On October 19, 2010, a Cook County jury returned a defense verdict for a pain management specialist represented by DBMS.
The plaintiff, a 53-year-old married father of three children, who worked as a commercial truck driver, underwent an elective sphenopalatine nerve block performed by the firm’s client, a pain management specialist, to treat chronic migraine headaches. The plaintiff previously underwent nine nasal surgeries and a variety of pain mediations in an attempt to alleviate the headaches with no success. The sphenopalatine block was performed with a TAC solution, consisting of Tetracaine, Lidocaine and Cocaine.
Approximately 10 minutes following the procedure, the plaintiff began to complain of light-headedness, nausea and stomach pains and his vital signs were abnormal. The plaintiff was instructed to lay back and cool compresses were applied to his head. The plaintiff’s vital signs thereafter improved; however, approximately 20 minutes later, the plaintiff was very pale and began to complain of severe headache and shortness of breath and there was evidence of fluid in the lungs. The plaintiff’s vitals were taken and showed an elevated blood pressure and pulse and low oxygen saturation levels.
An ambulance was called and the plaintiff was taken to a nearby emergency room and diagnosed with a subendocardial myocardial infarction, or a mild heart attack, secondary to Cocaine. The plaintiff remained at the hospital for three days. The plaintiff claimed the heart attack was a life-changing event, leaving him anxious and fatigued with difficulty sleeping and constant fear of sudden death from another heart attack.
The plaintiff alleged that the firm’s client negligently performed the sphenopalatine block using TAC solution. According to the plaintiff’s expert, the TAC should not be used in patients with a history of hypertension because Adrenaline and Cocaine act to constrict the blood vessels, increasing the risk of heart attack. The plaintiff also alleged that the nine prior sinus surgeries created scar tissue, which allowed for a rapid uptake of the Cocaine solution.
The defense successfully contended that while the plaintiff suffered a heart attack, it was a remote and unforeseeable risk of the procedure. The defense expert testified that TAC solution is appropriate to use on patients with controlled hypertension, such as the plaintiff. The defense expert also testified that scar tissue is less vascularized than mucosa, and therefore, acts to restrict the absorption rate of the solution.
According to the defense expert, the heart attack was an unpredictable, idiosyncratic reaction to medication. Plaintiff’s counsel suggested in closing argument that the defendant’s records were altered and therefore unreliable, which the defense denied.
Over the defendant’s objection, the jury was given a “missing evidence” instruction because no prescription for the TAC solution was contained in defendant’s records, permitting an inference that the evidence would have been adverse to the defendant.
Notwithstanding, the jury deliberated for one hour over lunch and returned a unanimous verdict in favor of the defendant.