Client Developed Permanent Steroid Myopathy

Phil Russotti recently obtained the second largest medical malpractice jury verdict in the State of Hawaii's history, a $4,250,000 award on behalf of our client, a young woman who developed permanent steroid myopathy after administration of excessive amounts of steroids. This verdict is second only to the largest verdict of $6.15 million, which was also obtained by Phil on the same case. However, that verdict was overturned by the Hawaii Supreme Court on evidentiary grounds and sent back for the retrial, which just occurred.

The case concerned a 14-year-old girl who presented to a local hospital with symptoms of lupus. She was started on a course of high dose, intravenous pulse steroids comprised of three (3) grams of Solu-Medrol a week for four consecutive weeks. Despite the fact that she made dramatic improvement after the first pulse and was discharged from hospital, the doctor continued administering these very large doses of steroids, for which complications are dose and duration related. After the third week, our client developed muscle weakness (myopathy), a known complication of steroids which usually resolves. Her family transferred her via air ambulance to New York Cornell Hospital in New York City. She continued to decline and, after three weeks, could not move any muscle below her neck and was placed in the ICU. There she developed aspiration pneumonia and had to be intubated. She remained in the ICU for three months, unable to move a muscle and only able to communicate by blinking her eyes. She was transferred to a rehabilitation hospital where she underwent seven months of grueling physical therapy which enabled her to be able sit up in a wheelchair. Thereafter, she underwent seven months of physical therapy, for three hours a day, five days a week until she was able to walk short distances with crutches. She was otherwise wheelchair-bound.

The case proceeded to trial on the theory that the doctor administered a treatment protocol that was not generally recognized within the medical community because it had not been peer-reviewed, published in any medical text, or discussed at pediatric rheumatology national meetings. The defense was that this protocol was taught to the treating doctor during her fellowship at a respected program in Texas. However, Phil obtained an admission from the defendant's expert that it was, in fact, not a recognized treatment protocol. Additionally, Phil proved that there was a lack of informed consent under Hawaii law, because the doctor did not advise the parents of recognized alternatives to the treatment which would have used less steroids and, therefore, had fewer risks of complications. This was a direct result of the ruling by the Hawaiian Supreme Court, which held for the first time in Hawaii, that an alternative dose of the same medication can be a recognized alternative under the Hawaii informed consent statute. Phil was able to get the defendant's informed consent expert to admit that two other treatment protocols were recognized alternatives to the one recommended by the treating doctor, and that she "should have advised the parents about" them but failed to do so. The doctor contended they did not apply to this situation and that is why she did not advise the parents. However, Phil showed that the Hawaii statute required mandatory disclosure if the alternative was recognized. Once the defendant's expert admitted that the alternative treatments were recognized, there was no defense to the informed consent claim.

Accordingly, it is believed that an appeal will be unlikely and our client will finally receive her award after seven years of litigation, two trials and an appeal to Hawaii's highest court.

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