Dr. Bennet Omalu testifies at West Mifflin concussion trial

A world-renowned neuropathologist recognized for linking chronic traumatic encephalopathy, or CTE, to the game of football testified Monday in Pittsburgh he’s certain that symptoms experienced by a West Mifflin man resulted from blows to the head while playing football.

“All it takes is just one season,” Dr. Bennet Omalu told the jury before Allegheny County Common Pleas Judge Arnold Klein. “You cannot play football without having hits to your head.”

Omalu said studies have shown that a player can receive as many as 40 to 60 such blows during one practice.

While not all players sustain a concussion or go on to have permanent brain damage, Omalu said that Shane Skillpa did.

Skillpa, 29, is suing the West Mifflin Area School District, as well as the Western Pennsylvania Interscholastic Athletic League and the Pennsylvania Interscholastic Athletic Association for negligence, alleging that the defendants failed to follow proper concussion protocol the day Skillpa was injured. He is seeking $5 million in damages.

Skillpa, who was a sophomore at the time, was participating in what is known as “an Oklahoma drill” on Aug. 24, 2009. During the drill, he said, he and his opponent collided helmet to helmet.

Skillpa’s face mask broke, and he testified that he was dizzy.

“The coach told me my bell had just been rung,” Skillpa testified early in the trial. “He made it sound like it’s something that just happens.”

Skillpa sat out for a few minutes, got a new helmet and returned to practice that day and continued to practice for a few more days.

However, a few days later, his mother noticed that he seemed unwell. He visited his pediatrician and was referred for evaluation of a possible concussion.

Skillpa was treated on and off for two years for concussion symptoms and was released from care in early 2011.

As Skillpa went through college and then after graduation, he said he began experiencing a variety of symptoms — an inability to concentrate, lack of short-term memory, anxiety and depression.

After seeing several doctors who treated his symptoms but did not link them to the concussion, Skillpa was referred by his attorneys to Dr. Thomas Franz.

Franz testified Monday that he first saw Skillpa in 2016. He was the first to link all of Skillpa’s symptoms to the traumatic brain injury caused by his concussion.

“There’s no evidence of anything other than the concussion and the substantial problems that developed,” Franz said.

He said that Skillpa’s other doctors failed to “connect the dots back to the concussion.”

“They failed to recognize a critical connection. I’m not criticizing them for it. Perhaps they didn’t have all the information I did.”

The attorneys representing the defendants in the case have suggested four possible other causes for Skillpa’s symptoms, including pre-existing conditions, family history, occasional marijuana use or an unexplained cause.

Franz said none of those suggestions are credible. Instead, he testified that he is 99% certain that Skillpa’s symptoms were caused by the concussion.

Franz speculated that, because of the severity of Skillpa’s symptoms, he will have to stop working as a registered nurse within five to 10 years. Already, Franz has suggested that Skillpa should work only about 24 hours each week and receive accommodations at work to ensure patient safety.

“We expect this to only get worse,” Franz said. “At this point, Shane already has CTE or will develop it.”

Omalu, who worked in the Allegheny County coroner’s office earlier in his career, was the inspiration for the 2015 Will Smith movie, “Concussion.”

He left Pittsburgh in 2007 and moved to California, where he is now a full professor at the University of California, Davis.

Omalu was retained by Skillpa’s attorneys to review his medical records and history. He said that his practice was paid about $20,000 for his work on the case.

Omalu testified that in August 2009, Skillpa suffered multiple, violent blows to his head in a short period of time, consistent with second impact syndrome — when a person sustains a concussion and then has another blow to the head before the initial symptoms have abated.

With traumatic encephalopathy, Omalu said, symptoms can begin to manifest immediately after a blow to the head.

“When you suffer a concussion, you suffer brain damage,” the doctor said. “His injury is permanent and progressive. As he gets older, it will be more severe.”

The human brain does not have the capacity to heal itself, Omalu told the jury.

Omalu said Skillpa’s symptoms will continue to worsen, estimating that Skillpa could die as much as 26 years prematurely because of the trauma he suffered.

Omalu told the jury that his confidence level in his diagnosis is 90% to 95%.

“Medicine is not an absolute science,” he said.

Although proving CTE requires a study of brain tissue taken during an autopsy, Omalu said it is still possible to make the diagnosis.

“Mr. Skillpa does not have to be dead for us to make a diagnosis of brain damage,” Omalu said. “You can make a diagnosis with or without tissue based within a reasonable degree of medical certainty.”

Omalu said he is working to develop a more sensitive scan — still some time away — that could be used on live patients.