Georgia affirms 75 million verdict against EM doc

[Brigade4Radiant]

Georgia Court of Appeals Affirms Record Verdict in “Locked-in Syndrome” Case

The Georgia Court of Appeals has affirmed a landmark $40 million medical malpractice verdict against Dr. Matthew Womack, an emergency room physician at North...

www.businesswire.com

Ridiculous how is he going to get 75 million he has more debt than assets and this is I. Georgia too.

Hopefully the tort reform law that Georgia just passed prevents future cases like this

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[RustedFox]

- and the chiropractor who, ahem, injured the man?

 

[HoosierdaddyO]

Can someone summarize why the ER doc and radiologist were held liable. Was CT angio not ordered, was the read wrong if they were ordered? What’s the learning point here besides getting out of medicine and especially emergency medicine?!

 

[Jabbed]

CT angio ordered, showed age indeterminate dissection. ED doc talked to stroke neuro— this was documented by scribe and then attending modified the note the next day to include that he discussed the chiropractic manipulation and age indeterminate dissection. That seemed to be a big sticking point in the case as stroke neurologist was found not at fault as he denied being told this information. For some reason they thought it was meningitis, so he was LP’ed and parked in the ICU. MRI next day showing completed brainstem stroke.

 

[Jabbed]

Realistically what do you do if you’re the doc in this case? I mean there’s really no point in ever working again as you will never pay this off.

 

[xaelia]

Ridiculous how is he going to get 75 million he has more debt than assets and this is I. Georgia too.

Some people win the lottery, some people lose it.

Product of an entirely broken system – along with the losers who stood up there and declared this guy was gonna recover fully if treated acutely.

 

[Mount Asclepius]

It’s not likely to occur for you individually, but because of scenarios like this I refuse to live/work in a state without caps. Vote with your feet.

 

[cyanide12345678]

It’s not likely to occur for you individually, but because of scenarios like this I refuse to live/work in a state without caps. Vote with your feet.

Yeah i don’t understand why people don’t consider malpractice laws when they decide to pick jobs.

When my wife and i moved after training was finished, we only considered malpractice reform, cost of living, and job opportunities. That’s it.

 

[WhatJobDoIPick]

Yeah i don’t understand why people don’t consider malpractice laws when they decide to pick jobs.

When my wife and i moved after training was finished, we only considered malpractice reform, cost of living, and job opportunities. That’s it.

Because there's more practical considerations besides tort reform.

Proximity to family etc is a bigger consideration than avoiding the rare lightening strike of a jackpot lawsuit.

 

[WhatJobDoIPick]

Realistically what do you do if you’re the doc in this case? I mean there’s really no point in ever working again as you will never pay this off.

Without knowing the ins and outs by consulting with a lawyer:

1) Declare Bankruptcy (retirement accounts are protected)

2) Pray that I'm in a state with some kind of homestead exemption

3) probably have to sell house

4) move into mom's basement?

 

[WhatJobDoIPick]

Truly a garbage field.

EMTALA says we must give all this free care, which is not compensated on the back end. Yet we are given no protections in its provisioning.

Trash.

Reason #385 not to do emergency medicine,.or medicine at all.

 

[AlmostAnMD]

I am obviously not a lawyer, but I thought these amounts could be knocked down on appeal? I've seen that happen before, anyway, since it's obvious this will never be paid.

OTOH, it's not worth 75 mil but editing your chart a day later to say you talked to the stroke neurologist about the chiropractor is no bueno. Even if he did and wanted to put it in, it has an air of admission of guilt to edit the chart after the fact. He would have been better off just saying he did and not documenting it and making it a he said/she said thing....

 

[dozitgetchahi]

Without knowing the ins and outs by consulting with a lawyer:

1) Declare Bankruptcy (retirement accounts are protected)

2) Pray that I'm in a state with some kind of homestead exemption

3) probably have to sell house

4) move into mom's basement?

What really happens in these situations is this:

1) regardless of the dollar amount of the judgment, these cases are often still settled for the maximum amount of the malpractice policy.

2) if the hospital was named, they will go after the assets of the hospital

3) doc moves to a state like Florida or Nevada, where it is much more difficult to go after assets. Recall that OJ Simpson moved to Florida after losing his civil suit for the murders; he never paid the vast majority of the judgment despite the other side trying every trick in the book to go after his assets.

 

[Jabbed]

I am obviously not a lawyer, but I thought these amounts could be knocked down on appeal? I've seen that happen before, anyway, since it's obvious this will never be paid.

OTOH, it's not worth 75 mil but editing your chart a day later to say you talked to the stroke neurologist about the chiropractor is no bueno. Even if he did and wanted to put it in, it has an air of admission of guilt to edit the chart after the fact. He would have been better off just saying he did and not documenting it and making it a he said/she said thing....

This was the appeal.

The initial chart was created by a scribe. My understanding is that he was reviewing it next day.

 

[AlmostAnMD]

This was the appeal.

The initial chart was created by a scribe. My understanding is that he was reviewing it next day.

Obviously I didn't read it, lol

well

that sucks

if he's out of options this is pretty horrid. Don't practice in Georgia!

 

[Brigade4Radiant]

- and the chiropractor who, ahem, injured the man?

It is thought that he settled.

The doc is now trying to sue his malpractice company for not settling


While the doctor absolutely was not grossly negligent, there is a pretty good argument that he made some poor decisions that made him look dishonest in the eyes of the jury, which made them get caught up in their emotions and resulted in this verdict.

If there’s any key MEDICAL learning pearl from this case, it’s that if you suspect vertebral artery dissection, you should do a stroke activation. If there’s a key LEGAL learning point, it’s that you shouldn’t go back and add info to the chart after you find out about the bad outcome.

Case Update: Locked-In Syndrome

This Locked-In Syndrome lawsuit I published a few years ago was already one of the wildest cases I’ve seen, and it just got even crazier.

substacktools.com

 

[WhatJobDoIPick]

This doesn't apply to this case really, but to the senior residents and young attendings 1-3 years out: you want to be on the right side of your group's curve on admissions, imaging and antibiotic administration. Not so far that you're an extreme outlier, but somewhere between 0.1 and 1 standard deviations above the mean. The system will not applaud you for "saving cost" but will crucify you for a bad outcome.

 

[dozitgetchahi]

This doesn't apply to this case really, but to the senior residents and young attendings 1-3 years out: you want to be on the right side of your group's curve on admissions, imaging and antibiotic administration. Not so far that you're an extreme outlier, but somewhere between 0.1 and 1 standard deviations above the mean. The system will not applaud you for "saving cost" but will crucify you for a bad outcome.

This applies across all of medicine.

The system absolutely will not support your efforts to cut costs. At all. It’s rare for me to wish that I hadn’t ordered something, but more common for me to wish that I did.

 

[Porfirio]

Horrible, just all around.

Day one of medicine will be meeting with asset protection lawyer now. Everything will be in a trust out of the Cook Islands.

 

[Janders]

just for others knowledge. If you get towards the end of a malpractice case that may have a blockbuster verdict, you talk to your malpractice co and discuss settling for policy limits. If they refuse and want to go to jury, you get it in writing (they control the decision); then if you lose you sue them to pay all the costs as they didn’t allow you to settle…

 

[WhatJobDoIPick]

just for others knowledge. If you get towards the end of a malpractice case that may have a blockbuster verdict, you talk to your malpractice co and discuss settling for policy limits. If they refuse and want to go to jury, you get it in writing (they control the decision); then if you lose you sue them to pay all the costs as they didn’t allow you to settle…

Will this actually matter?

Can you force them to settle?

What is feasibility of suing? Cost? Time?

 

[Janders]

in many areas you cannot force the malpractice company to settle.

The above tactic is uncommon but has worked (as per my lawyers when this topic came up)

 

[cyanide12345678]

Because there's more practical considerations besides tort reform.

Proximity to family etc is a bigger consideration than avoiding the rare lightening strike of a jackpot lawsuit.

eh…. I’ve traveled so much in my life that honestly it doesnt even matter. Wherever you go, you create your own new friends circle and essentially the equivalent of a ‘family’.

Maybe if a dozen family members Lived in one spot, yeah i would get it. But family is a little over rated - you can create an amazing social circle whenever you go.

My parents were in houston and my brother was in Austin - the EM texas job market was so **** that there were barely any jobs in texas when i looked during covid days. Indiana on the other hand, had openings at every place i talked to. My sister is in boston and that place was automatically out because of **** cost of living.

Id take job security, low volume cushy job with decent income over proximity to my parents 🤣

I can visit them if i really really really feel the need to see them.

Most of the time i dont even feel the need to see them So there’s that too 🤣

 

[Apollyon]

I told my spouse, in the, as stated above, lightning strike situation, if I ever get the locked in syndrome, just let me die.

 

[JacobMcCandles]

I told my spouse, in the, as stated above, lightning strike situation, if I ever get the locked in syndrome, just let me die.

But not before she gets a $75M judgement.

 

[cyanide12345678]

I don’t understand how they proved harm.

The guy comes in with locked in syndrome. Was tpa or thrombectomy going to magically make him completely normal? Very unlikely.

Isn’t the most likely outcome exactly the outcome that the patient got.

If anything the chiropractor clinic is the only one to cause harm. Everyone else just couldn’t fix the harm that was already done.

It sucks that you don’t really need malpractice/negligence to get awarded a lawsuit, you just need a bad outcome.

Why do Americans think that a jury of essentially uneducated individuals can determine complex medical decision making? A jury/common public is too stupid to make determination of adequate medical care.

 

[RustedFox]

I don’t understand how they proved harm.

The guy comes in with locked in syndrome. Was tpa or thrombectomy going to magically make him completely normal? Very unlikely.

Isn’t the most likely outcome exactly the outcome that the patient got.

If anything the chiropractor clinic is the only one to cause harm. Everyone else just couldn’t fix the harm that was already done.

It sucks that you don’t really need malpractice/negligence to get awarded a lawsuit, you just need a bad outcome.

Why do Americans think that a jury of essentially uneducated individuals can determine complex medical decision making? A jury/common public is too stupid to make determination of adequate medical care.

I had a whole thread on this.

It was something like: "My Last Lawsuit (or) RustedFox and Morty."

 

[WhatJobDoIPick]

I don’t understand how they proved harm.

The guy comes in with locked in syndrome. Was tpa or thrombectomy going to magically make him completely normal? Very unlikely.

Isn’t the most likely outcome exactly the outcome that the patient got.

If anything the chiropractor clinic is the only one to cause harm. Everyone else just couldn’t fix the harm that was already done.

It sucks that you don’t really need malpractice/negligence to get awarded a lawsuit, you just need a bad outcome.

Why do Americans think that a jury of essentially uneducated individuals can determine complex medical decision making? A jury/common public is too stupid to make determination of adequate medical care.

You don't have to prove harm.

Bad outcome + sympathetic plaintiff = lawsuit

 

[xaelia]

Here's more reading, if it would please the court:

BUCKELEW v. WOMACK (2025) | FindLaw

Case opinion for GA Court of Appeals BUCKELEW v. WOMACK. Read the Court's full decision on FindLaw.

caselaw.findlaw.com

 

[xaelia]

Here's more reading, if it would please the court:

BUCKELEW v. WOMACK (2025) | FindLaw

Case opinion for GA Court of Appeals BUCKELEW v. WOMACK. Read the Court's full decision on FindLaw.

caselaw.findlaw.com

Oh god ... what a great help from the defense expert:

"Over objection, Buckelew then impeached Dr. Delaney with a clip from a podcast that he co-hosted, “E.R. Cast,” “Straight Talk About Emergency Medicine.” In the 48-second clip played for the jury, Delaney said that adding or changing a plaintiff's medical record is a “death blow to any defense” if the medical provider is subsequently alleged to have committed malpractice. Dr. Delaney explained on redirect that the podcast was “med-u-tainment” ..."

 

[HemorrhagicShock]

The only lesson learned here is don't practice in Georgia

Let that state burn when it comes to quality physician care

 

[cyanide12345678]

You don't have to prove harm.

Bad outcome + sympathetic plaintiff = lawsuit

And that’s basically the entire problem with the health care system.

My one lawsuit was a dude who left ama with nstemi and ekg changes, comes back the next day, gets admitted, dies over night while waiting on cath in AM. Code blue. I responded to code as ICU resident, and essentially got named for existing and responding to code.

Family was suing because basically bad outcome.

Took 1 year to get dropped from the case even though i barely did anything - cardiology fellow was running the code when i arrived.

I hate the malpractice situation in the US.

 

[RustedFox]

The only lesson learned here is don't practice in Georgia

Let that state burn when it comes to quality physician care

Wasn't that long ago that Georgia was lauded as a medicolegally great place to be for docs .

My how things have changed .

 

[Brigade4Radiant]

For this case the plaintiff attorney basically got the doc to admit on stand that not communicating with the neurologist. I guess I should leave this forsaken state. However Georgia passed a new tort reform bill.

Notice how police are never held to large sums of money like us or insurance or pharmaceutical companies

 

[southerndoc]

Georgia has a 25% cap on garnishing wages. They can never take more than 25% of his wages even if he has 20 judgements against him with the same dollar amount.

Reading from online sources, a couple of points:

1. The doc was alleged to have changed his note after he knew the outcome (the day after),
2. He stated he communicated to the neurologist the CTA findings, but the CTA read wasn't available yet and he said the neuroradiologist never called him,
3. Georgia has a gross negligence clause. The defense got him to answer "yes" to the question "would it be grossly negligent to not communicate the CTA findings to the neurologist" (paraphrasing as it's been a while).

The combination of things is what hosed him. I feel sorry for the guy. Common mistakes that could happen to any of us.

 

[WhatJobDoIPick]

Georgia has a 25% cap on garnishing wages. They can never take more than 25% of his wages even if he has 20 judgements against him with the same dollar amount.

Reading from online sources, a couple of points:

1. The doc was alleged to have changed his note after he knew the outcome (the day after),
2. He stated he communicated to the neurologist the CTA findings, but the CTA read wasn't available yet and he said the neuroradiologist never called him,
3. Georgia has a gross negligence clause. The defense got him to answer "yes" to the question "would it be grossly negligent to not communicate the CTA findings to the neurologist" (paraphrasing as it's been a while).

The combination of things is what hosed him. I feel sorry for the guy. Common mistakes that could happen to any of us.

The more I wade through the toxic sludge that is US medicine, the more I realize that except for a few grossly negligent cases, most of this comes down to "you were the unlucky SOB that picked up this chart."

 

[cyanide12345678]

The more I wade through the toxic sludge that is US medicine, the more I realize that except for a few grossly negligent cases, most of this comes down to "you were the unlucky SOB that picked up this chart."

But to completely have your entire life screwed over, needing to declare bankruptcy Ava then essentially most likely paying 25% of future wages in perpetuity to some random person.

This is so depressing. Poor guy.

 

[Jabbed]

Georgia has a 25% cap on garnishing wages. They can never take more than 25% of his wages even if he has 20 judgements against him with the same dollar amount.

Reading from online sources, a couple of points:

1. The doc was alleged to have changed his note after he knew the outcome (the day after),
2. He stated he communicated to the neurologist the CTA findings, but the CTA read wasn't available yet and he said the neuroradiologist never called him,
3. Georgia has a gross negligence clause. The defense got him to answer "yes" to the question "would it be grossly negligent to not communicate the CTA findings to the neurologist" (paraphrasing as it's been a while).

The combination of things is what hosed him. I feel sorry for the guy. Common mistakes that could happen to any of us.

So garnished wages + taxes = 50% take-home pay.

Imagine 50% of your income just going to everyone else.

 

[JacobMcCandles]

So garnished wages + taxes = 50% take-home pay.

Imagine 50% of your income just going to everyone else.

Kind of sounds like a divorce.

 

[TooMuchResearch]

Sounds like an excellent opportunity to leave the country.

 

[Porfirio]

Radiologist too. Was it a delay in radiology report?

 

[Brigade4Radiant]

Divorce is worse they can't take his primary car or house or touch his 401k. Also garnishing wages for civil cases is expensive and time consuming. In the end I doubt he pays anything.

 

[cyanide12345678]

Divorce is worse they can't take his primary car or house or touch his 401k. Also garnishing wages for civil cases is expensive and time consuming. In the end I doubt he pays anything.

Radiologist seems to have assets. That guy/gal is screwed.