When a young athlete suffers a catastrophic brain injury after returning to play too soon following a concussion, families often wonder: can we sue? The answer is yes—and these cases involve what medical professionals call second-impact syndrome (SIS), one of the most devastating and preventable sports injuries.
Second-impact syndrome occurs when an athlete sustains a second concussion before fully recovering from an initial one. The results can be fatal or cause permanent, life-altering brain damage within minutes. In New York, these cases typically involve lawsuits against schools, coaches, athletic trainers, and medical staff who failed to protect young athletes from premature return to play.
This guide explains what second-impact syndrome is, who can be held legally responsible, New York’s strict concussion protocols, and what families need to know about pursuing a lawsuit.
What Is Second Impact Syndrome?
Second-impact syndrome is a rare but catastrophic condition where the brain swells rapidly and uncontrollably after a person experiences a second head injury before symptoms from an earlier concussion have resolved. This second blow may occur minutes, days, or weeks after the initial concussion—and neither impact needs to be severe for SIS to occur.
How Second Impact Syndrome Happens
According to StatPearls Medical Research, when an athlete suffers an initial concussion, the brain’s ability to regulate blood flow becomes compromised. The brain’s arterioles—small blood vessels that normally control blood flow—lose their ability to regulate their diameter. If another head injury occurs before the brain has fully recovered, this dysregulation triggers a catastrophic chain reaction:
Brain’s autoregulation mechanisms become impaired. Neuronal disruption causes potassium to leak while sodium and calcium accumulate, disrupting neurotransmitter balance.
Athlete returns to sports before brain has fully healed—often within days or weeks of initial injury.
Even a mild blow to the head triggers massive cerebral edema (brain swelling) because blood flow regulation has failed.
Intracranial pressure increases rapidly, causing brain herniation and brainstem damage. Brain death can occur in as little as 3-5 minutes.
Symptoms of Second Impact Syndrome
Symptoms usually appear immediately following the second impact and progress with alarming speed. Medical professionals look for these warning signs:
Immediate Symptoms (Seconds to Minutes)
- Athlete collapses shortly after impact
- Rapid loss of consciousness or deep coma
- Dilated pupils that may not respond to light
- Loss of eye movement control
- Respiratory distress or failure
- Decreased heart rate
Additional Warning Signs
- Seizures
- Severe vomiting
- Intense headache before collapse
- Semi-comatose state
- Combative behavior (3-5 minutes)
- Then rapid deterioration
Who Is at Risk?
While second-impact syndrome can affect anyone who sustains repeated concussions, certain populations face significantly higher risk:
| Risk Factor | Why It Increases Risk |
|---|---|
| Age (13-24 years) | Adolescent brain is 60 times more sensitive to post-traumatic metabolic changes. Young brains experience more diffuse cerebral swelling. |
| Male Athletes | Higher participation rates in contact sports; may underreport concussion symptoms due to pressure to play. |
| American Football | Highest documented incidence. Helmet-to-helmet hits common; culture of “toughness” may discourage reporting injuries. |
| Hockey & Boxing | Frequent head impacts; similar risk profile to football. |
| First 7-10 Days Post-Concussion | Brain most vulnerable during acute recovery period when autoregulation remains impaired. |
The Devastating Outcomes: Mortality and Permanent Disability
Second-impact syndrome is often fatal. According to medical research, the mortality rate is at least 50% when diffuse cerebral swelling occurs. For those who survive, the prognosis remains grim:
- Almost everyone who survives is severely disabled for life
- Common permanent injuries include limited speech, inability to walk independently, wheelchair dependence, cortical blindness, and short-term memory loss
- Survivors require 24-hour medical care for the remainder of their lives
- Permanent inability to work, resulting in lost earning capacity ranging from $2-5 million or more
- Need for lifetime medical treatment, rehabilitation, adaptive equipment, and home modifications
The Preston Plevretes Case: A $7.5 Million Landmark Settlement
No case better illustrates the legal and human consequences of second-impact syndrome than the 2005 lawsuit against La Salle University. This landmark case established critical precedents for institutional liability in concussion management.
Case Background
Preston Plevretes was a 19-year-old sophomore linebacker for La Salle University’s football team. On October 4, 2005, he sustained a helmet-to-helmet hit during practice. He complained of a headache and took himself out of the following game in the fourth quarter.
A university nurse practitioner diagnosed Preston with a concussion. Remarkably, just two days later, he was cleared to resume full-contact play.
Three games after returning, Preston covered a punt in a game at Duquesne University. A Duquesne player’s helmet slammed into Preston’s ear hole. He was briefly knocked unconscious, then became combative for 3-5 minutes before lapsing into a coma.
The Diagnosis: Second Impact Syndrome
The impact caused Preston’s brain to swell massively, then herniate—the textbook definition of second-impact syndrome. According to the lawsuit, the initial concussion one month earlier had made him vulnerable to the second, catastrophic blow.
Preston’s Current Condition
Now in his late 30s, Preston Plevretes:
- Has severely limited speech
- Can walk only short distances
- Suffers from short-term memory loss
- Requires constant 24-hour care
- Is permanently unable to work
- Has lost earning capacity estimated at $2-5.5 million
The Settlement
In November 2009, La Salle University agreed to pay $7.5 million to settle the lawsuit brought by Preston’s family (ESPN coverage). The settlement covers his need for lifetime, round-the-clock medical care.
The university settled without admitting wrongdoing. The settlement was covered by insurance. La Salle discontinued its football program in 2007, two years after Preston’s injury.
Legal Basis for Liability
The lawsuit argued that La Salle University:
- Failed to properly treat Preston’s initial concussion
- Provided premature return-to-play clearance (only 2 days after diagnosis)
- Did not follow the National Athletic Trainers’ Association (NATA) 2004 recommendations
- Failed to implement adequate concussion management protocols
During the case, it was revealed that only 3% of athletic trainers were following NATA’s 2004 concussion management standards at the time of Preston’s injury. This established that La Salle’s treatment fell far below the standard of care—even for 2005.
Who Can Be Held Legally Liable in a Second Impact Syndrome Lawsuit?
When an athlete suffers second-impact syndrome, multiple parties may share legal responsibility. New York law recognizes that protecting young athletes is a shared duty among various individuals and institutions.
1. Schools and Universities
Legal Duty: Schools have a legal obligation to protect student-athletes from foreseeable risks of harm.
Potential Liability For:
- Failing to implement New York’s mandated concussion protocols
- Not maintaining written concussion management policies
- Failing to provide trained medical personnel at games and practices
- Inadequate staff training on concussion recognition
- Allowing coaches to override medical decisions
- Failing to educate athletes and parents about concussion risks
Vicarious Liability: School districts bear responsibility for coaches’ negligent acts performed within the scope of employment, meaning injured athletes can pursue damages from both individual coaches AND school districts.
2. Coaches
Legal Duty: Coaches must exercise reasonable care to prevent foreseeable risks of harm to players.
Potential Liability For:
- Forcing or pressuring a player to return when showing concussion signs
- Ignoring medical restrictions or clearance requirements
- Failing to remove athlete from play after suspected head injury
- Creating a culture that discourages injury reporting
- Not following New York’s mandated return-to-play protocols
- Overriding medical professional recommendations
Personal Liability: Coaches can face personal lawsuits alongside institutional liability. Districts cannot escape responsibility by claiming they didn’t authorize dangerous coaching decisions.
3. Athletic Trainers
Legal Duty: Must conform to National Athletic Trainers’ Association (NATA) standards of care and New York state requirements.
Potential Liability For:
- Failing to properly evaluate an athlete showing concussion symptoms
- Inadequate documentation of injury details, testing, and athlete responses
- Clearing athlete to play without physician authorization
- Not following graduated return-to-play protocols
- Failing to communicate injury information to physicians or parents
- Inadequate education of athletes about concussion risks
Standard of Care: Athletic trainers are held to the “reasonable person standard”—they must act as a reasonable sports medicine professional would under the same circumstances, considering available resources and equipment.
4. Medical Staff (Physicians, Nurse Practitioners)
Legal Duty: Medical professionals must meet the standard of care for diagnosing and treating concussions.
Potential Liability For:
- Failure to properly diagnose a concussion
- Premature medical clearance for return to play
- Giving improper medical advice about recovery timeline
- Not following current medical protocols and guidelines
- Inadequate examination or testing
- Failing to document examination findings
Malpractice Claims: Medical professionals face professional liability under medical malpractice law, which requires proving negligence caused injury and damages.
5. Sports Organizations (NCAA, Pop Warner, etc.)
Legal Duty: Organizations must establish and enforce adequate safety rules and concussion protocols.
Potential Liability For:
- Inadequate concussion safety rules
- Failure to enforce existing protocols
- Not requiring medical personnel at games/practices
- Systemic failures in concussion management
- Inadequate training requirements for coaches and staff
Example: The family of Derek Sheely, a Frostburg State football player who died from second-impact syndrome in 2011, filed a wrongful death lawsuit against the NCAA, coaches, athletic trainers, and helmet manufacturers for systemic failures.
6. Equipment Manufacturers
Legal Duty: Manufacturers must produce reasonably safe protective equipment with adequate warnings.
Potential Liability For:
- Defective helmet design
- Failure to provide proper warnings about concussion risks
- Marketing helmets as “concussion-proof” when no helmet can prevent concussions
- Unreasonably dangerous products
- Inadequate protective equipment
Product Liability Claims: These claims don’t require proving negligence—only that the product was defective, lacked warnings, or was unreasonably dangerous.
New York’s Strict Concussion Management Laws
New York State has implemented some of the nation’s most comprehensive concussion protection laws for young athletes. Understanding these requirements is critical for both preventing injuries and establishing liability in second-impact syndrome lawsuits.
The Concussion Management and Awareness Act (CMAA)
New York’s Concussion Management and Awareness Act applies to ALL schools—both public and private. As of July 1, 2023, Governor Kathy Hochul extended these mandatory requirements to nonpublic schools, which previously could opt in voluntarily (NY State Education Department Guidelines).
Mandatory Training Requirements
New York requires the following individuals to complete sports concussion management training every two years:
- School nurses
- Certified athletic trainers
- Coaches (all levels, all sports)
- Physical education teachers
This training must cover concussion recognition, removal from play protocols, and return-to-play requirements.
New York’s 6-Day Graduated Return-to-Play Protocol
Once a concussion is diagnosed, New York law mandates a strict process before an athlete can return to full participation. This protocol is designed specifically to prevent second-impact syndrome.
| Phase | Day | Activities Allowed | What to Watch For |
|---|---|---|---|
| Phase 1 | Day 1 | Light aerobic activity: walking or stationary bike. Low impact, non-strenuous. | Any return of symptoms means STOP and restart after 24 symptom-free hours. |
| Phase 2 | Day 2 | Moderate aerobic activity: running or jumping rope. NO resistance training. | Higher exertion monitored. Symptoms = immediate stop. |
| Phase 3 | Day 3 | Sport-specific non-contact activity. Movement drills without contact. | Athlete performing sport movements but avoiding hits. |
| Phase 4 | Day 4 | Sport-specific non-contact drills. Higher resistance weight training with spotter. | More intense but still NO contact with other players. |
| Phase 5 | Day 5 | Full contact training drills. Intense aerobic activity. | First day of contact. Closely monitored for any symptoms. |
| Phase 6 | Day 6 | Return to full activities without restrictions—requires school physician approval. | Final clearance from school physician required before game participation. |
Important: If symptoms return at ANY phase, the athlete must stop, remain symptom-free for 24 hours, and restart the protocol from Phase 1.
Medical Clearance Requirements
New York law requires that a student with a suspected concussion must be evaluated by and receive written and signed authorization from a physician before returning to athletic activities. This clearance must specifically state the athlete is medically cleared to begin the graduated return-to-play protocol.
Return to Learn Provisions
New York is one of only 7 states—along with Hawaii, Maryland, Massachusetts, Nebraska, Vermont, and Virginia—that have included specific “Return to Learn” language in their youth sports concussion law.
This means schools must provide academic accommodations for students recovering from concussions, including:
- Cognitive rest (reduced screen time, limited reading/homework)
- Modified class schedules
- Extended time on tests and assignments
- Gradual return to full academic workload
Proving Negligence in a Second Impact Syndrome Lawsuit
To succeed in a second-impact syndrome lawsuit in New York, your attorney must prove four elements of negligence. Understanding these elements helps families evaluate whether they have a viable case.
The defendant owed a legal duty to the injured athlete. This is usually easy to establish—schools, coaches, trainers, and medical professionals all have clearly defined duties to protect student-athletes.
Example: A high school football coach has a legal duty to protect players from foreseeable risks of harm, including removing players showing concussion symptoms.
The defendant failed to use reasonable care in executing that duty. This means their conduct fell below the standard expected of a reasonable professional in their position.
Example: The coach pressured the player to return to the game despite visible concussion symptoms, or an athletic trainer cleared the athlete without physician authorization, violating New York law.
The defendant’s breach of duty directly caused the injury. This is often the most challenging element in SIS cases, as you must prove the initial mismanagement made the athlete vulnerable to the second catastrophic injury.
Example: Medical records show the athlete sustained an initial concussion that was improperly managed, then suffered the second impact during the vulnerable recovery period, causing permanent brain damage.
The athlete suffered actual harm as a result of the defendant’s conduct. In SIS cases, damages are typically catastrophic.
Example: The athlete requires 24-hour medical care, cannot work, has lost $3 million in earning capacity, and needs lifetime medical treatment costing $8 million.
The Causation Challenge: Scientific Controversy
One unique challenge in second-impact syndrome lawsuits is the scientific controversy surrounding SIS itself. According to research published in the Journal of Athletic Training, some medical experts question whether SIS is even a valid medical condition.
- Some researchers state: “The scientific evidence to support [SIS] is nonexistent”
- SIS is not recognized by the World Health Organization
- SIS does not have its own unique ICD-10 diagnostic code
- Only 36 cases documented in medical literature
- Difficult to differentiate impact of second injury from primary injury
However: Despite scientific skepticism, courts regularly allow SIS claims to proceed. Expert medical witnesses routinely testify to SIS’s existence in catastrophic concussion cases, and juries consistently award damages based on SIS theories. The Preston Plevretes case is proof that scientific uncertainty does not prevent successful lawsuits.
Establishing the Standard of Care
The “standard of care” evolves over time based on scientific discoveries and best practices. What matters is whether the defendant met the standard that existed at the time of the injury.
| Time Period | Standard of Care | Key Requirements |
|---|---|---|
| 2004-2010 | NATA Position Statement (2004) | Documented concussion management plans; no same-day return to play; graduated exertional activities. (Only 3% compliance in 2005!) |
| 2010-2015 | State concussion laws emerge | Mandatory removal from play; medical clearance required; parent/athlete education mandated. |
| 2015-Present | Stricter protocols + baseline testing | Baseline neuropsychological testing; written protocols mandatory; independent medical authority; graduated RTP (6+ days); Return to Learn provisions. |
| 2023-Present (NY) | NY CMAA expanded to all schools | Mandatory 6-day graduated protocol; 24-hour symptom-free requirement; biennial training for all staff; written physician clearance. |
In the Plevretes case, even though the standard was less developed in 2005, the court found La Salle liable because the university failed to meet even the minimal 2004 NATA standards that existed at the time.
Types of Damages in Second Impact Syndrome Lawsuits
Because second-impact syndrome causes catastrophic, permanent injuries, damage awards can be substantial. New York law allows injured athletes and their families to recover several categories of damages.
Economic Damages
These cover actual financial losses:
- Past Medical Expenses: Emergency care, hospital stays, surgery, rehabilitation
- Future Medical Expenses: Lifetime medical care, equipment, medications, therapy
- 24-Hour Care Costs: In-home nursing care or residential facility costs for life
- Lost Earning Capacity: What the athlete would have earned over their lifetime ($2-5 million or more)
- Home Modifications: Wheelchair accessibility, medical equipment, safety features
- Adaptive Equipment: Wheelchairs, communication devices, specialized tools
Preston Plevretes example: Lost earning capacity alone was estimated at $2-5.5 million, with total settlement of $7.5 million covering all economic damages.
Non-Economic Damages
These compensate for intangible losses:
- Pain and Suffering: Physical pain and emotional distress
- Loss of Enjoyment of Life: Cannot participate in sports, hobbies, normal activities
- Emotional Distress: Anxiety, depression, PTSD from catastrophic injury
- Loss of Consortium: Impact on family relationships and companionship
- Disfigurement: Physical changes or disabilities
- Loss of Future Opportunities: Career, education, family planning
Note: New York has NO CAP on non-economic damages in personal injury cases, unlike some other states.
Wrongful Death Damages
When second-impact syndrome proves fatal (50% or higher mortality rate), surviving family members may file a wrongful death claim under New York’s wrongful death statute. Recoverable damages include:
- Fair and just compensation for the pecuniary injury to the estate
- Loss of financial support the deceased would have provided
- Loss of parental guidance (if deceased was a parent)
- Loss of services the deceased would have performed
- Medical and funeral expenses
- Reasonable funeral and burial costs
New York Statute of Limitations for Second Impact Syndrome Lawsuits
Time limits for filing lawsuits are strictly enforced in New York. Missing these deadlines means losing your right to sue forever—regardless of how strong your case is.
| Type of Claim | Deadline | When Clock Starts | Special Rules |
|---|---|---|---|
| Medical Malpractice | 2.5 years (30 months) | Date malpractice occurred OR end of continuous treatment | Discovery rule may extend up to 7 years if injury not immediately apparent |
| Personal Injury (Negligence) | 3 years | Date of injury | Discovery rule may apply if injury cause not immediately known |
| Wrongful Death | 2 years | Date of death | Strictly enforced; few exceptions |
| Minors (Under 18) | Until age 21 | For medical malpractice: 3 years from 18th birthday, BUT negligent act must have occurred within previous 10 years | Statute “tolls” (pauses) during minority |
| Municipal Hospitals/Schools | 90 days for Notice of Claim; then 1 year and 90 days for lawsuit | Date of injury | CRITICAL: Must file Notice of Claim within 90 days or lose right to sue |
Special Considerations for Brain Injury Cases
According to New York medical malpractice attorneys, brain injury cases may qualify for extended deadlines under certain circumstances:
This means if the SIS victim is in a coma, semi-comatose, or severely brain-damaged to the point they cannot manage their own affairs, the statute of limitations may pause until they regain capacity or a legal guardian is appointed.
Continuous Treatment Doctrine
Under New York’s Continuous Treatment Doctrine, if the athlete continues receiving ongoing treatment for the concussion or brain injury from the same medical provider who committed malpractice, the 30-month clock doesn’t start ticking until treatment ends. This recognizes that filing a lawsuit during treatment could adversely affect the patient’s care.
Steps to Take After a Suspected Second Impact Syndrome Injury
If your child or loved one has suffered a catastrophic brain injury after returning to play following a concussion, taking immediate action can save their life and strengthen a future lawsuit.
Call 911 or get to an emergency room. Second-impact syndrome progresses within minutes—every second counts. A CT scan must be performed to assess cerebral swelling and herniation.
Preserve evidence while details are fresh:
- Write down exactly what happened and when
- Document any concussion symptoms before the second injury
- Record who cleared the athlete to return to play and when
- Save all text messages, emails, or communications with coaches/trainers/medical staff
- Take photos of any visible injuries
- Get contact information for witnesses
Immediately request records from:
- School nurse or athletic trainer
- Any physicians who evaluated the athlete
- Emergency room and hospital
- Any prior concussion evaluations or baseline testing
Under HIPAA, you have a right to these records. Schools must provide them within 30 days (often sooner in NY).
Do not discard:
- Helmet and protective equipment worn during both injuries
- Practice/game videos showing the incidents
- Athlete’s journal or notes about symptoms
- Return-to-play forms or clearance documents
If the injury occurred at a public school or municipal facility, you have ONLY 90 DAYS to file a Notice of Claim with the school district. Missing this deadline bars your lawsuit forever. Consult an attorney immediately.
Second-impact syndrome cases are complex, involving medical science, education law, and significant damages. You need an attorney experienced in catastrophic brain injury litigation who understands both the medical and legal aspects.
What Evidence Strengthens a Second Impact Syndrome Lawsuit?
Successful SIS lawsuits require compelling evidence that the defendant’s negligence caused the catastrophic injury. The stronger your evidence, the more likely you’ll achieve a favorable settlement or verdict.
Medical Evidence
- CT/MRI Scans: Showing cerebral edema, brain herniation, subdural hematoma
- Initial Concussion Documentation: Proving first injury occurred and was diagnosed
- Symptom Records: Showing athlete had ongoing concussion symptoms before second impact
- Emergency Medical Reports: Documenting rapid deterioration consistent with SIS
- Expert Medical Testimony: Neurologist or neurosurgeon explaining SIS mechanism and causation
- Baseline Testing: Pre-injury neurocognitive testing showing normal function
- Current Medical Assessments: Documenting permanent disabilities and future care needs
School/Institutional Records
- Concussion Management Policy: (Or lack thereof) showing school’s protocols
- Trainer/Nurse Documentation: Injury reports, symptom checklists, treatment notes
- Return-to-Play Clearance Forms: Showing who cleared athlete and when
- Coaching Communications: Emails, texts showing pressure to play or dismissal of injury
- Staff Training Records: Whether coaches/trainers completed required NY concussion training
- Prior Incidents: Other concussions mishandled by same school/staff
- Game/Practice Videos: Showing both impacts and athlete’s visible impairment
Timeline Evidence
- Date/Time of First Concussion: When initial injury occurred
- Symptom Duration: How long symptoms persisted
- Clearance Date: When athlete was cleared (premature?)
- Return to Play Date: How soon athlete returned to full contact
- Date of Second Impact: Timing relative to initial injury (days? weeks?)
- Progression Timeline: How quickly athlete deteriorated after second impact
Example: Preston Plevretes was injured October 4, cleared 2 days later, and suffered catastrophic SIS injury at a game 3 weeks after initial concussion—well within the vulnerable 7-10 day high-risk window extended by premature return.
Expert Testimony
- Neurologist/Neurosurgeon: Explains SIS pathophysiology and causation
- Sports Medicine Expert: Testifies about proper concussion protocols and standard of care
- Life Care Planner: Projects lifetime medical needs and costs
- Economist: Calculates lost earning capacity and economic damages
- Athletic Training Expert: Explains NATA standards and how defendant breached them
- Education Policy Expert: Testifies about New York concussion law requirements
Why Second Impact Syndrome Cases Are Different from Standard Concussion Lawsuits
While many concussion lawsuits focus on long-term effects like chronic traumatic encephalopathy (CTE), second-impact syndrome cases have unique characteristics that require specialized legal strategies:
| Factor | Standard Concussion Cases | Second Impact Syndrome Cases |
|---|---|---|
| Injury Timeline | Symptoms develop over years (CTE, post-concussion syndrome) | Catastrophic injury within minutes of second impact |
| Causation | Difficult to prove which impacts caused cumulative damage | Clear causal link between premature return and second catastrophic injury |
| Damages | Often cognitive decline, mood changes, headaches | Death or severe permanent disability requiring lifetime 24-hour care |
| Liability | May involve multiple parties over many years | Usually clear defendants (who cleared athlete to return prematurely) |
| Scientific Controversy | CTE can only be diagnosed posthumously; causation debates | SIS scientifically controversial but courts allow claims to proceed |
| Settlement Values | Wide range depending on severity ($100K-$5M) | Typically multi-million dollar damages ($5M-$15M+) due to lifetime care needs |
Questions to Ask When Hiring a Second Impact Syndrome Attorney
Not all personal injury attorneys have the expertise to handle catastrophic brain injury cases. When evaluating lawyers, ask these critical questions:
Essential Questions
- How many second-impact syndrome or catastrophic brain injury cases have you handled? (Look for attorneys with specific experience, not just general personal injury practice)
- What were the outcomes of those cases? (Settlements? Verdicts? Amounts?)
- Do you have relationships with qualified medical experts who can testify about SIS? (Neurologists, neurosurgeons, sports medicine specialists)
- Have you handled cases involving New York’s Concussion Management and Awareness Act? (NY-specific expertise matters)
- How will you investigate my case? (Should include obtaining all medical records, interviewing witnesses, reviewing school policies, consulting experts)
- What is the timeline for these cases? (Be wary of promises of quick settlements—complex cases take time)
- How do you handle expenses? (Most brain injury lawyers work on contingency and advance all costs, but confirm this)
- What is your fee structure? (Typically 33-40% contingency fee, but clarify what percentage applies at different stages)
- Will you personally handle my case, or will it be passed to associates? (You want experienced attorney involvement throughout)
- Can you provide references from past clients with similar cases? (Reputable attorneys should be able to provide references)
Prevention: Protecting Young Athletes from Second Impact Syndrome
While this article focuses on legal recourse after SIS occurs, prevention remains paramount. Parents, coaches, and athletes must work together to prevent these catastrophic injuries.
What Parents Should Do
- Educate yourself about concussion symptoms and risks
- Teach your athlete that reporting injuries shows strength, not weakness
- Watch games and practices for signs of head injuries
- Question any clearance that seems premature
- Demand written physician clearance before return to play
- Trust your instincts—if your child seems “off,” keep them out
- Know your rights under New York’s concussion laws
- Don’t let coaches pressure your child to return before medically cleared
What Athletes Should Know
- Report ALL head injuries immediately, no matter how “minor”
- Never hide symptoms to stay in the game
- Understand that concussions are brain injuries—not just “getting your bell rung”
- Follow return-to-play protocols completely, even if you feel fine
- Your brain is more important than any game—long-term health comes first
- Speak up if coaches pressure you to play while symptomatic
- Know the symptoms: headache, dizziness, confusion, nausea, sensitivity to light/noise
What Coaches Must Do
- Complete required NY concussion training every 2 years
- Immediately remove any athlete showing concussion signs
- Never pressure athletes to return before medical clearance
- Create a culture where reporting injuries is encouraged
- Follow New York’s 6-day graduated protocol strictly
- Maintain written policies and document all concussion-related decisions
- Communicate with parents about injuries and return-to-play status
- Prioritize athlete safety over winning games
What Schools Must Implement
- Written concussion management policies complying with NY CMAA
- Baseline neuropsychological testing for all athletes
- Trained medical staff at all contact sport games/practices
- Annual education for athletes and parents about concussion risks
- Biennial training for all coaches, nurses, trainers, PE teachers
- Clear documentation systems for injuries and return-to-play clearances
- No-tolerance policy for coaches who ignore protocols
- Return to Learn accommodations for recovering athletes
Frequently Asked Questions About Second Impact Syndrome Lawsuits
What is the difference between second impact syndrome and post-concussion syndrome?
Second impact syndrome (SIS) is an acute, catastrophic event that occurs within minutes when an athlete sustains a second concussion before recovering from an initial one. It causes rapid brain swelling, often leading to death or severe permanent disability within 3-5 minutes. Post-concussion syndrome (PCS), by contrast, involves prolonged symptoms (headaches, dizziness, cognitive issues) that persist for weeks or months after a concussion but is not immediately life-threatening. SIS is a medical emergency; PCS is a chronic condition requiring ongoing management.
How long do I have to file a second impact syndrome lawsuit in New York?
The statute of limitations varies by claim type: 2.5 years for medical malpractice (from date of malpractice or end of continuous treatment), 3 years for personal injury negligence claims (from date of injury), and 2 years for wrongful death claims (from date of death). For minors, special rules apply—they generally have until age 21 to file medical malpractice claims (or 3 years from their 18th birthday, whichever is longer). CRITICAL: If the injury occurred at a public school or municipal facility, you must file a Notice of Claim within 90 days or lose your right to sue. Consult an attorney immediately—these deadlines are strictly enforced.
Can I sue if my child signed a liability waiver for sports participation?
Generally, yes. While schools and sports organizations often require parents and athletes to sign liability waivers, New York courts have held that these waivers cannot excuse gross negligence or reckless conduct. If a school, coach, or medical provider violated New York’s Concussion Management and Awareness Act, failed to follow basic safety protocols, or acted with reckless disregard for the athlete’s safety, the waiver will likely not protect them. Waivers also cannot waive the rights of minors in many cases. An experienced attorney can evaluate whether the waiver is enforceable in your specific situation.
Who can I sue if my child suffered second impact syndrome?
Potentially liable parties include: (1) The school or university for failing to implement proper concussion protocols, (2) Coaches for pressuring the athlete to return or ignoring injury signs, (3) Athletic trainers for improperly clearing the athlete without physician authorization, (4) Medical staff (doctors, nurse practitioners) for medical malpractice in diagnosing or clearing the athlete too soon, (5) Sports organizations (NCAA, Pop Warner) for inadequate safety rules, and (6) Equipment manufacturers for defective helmets. Multiple parties can share liability. An attorney will investigate who was responsible for the decisions that led to the catastrophic injury.
What damages can I recover in a second impact syndrome lawsuit?
Economic damages include past and future medical expenses, lifetime 24-hour care costs, lost earning capacity ($2-5 million or more), home modifications, and adaptive equipment. Non-economic damages cover pain and suffering, loss of enjoyment of life, emotional distress, and loss of future opportunities. New York has NO CAP on damages in personal injury cases. If the athlete dies, wrongful death claims can recover loss of financial support, loss of parental guidance, medical/funeral expenses, and pecuniary losses to the estate. The Preston Plevretes case resulted in a $7.5 million settlement covering lifetime care and lost earning capacity.
How do I prove my child’s injury was second impact syndrome and not just a bad concussion?
Proving SIS requires medical evidence and expert testimony. Key evidence includes: (1) Documentation of the initial concussion and ongoing symptoms, (2) CT/MRI scans showing rapid, massive cerebral edema and brain herniation characteristic of SIS, (3) Medical records showing the rapid deterioration timeline (seconds to minutes), (4) Expert neurologist testimony explaining how the second impact triggered catastrophic brain swelling due to impaired autoregulation from the first injury, (5) Timeline evidence showing the second impact occurred during the vulnerable recovery period. Your attorney will work with medical experts to establish that the injury pattern is consistent with SIS rather than a standard severe concussion.
What if my child returned to play on their own without being pressured by coaches?
The athlete’s decision to return does not necessarily absolve the school, coaches, or medical staff of liability. Under New York law, schools and coaches have an independent duty to protect athletes from foreseeable risks—including protecting them from their own desire to play while injured. If the school failed to implement proper concussion protocols, if coaches allowed the athlete to practice/play without proper medical clearance, or if medical staff cleared the athlete prematurely, they can still be held liable even if the athlete wanted to return. Young athletes often don’t understand the serious risks and may minimize symptoms. That’s precisely why New York requires adult supervision, mandatory removal from play, and written physician clearance before return.
Does it matter that some scientists say second impact syndrome doesn’t exist?
While some medical researchers question whether SIS is a distinct medical entity, this scientific debate does not prevent successful lawsuits. Courts routinely allow SIS claims to proceed, and juries frequently award substantial damages in cases involving catastrophic brain injuries after premature return to play. What matters legally is whether the defendants breached their duty of care by allowing an athlete with a recent concussion to return to play too soon, and whether that decision caused catastrophic injury. Expert medical witnesses can testify that the injury pattern is consistent with SIS. The Preston Plevretes case resulted in a $7.5 million settlement despite scientific controversy—the key was proving the school failed to properly manage the initial concussion.
What is New York’s 6-day graduated return-to-play protocol?
New York law requires a mandatory 6-day graduated protocol before an athlete can return to full participation after a concussion. The athlete must first be medically cleared by a physician AND remain completely symptom-free for 24 hours. Then: Day 1 – Light aerobic activity (walking, stationary bike); Day 2 – Moderate aerobic (running, jumping rope), no resistance training; Day 3 – Sport-specific non-contact activity; Day 4 – Sport-specific non-contact drills, higher resistance training with spotter; Day 5 – Full contact training drills; Day 6 – Return to full activities with school physician approval. If symptoms return at ANY phase, the athlete must stop, remain symptom-free for 24 hours, and restart from Phase 1. Violations of this protocol can establish negligence in a lawsuit.
How much does it cost to hire a second impact syndrome lawyer in New York?
Most catastrophic brain injury attorneys work on a contingency fee basis, meaning you pay NOTHING upfront and NOTHING unless they win your case. The attorney advances all costs including expert witness fees, medical record fees, court filing fees, and investigation expenses. If they win, they take a percentage of the recovery (typically 33-40% depending on whether the case settles or goes to trial). If they don’t win, you owe nothing—the attorney absorbs the costs. This system allows families to pursue justice against well-funded defendants (schools, insurance companies) without financial barriers. Always clarify the fee structure and who pays expenses during your initial consultation.
Connect with a Qualified New York Brain Injury Attorney
Second-impact syndrome cases are among the most complex and high-stakes personal injury lawsuits. They require attorneys with deep knowledge of sports medicine, New York concussion laws, institutional liability, and catastrophic injury damages.
If your child or loved one has suffered a catastrophic brain injury after returning to play following a concussion, you need experienced legal representation immediately. Time is critical—evidence must be preserved, deadlines must be met, and responsible parties must be held accountable.
Free Legal Consultation – No Cost to Families
We are NOT a law firm—we are an educational resource that connects brain injury victims and families with qualified New York attorneys who specialize in catastrophic brain injury cases.
Our service is completely free for families. Attorneys work on contingency—you pay nothing unless they win your case.
- Free case evaluation with no obligation
- Connect with experienced NY brain injury attorneys
- No upfront costs or fees
- Attorneys handle all case expenses
- You only pay if you win
Don’t wait. Statutes of limitations are strict, and critical evidence can disappear. If a school, coach, athletic trainer, or medical provider failed to protect your child, they must be held accountable—not only to obtain justice for your family, but to prevent this tragedy from happening to another young athlete.
Second-impact syndrome is preventable. When it occurs, it’s almost always because someone failed to follow established protocols designed to protect young brains. Your lawsuit can change policies, improve safety, and ensure that the responsible parties take concussion management seriously.
