The Vivid Opening that Led to a $26M Med Mal Verdict

A key to building a successful plaintiff’s med mal case is placing jurors in the patient’s shoes and ensuring they understand the sometimes complex series of events underlying a claim. In Tidwell v. St. Francis Hospital, Lloyd Bell combined vivid description with an innovative use of demonstratives in his opening statement to set the stage for an eight-figure medical malpractice verdict against a Georgia hospital.

Sandra Williams suffered lifelong brain damage after going without sufficient oxygen for at least 20 minutes while being treated at St. Francis Hospital for a hematoma, or blood clot, that had closed off her trachea.

Williams’s attorney, the Bell Law Firm’s Lloyd Bell contended the damage could have been avoided if Dr. Erik Westerlund had treated her earlier and if Dr. Christopher Tidwell had performed an intubation in an operating suite.

In his opening statement, Bell led jurors through the hours Williams waited as the hematoma continued to press on her windpipe, gradually closing off her airway. He then walked jurors moment by moment through the anxious minutes when doctors decided she needed a bedside intubation.

“So they make the decision to put a tube down her throat. The problem is, Sandy has got a big hematoma that is squeezing and pushing on her airway,” Bell said, using a cardboard tube to represent Williams’ airway and a red balloon the size of a fist to represent the clot as it pressed on the trachea.

Bell told jurors Tidwell ordered Williams receive sedation for the intubation. “You’re going to hear that, in a patient whose airway is squeezed down, is having a hard time breathing, the last thing you want to do is give them sedation,” Bell said, holding the cardboard tube with a crink in it. "Because if you give them sedation, you cause them to go to sleep, cause them to relax, they can lose their airway.

“It can close off completely,” Bell added, as he twisted the tube tighter.

Nonetheless, Bell said the doctors went ahead with the intubation, “flying blind” as they tried to insert a tube in Williams’ trachea, all while her oxygen level descended to critical levels. Bell said Tidwell soon realized he couldn’t insert the tube properly. “Of course you can’t, when your airway’s distorted,” Bell told jurors, as he knocked up against the inside of the twisted cardboard tube. “You can’t get the tube in. It won’t work, there’s blockage there. You can’t get the tube where it’s supposed to be.”

The attempt concluded with Westerlund attempting to scoop out the hematoma with his hands, wiping it on his pants, Bell detailed, as he mimicked Westerlund. Williams was successfully intubated only after another physician arrived on the scene. But by then Williams had turned blue and had gone without enough air for 20-25 minutes, Bell said.

Bell's opening keyed the jurors' understanding of the case. Although Tidwell was cleared, St. Francis Hospital, which employed Westerlund, was hit with a $26 million verdict for Westerlund’s care that jurors found led to Williams' brain damage.