne Police Athletic League field.
Domalewski was pitching, on the mound 45 feet from home plate. He wasn't a hard thrower, but he had excellent control. In the fourth inning, the first two batters reached base. He went to a full count on the third batter.
What happened next unfolded in a flash, but has resulted in an agonizing, slow-motion purgatory for Steven and his family.

The batter rocketed a shot off a 31-ounce metal bat. The ball slammed into Steven's chest, just above his heart, knocking him backward. He clutched his chest, then made a motion to reach for the ball on the ground to pick it up and throw to first base.
But he never made it that far. The ball had struck his chest at the precise millisecond between heartbeats, sending him into cardiac arrest, according to his doctors. He crumpled to the ground and stopped breathing.
His father, a school teacher who had been on the sideline, and a third base coach from the other team ran onto the field. Steven already was turning blue.
Someone yelled, "Call 911!'' Within 90 seconds, a man trained in cardiopulmonary resuscitation who had been playing catch with his 9-year-old daughter jumped the fence and started to work on Steven.
Paramedics, who were a quarter-mile away doing a CPR demonstration, arrived within minutes. They placed an oxygen mask over Steven's face and rushed him to a hospital. But the damage had been done; his brain had been without oxygen for 15 to 20 minutes.
"Pretty much, he died,'' Joseph Domalewski said, wiping away tears. "It was just so fast. The thud, you could hear. When it hit him, that seemed to echo.''
Debate surrounds 'safer' bats
The lawsuit is to be filed in state Superior Court in Passaic County, naming Hillerich & Bradsby Co., maker of the Louisville Slugger TPX Platinum bat.

The suit also will name Little League Baseball and the Sports Authority, which sold the bat. It claims the defendants knew, or should have known, the bat was dangerous for children to use, according to the family's attorney.
Hillerich & Bradsby said Domalewski's injury, called commotio cordis, happens more often in baseball from thrown balls than batted ones.
"Our 124-year old, fifth-generation family-owned company never wants to see anyone injured playing baseball, the game we love,'' the company said in a statement. "But injuries do occur in sports. While unfortunate, these are accidents. We sympathize with Steven and his family, but our bat is not to blame for his injury.''
Stephen Keener, president and chief executive officer of Little League Baseball, declined to comment on Domalewski's case, but said in a statement, "Little League will continue its strong commitment to player safety, and we feel our well-documented record of safety in youth baseball speaks for itself.''
On its Web site, Little League denied that metal bats are inherently riskier.
"Little League International does not accept the premise that the game will be safer if played exclusively with wood, simply because there are no facts — none at all — to support that premise,'' the organization wrote.
Representatives of The Sports Authority did not return repeated telephone messages.
Critics say metal bats too dangerous for Little League, youth sports
Steven Domalewski, center, sits with his parents, Joseph and Nancy, during an interview. Domalewski is severely disabled, left with brain damage after being struck in the chest by a line drive that stopped his heart while he was playing in a youth baseball game.
Why the switch to metal?
The suit touches on a hotly disputed issue that has been roiling youth and scholastic baseball programs for years.
In 2003, Brandon Patch, an 18-year-old pitcher for an American Legion team in Helena, Mont., was hit in the head by a line drive off an aluminum bat and died several hours later. In Pennsylvania, 15-year-old Donald Bennett was struck in the face by a line drive from a metal bat while pitching in a 2001 game, causing him to lose an eye.
New York City and North Dakota have banned metal bats for youth and school sports, and New Jersey is considering a similar ban.
Several states are studying the issue. Pennsylvania rejected a proposed ban, and Massachusetts did likewise last year — two months after a high school freshman throwing batting practice was hit in the head by a line drive that fractured his skull. He survived and is expected to make a full recovery.
The National Federation of State High School Associations lets its members choose whether to use metal or wood; most colleges use metal bats.
Metal bats are priced at as much as $300 but are considered more cost-effective than wood bats — which sell for under $100 — because they are far less likely to break and can last for years.
Domalewski was playing in a Police Athletic League game, but Little League was sued because the group certifies that specific metal bats are approved for — and safe for — use in games involving children.
Little League reached an agreement with the major manufacturers of metal bats in the early 1990s to limit the performance of metal bats to that of the best wooden bats. On its Web site, the league said injuries to its pitchers fell from 145 a year before the accord was reached to the current level of about 20 to 30 annually.
The league said that since it started keeping records in the 1960s, eight players were killed by batted balls, six of which were hit by wooden bats. The two metal bat fatalities occurred in 1971 and 1973, before the new standards were adopted. In 2002, the U.S. Consumer Safety Product Commission ruled that there was inconclusive data to support a ban on metal bats in youth and high school baseball games. Its own study found that from 1991 to 2001, there were 17 deaths nationwide because of batted balls — eight from metal, two from wood, and another seven of unknown origin.
Joseph and Nancy Domalewski pray that their son will return to what he was before the injury. But no doctor has told them that is likely.
"I miss my boy, the way he was,'' his mother said. "You can't take away our hope.''
"We describe our days as painful, and somewhat less painful,'' his father added. "Our hope is that he walks and talks and becomes a functioning member of society and has kids.''
The Domalewskis have purposely left unfixed the arrow hole that Steven made in the basement.
"We're saving that for him to spackle when he gets better,'' his father said.