He doesn't do anything, leaves the room. Twenty minutes from now, twenty minutes from now something horrible is about to happen to Paul and to Linda. Their lives as they knew them are about to change. He has what's called hemiparesis and aphasia. Hemiparesis means the right side of his body left side brain injury, right side is where it affects you. Right side of his body doesn't work very well even now caused from medical negligence.
Ladies and gentlemen, let's go back to February 3rd, 1993, at 11:30 at night. Nurse Adique is caring for Paul who, in her mind, is just another routine patient. Eleven hours ago Paul has had a routine neurological procedure that lasted 33 minutes.
Nurse Adique has cared for hundreds of patients like she thinks Paul is. She has no reason to believe that Paul isn't like everybody else who's had this same procedure. Nobody's told her anything different. Paul's not in intensive care; he's on a regular floor where nurse Adique cares for patients. There's no orders in the chart other than routine orders. No one told her anything out of the ordinary happened to Paul. There's a drain in Paul's head. And it looks something like this, it's called a Jackson-Pratt drain. When they did this procedure -- and I'm going to go into it in more detail a little later.
But when they did this procedure to drain fluid out of his head -- not out of his brain but out of his skull, inside his skull. They put this tube in. They suction it like a turkey baster. And as fluid accumulates after the procedure, it gradually fills up over maybe a three, four hour period.
When it fills up, the nurses empty it and they resuction it. When that happens to a patient, it is a non-event. Patient does not know it's happening. They don't feel anything. The first or five times that that was done during the day, it was routine. Nothing happened. Nurse Adique by 11:30 had been on duty for four or five hours and everything was routine, until 11:30. At 11:30 something happened that she had never seen before in 20 years. This is her note. And let's go to the note for 11:30.
At 11:30, when Nurse Adique resuctioned this drain or a drain like this, Paul complained of a throbbing pain from the suction. His blood pressure shot up to 156, his heart rate went down from the 90's to 58. He was on a cardiac monitor -- cardiac apnea monitor which was routine all of the patients that had had his procedure were on that. That showed an irregularity. He became cool and clammy and he threw up.
In 20 years doing hundreds of patients, probably 1,000 or more times suctioning a drain, Nurse Adique hadn't seen that. So what did they do? She did what she was supposed to do, she called Dr. Byrne.
Dr. Byrne is a second year resident. He became a doctor about a year and a half before this night. He was in a neurosurgical residency at Rush. He had -- the first year was just a general surgery one, so he had been in neurosurgery for about seven months.
The drain -- Nurse Adique called him, told him everything. He read the note. And he did a neurological exam. There's no evidence -- excuse me. There's nothing in the chart about the neurological exam but he did one. And Paul, by the time the doctor got there, was back to normal. Dr. Byrne had never seen this before, Nurse Adique had never seen this before and something bad was happening in Paul's head. Dr. Byrne didn't do anything. He didn't issue a new order, he didn't tell Nurse Adique to do anything different, he didn't even tell her to clamp the drain or not to suction it. So when he left the room, he knew that three, four hours later, this was going to happen again. And even if the only thing that was happening was that Paul was suffering this excruciating pain, he knew it was going to happen again and didn't do anything about it.
Now, what you're going to hear is that Dr. Byrne didn't know what a typical reaction was to emptying one of these drains and resuctioning it. He didn't know -- no one had ever told him that it was supposed to be a non-event. In fact, he didn't even use these drains, wasn't familiar with them. So nothing happened.
But Paul, in Nurse Adique's mind -- she's an experienced nurse -- is no longer a routine patient, in her mind. On her own at 2:00 in the morning she gave her other patients away to other nurses and stayed with Paul. She also gave Paul an injection of codeine for his pain.
And she did that about ten minutes or so before she was about to resuction the drain again. And she knew something was going to happen. And, in fact, let me show you what she did. They have -- I mentioned the cardiac apnea monitor. You can print out a script from the apnea monitor. She -- you have to press a button and the strip prints out. It's not there -- at 11:30 the strip wasn't there when Dr. Byrne came in.
The -- that says pre-emptying of JP. Why would she print that out when it was normal and that's a normal script. It looks normal, it is normal. Why did she print it out? In her words she printed it out because she wanted proof. She knew something was going to happen. And she got her proof together.
She then resuctions the drain and looks at the strip. That's what happened. She knew it was coming and it came. She then -- she writes a note then at 2:30. We know from the script though that this happened at 2:17. And you'll see on the script, this is -- there's times along here, so it started going bad at 2:17. So that's the precise time. And look what happened, she suctions the grenade, Paul's headache getting worse. And she'll tell you it was 10 out of 10, nauseous and vomits again.
The monitor showed the heart rate down to 50. This is from 90 to 50, again, blood pressure goes up. He's cold and clammy again. As the suction is decreased, he starts coming back to normal. Nurse Adique again does what she's supposed to do. She calls Dr. Byrne; it's deja vu all over again.
Now Nurse Adique has seen this twice in her life. And Dr. Byrne comes in, he doesn't call his supervisor, Dr. Hurley. He doesn't call Dr. D'Angelo. He doesn't clamp the drain with a little clamp. He doesn't tell Nurse Adique to not suction it again. He doesn't order a CT scan to see what's going on in Paul's head.
He doesn't do anything, leaves the room. Twenty minutes from now, twenty minutes from now something horrible is about to happen to Paul and to Linda. Their lives as they knew them are about to change.
And before I go into that, let me tell you a little bit about Paul so you know something about him. Paul was an intensely hard worker. He doesn't like me -- he doesn't like to hear me say it. But he was a very average student. He went to Northwestern on a golf scholarship.
He was almost a world class golfer. He became captain of Northwestern's golf team. He graduated Northwestern. He was average. And he worked very hard to be an average student at Northwestern, which I guess is a pretty good school.
Because of golf, because he was such a good golfer, he got a job with terrific opportunity. He got a job in a company that sells or that handles municipal bond offerings. For instance, the City of Chicago, when they do Soldier Field, they might have a billion dollar bond to finance it. And I have no idea if that number is anywhere close. But they will then use a company like Paul's to try to sell the bonds. After years in training, Paul became the best salesman that they ever had.
In 1990 -- around 1990, 1989 Paul had an opportunity that was even better than where he was. He had an opportunity to go to a company called William Blair & Company, it's a big investment banking house. Paul was not an investment banker. He was an institutional municipal bond salesman.
He was a salesman. He could have been selling cars, he could have been selling widgets. He was selling institutional bonds. He knew them backwards and forwards. And his clients, his customers loved him. He would go sell to companies like State Farm, you know, a hundred million dollars worth of bonds or 50 million. He sold in big quantities to a limited number of customers.
At 30 years old he was making almost $700,000 a year. He was, as his former -- as you're going to hear, he was the Michael Jordan of an institutional bond salesman. He became the youngest partner ever, ever in the history of William Blair. At the end of 1992 Paul and Linda and their two little babies were truly living the American dream.
Let's go back to 1992. It was December of 1992 Paul was down in Texas on business. On December 2nd -- excuse me, December 3rd in Texas he was a victim of an armed robbery and a mugging. He got beat up and was kicked in the head, went to the hospital there for a couple of days where he was placed in a regular room. And they did a CT scan and an MRI.
And what they found was that Paul had -- he had what's called an arachnoid cyst. It had been with him his whole life. His brain never formed completely. See, it's -- this whole area here is filled with spinal fluid. It's a -- there is membranes around it, very, very thin tissue-like membranes. And he's got spinal fluid where most people have brain.
Now, he had it his whole life. And as obviously, he functioned pretty well being captain of the Northwestern golf team and making $700,000 a year. So it never got in his way. It was asymptomatic. But they found this in his head.
Any of us who haven't had CAT scans might have one. We don't know. You don't know until they do a CAT scan because if you're living with it normally, you function fine. So they told him, don't worry about the cyst, don't do anything with it, go back to Chicago. When you get to Chicago, because you've had it -- you've been kicked in the head and your teeth knocked out, go see a neurosurgeon in Chicago.
Let me tell you -- let me back up a little bit and talk about the arachnoid cyst. I think I'm running a little bit ahead. This is -- all of this is happening in a fraction of an inch inside the skull, just so you know. See, that little area of skull that's blown up. And I just want to talk briefly about the -- some terms that you might hear, the dura membrane, that's right underneath the skull, underneath that is the arachnoid membrane, underneath that is basically the brain that's sealed in a membrane called the pia.
The -- under the arachnoid membrane is cerebrospinal fluid from your spine. The arachnoid membrane in Paul's case, when he was in his mother's womb, got misshaped. And it developed a pocket, so instead of just being one skinny thin membrane, it became two. And it filled with fluid, and his brain grew around it. And that's called an arachnoid cyst. It's a deformity of the arachnoid membrane.
Now, Paul comes back to Chicago and meets with a Dr., Dr. Cerrullo and meets with Dr. D'Angelo -- Paul and Linda. And Dr. D'Angelo says, you know -- they both say, we'll follow you and see if something develops. And we're not going to -- you've had the cyst your whole life, don't worry about it. We'll watch it to make sure nothing happens to the cyst and make sure that there's no head injury.
And Paul likes Dr. D'Angelo, Linda likes Dr. D'Angelo. And they choose to go with Dr. D'Angelo and not Dr. Cerrullo. Dr. D'Angelo says, I'd like you to get another MRI, this time with a contrast so that we can see if there's more things going on, come back in three weeks or so and we'll do that.
So on December 29th they do an MRI again at Rush. This time the MRI shows a problem. It shows two compartments instead of one where the cyst used to be. This is the cyst, now this is a subdural hematoma. You've all heard the term hematoma, you bruise your arm, you get a black and blue mark, that's a hematoma.
Paul had a hematoma under his skull, subdural, under the dura, remember, the dura's the outer most membrane. It was -- it's called chronic because it didn't happen immediately after the injury. An acute hematoma is life-threatening, and it's something nobody wants.
This developed over a period of a couple of months. And the fluid in there is bloody fluid, it's the consistency -- the doctors will tell you it's something like motor oil, it's sort of like blood that's been sitting around for a while. And there is this membrane clearly dividing the two compartments. And there's another -- let me tell you a little bit about MRI's, the doctors will do a much better job.
These are taken like from the top down. And they're cuts of your head. So if you cut have -- if you cut your head into 50 slices or 20 slices, they're looking down in that slice. So that's just a different slice higher up.
And there's -- there is the membrane, that's the outer limit of the cyst and the inner limit of the subdural hematoma. Well, they go see Dr. D'Angelo on January 5th, Paul and Linda. And we're now beaten up, MRI shows the cyst, visit D'Angelo, MRI shows the cyst and hematoma and now here we are at the next office visit with Dr. D'Angelo.
Dr. D'Angelo doesn't tell them about the hematoma; he just says, we'll continue to watch you. Paul is, by the way, back at work -- he's back at work right in here, December 14th. January is Paul's best month ever, selling. But he starts getting headaches; they're getting worse. And he's getting disoriented.
They're supposed to go on a family vacation to Florida with their little babies. And they're worried maybe they ought to see Dr. D'Angelo before their scheduled appointment. So they called and they go in to see him on February 2nd.
And Dr. D'Angelo tells them that he's going to need -- he said something like, you're bucking for a hole in the head. And I'll explain what that is in a second. But he tells him that he's going to need this procedure to -- I'll show you now. You're going to need this procedure to relieve this pressure in your head, to get this fluid out, to get this hematoma out, this blood product.
And the procedure, he explains to him, is -- this is the kind of drill they use. They drill through the skull. They then -- when they get to the skull, they take something like this, it's not this but something in a dentist office is what I picture it. And when they get through the skull, they stop. And then they -- they're at the dura.
They cut open the dura. And then they're at this subdural membrane which has now formed.
They take this, they nick it, the fluid under pressure flies out and then the pressure's relieved. They put the drain in, that's what the procedure as Paul and Linda understood it and as Nurse Adique thought Paul had.
So first Dr. D'Angelo says, you'll come back Friday. This is on a Tuesday. And we'll do it then. But he sends him down to an ophthalmologist. Paul and Linda come back from the ophthalmologist. And Dr. D'Angelo says we better do this tomorrow.
This procedure is a resident's procedure. It is a one out of ten for a neurosurgeon. As somebody described, you don't go to medical school and become a neurosurgeon to do evacuations of chronic subdural hematomas, it's like going to law school to do parking tickets. It's the bottom of the totem pole. And it's usually done by residents.
So you've heard it described during jury selection as brain surgery, I guess it could be. But they're not doing surgery on the brain, they're relieving pressure by evacuating fluid. They're definitely not cutting into the brain or looking at the brain in this procedure.
The combination of the cysts with the hematoma is often a once-in-a career event for a neurosurgeon. You'll hear that so far in his career, Dr. Hurley has seen it once, Dr. Byrne has yet to see it. You're going to hear from some experts who have been practicing for up to 40 years that have seen it once. So this is -- this is big time.
Now, they do the procedure. February 3rd, 12:09 they start, 12:42 they finish, 33 minutes. On February 2nd, when Dr. D'Angelo sent Paul -- told him he had to come to the hospital the next day, he sends him for a -- to Rush to get his lab work and the radiology. For reasons which we'll learn apparently, they don't do an MRI, but they do a skull x-ray, which has no value at all.
So there's no current MRI. The MRI, when they drill into Paul's head, is five weeks old. Dr. D'Angelo is assisted during this procedure by
Dr. Hurley. Dr. Hurley is apparently doing the routine parts of it and observing. Dr. Hurley's never seen this before because it's so unusual. During the procedure, the chronic subdural fluid flies out, and Dr. D'Angelo elects to keep going. And he gets to this membrane, this outer membrane. And he says he doesn't know if on the other side is cyst fluid, spinal fluid, clear fluid or if maybe it's another compartment of the subdural and apparently that can happen.
The subdural can have things in its compartment, membranes can develop called loculations and septations. Well, in this case we know they didn't. How do we know they didn't? Because they weren't there.
Dr. D'Angelo punctured the inner membrane and spinal fluid flowed out. So we know that there was just this one membrane that showed up on December 29th and, according to our experts, would have shown up on February 2nd and would have made it completely unnecessary to puncture the second membrane. You'll hear from Dr. Hurley that Dr. D'Angelo essentially made no mention during the procedure of this membrane. They didn't discuss it. They didn't discuss the uniqueness. They didn't discuss anything.
So after the procedure, they had -- they put this suction drain in again. And there were options. And you'll hear that, there was lots of options, lots of doctors never use a suction drain. But all they needed to do if they needed to drain at all was just put a gravity drain in. You could be laying down. And if there's fluid collecting, it would come out without the suction, without the suction on these abnormal blood vessels that were around the cyst in the brain.
But they chose to go ahead and do this. They chose at that point to put him on the regular floor. In fact, they chose to do nothing different than if he didn't have this once in a lifetime event for a neurosurgeon. They treated it from that point on as if the cyst didn't exist, as if the cyst wasn't punctured, as if it didn't matter at all if it was punctured.
They put him in Nurse Adique's care, Nurse Adique's care later on in the afternoon on a regular surgical floor. And let me just go through the list of names just to make sure we're all on
the same wavelength. Dr. D'Angelo was the attending neurosurgeon. Dr. Hurley was the chief resident. He was in his sixth year out of medical school and had performed all kinds of neurosurgical procedures. Dr. Byrne was beginning his second year of his residency but his first year on the neurosurgical floor. Nurse Adique was a nurse on this regular floor, neurosurgery, orthopaedics, general surgery, that's the floor they put Paul on. And Nurse Adique was an experienced -- 20 years of experience nurse on that floor.
I want to tell you briefly a little bit about some of the experts. And you're going to hear from lots of experts. But we have one expert who will be testifying on behalf of Paul and Linda, Dr. Daniel Hanley.
Dr. Hanley is the founder of the neuro-intensive unit at Johns Hopkins Medical Center. He is a professor of neurology, critical care medicine, neurosurgery and nursing at Johns Hopkins. He has published over 200 articles. He founded the neuro-intensive unit there and has trained neuro-intensivists all over. He published an article new in the Journal of Medicine just a year or so ago on cerebral hemorrhages, bleeds in the brain. He has -- you know, some of us like fishing or golf or whatever, he likes brain bleeding, that's his life, that's what he studied. You're going to hear from him.
You're going to hear also from a Dr. Glenn Meyer. Dr. Meyer is a senior neurosurgeon at the Medical College of Wisconsin, at Froedtert Hospital in Milwaukee. I don't know if any of you are familiar with that. He's been in practice for a long time. And he'll tell you -- he's written an article on arachnoid cysts.
He'll tell you that the MRI was absolutely required before this event that day and the day before, that if the MRI had been done, there would have been no need to puncture the cyst. So if they -- once they punctured the cyst, however, all bets are off, intensive care, no suction drain, very close monitoring because the drain, if there is a drain -- suction drain can damage the brain now that we've got this cyst punctured. And the brain's going to be expanding.
The -- they'll both tell you that the combination of the cyst and the Jackson-Pratt drain are a dangerous combination and a potential for way too fast expansion of Paul's brain that has been compressed. Dr. D'Angelo will tell you that the MRI on -- the MRI on February 3rd, February 2nd wouldn't have helped one iota, that's their position.
Let's talk about the drain. Another expert that you're going to meet on behalf of Paul and Linda, her name is Sherry Fox. She is just about finished with her doctorate in nursing. She has just been appointed as an assistant professor at the University of Virginia Nursing School.
She has been doing this for 20 years. She's very familiar with Jackson-Pratt drains. Some of the doctors there use them, some don't. But she's very familiar. She'll tell you she's never seen this reaction, just like Nurse Adique never saw this reaction. That emptying the drain is simply a non-event. The patient doesn't know it's happening.
Now, why did Nurse Adique -- why did she think Paul was routine, why did she think that he was like the hundreds of other patients she's had over the years, because nobody told her about the cyst, nobody told her that it was punctured, nobody told her that this drain was draining spinal fluid as well as chronic subdural fluid, nobody told her that this brain was expanding into an area beyond where it had been before because the cyst was now punctured. She had no idea.
And so she resuctions the drain. And she knows something bad is happening and, like I said, nurse -- Dr. Byrne comes down, he sees all of these things. And let me just remind you, at 11:30 he sees all of these things, he sees throbbing pain, throwing up, blood pressure way up, pulse way down, the monitor showed an irregularity. He's a rookie, he's a kid. I think 27 years old at the time.
He doesn't pick up the phone and call Dr. Hurley and say, hey, Nurse Adique's telling me that something bizarre's happening here, she's never seen this, what should I do. What you're going to hear from Dr. Hanley and Dr. Meyer is that what to do is easy, you stop draining, you clamp the draining and you take him for a CAT scan, very simple solutions when you see something that you've never seen. You don't assume it's a harmless explanation.
And it happens again. And he does the same thing. He still doesn't clamp the drain, and he still doesn't call Dr. Hurley. What our experts will say, Dr. Hanley and Dr. Meyer, is that at 11:30 this is a unique event that you don't need to know what's happening, you just need to know that something bad might be happening. That's all you need to know, that the -- if you clamp the drain here, just clamp the drain, don't do this -- don't put him through this again, Paul would be fine today.
If you get a CAT scan, most likely it's not going to show there's any bleed going on. But if there is a bleed, you go in -- that's brain surgery, then you go in and you operate. And you get it early and you take care of it. But most likely there was no bleed going on. So simply clamping the drain ends it.
Now, let me say a couple of things about Nurse Adique. She was very experienced. She was a good nurse. But she was supposed to tell Dr. Byrne that he was wrong. She knew he was wrong, that's why she got proof three hours later. That's why she pressed that strip. She knew this was going to happen. But she had her orders.
There's a time -- and that's what Sherry Fox -- Nurse Fox is going to tell you, there's a time where you have to stand up for your patient. And I think she knows that, Nurse Adique. But it just wasn't in her makeup to tell Dr. Byrne that he was wrong. And it wasn't in her makeup to go over his head. And it wasn't in her makeup to call her supervisor and say, this young resident is making a mistake. And for that we say that Nurse Adique did something that she shouldn't have done or failed to do something she should have done.
So here we are, Dr. Byrne looks at Paul again, doesn't write a note, doesn't do anything, no orders, no nothing, it's 2:17, 2:20, 2:25 or whatever, 20 minutes later the monitors go off. Paul's having a seizure. He's having convulsions. He's out of control.
Nurse Adique calls Dr. Byrne and calls the whole team. This is now the crisis, obviously. And the whole team comes in. He's having a grand mal seizure at 2:40. Nurse Adique's going to tell you not only has she never seen this before, not only has she never seen this before but she's never seen somebody have a seizure after an evacuation of a chronic subdural hematoma. She's never seen this after this procedure that she thought was a routine procedure.
So Dr. Byrne contacts Dr. Hurley. And they -- Dr. Byrne enters an order that Dr. Hurley's coming to the hospital, I think. There's an order at 3:00 o'clock. That's the order, number 7, clamp JP. After the seizure, they finally decide to do what we say had to have been done four hours earlier. They finally enter an order to do it. One problem, nobody does it. But at least the order was entered.
Now, there's one thing very important thing missing from that order. When somebody has a seizure after surgery, you immediately give them an anticonvulsant drug, Dilantin. Some of you may have heard of Dilantin, some may not. It is routine. You give Dilantin.
Why do you give Dilantin? Because all of a sudden this patient of yours who's not routine is much more likely to have another seizure, much more likely. If you give Dilantin, they probably won't have another seizure. But they didn't order Dilantin. And they don't even know if they considered ordering Dilantin.
Obviously our experts say, you give Dilantin, you clamp the drain. There is no question about it. So at 4:15 they take Paul -- this happens at 2:40. They stabilize him. They take him for a CAT scan. And here's what it looks like at 4:15 and here's what it looked like on December 4th.
This area, there was a cyst is no longer, the brain has now expanded into this area, way into the area. More than that though, there is a substantial area there that is a bleed. Paul's vessels have ruptured. Our experts say they were on the surface of the brain ruptured, their experts say that they were not on the surface of the brain.
And the bleed went in.
There was also a bleed that went out into the subdural space -- excuse me, the subarachnoid space where the spinal fluid is and that's called a subarachnoid bleed. That's not a serious event.
But an intracerebral hemorrhage, an intracerebral bleed is a catastrophic event. And now it's 4:15. Let me just put this up. These are the two hemorrhages Paul has, subarachnoid, intracerebral.
MR. BAIZER: Your Honor, how much more time do I have? I thought so.
BY MR. BAIZER:
At 4:45, 4:40 -- now they bring him to intensive care, it's called SIT, surgical intensive care. At 4:40 -- 4:35 he arrives in intensive care and right after that, he has another seizure. He has another seizure during which his blood pressure goes way higher than it had gone earlier, now it goes up to 220 over 80.
And now after the second seizure, Paul can no longer move his right side. Then they gave him Dilantin. And Paul never has another seizure again. I'll show you Dr. Hurley's 4:00 o'clock note. This is a 4:00 o'clock note that you'll see is really written after 4:30, because it goes through him having the seizure. But let me -- I'm going to highlight that area there.
This is Dr. Hurley's note, and it continues on the next page. Look at the last sentence there that's highlighted, patient's only complaint was mild headache. This is after, after his second seizure that -- when he says that throughout the night, somebody told him that Paul's only complaint up until the seizure was a mild headache. You remember -- you might not. Here's throbbing pain at 11:30, headache getting worse at 2:17.
Dr. Hurley says that's a mild headache, got codeine for this mild headache. That's the way they were communicating there this night when Paul was there. Dr. Hurley writes an order at 6:00 o'clock -- 5:45, it's a long order. And it goes on to page 2. And on page 2 at 6:00 o'clock, number 15, clamp JP drain.
Dr. Hurley now says to clamp the drain at 6:00 in the morning, not at 11:30, not at 2:17, at 3:00 they said to clamp it but didn't do it. And now it gets clamped, 6:00 in the morning. Why did they clamp the drain? For two reasons, to slow down the expansion of the brain, according to Dr. Hurley, and to try to help seal this bleed which might have started as long ago as 11:30, only then it was a little trickle.
If there was a bleed ongoing at 11:30, it was before the event of 2:17, before the seizure, before the CAT scan and before the second seizure.
The -- I have to get moving here. Let me just briefly review some of these scans and you can see the damage to Paul's brain. This was Paul for his whole life. This is Paul at 4:00 in the morning on February 4th.
Our experts say, go in and do surgery, that's what brain surgeons do, try to seal it, try to evacuate it before it spreads, before it gets worse, before that second seizure. Here's the hemorrhage, the bleed two days later spreading from the surface into the brain, February 4th, February 6th -- February 4th, February 6th.
Now we have September 16th, this is six months, seven months later. And I'm going to explain what's there. This used to be brain here. This is the cyst, this is a giant hole in Paul's brain now filled with cerebrospinal fluid, that's dead brain. That's what the hemorrhage did.
That's what Paul is missing.
Let me talk for a second about the mechanism of Paul's injury. Our experts say that it was caused because the suction -- the cyst was drained, the drain was too much suction for the fragile vessels on the surface of the brain, the brain started bleeding and went in and nobody did anything about it.
Their experts say and the defendants say that these things just happen, that you can have this kind of a bleed from the evacuation of a subdural hematoma from the re-expansion of the brain, that puncturing the drain is irrelevant, that using a suction -- puncture -- excuse me, puncturing the cyst is irrelevant, using a suction drain is irrelevant, not giving Dilantin is irrelevant, not clamping the drain is irrelevant, nothing would have mattered, nothing caused it. They didn't do anything to cause this, it was just meant to be.
Our experts say, the mechanism doesn't really matter, at 11:30 clamp the drain and Paul's fine, take a CT scan, see if there's a bleed. So what I'd like you to consider are questions during the course of this trial, why no preoperative MRI --
MR. PETREK: Objection to this as argumentative.
THE COURT: This is argumentative. Sustained. BY MR. BAIZER:
Let me tell you a little bit about Paul and Linda since this happened. Paul spent a month at Rush. For a few days they thought he probably wouldn't live. And then they thought he'd probably never talk or walk. He was there for a month. He started making very good progress. They sent him to the Rehab Institute. Most of you probably have heard of the Rehab Institute of Chicago. He was there for two months. He made sensational progress.
He has what's called hemiparesis and aphasia. Hemiparesis means the right side of his body -- left side brain injury, right side is where it affects you. Right side of his body doesn't work very well even now. And he's worked at it. He's completely numb on the right side of his body straight down the middle. But he drives a car. He uses a left foot pedal. And I've been with him, he's a good driver. Plays golf, golf got him rehabilitated. At the Rehab Center they said, go to the driving range, you know. This is something that is very important to Paul, got him into college. He got his job. He went to play golf. You'll see a little bit of a video. He started out, he couldn't put the ball on the tee with his right hand. He took lessons and he worked at it. And before long, he was shooting in the 80's again. He can't do it all the time, but he can break 90. And for some of us, without Paul's disability, breaking 90's pretty good. He doesn't shoot in the 60's anymore. He's not a captain of the Northwestern golf team caliber anymore. But he can play. He usually plays alone because he doesn't want to play with his kids.
But he has made a remarkable recovery from that injury, the right-sided injury. He has no feeling. He works at it, he works out, works on a treadmill. He has no feeling in his right side. One day he wore through his hand and had blood poisoning. He had to go to the hospital and get that fixed.
But his golf scores are remarkable, remarkable evidence of his determination and his hard work. But the problem is his aphasia. And you've heard about strokes, strokes, strokes. Well, Paul didn't have what most people think of as a stroke. He didn't have a blood clot that came suddenly to someone with high blood pressure or something. He had a bleed in his brain. The end result is the same, there's dead brain.
And if you call it a stroke -- because of the stroke, he has a lot of difficulty talking. He cannot just talk, he has trouble finishing sentences. His cognitive abilities are reduced but it's mostly a speech issue. He reads at a fourth grade level. If it's untimed -- and you might see some of that. But if he has an unlimited amount of time, maybe he reads at a seventh grade level. He doesn't process information. He can't read to his children. They had a third child. They have a little girl. And you'll meet the three of them during the trial. And she's now seven. Paul can't read her books to her. He's antisocial. He used to be obviously the life of the party. He was a salesman's salesman.
He gets frustrated, as you can imagine, very easily. He gets angry. He gets impatient. He's not easy to live with. He's got no self-esteem. He's embarrassed when people meet him. He doesn't like to go out in public because he feels dumb when he talks.
This is Linda's case also. And we're going to be asking at the end of this case to award damages for Linda. And she's been through a nightmare, and she's a saint. And for her it's sort of like having four kids or maybe -- maybe worse.
Let me move ahead. I want to talk for a second about lost income. You're going to hear from Paul's former boss, you're going to hear from Paul's -- one of Paul's customers. They're going to rave about Paul's abilities then and they've seen him now. And they'll tell you the difference.
And they're going to tell you that Paul would be easily making over two million dollars a year now. Paul's boss at Blair said that he would have been making twice his 1992 income by 1996. The municipal bond business is thriving. As interest rates go down, it thrives. As the stock market goes down, people go to things that are more secure. So their business is going gangbusters. And Paul would be there.
Let me show you -- this is Paul's income growth from the time he got a job. I think it starts the second year. I'm sure they didn't start him that high. But it goes from 40,000, on a pretty gradual basis, to $657,000 before he's made a partner. He's 29 years old 10 years ago, before he's made a partner. And the partnership income at William Blair, you're going to hear, is a lot.
His income increased year to year after inflation at a rate of 67 percent per year. Now, nobody can get up here and tell you it was going to keep going like this, it would now be the gross national product. But we're going to have Professor Korajczyk from Northwestern, from Keller, he's a professor of finance, former head of the department. He's going to come here and explain what different scenarios would come to on present value.
And he's never testified for a plaintiff, he's only testified for defendants in these type of cases. And he's going to tell you, he's using the exact, exact same methodology for Paul that he would use against Paul if he were on the other side. And what he's going to tell you is that if that 67 percent growth turned into something like three percent a year, that would be 50 million dollars lost income.
So if you believe that Paul was a superstar and if you believe what the witnesses tell you, 50 million dollar present value cash is no stretch at all. You're going to see a report from their expert that estimates his income at almost 25 million, that's their expert. And you're going to find out his methodologies are much different from a plaintiff to a defendant.
So we're going to be presenting witnesses over the next week or so in our case. And the order that they come in on is not really within our control. So you sort of have to keep the pieces of the puzzle together, you know, our expert from Johns Hopkins can't come in until next week, so we'll have some witnesses on. They may come out of sequence and I'm sure they will. So just keep track of everything as the trial continues.
And with Paul's income loss at least 50 million -- and I think you'll probably agree more. And we're going to ask you at the end of this case to consider compensating Paul and Linda for the lost income, for pain and suffering, for his disability, for Linda's loss of society, for all of that. And we're going to ask you to consider a verdict in the range of 100 million dollars or more for this case.
Thank you. (Whereupon, further proceedings in said cause were adjourned to 7/31/02 at 2:20 p.m.)
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