D.C. Metro Verdicts

Plaintiff(s):

Tracy M. Smith , 

Estate of Melanie J. Smith (Female, 40 Years)

Plaintiff Attorney(s):

Humes J. Franklin III;
Wharton Aldhizer & Weaver, PLC;
Staunton,
VA,
for
Tracy M. Smith, Estate of Melanie J. Smith ■ Charles F. Hilton;
Wharton Aldhizer & Weaver, PLC;
Staunton,
VA,
for
Tracy M. Smith, Estate of Melanie J. Smith ■ Alexandra Humphreys;
Wharton Aldhizer & Weaver, PLC;
Staunton,
VA,
for
Tracy M. Smith, Estate of Melanie J. Smith

Plaintiff Expert(s):

Bruce Janiak; M.D.; Emergency Medicine; Atlanta,
GA called by:
Humes J. Franklin III, Charles F. Hilton, Alexandra Humphreys ■ Derek Riebau; M.D.; Neurology; Nashville,
TN called by:
Humes J. Franklin III, Charles F. Hilton, Alexandra Humphreys

Defendant(s):

Antonio Baca, 

Stephen D. Turner, 

Augusta Emergency Physicians

Defense Attorney(s):

Allison J. Becker;
Yates McLamb & Weyher;
Raleigh,
NC,
for
Antonio Baca, Stephen D. Turner, Augusta Emergency Physicians ■ John W. Minier;
Yates McLamb & Weyher;
Raleigh,
NC,
for
Antonio Baca, Stephen D. Turner, Augusta Emergency Physicians

Defendant Expert(s):

Mark Sochor;
Emergency Medicine;
Charlottesville,
VA called by:
Allison J. Becker ■ Tomer Feldman;
Emergency Medicine;
Harrisonburg,
VA called by:
Allison J. Becker ■ Richard Zweifler;
Neurology;
New Orleans,
LA called by:
Allison J. Becker

On June 15, 2015, at approximately 8:20 p.m., plaintiff’s decedent Melanie J. Smith, 40, a customer service employee, complained of a severe headache, slurred speech, dizziness, right-sided weakness, nausea and vomiting while at her parents’ home in Highland County. Her mother called 9-1-1 at approximately 8:25 p.m. and told the dispatcher she thought her daughter was having a stroke. An ambulance arrived at the home at approximately 9:05 p.m. Smith was transported to Augusta Health Hospital, in Augusta, by ambulance. She arrived at the emergency room at 10:42 p.m. Emergency room physician Antonio Baca was the physician in charge. On arrival to the emergency room, a nurse examined Smith and diagnosed her with a complex migraine headache. The nurse prescribed Smith medicine for the migraine headache. At 1:30 a.m., on June 16, 2015, a nurse ordered MRI imaging of Smith. The MRI showed Smith had suffered an ischemic stroke. On June 19, 2015, Smith died of complications from the stroke. Tracy M. Smith, as personal representative of the estate of his deceased wife, sued Baca and Stephen D. Turner, another emergency physician who treated Smith after Baca, for medical malpractice and wrongful death. The estate also sued Augusta Emergency Physicians, claiming it was vicariously liable for the negligence of the physicians because they were agents/employees at the time. Prior to trial, Turner was dismissed from the case. The case proceeded against Baca and Augusta Emergency Physicians. The estate’s medical experts opined that Baca should have consulted a neurologist as soon as Smith arrived at the emergency room with a history of stroke symptoms. They opined that Baca departed from the standard of care by not initiating a stroke alert for Smith. According to the experts, if Smith had been given tissue plasminogen activator (tPA) within the essential 4.5-hour window, it would have saved her life. They opined that Smith’s stroke began at approximately 8:20 p.m. at her parents’ home and, therefore, by the time the stroke was confirmed by MRI at 1:30 a.m., it was outside the 4.5-hour window. Baca denied departing from the standard and care. Baca testified that Smith’s neurological exam was normal except for a headache and tingling in her right hand and forearm. He asserted that tPA is a drug with dangerous side effects and is generally not given to patients with mild symptoms like Smith was exhibiting because the risks outweigh the benefits. The defense’s two emergency medicine experts testified there was no reason for Baca to call a stroke alert given Smith’s mild symptoms when she arrived at the emergency room and that a stroke alert should only be called in the event that a patient is experiencing more severe symptoms. They further opined that Baca acted within the standard of care when he evaluated Smith, examined her and ordered a head CT scan. The experts further maintained that complex migraines can cause stroke-like symptoms, which typically resolve on their own, and Smith’s symptoms at the time she was examined in the emergency room were more consistent with a complex migraine than a stroke. The experts additionally opined that Smith was monitored appropriately by Baca and the hospital staff and, when her symptoms returned and switched sides (after the tPA window had closed), Baca appropriately ordered additional testing and consulted a neurologist. Per the experts, even if Smith had been diagnosed with a stroke immediately upon her arrival at the emergency department, treatment with tPA would not have been appropriate. They opined that tPA is a dangerous drug that can cause life threatening side effects and there is no scientific evidence that tPA prevents death in any patient. In fact, the experts testified, tPA has been shown to have no effect on mortality at all. The defense argued that the paramedic who evaluated Smith at her home testified that Smith complained only of headache and tingling on her right side when he examined her. He also testified that he performed nine Cincinnati Stoke Scale tests on Smith during transport to evaluate her for slurred speech, arm drift and facial droop. The paramedic testified that he documented normal results for each of these tests.

Melanie Smith died on June 19, 2015, due to complications from an ischemic stroke. Smith’s husband and two minor children sought damages for their own pain and suffering and loss of society as a result of Smith’s death. The estate also sought damages for loss of earnings as a result of Smith’s death. The defense did not actively dispute the issue of damages.

The jury found Baca negligent and determined that the estate’s damages totaled $3.5 million.

Judge:

W. Chapman Goodwin

Trial Length:

6
 days

Trial Deliberations:

5
 hours

This report is based on information that was provided by plaintiffs’ and defense counsel.