“Face the Jury” is a podcast dedicated to all issues involving medical malpractice – what it is, how to spot it and how to prevent it while protecting yourself and your family.
Today, Laura Shamp returns to Face the Jury to continue our conversation about our shared $75M medical malpractice verdict – the largest in Georgia history. In Part 1, we talked to Laura about Jonathan Buckelew’s “locked-in” case and the preparation that goes into a years-long case. Today, we round out that discussion.
Lloyd: Laura, you told me that Jonathan Buckelew’s case was one of the most impactful cases in your career. I’d like you to talk about it, how the trial went and how it impacted you.
Laura: When you have a catastrophically injured patient like Jonathan, you feel a great responsibility to that patient to get them justice. I certainly felt that burden trying this case. It puts a lot of pressure on you as a lawyer.
Half of my clients are wrongful death cases where the patient is deceased. This case was highly complicated and intellectually challenging for my team and me. We had to understand the medicine and then present the details in a way a layperson could understand.
I have read hundreds of articles about stroke and stroke care. There are a lot of different kinds of strokes, and the type in this case is probably the worst. One of the defense arguments was that this was such a bad stroke that no intervention would have made a difference even if our doctors had done the right thing. The difficulty from a lawyer’s perspective, we had to understand all of this and then present it simply. Lloyd, you help with this.
Lloyd: When you look at the medical language as a lawyer, you can get pulled into the terminology and get kind of proud of yourself for being able to speak the same language as doctors. But our job as lawyers is to simplify things and make them accessible to the jury.
Simple analogies connect with jurors. In this case, a stroke is like a clog in your bathroom pipe. When there’s a clog and the water is still running because you can’t turn the water off, bad things will happen the longer that clot stays in place. You’re going to flood your kitchen, the floor and all those things. It’s essential to get the clog out as quickly as possible.
Two things can pull a clot out. TPA clot buster, or a thrombectomy, is a tool that weaves through the arteries into the brain to remove a clot. We brought in a bottle of liquid drain and a plumber snake to demonstrate the analogy. Using those kinds of examples helps the jury demystify the medicine. Fortunately, we had Dr. Raul G. Nogueira, former head of the stroke unit at Grady hospital, at trial. Can you speak about the role he played at trial?
Laura: You try and find that balance between an expert witness well-credentialed in their field and an expert in the trenches. You need somebody doing this work instead of writing and researching as an academic.
Dr. Raul Nogueira, a leading expert on basilar artery occlusions at Grady, was that expert for us. He was willing to step in and give us causation testimony. He testified to 400 articles in the medical literature, and he clinically treats these kinds of patients.
If Mr. Buckelew had been diagnosed, it would likely have been Dr. Nogueira who would have done the necessary procedure on him. He did a great job of letting the jury know that John’s life could have been different had the appropriate interventions been undertaken promptly.
Lloyd: He’s a natural teacher and was able to help the jury understand the medicine but also the data. He is a pioneer in much of the literature, and research showing early prevention would have made a significant difference in this case.
Laura: There was no treatment for this stroke 20 years ago. Due to Dr. Nogueira’s work, physicians have started treating these kinds of strokes, and they have good outcomes if treated promptly.
Lloyd: What parts of the trial will stick with you forever?
Laura: There was an army of defense lawyers, and we had a lot thrown at us. As a lawyer, you call upon your best self to focus and keep going despite multiple motions and evidentiary issues thrown at you. You have to be a storyteller and a lawyer.
Lloyd: Tell us about John’s testimony.
Laura: We explained all the medical evidence and how much it costs to take care of him. We brought John in as our last witness, and he can only speak by lifting his eyes at the letter of the word someone else spells. So, we set him in front of the jury and asked him some questions. It was a beautiful moment because his mother was listing the letters, and the jury dialed in on him.
Another moment that completed everything was the podcast moment.
Lloyd: I’ll set the scene. The emergency room doctor had gone back in and changed his medical record after he learned Jonathan had experienced a terrible stroke. Laura got the audit trail data, and the information revealed this change. The ER doctor is questioned by his attorney, and explains that it is perfectly fine for ER doctors to change their notes.
We did our research and learned that this particular medical expert had done a podcast on medical-legal issues. I had a clip of his podcast where he explains altering medical notes is the death blow to your defense.
The beauty of a trial is to reveal the truth, and the truth was this doctor came across like a paid hired witness willing to say anything.
Laura: You’ve got to remember that podcast came out three months before the trial. You can’t just rely on the research you did on the witness a year ago because there’s more out there.
Lloyd: For any lawyers that are listening, I would recommend and urge that Sherlock Holmes’s instinct to keep digging. Be diligent and look under every stone.
Are there any other moments that stand out for you?
Laura: The defendants brought in a witness to say that John, who had already lived seven years from the event in 2015, was only going to live nine more years. I had gotten some information about inconsistent and damaging things that the witness had said in the past from other transcripts.
As I started to ask him questions, he began to shake. I think he lost all credibility in front of the jury, which was an important point. We needed the jury to understand that they needed to give enough money to help John through the rest of his life, not for nine years but what we said it would be – 33 more years.
Lloyd: The defense said, “give him less money because he will probably be dead from what we caused.” It was a really ugly argument.
Laura: Another thing was there were so many defendants at odds with each other. It’s uncommon in the medical malpractice world.
Lloyd: One aspect I will never forget is how resilient you were. You received a lot of little barbs and not-so-subtle attacks because you’re a woman. You endured little sexist comments and mockery. I was impressed with your poise.
Laura: It’s a challenge not to let yourself get drawn down in the fights with opposing counsel that distract you from the jury. Occasionally during the trial, Lloyd would send me notes that said, “chill, we got this.” A lesson for young lawyers to learn is that you have one audience – the jury.
Lloyd: When you’re attacked, you feel you need to respond. It’s human nature. It’s easy to lash out, and that is the wrong thing to do in court because you’re right; the jury is the audience.
Talk to us about how the jury chose to stick around and talk to us afterward.
Laura: When selecting a jury, you just see these people you’re plucking out of their lives. You tend to think, I’m asking a lot of them, but this jury came on time every day for three weeks.
You must respect their time when you’re putting on your case.
I encourage every person I meet that when you’re called for jury duty, go with the heart that says what I’m doing is important. It’s an honor to serve your country, community, and state.
Lloyd: The jury duty experience seems to impact the jurors as much as it does the clients and the lawyers. It ignites the belief in the human condition. One gentleman who moved from India a couple of years prior told me that he had learned more about this country in the past three weeks than in all the years he had lived here. That is a moment I will cherish.
The fight isn’t over yet. There are still some post-verdict activities. What is next for Jonathan and his family?
Laura: We’ve asked for prejudgment interest, and we will have a hearing on whether we get interest in addition to the final verdict. Then we’re going to start the appeal and collection process. It’s not over, but this is step one, which was a victory.
Lloyd: It’s been an honor to work with you on this case and have you on my podcast. I look forward to working on this case and getting a final decision.
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