Category Archives: Blog

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Catastrophic and Serious Injuries from Automobile, Motorcycle and Trucking Accidents in Georgia – Level One Trauma Centers

Level One Trauma Centers in Georgia

 Treating catastrophic and other serious trauma related injuries from automobile, motorcycle or trucking accidents in the state of Georgia

When involved in a serious automobile accident in Georgia, close proximity to a Level One Trauma Center can be the difference between life & death. Georgia currently has five hospitals with the distinction.

What is a Level One Trauma Center?

A Level One Trauma Center refers to the capabilities of a hospital to serve the critical needs of patients severely injured through a trauma related incident, whether from an automobile, motorcycle or trucking accident (or another cause of trauma related injury). As the highest trauma center rating in the state, hospitals strive to maintain the distinction.

To be designated as a Level One Trauma Center by the Georgia Department of Community Health, a hospital must be able to prove that it staffs its emergency department and trauma operating room at all times with a full team of doctors including surgical staff in different disciplines such as neurological or orthopedic specialty areas. It must show it has the best equipment and resources available to treat patients with catastrophic injuries (whether from an automobile, motorcycle or trucking accident or other traumatic injury). And, it must be able to show that it treats a high volume of trauma related patients throughout the year. Individuals critically injured in an automobile accident will increase their chance of survival by up to 25% by receiving treatment in a Level One Trauma Center, according to the Atlanta Medical Center.

The Georgia Trauma Commission ( was established to promote the long term development of the trauma care network in the State of Georgia and identify limitations and develop a long term vision for an enhanced network capable of best serving patients in critical need of trauma related care in Georgia. The Commission recently developed a strategic plan to help it realize its vision to expand the system, help reduce traumatic injury, coordinate with disaster/homeland security preparedness, enhance support for rural Georgia and more.

The five Level One Trauma Centers in the State of Georgia serving severely injured automobile, motorcycle and trucking accident victims are:



80 Jesse Hill Jr. Drive SE

Atlanta, GA 30303

Telephone: (404) 616-1000

Grady was well known in the Metro Atlanta area as being the only Level 1 Trauma Center in the area for a long time (until Atlanta Medical Center was recognized as a Level One Trauma Center in 2011). The hospital’s emergency department treats upwards of 300 patients per day (that’s 100,000 per year). Of those, upwards of 3,000 are trauma patients each year.

In partnership with Emory University and Morehouse School of Medicine, Grady is able to operate a trauma operating room that never closes, staffed with a surgical team from many medical disciplines.



303 Parkway Drive NE

Atlanta, GA 30312

Telephone: (404) 265-4000

The third busiest trauma center in the State of Georgia, Atlanta Medical Center recently was awarded the distinction as a Level One Trauma Center in 2011.



777 Hemlock Street

Macon, GA 31201

Telephone: (478) 633-1000

Located in Macon, the Medical Center of Central Georgia is the second largest hospital in Georgia and provides the only Level One Trauma Center in its region of the state. The Emergency & Urgent Care Services unit at the Medical Center of Central Georgia serves approximately 65,000 patients per year. The hospital’s EMS department generally serves patients from Baldwin, Bibb, Jones and Twiggs counties.


(formerly Medical College of Georgia)


1120 15th St

Augusta, GA 30912

Telephone: (706) 721-3153

Serving over 13 counties, the hospital at the Georgia Health Sciences University (formerly referred to as the Medical College of Georgia ) in August, Georgia serves thousands of patients each year as the only Level One Trauma Center in its region.



4700 Waters Avenue

Savannah, GA 31404

Telephone: (912) 350-8000

As the only Level One Trauma Center in the southeastern corner of the state, Memorial Health University Medical Center’s emergency services unit serves approximately 80,000 patients per year. The hospital serves 28 counties in Georgia and South Carolina.

Additional Resources


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First Offender Pleas in the State of Georgia

First Offender Pleas in the State of Georgia

Despite its significant pitfalls and severe consequences for non-compliance with sentence conditions, the State of Georgia’s First Offender Act provides individuals not previously convicted of a felony with the opportunity to plead guilty to a criminal charge, pursuant to the provisions of the law, and avoid adjudication of guilt if they comply with the conditions of their sentence.  Recognizing the need to provide certain individuals who have not previously been convicted of a felony with the opportunity for a second chance, the State of Georgiaenacted the provisions of Georgia Code (O.C.G.A.) §42-8-60 et. seq. The provisions of the First Offender Act are available for most charges; however, it does not apply to serious violent felonies and does not exempt sexual offender registration requirements or disclosure for background checks for individuals seeking employment providing care for minor children or the elderly.

Following the plea of guilty under the First Offender Act, the judge withholds the adjudication of guilt that would normally follow and instead defers judgment in the case and sentences the Defendant to a term of probation or incarceration (or a combination of both) along with other conditions of the sentence. Upon successful completion of the sentence conditions, a discharge is filed which “completely exonerates the defendant of any criminal purpose and shall not affect any of his or her civil rights or liberties.” Accordingly, the individual does not have a criminal conviction in connection with the case pled under the First Offender Act and, thus, isnota convicted felon, may continue to vote, own or possess lawfully a firearm, and maintain other rights or liberties that would be lost with a felony conviction. 

The Cost of Exoneration

The First Offender Act does not, however, provide a Get Out of Jailfreecard. In fact, the potential for complete exoneration comes at a potentially hefty cost. As set forth in O.C.G.A. 42-8-60(b), a violation of the terms of the first offender sentence affords the court the opportunity to enter the adjudication of guilt and sentence the Defendant to the maximum punishment allowable under the law. By contrast, with a traditional sentence a violation of the terms of probation can result in a revocation of only the remaining term of probation. 

What is Probation?

It is important to note that probation is essentially a sentence of confinement that allows a Defendant to serve the allotted time outside of jail as long as they meet certain conditions. Upon a violation of those conditions, the probation can be revoked and the Defendant sentenced to confinement for any period of time up to the remaining term of probation. 

By contrast, a sentence of probation under the First Offender Act operates under different rules. Violations of probation in such cases (or conviction of another crime, which would likely be a violation of probation) can result in the judge sentencing the offender to the maximum term allowable based on the charge, even if that sentence would result in confinement for a period longer than the original probated sentence.

As a hypothetical example, Defendant X pleads guilty to felony burglary in violation of O.C.G.A. Section 16-7-1 and is sentenced to three years probation under the First Offender Act.  Two years into his sentence he violates the terms of his probation.  Defendant Y also pleads guilty to felony burglary, but he agrees to a traditional plea of guilty without invoking the benefits of the First Offender Act and is sentenced to three years probation.  Two years into his sentence he violates the term of his probation.  Both Defendants go before the same judge on the same day for probation revocation hearings.  The judge can adjudicate Defendant X as guilty and sentence him to as much as twenty (20) years in prison, likely with credit for time served.  On the contrary, Defendant Y may have his probation revoked; however, the judge can only sentence him to the one year of confinement remaining in his original probated sentence.   

Due Process

During a plea under the First Offender Act, the prosecutor will usually require the Defendant to state on the record that s/he has not pled guilty or been otherwise convicted of a felony in the past and that s/he has never used first offender protection. To ensure that the Defendant understands the ramifications of a plea under the First Offender Act, both good and potentially bad, the presiding judge will likely inquire of the Defendant on the record whether s/he understands the benefits and drawbacks of the program. In the event that a otherwise eligible individual is pleading guilty to a felony and electing not to use the provisions of the First Offender Act, the judge will likely also have the Defendant state on the record that they do not want to be afforded first offender status.

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Why Chiropractic Care?

Why Chiropractic?

As members of a commonly misunderstood health care profession, doctors of chiropractic (chiropractors) are constantly having to fight against the misconception that their area of treatment is hokey, ineffective or misguided. However, speak to most people treated by chiropractors after a car accident and they will usually tell you that they experienced the greatest relief and best moved along the path to recovery from their soft tissue injuries after the treatment from their chiropractor.

Chiropractors focus on musculoskeletal and nervous system disorders, using a variety of treatment methods including, but not limited to, spinal manipulation, hot/cold therapy, electrical stimulation, exercises and more. Their treatment plans are often combined with physical therapy treatment and oversight by a medical doctor.

But, again, why chiropractic? Chiropractic care is a well regulated, organized complementary and alternative medical treatment option. The manual therapy and hands-on approach of chiropractic care often provides patients with greater relief than traditional medical treatments (physiotherapy, medicine, counseling and education). Of course, chiropractic care is not appropriate for many types of injuries, especially those that may require more specialized care, surgical intervention or complex treatment. Chiropractic care can be complementary to other treatment regiments from medical doctors, therapists, counselors, and other providers.

Chiropractors and medical doctors have not always worked well together. As discussed in a 1989 letter to the editor in the American Journal of Public Health, the AMA declared in 1965 that it would be an ethical violation for medical doctors to associate professionally with chiropractors. It ultimately took a judge’s order, resulting from an anti-trust suit filed by chiropractors against the AMA, for the AMA to reverse course. That hard line stance has softened over the years. A 1992 opinion by the AMA states that:

It is ethical for a physician to associate professionally with chiropractors provided that the physician believes that such association is in the best interests of his or her patient. A physician may refer a patient for diagnostic or therapeutic services to a chiropractor permitted by law to furnish such services whenever the physician believes that this may benefit his or her patient. Physicians may also ethically teach in recognized schools of chiropractic.” –Opinion 3.041, Issued March 1992

Recognizing the benefits of chiropractic care in appropriate situations, now medical doctors, chiropractors and physical therapists work side by side to develop treatment plans that are in the best interests of their patients and promote the most effective and efficient recovery from injuries sustained in an auto accident.

It is the hands on approach of chiropractic care that uses spinal manipulation and other treatments to help promote the natural healing capabilities of the human body. Rather than relying simply on medication and home care exercises, chiropractic techniques essentially work with the body’s own healing mechanisms and ultimately can help relieve pain, promote health, increase range of motion and help auto accident victims to try to return to their normal, daily routine.

When choosing a chiropractor, patients need to be sure to select a provider that is well informed in the latest chiropractic techniques, knows the patient’s history, has the proper equipment and resources to ensure that the patient is not suffering from an injury that needs a different method of treatment or that could be exacerbated by manipulation, and that cares about promoting the recovery of the patient rather than simply pushing them through a cookie cutter treatment plan.

According to WebMD, research supports the benefits of chiropractic care for back and neck pain and relief from headaches. A vast majority of personal injury attorneys would likely attest that the majority of their clients suffering from soft tissue injuries obtain significant relief from the treatment afforded by chiropractors. And, many insurance companies now recognize the benefits of chiropractic care and include such treatment in the covered options of their plans (albeit sometimes with limitations of the number or type of treatments that are authorized).

For information about the benefits of chiropractic care, individuals injured in an auto accident should consult with their doctors about whether such care would be appropriate and set up an appointment with a chiropractor to better understand how he or she can help promote the patient’s recovery.


  • American Chiropractic Association (
  • National Center for Biotechnology Information website publication of a 1989 publication of the American Journal of Public Health (
  • American Medical Association (
  • WebMD (

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What is an immigration hold?

Immigration Holds

Upon a determination by the Department to issue a detainer for an alien not otherwise detained by a criminal justice agency, such agency shall maintain custody of the alien for a period not to exceed 48 hours, excluding Saturdays, Sundays, and holidays in order to permit assumption of custody by the Department.”     – 8 C.F.R. §287.7(d)

If Immigration and Customs Enforcement (ICE) identifies an individual in the custody of a local criminal justice agency as someone they want to take into custody to place into removal proceedings, they can place a detainer on the person (referred to as an immigration hold).  The regulatory authorization for a jail to detain the person based on the immigration hold comes from the Code of Federal Regulations (8 C.F.R. §287.7(d)).  When the individual that is the subject of the detainer would not otherwise be detained by the jail (for example, because they paid a bond, completed a sentence or their case was dismissed), ICE has forty-eight (48) hours (not including Saturdays, Sundays or holidays) to take the individual into custody.   If ICE does not take the person into custody, the criminal justice agency is no longer authorized to detain the individual and “hold” them for ICE.

The personnel and management of many jails do not understand the forty-eight hour rule and miscalculate when the time period actually begins (which should be when the person would otherwise be released – such as when they pay their bond).  ICE has recently revised the detainer form (I-247) used to notify the criminal justice agency to hold the individual.  To stress to jails that the person should not be held longer than forty-eight hours, ICE has even titled the form “MAINTAIN CUSTODY OF ALIEN FOR A PERIOD NOT TO EXCEED 48 HOURS” in all caps and bold face type.  Citing the conditions of 8 C.F.R. §287.7(d), the new form states:


“Maintain custody of the subject for a period NOT TO EXCEED 48 HOURS, excluding Saturdays, Sundays, and holidays, beyond the time when the subject would have otherwise been released from your custody to allow DHS to take custody of the subject. This request flows from federal regulation 8 C.F.R. § 287.7, which provides that a law enforcement agency “shall maintain custody of an alien” once a detainer has been issued by DHS. You are not authorized to hold the subject beyond these 48 hours.” (Emphasis in original)


Despite the clarity of the regulation and the I-247 detainer form, the personnel and management of local jails still believe that they are authorized (or, at least, justified by an “ends justifies the means” mentality) to hold an individual beyond the forty-eight hours if they think ICE is coming to take the person into custody.


The second and third pages of the form provided to detainees provide a notice in multiple languages regarding the forty-eight hour rule.  The form provides detainees with a number to call if they are not released timely, as well as a number for US citizens or victims of crimes to call for specialized support.


The notice reads in English:

The Department of Homeland Security (DHS) has placed an immigration detainer on you. An immigration detainer is a notice from DHS informing law enforcement agencies that DHS intends to assume custody of you after you otherwise would be released from custody. DHS has requested that the law enforcement agency which is currently detaining you maintain custody of you for a period not to exceed 48 hours (excluding Saturdays, Sundays, and holidays) beyond the time when you would have been released by the state or local law enforcement authorities based on your criminal charges or convictions. If DHS does not take you into custody during that additional 48 hour period, not counting weekends or holidays, you should contact your custodian (the law enforcement agency or other entity that is holding you now) to inquire about your release from state or local custody. If you have a complaint regarding this detainer or related to violations of civil rights or civil liberties connected to DHS activities, please contact the ICE Joint Intake Center at 1-877-2INTAKE (877-246-8253). If you believe you are a United States citizen or the victim of a crime, please advise DHS by calling the ICE Law Enforcement Support Center toll free at (855) 448-6903.


Many individuals are often held beyond the forty-eight hours authorized by federal regulations because the personnel and management of local jails have misinterpreted their limited authority to detain an individual so that they can be taken into custody by ICE, despite the efforts by ICE to clarify the forty-eight hour rule and dispel the belief amongst local criminal justice agencies that individuals can be held ad infinitum if ICE is coming to get them.  It is not uncommon for attorneys to hear “ICE wants ’em, and ICE is gonna get ’em,” even though ICE itself has stressed in the detainer form that after forty-eight hours the individual should be released.

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Bond set at $1,000,000 for George Zimmerman

The judge in the George Zimmerman case, Seminole County, Florida Circuit Judge Kenneth Lester, Jr., ordered George Zimmerman’s bond to be set at $1,000,000 with additional conditions including electronic monitoring, restrictions on leaving Seminole County, Florida without permission, check ins required every forty eight hours, curfew between 6:00pm and 6:00am, as well as requirements that he not enter the Orlando-Sanford International Airport, open or maintain a bank account, or apply for or obtain a passport. According to the judge’s order, the “increased bail is not a punishment; it is meant to allay [the] Court’s concern that [George Zimmerman] intended to flee the jurisdiction and a lesser amount would not ensure his presence in court.”

A bond is set in a criminal matter in an amount reasonably determined by the judge to be sufficient to deter the Defendant from absconding and failing to return to Court. If a criminal Defendant bonds out of jail and subsequently fails to appear in Court, in most circumstances the judge can order that the bond be forfeited. Courts reason that if bonds are too low on serious charges, a criminal Defendant could decide that they would rather forfeit the money paid for the bond rather than return to the Court.

Zimmerman’s bond was increased after initially being set at $150,000 and subsequently revoked after the State of Florida sought revocation of the bond based on the allegation that the Defendant had presented false testimony at the initial bond hearing. In the latest bond order, Judge Lester, Jr. stated that the Defendant “has flaunted the system” and that a higher bond was appropriate in this case. The eight page bond order outlines in extensive detail the analysis followed by the Court in determining the bond amount. The Court considered the nature and circumstances of the offense charged, the weight of the evidence against the Defendant, the Defendant’s ties to the community, employment history, financial resources and mental condition, the Defendant’s past and present conduct, whether the Defendant is a danger to the community, the source of funds to post bail, the probability that the Defendant would pose a threat to the victim’s family (noting that the Court found no evidence that the Defendant would pose any threat), whether the Defendant had committed a new crime while on pre-trial release, and the ability of the Defendant to pay the bail (noting that “setting an excessive bail is the functional equivalent of setting no bail at all.”

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Supreme Court strikes bulk of Arizona Immigration law (SB 1070)

The Supreme Court recently affirmed in part and reversed in part, in a 5-3 decision, the ruling of the Court of Appeals for the Ninth Circuit in the constitutional challenge to Arizona’s immigration law (SB 1070).  The Court ruled that the powers granted to the federal government by the Constitution of the United States preempt the attempted efforts of Arizona to regulate immigration within its borders.

The history of the United States is in part made of the stories, talents, and lasting contributions of those who crossed oceans and deserts to come here.  – Opinion of the Court (No. 11-182)

The decision halted enforcement of sections 3, 5(C) and 6 of SB 1070 that had been challenged in the case.  The decision was based on the clear “broad, undoubted power over the subject of immigration and the status of aliens” held by the federal government.  Despite the well settled preemption of immigration regulation by the federal government, states such as Arizona have attempted to pass legislation that attempts to usurp such power and authorize its own regulation of immigration.  The Supreme Court has sent a clear message to Arizona and other states that such legislation must not violate the constitution no matter how frustrated the state is with the federal government’s abject failure to come up with a fair, reasonable and workable solution to the immigration problem in the United States.

The Court did allow Section 2(b) of SB 1070 to stand for the present time without fully addressing the constitutionality of such provision.  The section states: “For any lawful contact made by a law enforcement official or agency of this State or a county, city, town or other political subdivision of this State where reasonable suspicion exists that the person is an alien who is unlawfully present in the United States, a reasonable attempt shall be made, when practicable, to determine the immigration status of the person.”  The Supreme Court’s opinion, delivered by Justice Kennedy, does not state outright that such provision is constitutional but rather that the “nature and timing of this case counsel caution in evaluating the validity of Section 2(B).”  The Supreme Court is always very careful to address only those issues that are properly before it, from both a substantive and procedural basis.  The Court found, for example, that if the provisions of Section 2(B) could be interpreted or enforced in an unconstitutional way (such as “[d]etaining individuals solely to verify their immigration status”), and thus be subject to legal challenge.


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Governor Neal Signs Pro Life Bill

"Photo by Alana Joyner, Photographer for Governor Neal - Used with permission

A copy of HB 954 as passed can be found on the website of the Georgia Legislature (

The press release from the Governor’s office regarding the signing of the bill can be found on the Governor’s website (,2668,165937316_165937374_184598709,00.html).

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Governor Neal Signs Major Criminal Justice Reform Legislation

Georgia’s governor has signed HB 1176 into law, enacting legislation passed by the Georgia legislature in the recent session to make significant changes to the criminal justice system in Georgia.  Aimed at encouraging more efficient use of the limited resources of the justice system in Georgia, HB 1176 encourages the enhanced use of outside of the box sentencing programs, such as pre-trial diversion and alternative courts (such as DUI courts) and increases the threshold between misdemeanors and felonies and modifies sentencing requirements for certain theft and drug charges (in order to reduce the number of individuals in prison for relatively minor offenses).  The bill will also extend the statute of limitations for certain crimes against children.

The Governor has vowed to continue to fund efforts in the State to increase efficiency in the system and search for alternative methods of prosecution and sentencing to limit the use of expensive bed space for low level criminal offenders. 

A copy of HB 1176 as passed can be found on the website of the Georgia Legislature (

The press release from the Governor announcing the signing of the bill into law can be found on the Governor’s website (,2668,165937316_165937374_184643488,00.html).

The report of the Special Council on Criminal Justice Reform report can be found on the Georgia Legislature’s website (

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