Hospital Staff’s Failure to Act Results in Stroke Victim’s $29M Award

Case Overview

Case Name: Khary Roberts, Kimberly Roberts, as Co-guardians of Person and Property of and Carlyle Roberts v. New York City Health and Hospital Corporation, No. 507744/14

Case Type:

• Medical Malpractice – Brain Injuries; Failure to Test; Delayed Diagnosis; Delayed Treatment; Failure to Communicate

Injuries:

• Brain – stroke; brain damage; subdural hematoma; internal bleeding
• Other – seizure; craniotomy; infarction; physical therapy
• Surgeries/Treatment – tracheostomy/tracheotomy
• Mental/Psychological – dementia
• Paralysis/Quadriplegia – hemiplegia; paralysis, partial

Plaintiff Attorney(s): Robert Miklos; Silberstein, Awad & Miklos, P.C.; for Carlyle Roberts

Defense Attorney(s):

• Charles K. Faillace; Vigorito, Barker, Patterson, Nichols & Porter, LLP
• Natalie Socorro; New York City Health and Hospitals Corp

Case Outcome: Verdict-Plaintiff

Award Amount: $28,057,287.84

Actual Award: $29,361,117.15

What Happened?

Carlyle Roberts, a retiree, went to Brooklyn’s Kings County Hospital Center on June 11, 2013 for ankle and head injuries. Doctors promptly operated on his ankle condition. However, the medical team identified that Roberts had suffered a hematoma from his head injury. The medical team extended his hospital stay because of Roberts’s confusion, disorientation, and other symptoms connected to the hematoma. His confusion and disorientation persisted for 41 days.

Subdural Hematoma

Roberts was suffering from multiple subdural hematomas. This condition commonly occurs when someone has a severe head injury that causes a blood vessel to break within the confines around the brain. When this happens, the seeping blood collects between the dura, the outer layer of connective tissue that protects the brain, and the middle protective layers called the arachnoid layers. The pool of blood can damage tissue by pressing against the brain. A subdural hematoma can be mild or life-threatening. Older adults are at elevated risk for a subdural hematoma even when mild because older veins are more likely to tear.

On the morning of July 23, 2013, the physiatrist was treating Roberts as part of his rehabilitation. At this time, the physiatrist noted that Roberts was so sleepy that he couldn’t remain in an upright, seated position. However, the physiatrist did not report this to Roberts’s doctor. That same day, Roberts began slurring his speech. Four hours later, the hospital performed a computerized tomography (CT) scan on his brain. The scan showed that one of his hematomas was dangerously expanding. The medical team immediately performed a craniotomy to evacuate the hematoma. Unfortunately, the hematoma had already caused a stroke. Roberts had seizures in the surgery’s aftermath. His condition was such that doctors also cut a hole in the front of his neck for assistance with breathing.

The Aftermath

After the stroke, Roberts had permanent brain damage. Paralysis set into his left arm and left leg, requiring him to use a wheelchair. Roberts also suffered residual dementia. Additionally, this post-stroke condition required over a year of hospital stay for inpatient rehabilitative therapy including physical therapy. When he was able to go home, his guardians arranged for an aide to assist him with his daily activity. However, Roberts rejected the aide’s help. As a result, his son replaced the aide. The plaintiff’s counsel maintains that a nurse is what he needs.

Allegations and Testimony

Plaintiffs’ Allegations in the Brain Injury-Related Lawsuit

Roberts’s children, Khary Roberts, and Kimberly Roberts, acting on behalf of their father as his guardians, filed a medical malpractice lawsuit concerning the brain injury against Kings County Hospital Center’s operator, New York City Health and Hospitals Corporation. The guardians alleged that the hospital staff’s failure to appropriately treat his subdural hematoma was malpractice. Moreover, the plaintiffs asserted that New York City Health and Hospitals (NYCHH) was responsible for the staff’s actions.

The plaintiffs contended that if the NYCHH had timely addressed Roberts’s growing hematoma then he would not have suffered the life-changing, ongoing post-stroke symptoms. The Roberts family pointed out that for 41 days after his hospital admittance and initial hematoma detection, he exhibited persistent confusion and disorientation. The plaintiffs also alleged that the symptoms should have led to an immediate CT scan that could have allowed for timely surgery to prevent permanent brain damage.

Furthermore, even when a Magnetic Resonance Imaging (MRI) scan suggested a progressing hematoma on July 2, 2013, the plaintiffs allege that the hospital failed to properly respond with further radiological studies.

The plaintiffs alleged two specific staff transgressions on July 22 and July 23, 2013. First, the NYCHH physiatrist should have immediately reported her observations about Roberts’s extreme sleepiness and inability to stay in a seated position when she observed them on July 22. Second, the plaintiff’s counsel claimed that a nurse observed extreme lethargy and slurred speech in Roberts on July 23. However, the nurse failed to urgently inform his doctors. Instead, four hours went by before the hospital performed a CT scan on Roberts and intervened with a craniotomy. This allegedly caused the needless progression of Roberts’s injuries.

The Defense Response

A neurosurgeon expert for the defense believed the MRI scan did not suggest a progressing hematoma.

The defense also claimed that the physiatrist hadn’t failed to report symptoms suggesting a progressing hematoma or a neurological problem. The defendant maintained that Roberts’s sleepiness could have been the result of three hours of physical therapy. Additionally, the defendant argued that Roberts consuming a meal could have contributed to his symptom.

In addition, the defendant asserted that there was no issue of timely treatment of Roberts on July 23. The defense contended that Roberts’s condition did not worsen during the four hours before radiological staff performed a CT scan. The defendant also proffered medical literature in this area, which suggested that time isn’t a factor in subdural hematoma treatment. The defense also disagreed with the plaintiffs’ claim that earlier surgical intervention would have lessened Roberts’ brain damage.

Who Won the Brain Injury Lawsuit?

A 6-0 jury found that the hospital’s staff failed to properly address the indications of the July 2 MRI scan. Furthermore, the fact-finders agreed with the plaintiffs that the hospital should have performed a CT scan on Roberts on July 22. They found that the defendant did not timely perform the CT scan.

The jury awarded Roberts $28,057,287.84 in damages. Additionally, the jury added the stipulated past medical expenses, making the total recovery $28,384,136.99. The award amount was subject to adjustments for inflation and present-day valuation. As a result, the final recovery in the brain injury lawsuit totaled $29,361,117.15.

Roberts’s damages broke out as follows:

• $6,557,288 personal injury award for future medical cost
• $10,000,000 personal injury award for past pain and suffering
• $11,500,000 personal injury award for future pain and suffering (11.5 years)

Expert Specialties

The plaintiff retained expert witnesses in:

• Neurology
• Economics
• Neurosurgery
• Physical Medicine
• Life Care Planning

The defendant retained an expert witness in:

• Neurosurgery

Key Takeaways

This case reminds medical malpractice lawyers that the proper response to an MRI indicating a possible hematoma is to order further radiological studies. Furthermore, medical staff must promptly report changes in the behavior of patients with subdural hematomas immediately. Then, the medical team can use timely diagnostic tools and properly intervene when necessary to avoid bad outcomes for patients.

Plaintiff lawyers bringing medical malpractice actions should keep in mind that well-qualified, credible expert witnesses are central to proving deviations from medical practice standards. Case outcomes may depend on a specialized expert witness conveying to a jury exactly what the medical standard is for certain medical situations.