Last week, former TCU wide receiver Kolby Listenbee filed a lawsuit against TCU coach Gary Patterson, the university and the Big 12 Conference, alleging a pattern of abuse and harassment following an injury he suffered during a touchdown catch against SMU in September 2015.
The full copy of Listenbee and his attorney’s claims can be seen here.
He is seeking damages in excess of $1 million.
While there are a number of financial, legal and ethical issues at play in this particular situation, the basis of this lawsuit is founded upon Listenbee’s injuries and subsequent treatment. That’s why the medical experts are likely to re-enter the picture, to argue for and against the merits of these claims.
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Dr. T.O. Souryal has served as the team physician for Dallas Mavericks and as the president of the NBA Physicians Association. Currently, Souryal serves as the medical director of the Texas Sports Medicine and Orthopedic Group.
He describes osteitis pubis, the diagnosis Listenbee received on his injured pelvis, as an “inflammatory condition that is typically the result of a cumulative trauma,” and is “readily identifiable on an MRI.”
“Cumulative injury does not necessarily mean he was symptomatic for weeks and months,” Souryal said. “At some point, one crosses a threshold where it becomes symptomatic. For example, you may have been developing tendinitis for months of running, but it was only after the White Rock Marathon (The BMW Dallas Marathon) did you really present with symptoms of tendinitis.”
While Souryal said that it’s difficult to diagnosis each patient’s pain threshold, physicians always have to take a patient at their word in terms of how they are feeling.
In his view, the case has a number of competing complexities in regards to the response and medical treatment of the injury.
“If Dirk Nowitzki sprained his ankle before Game 7 of the NBA Finals, he would tape up and play in pain,” he said. “Yes, osteitis pubis may take 8 to 12 weeks, or even longer, to fully heal, but you don’t necessarily keep the athlete out for that entire time because that’s just not practical sports medicine.”
At the same time, Souryal wondered about the frequency of the treatment. In his experience with the injury, cortisone injections are more of a last resort. If physicians do proceed with cortisone injections, there would typically be one, which might be followed by a second injection six weeks later.
As opposed to illegal anabolic steroids associated with cheating scandals, such as those in Major League Baseball, anti-inflammatory steroidal injections are common treatments for a common patient ailment like shoulder soreness or bursitis.
Listenbee claims he was injected with local anesthetics and corticosteroids before the remainder of post-injury games that season, and sometimes even at halftime.
If true, that frequency of injections would be unusual, in Souryal’s view.
“What we don’t know is what were all these injections? Were some of them anti-inflammatory injections or were all of them cortisone injections?” he said.
“The problem with the frequent use of cortisone injections is that they do deteriorate the tissues over time. And if in fact the claims are true that he had these types of cortisone injections on a weekly basis, then he may have a legitimate claim that they may have led to a deterioration of his tissues.”
And that could have impacted Listenbee’s professional football career.
Traditionally, the head athletic trainer (Dr. Michele Kirk is the one named in the lawsuit) serves as the liaison between the doctor and coach. The physician will evaluate the athlete, relay the findings to the trainer, who often is present, and the trainer will translate that to the coaching staff about whether the player is available or not.
“The lines of communication are clear,” Souryal said. “This has been the way that this has occurred for decades and it works well. Now, I suspect that different programs have coaches that are more involved, and some coaches are not involved at all with the medical.”
If a 2010 sideline incident captured on ESPN is any indication, it’s possible Patterson falls into the more involved camp. After a game against SMU, then-team physician Samuel Haraldson told American Medical News that he was “verbally accosted” by Patterson after he wouldn’t allow concussed running back Ed Wesley to re-enter the contest.
In TCU’s motion filed in Tarrant County, the university said: “Employees or agents of JPS Physician Group were not to be deemed or construed to be the employees of TCU for any purpose. Kirk and [Dr. Jason] Mogonye’s services for TCU as pertaining to Listenbee were pursuant to the contract.”
A spokesperson for the JPS Health Network said that Kirk, Mogonye, or any other medical experts from the hospital were not permitted to discuss pending legal issues.
Going forward, the medical records of all of these instances will be the next major issue in the legal process.
“There’s going to be a discovery phase where [Listenbee’s] attorneys are going to request all the records that are available, and they will have an opportunity to review those records,” Souryal said. “Everyone is assuming that there were records kept of these events. But, if there was poor record keeping, then it is going to be his word against theirs.”