$11.7 M verdict against bystander doctor

by Ted Frank on March 24, 2007

A team of doctors at North Fulton Medical Center worked on Josh Coleman’s back surgery in 2003. Dr. Frank Puhalovich had a minor role: “he was only in the operating room for about 10 minutes making sure a technician properly hooked up a monitor that tracks nerve impulses along the spinal [cord] through electrodes attached to Coleman’s head and feet.” But after Puhalovich left, during surgery, the alarm went off: attorneys blame the surgeons’ failure to respond to the alarm in a timely fashion for Coleman’s paralysis. Coleman sued everyone involved, and all the doctors settled, except Puhalovich. So Coleman proceeded to trial against Puhalovich, blamed him also, and a jury awarded $11.7 million. The press coverage gives no indication what the theory of liability is against Puhalovich.

Joshua Coleman, sitting in a wheelchair next to his attorneys, Bill Stone and David Boone, smiled as the verdict was announced after the two-week civil trial.

“Josh is high as a kite right now,” Stone said. “He’s going to have a great weekend.”

(Beth Warren, “Paralyzed man awarded $11.7 million”, Atlanta Journal-Constitution, Mar. 24).

Update: Kevin, MD post with clever title Shotgun yields a jackpot.

{ 8 comments }

1 Anirban 03.24.07 at 1:13 pm

Josh is high as a kite right now,” Stone said

Should we read stone (not Josh)flying like a kite ?typo error ?

2 Ben Glass 03.24.07 at 10:21 pm

The story comes with no facts. How can anyone comment on a story with no facts. Presumably this doctor was defended by high dollar lawyers (probably a team of them) provided by his insurance company.

Buy the transcript…read it.. then make comment

3 Ted 03.24.07 at 11:31 pm

Thanks for taking the time to comment.

It’s untrue the story comes with no facts: I provided the publicly-reported facts. What comment did I make on the story? (That you think the recounting of the facts is adverse comment is surely telling.) Why does a defense by “high-dollar lawyers” innoculate the suit from mention or criticism? I also disagree that one needs to read a full transcript to mention a lawsuit: the AJC surely didn’t read the transcript, and neither will the appellate court judges who eventually rule on the case if it gets to that level.

4 Bill Poser 03.25.07 at 4:32 am

Is it necessary that the jury have found a connection between Dr. Puhalovich and Coleman’s paralysis? Could it be that the surgical team is being treated as a unit, jointly and severally liable?

5 William S. Stone 03.25.07 at 10:24 am

Ted needs to learn that you cannot believe all you read in the papers. Puhalovich admitted he was supposed to go to the OR to check to be sure a technician properly hooked up a monitor that tracks nerve impulses along the spinal [cord], but he never did go do that at the beginning of surgery. Instead, he was off at another hospital seeing other patients while this very dangerous, high risk procedure continued without proper monitoring. He admitted the standard of care required a neurologist to go check the equipment, and the evidence was that one never did that.
Furthermore,the first time he went to the OR was after the alarm critera were reached. The surgeon was under the misapprehension that a blood pressure decrease may have caused the neuro signal loss. Puhalovich admitted he failed to review the neuro monitoring record and compare it to the anesthesia record which would absolutely have proved that there was no blood pressure problem, and the signal loss was due to spinal hardware manipulation during surgery. The medical records made on the day of surgery proved that Puhalovich concurred with the erroneous diagnosis of signal loss and proceeding with the surgery despite signal loss. He was there to guard the spinal cord, and he failed to do his job in conformity with the standard of care for neurologists generally under similar circumstances. He was part of a surgical team whose members were required by the standard of care to communicate with each other and share all available information. He failed to do that.
As a result, Josh Coleman is paralyzed for the next 54 years from the waist down, has no bladder, bowel, or sexual function. His past medical bills were stipulated to be almost $900,000. The present value of his future cost of care was proved to be almost $7 million. the present value of his future earning loss was proved to be $1.6 million. The defense put on no evidence challenging damages.
For the 9 minutes Puhalovich was in the OR doing nothing he charged Josh $530.00. One of Puhalovich’s experts charged $2,000 per hour for his testimony, and finally ended up admitting that failure of the surgeon, the anesthesiologist, and the neurologist to have a collaborative discussion to examine all available information and come up with the most probable diagnosis of neuro signal loss was beneath the standard of care. He tesitifed that if that had been done, Josh would not have been paralyzed and there would have been no lawsuit for the jury to decide.
It’s real easy to criticize lawyers and juries when you are completely ignorant of the facts. This jury was a very well eductated jury comprised mostly of busines people and educators. The deliberated for 1-1/2 days before reaching a verdict. Puhalovich’s insurance company chose to evade responsibility and took his chances. Bad choice when the patient has a good case.

6 NE2d 03.25.07 at 11:38 am

Bill,

The only thing “necessary” is that the jury felt sorry for the plaintiff and thought he should be given money. A two-week trial allows the plaintiff to sufficiently bury the jury with so much medical and legal information that they can’t possible understand, leading them to just go with their gut.

7 Ted 03.25.07 at 3:08 pm

I thank Mr. Stone for his input on the record.

As my post indicated, the press coverage was incomplete; if they got the story wrong, it wouldn’t be the first time a newspaper account did so, though it is substantially identical to the Morelaw account.

I doubt that Mr. Stone’s account is entirely complete, either, as the insurance company is unlikely to have gone to trial if they had no rebuttal to the open-and-shut case of malpractice Mr. Stone portrays. It would be interesting to see what Mary Katherine Greene’s view of the case is.

8 Deoxy 03.26.07 at 10:39 am

Mr. Stone,

Assuming, for the sake of argumnt, that everything you said is true, this is STILL the wrong outcome; you stated that it was due to the failur of the team to have proper communication, etc, which would lend blam to the other surgon’s involved. Since they settled, then the damages should have ben reduced by the amount settled upon instead of all being placed on th person who dared to defend himself, with the settlements all being gravy.

This is indeed a bad thing to happen to someone, and it would appear that there was a medical error made (I don’t claim that doctors ar perfect), but even granted those things, I STILL find this outcome to be unjust.

Great system we’ve got here. And that’s giving you the benefit of the doubt on everything you said (which, as Ted pointed out, seems highly unlikely).

There will presumably be offset of the actual amount of settlement from the final damages award, though that does not change the residual unfairness Deoxy describes of being held 100% liable for the remainder. — TF

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