Plaintiff v. Defendant Neurosurgeon

Synopsis:

DBMS attorneys Jim Sloan, Richard Donohue and Ashley Dus successfully defended a neurosurgeon in a medical negligence trial in which the plaintiff asked the jury to award more than $11 million.

The patient, a 40-year-old mother of three young children, suffered a ruptured brain aneurysm in the morning on August 9, 2011. She was taken to a hospital on the north side of Chicago, where the defendant-neurosurgeon confirmed a ruptured aneurysm in the left middle cerebral artery (MCA). The patient was transferred to another hospital where a neuro-interventional radiologist secured the aneurysm by performing a “coiling” procedure. The neuro-interventional radiologist deployed four small coils into the aneurysmal bubble so that blood would no longer enter the aneurysm.

The patient was alert and communicative after the coiling procedure, but a follow-up CT scan performed at 6:35 p.m. showed additional bleeding from the left MCA. She arrived in the ICU at 7:00 p.m. and at 8:00 p.m. was found to have slurred speech, weakening right hand-grip strength and unequal pupils. A nurse in the ICU communicated those findings to the defendant-neurosurgeon, who ordered a medication to keep her blood pressure down. At 11:00 p.m., the patient became less responsive, and the defendant ordered another CT scan, which showed worsening cerebral edema (brain swelling) and a mid-line shift. The defendant ordered Mannitol in an attempt to control the swelling.

The defendant came to the ICU at 6:00 a.m. and attempted to place an external ventricular drain (EVD) to remove excess fluid from the ventricles, but no fluid could be removed because the ventricles were too compressed. After speaking with the patient’s husband, the defendant performed a craniectomy to create room for the brain swelling, but the swelling had been too aggressive, and the patient died during that procedure.

The plaintiff’s attorneys claimed that the defendant-neurosurgeon should have come to the ICU to place an intracranial pressure (ICP) monitor after receiving the 8:00 p.m. telephone call; that he should have come to the hospital to examine the patient in person after 11:00 p.m.; and that he should have inserted the EVD at approximately 1:00 a.m. Those measures, according to the plaintiff, would have given the patient a chance to survive.

DBMS successfully argued that the defendant took appropriate action at 8:00 by instructing the ICU staff to continue monitoring the patient, and that placement of an ICP monitor is not indicated or necessary when the patient is alert and responsive. In addition, DBMS maintained that the defendant-neurosurgeon would not have performed any type of invasive procedure overnight and therefore did not need to come to the hospital in person. Finally, regarding causation, DBMS argued that the ruptured aneurysm and, worse yet, the re-bleed caused patient to develop a severe form of cerebral edema that the defendant-neurosurgeon could not have successfully treated or halted by any medication or invasive procedure.

Following a week-long trial, the plaintiff asked for $11,375,000 in damages. The jury deliberated for one hour before returning a verdict for the defense.