Locked-In Syndrome Malpractice Case Ends With $75M Verdict Against Docs

Locked-In Syndrome Malpractice Case Ends With $75M Verdict Against Docs

Jurors handed down a $75 million verdict against two Georgia physicians, after finding them responsible for the “locked-in” paralysis one of their patients suffered during a catastrophic stroke.

Thursday’s award includes $29 million in medical expenses and $46 million in non-economic damages for Jonathan Buckelew, who suffered profound brain damage following a 2015 stroke. The incident, which occurred after a chiropractic adjustment, has left Buckelew with “locked-in syndrome,” in which he is unable to move any part of his body but his eyes, while his cognitive faculties remain intact. 

The Fulton County State Court jury attributed 60% of the fault to emergency room physician Dr. Matthew Womack and 40% of fault to radiologist Dr. James Waldschmidt. Jurors cleared other medical professionals who treated Buckelew, including neurologist Dr. Peter Futrell, physician assistant Christopher Nickum, and the intensive care unit nursing staff of Roswell, Georgia’s North Fulton Regional Hospital. Jurors also found Womack was acting as an independent contractor at the time of the incident and rejected a follow-up claim that Womack pursued a frivolous defense in the case. 

Jonathan Buckelew was thirty-two when he collapsed during an October 2015 chiropractic neck treatment and was taken to North Fulton Regional Hospital. Buckelew’s attorneys contend that, although imaging performed soon after his arrival indicated he was suffering a brain stem stroke, medical professionals failed to accurately diagnose or treat the condition until the next day, causing his catastrophic paralysis.

The trial focused on whether the healthcare professionals who treated Buckelew following his collapse met the applicable standards of care and whether any treatment would have prevented his paralysis. Meanwhile, the specifics of the claims and defenses involved left some defendants at odds with one another during the three-week trial. 

During closing arguments, Buckelew’s attorney, Shamp Silk’s Laura Shamp, argued that miscommunication and hospital rule violations caused key delays in accurately diagnosing and treating the stroke. 

Shamp told jurors ER doctor Womack knew Buckelew had symptoms of a stroke. But she said he failed to tell neurologist Futrell that Buckelew had a chiropractic neck adjustment – which is a stroke risk – or effectively communicate the results of imaging. Shamp added Womack later altered medical records when he learned of Buckelew’s true condition. Meanwhile, she said, radiologist Waldschmidt admitted that he missed seeing the stroke when examining imaging.

Further, Shamp argued, breakdowns in communication between those and other defendants all led to Buckelew’s paralysis. “The conversations that you heard evidence about lasted one minute; two minutes; 30 seconds,” Shamp said. “This…literally life-threatening, important information was communicated in seconds, when there was a person that everyone acknowledges was very sick.”

But Womack’s attorney, Hall Booth Smith’s John Hall, argued that evidence showed Womack properly ordered imaging and conveyed Buckelew’s background when consulting with other professionals, including neurologist Futrell. 

“[Womack] did what a reasonable emergency room physician in [those] circumstances, managing a patient load, going through that night… would do,” Hall said. “He met the standard of care.”

Radiologist Waldschmidt’s attorney, Huff Powell Bailey’s Scott Bailey, told jurors evidence showed his client read Buckelew’s imaging with an eye to answering the specific question of whether one of Buckelew’s arteries was torn. And Bailey argued Waldschmidt effectively communicated that tear, which other providers could have linked to a stroke. Reminding jurors of testimony comparing a stroke to a forest fire, Bailey said, “[Waldschmidt’s] job is not to go down there and put [the fire] out. His job is to identify the smoke, and he did that.” 

Meanwhile, neurologist Futrell’s attorney, Weathington’s Paul Weathington, argued Womack never told his client about the chiropractic neck adjustment preceding Buckelew’s collapse or of a specific type of imaging Womack ordered that would have tipped Futrell off concerning a stroke. Weathington added that changes Womack made to medical records to indicate he told Futrell that information was incorrect.

“We’re in this case, folks, for one reason: because this note [by Womack] got changed,” Weathington said, adding that Futrell treated Buckelew after the stroke was discovered. “[Buckelew’s parents] never would have allowed Peter Futrell to take care of their son if they thought he was so incompetent that he would ignore information about a chiropractic [adjustment and imaging].”

Physician assistant Nickum’s attorney, Huff Powell Bailey’s Brian Mathis, argued evidence showed his client treated Buckelew with the justified belief that doctors had ruled out a stroke and that Buckelew had meningitis instead.

“You have to ask yourself: were the symptoms that Chris Nickum saw that night consistent with meningitis?” Mathis said. “And the answer is absolutely yes.”

And Huff Powell Bailey’s Dan Huff argued the hospital’s ICU nurses properly recorded changes in Buckelew’s condition and conveyed that information to Nickum. He further contended there was no evidence that Buckelew’s outcome would have changed if nurses had immediately relayed changes in Buckelew’s condition to physicians. 

“No person testified in this case that, had a doctor been called… they would have come in and done something different,” Huff said. “There’s no testimony about that.”

Causation played a significant role in the case, with defendants pointing to evidence that Buckelew’s stroke was so severe his outcome would not have changed regardless of when he was treated for the condition. “The proximate cause of this event was the [non-party] chiropractor doing the manipulation when he had a two-week history of headaches,” Hall said in his closing. “That chiropractor is solely responsible.”

But Buckelew’s attorney, The Bell Law Firm’s Lloyd Bell, argued that expert testimony showed that time was of the essence in addressing Buckelew’s stroke and that earlier treatment could have led to a better result.

“How many nerve cells died on their watch while Jonathan was in the hospital, not moving, not talking, but looking with terror in his eyes?” Bell asked. “How many brain cells died because they couldn’t get their act together and practice medicine like they should have.”

Spinal Manipulation Can Have Near-Fatal Consequences

The effectiveness and safety of chiropractic adjustments often come under fire. Although post manipulation injuries are not common, they can have near-fatal consequences when they do occur.

Buckelew’s legal team said in a statement that his injuries would have been completely avoided had “the slew of healthcare providers…acted according to the standard of care, caught and treated his stroke earlier, and communicated more effectively.”

On the day of the chiropractic adjustment, Shamp said Axt had documented that Buckelew’s primary complaints — neck pain, a headache, and bouts of blurred vision and ringing in the ears — began after exercise and had continued for several days.

In his closing statement, Womack’s attorney said the “chiropractor is solely responsible” for the patient’s injuries because he performed manipulation despite the patient having a 2-week history of headaches.