9-Year-Old Wins $44.5 Million Verdict for Delayed Diagnosis of Brain Damage

Case Overview

Case Name: Bradley Metts, a Minor, by and through his parent and natural guardian Mark Daniel “Danny” Metts, II and Lyndsie Metts v. Nationwide Children’s Hospital, Ronald T. Grondin, M.D., University Medical Associates, Inc., Amy M. Zidron, D.O., Staci L. James, C.N.P. and Athens Medical Laboratory, Inc., No. 14-CV-002543 (Franklin County Court of Common Pleas, OH)

Case Type: Medical Malpractice – Delayed Diagnosis; Delayed Treatment

Injury:

• Brain – brain damage; edema, cerebral; brain abnormalities; meningioma
• Chest – empyema
• Other – atrophy; swelling; infection; jejunostomy
• Myocardial Infarction
• Sensory/Speech – loss of hearing; speech and language impairment
• Cognitive Impairment
• Paralysis

Plaintiff Attorneys:

• Gerald S. Leeseberg of Leeseberg & Valentine
• Craig S. Tuttle of Leeseberg & Valentine

Defense Attorneys:

• Michael J. Hudakand and Andrew S. Good of Roetzel & Andress for Athens Medical Laboratory Inc.
• Theodore P. Mattis of Vorys, Sater, Seymour and Pease LLP for Nationwide Children’s Hospital
• Frederick A. Sewards of Poling Law for University Medical Associates Inc. and Staci L. James
• Thomas J. Mazziotti of Hall Booth Smith, P.C. for Amy M. Zidron

Case Outcome: Jury verdict in favor of the plaintiffs, finding that Athens Medical Lab (the only defendant to proceed to trial) was negligent.

Amount: $44,514,226

Actual Award: $22,257,113

What Happened?

Plaintiff Bradley Metts, age 9 at the time, visited his pediatrician’s office, University Medical Associates, Inc., three times between October 28, 2013 and November 6, 2013. His symptoms continued to worsen each visit. He initially complained of ear pains and fevers. Then, he suffered from vomiting, headaches, fatigue, light sensitivity, appetite loss, and also experienced trouble urinating. On his last visit on November 6, he suffered from constant headaches. His pediatrician, Amy Zidron, D.O., diagnosed him with mononucleosis and gave him instructions to hydrate and rest at home.

However, Bradley’s condition did not improve, and he continued to suffer from severe headaches. As a result, his parents took him to the Nationwide Children’s Hospital. There, physicians diagnosed him with a rare and dangerous infection of the brain, known as a subdural posterior fossa empyema. The hospital immediately performed surgery to remove the empyema. Yet, the infection caused brain swelling and herniation of Bradley’s brain stem. The swelling and herniation caused severe brain damage. The brain damage rendered Bradley almost entirely paralyzed and incapable of volitional movement but for his left eye.

Bradley now suffers from mastoiditis, meningitis, cerebral edema, myocardial infarction, muscle atrophy and immobility, impaired cognition, and incontinence. Additionally, he has locked-in syndrome, a neurological disorder that results in total paralysis. Damage to the brain stem causes this disorder. Bradley requires total care for all activities of daily living, including a tracheostomy for breathing and a jejunostomy for feeding. He also suffers from permanent hearing loss. Bradley has only maintained the ability to move his left eye. As such, he has learned to communicate through a letter board and other assisted communication devices.

The Lawsuit’s Allegations

Bradley’s parents, Mark and Lyndsie Metts, filed a medical malpractice action against the pediatric office, University Medical Associates, Inc., Dr. Zidron, as well as nurse practitioner Staci James. They alleged that the defendants failed to properly examine, diagnose, and treat Bradley’s ear infection. Specifically, the Metts claimed that the STAT lab work that was ordered at the pediatrician’s office through Athens Medical Lab was not timely and properly reported, further leading to a delay in diagnosis. The Metts also sued Athens Medical Lab for negligence. They claim that the lab had lost the test results. Furthermore, the three-day delay resulted in a worsening of Bradley’s condition such that he could no longer be treated with antibiotics. Instead, Bradley had to undergo surgery.

The Metts also argued that the undiagnosed infection eroded Bradley’s mastoid bone, entered his brain, and formed the empyema. Additionally, they claimed that the nurse practitioner was negligent in failing to secure STAT lab results in a timely manner. Lastly, the Metts also sued Nationwide Children’s Hospital and Ronald T. Grondin, M.D., the neurosurgeon who performed the surgery. They alleged medical malpractice for their failure to provide intracranial pressure monitoring after the initial surgery. The plaintiffs argue that Bradley developed intracranial hypertension from the buildup of pressure inside his brain.

Athens Medical Lab was the only defendant to proceed to trial; the others had entered into an undisclosed settlement agreement. However, the jury was permitted to consider any potential contributory negligence of the other defendants for the purpose of liability apportionment.

Trial Testimony and Expert Specialties

Medical Experts

During the two-week trial, each side presented medical experts in support of their respective positions. The plaintiffs’ medical experts consisted of experts in pediatric emergency medicine, neurology, and neurosurgery. The experts opined that the pediatrician’s office failed to properly diagnose Bradley’s ear infection. Furthermore, the experts testified that the lab work indicated markedly abnormal results consistent with a bacterial infection. Therefore, the lost results caused a delay in the timely diagnosis and treatment of the infection.

The hospital did perform a CT scan, which immediately found the infection. However, at that point, the infection had spread, and it was too late to treat it with antibiotics. This resulted in the need for major brain surgery. Bradley’s permanent brain damage was due to the severity of and complications related to the infection, which was deep within his brain. The experts also testified that the failure of the hospital to relieve intracranial pressure resulted in brain stem herniation.

Life Planning and Economics Experts

Being that Bradley was so young at the time of the incident, the plaintiffs also presented experts in the fields of life planning and economics to calculate the damages of a lifetime of future medical costs. If Bradley is provided the best possible care, the neurology expert opined, he will be able to live to an estimated age of 65 years old, approximately 20 years less than he normally would have been able to. His life span can be shortened due to being at risk for many medical complications associated with his condition, such as pneumonia, infection, aspiration, and others. A life care planner testified Bradley’s estimated costs of living are around $17 million, with $19 million in future medical costs.

Athens Medical Laboratory denied negligence and offered the testimony of its own expert in pediatrics. The expert testified that the pediatrician’s office and nurse practitioner were responsible for following up on the missing lab results. Furthermore, the expert opined that even if the lab results had been provided sooner, it would not have significantly changed Bradley’s care and treatment.

Who Won the Case?

The jury found in favor of the plaintiffs and found that Athens Medical Lab acted negligently. However, the jury also determined that University Medical Associates and Staci James were negligent in failing to obtain the STAT lab results and that Nationwide Children’s Hospital was negligent in failing to provide intracranial pressure monitoring. Therefore, the jury apportioned 50% liability to Athens Medical Lab, 15% to University Medical Associates, 5% to Nationwide Children’s Hospital, and 30% to James. The jury did not find Dr. Zidron acted negligently.

The jury awarded $22 million for life-care costs, $20 million in compensatory damages, and $3.5 million for past medical expenses.

Expert Specialties

The plaintiff retained expert witnesses in:

• Pediatric Emergency Medicine
• Life Care Planning
• Neurology
• Neurosurgery
• Economics

The defendants retained expert witnesses in:

• Pediatrics

Key Takeaways

The Metts case is only one of the 12 million cases per year of diagnostic errors. It is estimated that 40,000-80,000 people die each year in the United States from a medical professional’s failure to diagnose.

In the context of medical malpractice litigation, it is critical for plaintiff attorneys (as well as defense attorneys) to have a clear understanding of all aspects and stages of the plaintiff’s care, from initial complaint to subsequent treatment. As proximate causation becomes more complex as a patient is seen by multiple doctors or undergoes different treatments, it is important to pinpoint when and how the patient was first diagnosed in order to determine whether that diagnosis was proper or delayed.

The Metts case proves how even a relatively short delay of mere days can have deleterious consequences that could have otherwise been avoided.