'I Used the Sesame Street Line': The Winning Strategy Behind a $10 Million Texas Verdict

"Testimony in this case uniformly was this was just an ordinary day, they weren't busy," said plaintiff counsel Michael Lyons. "During the course of the case, we proved to the jury there were 26 separate examples of written policies of the hospital that were not followed."

Originally published on Law.com's TexasLawyer.

A jury in Dallas County found the conduct of a hospital’s staff so egregious it awarded $10.1 million to a woman who suffered a spinal cord hemorrhage that left her a paraplegic.

Lead counsel for the plaintiffs, Judy Adams and her husband Richard Adams, said the burden to succeed on a claim of hospital liability for emergency medical services is heightened under the Texas Civil Practice & Remedies Code.

While the burden of proof in most civil cases is a preponderance of the evidence, plaintiffs in these cases must also prove willful and wanton negligence, said plaintiff counsel Michael Lyons of the Dallas firm Lyons & Simmons.

Plaintiff Adams, age 69 at the time of her 2019 disastrous outcome, went to her pain management physician for what should have been a routine steroid injection for back pain, attorneys said. But her doctor, Jon Vu, accidentally nicked a blood vessel, which started the hemorrhaging, plaintiff counsel argued.

What followed, as shown in the medical records, was a series of unconscionable delays, Lyons said.

“You have to show subjective awareness on the part of the hospital of extreme risk to the patient,” Lyons said. “The record shows they proceeded with conscious indifference, anyway.”

‘They Could Never Account for That’

Immediately upon awakening from sedation, Adams complained of pain, court records show. Vu and the staff at his clinic, aware of the extreme risk to Adams’ welfare, administered high concentrations of opioids but did not call an ambulance for two hours, plaintiff counsel argued.

Upon arriving at the Texas Health Presbyterian Hospital-Flower Mound, Adams was triaged in the Emergency Room at 5 p.m.—within about six minutes of arriving. The attending physician, Randhirji Odedra, ordered an immediate MRI; the MRI technologist saw the order nine minutes after it was entered, but allowed two and a half hours to pass before doing the MRI, Lyons said.

At 7:31 p.m., Odedra was informed of the location of the hemorrhage, and called the orthopaedic spine surgeon on duty, Dr. Stephen Tolhurst, to tell him of the need for immediate emergency surgery, he said.

“Hospital policy dictates that patients scheduled for an emergency procedure, it is to start within one hour. They don’t start surgery until 10 p.m.,” Lyons said. “Giving the hospital reasonable benefit of doubt of how long it should take, we told the jury there was approximately three hours and 15 minutes of unreasonable delay.”

The defense tried to argue that two and a half hours to perform an MRI is normal, Lyons said, but hospital records showed other patients that day were moved in and out of the MRI tube within 21 to 23 minutes.

“I used the Sesame Street line. I put Big Bird up there and said, ‘One of these is not like the other.’ They could never account for that,” Lyons said.

It was also noted that there was no wait time for an operating room because two were available, he said, nor was that day unusually hectic for the ER staff.

“Testimony in this case uniformly was this was just an ordinary day, they weren’t busy. During the course of the case, we proved to the jury there were 26 separate examples of written policies of the hospital that were not followed,” Lyons said.

Hospital on Trial

The jury trial took place in the 68th District Court over a two-week period, and the verdict came on the evening of Dec. 9.

The jury found the hospital 69% liable. It also found Dr. Jon Vu and his clinic 31% liable, however, they had settled separately, and the only defendant at trial was the hospital.

Adams was awarded $8,355,000 for past and future pain, disfigurement, physical impairment and medical expenses. Richard Adams was award $2,375,000 for losses of earning capacity, consortium and household services.

Attorney Russell Schell of Schell Cooley Campbell represented the hospital in Adams v. Flower Mound Hospital Partners LLC. He did not respond to a request for comment.

Lyons said the defense’s main arguments were that all fault lay with Dr. Vu because of the initial two-hour delay to get her to the ER. Therefore, he said, it argued there could not have been any proximate cause by hospital staff because the injury had already occurred.