Commotio Cordis
I’ve discussed commotio cordis a couple of times, most recently in relation to Batman #672-674.
Commotio cordis is a rare and frequently fatal condition. It occurs when an individual receives a direct blow (blunt trauma) to the chest at precisely the right time in the cardiac cycle to stop the heart and cause a cardiac arrest. Children are more susceptible to the condition than adults.
Sports injuries are a common cause of commotio cordis, particularly thrown baseballs and softballs. Other causes include physical blows to the chest during a fight, steering wheel impact in motor vehicle accidents, and even the blunt force of bullets stopped by body armor.
The best, and really only, treatment for commotio cordis is immediate cardiopulmonay resuscitation, usually requiring defibrillation and cardiac medications.
Wikipedia has a good write up on commotio cordis
Commotio cordis has been in the news recently because of a lawsuit filed by a New Jersey family against several groups: a maker of aluminum baseball bats, the Sports Authority*, and Little League Baseball**. It’s an unfortunate story on many levels: Twelve year-old Steven was pitching in a baseball game when a line drive hit by the batter caught him square in the chest, causing his heart to stop beating. He was eventually revived, but remained in a coma for several weeks, and now has severe brain damage.
It’s a sad story and an unfortunate case, but personally I think it’s a stretch to treat it as cause for a lawsuit. I know that we Americans always like to blame someone when something goes wrong, but there are times that it’s not appropriate. This is one of those times.
There is no hard evidence that aluminum bats are any more dangerous than wooden ones, particularly in cases of commutio cordis (remember, it’s an issue of timing, not an issue of force).
There is an inherent risk of injury in playing any sport. Proper safety precautions will minimize this, but never eliminate it entirely. I am well aware of this whenever I go for a bike ride on the back country roads near me. Who knows what drunk-driving redneck may be out there weaving across the center line?***
And suing Little League because they endorsed the bat? Give me a break.
*The store where the bat was purchased
**Not because it was a Little League game — it was not — but because they “endorsed” the bat as safe.
***It would be like me, after getting hit by a reckless driver, suing Ford because the person was driving a Mustang and those can go faster than other cars. It may be true (arguably), but it really has nothing to do with the accident and injury.
May 21st, 2008 at 1:25 pm
Scott, you know I’m not a lawyer, but I don’t think the plaintiff has too much of a chance in this case.
1 Expert medical testimony will say it’s an issue of timing, not an issue of force, and that the type of bat used is irrelevant. (Plaintiff counsel will probably counter that the ball was traveling faster due to the use of an Aluminum bat and therefore left less reaction time for the pitcher to react to protect himself but simple mathematics will show the milliseconds difference in the time of flight to be below what would make a difference in human reaction time.)
2 They have to prove that the Aluminum bat in question was inherently unsafe to use when compared to a wooden bat.
3 They would then have to be able to show negligence on the part of Sports Authority, Little League and the maker of the bat- that they either knowingly sold (or endorsed) an unsafe product or failed to take adequate steps to ensure the product was safe for use.
Of course in civil trails Juries often throw reason out the window and go on emotion and make someone pay for a tragedy, so I guess anything could happen.
May 21st, 2008 at 2:04 pm
This is a completely correct assessment. Especially the ’suing Ford because a Mustang hit you” analogy.
Suits like this are bad, especially where there are cases of corporate negligence that need to be addressed. I do feel for th family; sometimes when life deals a bad hand, you need to find someone to blame (and yelling at the universe doesn’t work)
May 21st, 2008 at 2:09 pm
Why not sue the ones who made the BALL?
May 21st, 2008 at 2:22 pm
What do you think about the statement by the American College of Cardiology?
May 21st, 2008 at 6:00 pm
I’m pretty sure this all came about because a lawyer found out that a kid was killed in a baseball game, approached the parents and said “hey, I can net you some cash”. Here’s hoping for a good counter-suit after the judge laughs in the plaintiff’s face. We need to start making examples of people who pull this stuff.
May 21st, 2008 at 7:58 pm
The Steven Domalewski incident happened in my adopted home town. Heck, I got married in the same church as his family attends. (His name still comes up in the prayer list every week.) But, yeah, his family doesn’t stand a snowball’s chance on this one. I think that either (A) a lawyer talked them into this or (B) the parents are just raging against the machine. Honestly, I’ve never met them, so I can’t make a character judgment here.
May 21st, 2008 at 10:39 pm
I’m surprised they didn’t sue EA because the kid who hit the ball played video game baseball and clearly didn’t recognize the difference between the game and…um…the game.
May 21st, 2008 at 10:55 pm
The other thing, besides faster bat speed as mentioned in the first post though, is that some of these modern high tech aluminum bats are practical like rubber with how much force can get transferred. While in the 14 and older divisions, Little League regulates Bat Exit Speed Ratio and length to weight ratios (-3), as far as I know there’s no regulation below that, so depending on the specific bat, it might possibly have been more dangerous. Not to mention, studies have shown up to an 8 mph difference between the wooden and aluminum bats. (http://www.kettering.edu/~drussell/bats-new/alumwood.html). I haven’t done the math, but I’d imagine that’d be enough to make a difference, even at the 45 foot mound to plate distance in younger leagues. I’m not saying they’re going way overboard with the suit, especially since you sign a waiver for almost all sports, but I think the aluminum bat probably did make a difference.
May 22nd, 2008 at 8:10 am
There’s also a common misconception (at least in modern times) that baseball is a “safe” sport. It most certainly is NOT a safe sport. In fact, it’s one of the most dangerous sports out there — but many parents THINK it’s safe because it’s a relatively slow-moving game in a setting thats more pastoral than most other sports. Consider that batters now wear helmets because too many people throughout baseball history suffered severe head injuries from being hit in the head with the ball. Consider that aluminum bats are now more popular than wooden bats because too many players were wounded by the wood “shrapnel” that came from splintered baseball bats. When you play baseball, you are putting yourself at risk — and you should be prepared to deal with the potential aftermaths of risk instead of trying to place blame on others.
May 22nd, 2008 at 9:45 am
If we accept that commotio cordis is dependent on the timing of impact relative to the cardiac cycle (and not the strength of the impact), and we accept the study that shows a difference in hit ball speed of up to 8mph, and we accept that an impact from a 98.6 mph ball hit from a wooden bat will have the same effect (relative to causing commotio cordis) as a 106.5 mph ball hit from an aluminum bat, the only basis for the aluminum bat being more dangerous (in this context of commotio cordis) is whether the faster ball significantly reduces the reaction time for the pitcher to avoid being hit with the ball.
Simplifying the math a little bit. and assuming the ball travels in a straight line and at a constant velocity (which it won’t), the 106.5 mph ball will reach the pitcher’s mound 60.5 feet away .046 seconds faster than the 98.6 mph ball. Try stopping and starting a stopwatch fast enough to register a time less then .05 seconds.
May 22nd, 2008 at 11:08 am
Wow, how has Commotio Cordis *not* been used/abused by Daredevil?! I dub it “The Chris Sims Punch of Awesomeness”.
May 22nd, 2008 at 3:21 pm
If I ever get shot, can I sue the company that made the gun?
May 22nd, 2008 at 7:32 pm
Like I said Karl, hadn’t done the math. In the younger leagues too, its only 45 feet from the mound to the plate, so should be even less of a difference.
May 28th, 2008 at 2:58 pm
Now if you want a safe sport, take up martial arts. As bizarre as it may sound, it has a rather low injury rate, probably because the people involved are more aware of what they’re doing and how it could hurt themselves or others. As I understand it, the majority of injuries in martial arts are from people returning to it after a prolonged absence. They’ve already overcome the mental block that allows you to snap your arm out to an almost full extension at high speeds and with direct force. They’ve lost the reflexes and muscle tone to be able to stop said limb before joints hyper-extend… and don’t even ask about the time that I was out of Tae-Kwan-Do for a month and then did a kick above my head…
I’ll chime in that it is a dumb lawsuit. What they may be gambling on is that the companies involved will be so worried that they’ll get a hanging jury (when children are involved, people are often rather irrational) that they’ll settle out of court.
June 26th, 2008 at 9:27 pm
My son actually had an episode of commotio cordis but it was by a pitch that was thrown at him while he was up to bat. My son is ok thanks to early CPR and defibulation. I do feel bad for this family but suing all these people will not help. Commotio cordis is caused by the timing not the strenght of the hit. It could happen with a lot less of impact than he had. That little boy suffered because people on the scene did not either know how to help him or “something” for 20 minutes. AED’s should be on all ballfields. ALL COACHES SHOULD KNOW CPR!!!!!
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