Michael Barbour v. Piedmont Newnan Hospital was a medical malpractice case our firm tried to verdict in downtown Atlanta, involving a gentleman who sustained a permanent injury that resulted in chronic, life-long pain. His case was a challenging one, but one that underscores the importance of human connection and creativity in the courtroom.
At 42 years old, Michael Barbour went to Piedmont Newnan hospital complaining of chest pains. The healthcare workers completed initial testing on Michael and decided to keep him overnight, with plans to perform a nuclear stress test the following morning to rule out any possible blockages.
This is a procedure where a small amount of nuclear material is injected into the bloodstream. Once it travels to the heart, a picture of the heart is taken. Afterwards, a patient is placed on a treadmill to raise their heartrate. Then, more of the material is injected to take a picture of the heart once the heartrate is elevated. Pictures are then compared of the heart at rest vs. the heart when elevated.
A catheter was placed in his arm the night before, so the nurse would have access to inject the material quickly the next day. The following morning, they completed resting part of the procedure without any issue. They injected the material into his arm, it went to his heart, and they took a picture.
Michael then ran on the treadmill to raise his heart rate. They went to inject the material again, but the nurse failed to confirm whether the catheter was still inside Michael’s blood vessel. You do this by injecting a small amount of saline solution through the catheter. This is important, because catheters can easily get dislodged, especially if you’re running on a treadmill.
However, the nurse didn’t do that, and instead she injected the material directly through the catheter. Rather than going into his blood vessel, the material went into the subcutaneous tissues – the tissues around the blood vessels – and the fascia of the arm. His arm bubbled up, and he immediately felt a burning, searing pain in his arm. Unfortunately, this pain did not go away, but developed into a chronic pain condition known as complex regional pain syndrome (CRPS).
Complex Regional Pain Syndrome
CRPS is an unremitting pain condition. This pain is not located in the limb but lives in the spinal cord and in the brain of the patient. We had the case reviewed by medical experts and they confirmed the rule violation: the catheter always has to be confirmed to be in the right place before ever injecting something into the human body. The nurse didn’t do that, and it caused Michael harm.
We filed the lawsuit and ultimately, the case ended up in trial. The biggest challenge of the case wasn’t proving that the nurse did the wrong thing by not checking the catheter, but rather proving that Michael truly suffered from CRPS.
The defense called an expert from Rhode Island who’s very highly regarded in the medical community, particularly among defense lawyers. Tall, good looking with a nice, rich baritone voice, the doctor strode into the courtroom and pronounced that Michael did not have CRPS. Rather, the paid expert testified Michael had a minor “pain condition” at most.
At that point, we made a bold decision. We gave this doctor an opportunity to touch Michael. This probably sounds crazy – you don’t typically allow an opposing expert to lay a finger on your client. However, one of the issues of this case was the CRPS diagnosis, and one of symptoms that Michael displayed was temperature asymmetry – his right arm was cooler than his left. This temperature difference is a sign of CRPS.
The doctor was a little surprised, but he agreed, stepped off the witness stand and stood in front of the jury. I brought Michael up, he put his hands out, the doctor felt them and without any warning or mention, he took his thumb and drove it into the affected area of Michael’s arm, just above his hand. Michael recoiled in pain and pulled back reflexively. The doctor was trying to see if Michael was faking the whole thing. If Michael was faking, he wouldn’t have felt any significant pain at what the doctor did. But since Michael does in fact have CRPS, he jerked his arm back immediately.
The Power of Touch
After touching Michael’s hands (and jabbing his thumb into Michael’s arm), the defense doctor claimed he could not feel a temperature difference. At that point, we had one expert claiming there was a temperature difference and the defense expert claiming otherwise.
So, I asked the judge if we could give the jury members the opportunity to feel Michael’s hands for themselves and determine if they felt a temperature difference, since it was a vital fact in the case. Over the intense objections of the defense, the judge granted this request, stating that Michael’s hands were now evidence.
The first juror volunteered. Michael stepped over to the gentleman on the front row, held his hands out, and the juror very gently touched Michael’s hands and nodded. The next juror said he would like to touch Michael’s hands too, and then the next, until nearly everyone on the jury had the opportunity to connect with Michael and touch his hands.
Creating Literal Connection
This was a very profound moment in the trial because it helped create literal connection between the jury and my client, while also revealing the dishonesty of the defense expert. Ultimately, this was an example of a high-risk decision in the heat of battle – one that required creativity and quick thinking.
The statistics for medical malpractice cases nationally are staggering, with a reported 90% win-rate for doctors over patients. In Georgia, the numbers are more favorable for the plaintiff, but the national statistics underscore how difficult these cases can be. In order to be successful, you have to be willing to take risks and think creatively to prove your case to a jury. In Michael’s case, the jury returned a verdict of over $4M.