“Face the Jury” is a podcast dedicated to confronting the issues involving medical malpractice in America– what it is, how to spot it and how to protect you and your family from medical negligence.
In this episode, we’re joined by a leading trial lawyer in Atlanta, Laura Shamp. Laura is a strong appellate advocate dedicated to improving the quality of medical care in Georgia. She studied patient safety and medical errors from leaders in the field of patient safety and serves on several committees to address medical errors and patient safety. We will discuss our historic $75M medical malpractice verdict.
Lloyd: In this episode, we welcome my friend and fellow warrior, Laura Shamp. She is a trial lawyer here in Atlanta. She specializes in medical malpractice cases, and I recently had the pleasure of trying a case with Laura as co-counsel and achieving one of the largest medical malpractice verdicts in Georgia history. It’s my pleasure to welcome Laura to the show.
We’ll jump into it and talk about the case we worked on and achieved a verdict, Jonathan Buckelew vs. North Fulton Hospital. Tell us a little bit about the case and what happened to Jonathan.
Laura: This was a very complex medical malpractice case. John Buckelew is a 32-year-old man who was married and worked in IT. He had some neck pain and went to a chiropractor for a neck adjustment, which caused a blood clot in his brain, causing a brain stem stroke in the back of his brain. The chiropractor called 911, and he was immediately transferred to North Fulton hospital.
He was seen by an ER doctor who did not recognize that this was a stroke and sent him for some imaging. The radiologist missed a clot appearing in the basilar artery, so he did not transmit the information to the ER doctor. Then there was a phone call to a neurologist, which is up for dispute about what was said.
John went almost 24 hours before his stroke was diagnosed, which caused him to be “locked-in.” He is cognitively intact, so he can understand and think, but he’s unable to speak or move any part of his body other than his eyes. So, he communicates by lifting his eyes up and down.
Lloyd: We have been trying to raise public awareness about the dangers of chiropractic neck adjustments and medical errors. People think chiropractic adjustment is safe. Talk to us about how this can cause a stroke, and explain why the chiropractor wasn’t part of the lawsuit or trial.
Laura: Chiropractors can be helpful if they stay in their lane. They can adjust your lower back but never let them adjust your neck. A neck adjustment is when they take the head and turn it quickly to adjust the cervical spine. Don’t ever let anybody do this. Some sensitive arteries go through the neck and carry blood to the brain. If those arteries are damaged, it could cause a stroke.
Lloyd: In this case, Johnathan went to the chiropractor for neck pain, and the chiropractor did this neck manipulation, and within just a few moments of the manipulation, he became severely neurologically altered. He started foaming at the mouth and lost the ability to speak. He was awake but was cognitively impaired. How did that happen so quickly from a chiropractic adjustment?
Laura: You have four arteries that supply blood to your brain. The first two you use when you take your pulse on your carotid. The two arteries in the back of your brain are your vertebral arteries. In this case, John’s vertebral artery was damaged, which could have happened by lifting weights or sneezing violently. The body then formed a blood clot around that slight injury, which was why he had neck pain. When the chiropractor violently turned his neck, it threw the blood clot, and it traveled up into the smaller arteries in the brain and clogged one of them, causing a stroke. A stroke happens anytime the blood supply is cut off to a part of the brain.
Lloyd: What the doctors and medical providers did wrong?
Laura: We’ll start with the ER doctor. The critical piece in this case and what we had to educate the jury about is that doctors know this association between a neck adjustment and stroke. They’re taught it at medical school. The ER doctor admitted that he knew that. So, when John came in with a sudden change in his mental status after getting a neck adjustment, stroke should have been the number one thought.
But he didn’t call a stroke alert. A stroke alert sets certain things in motion to happen quickly, but that didn’t happen. When John went to the radiologist for imaging, the radiologist didn’t have stroke on his potential list. But when he looked at the imaging, he missed the blood clot, which was visible at trial. He was busy looking at many films quickly and did not pay attention.
Then the ER doctor decides to call a neurologist. The brain specialist doesn’t know that stroke was suspected, so he thinks it’s meningitis. There is a “he-said-she-said” aspect to the trial where the ER doctor claims one thing, and the neurologist claims something else.
Then there was a PA doctor involved. The patient went to the ICU, and the nurses didn’t recognize a stroke.
Lloyd: The lack of communication and miscommunication is a universal theme in medical malpractice cases.
You touched on the outcome of John, which is locked-in syndrome condition. I remember you told the jury that there are many names for different diseases, but “locked-in syndrome” describes what we’re talking about with the patient in this case. He is locked into his body. His brain is perfectly functional, but he can’t swallow and has no sensation. Explain the challenges of representing somebody severely injured and telling his story at trial.
Laura: Part of the challenge we faced was explaining to the jury that John wanted to live and that he had a life worth living. We decided John should testify, which was a task. He’s in a wheelchair and monitored 24/7. I thought it was important for the jury to see John and understand that he did want to live.
Lloyd: You worked on this case for years before I got involved. Explain the challenges of preparing this case for trial. What all went into getting a $75 million verdict?
Laura: I was given 13,000 pages of documents and said to see if I could figure out what happened. I looked at the records and sent them to a neurologist, who pointed out the clot.
At that point, I had to investigate who fell below the standard of care and what care providers were negligent. That involved hiring experts to review the records. You sue the parties involved, and then the defense asks for depositions. There were years of depositions, learning the medicine, and working with expert witnesses.
Lloyd: You brought me on board, and we had a couple of trial settings before we got our trial date. Describe the trial and some of the lessons learned from this case.
Laura: One thing I tell my clients and family members is to be an educated patient. Ask your doctor questions. Why are you doing this? Have you spoken to the other doctors? Can I talk to them?
You have a right to talk to your doctor. If you ask to speak to a doctor, the standard of care obligates the nurse to get a doctor on the phone. You have rights as a patient and as a patient’s family.
Lloyd: I tell people to be educated but also be an advocate. Take notes and ask to audio record conversations to fully understand what your doctor is saying.
Laura: It’s your right to speak to a doctor directly. You can even talk to them on the telephone. They are paid to do that job.
Lloyd: They are paid very well to do a job correctly. It helps juries to understand doctors have a job, and if they do it the wrong way, they cause harm.
I’m pro-doctor, but I’m also pro-patient and patient safety. It’s about holding folks accountable to make the system safer when they don’t do their job. It’s not just about getting a fair outcome for your client but changing behavior while raising awareness, so there’s not another Jonathan Buckelew.