Lloyd Bell and the Biting Direct Exam That Led to a $26M Med Mal Verdict

In a medical malpractice case, where so much rides on opposing treatment opinions, undercutting a witness’ credibility can be the key to securing a verdict. Lloyd Bell did just that, with a masterful examination of a defendant physician’s partner to open the door for an eight-figure damage award. Williams v. St. Francis Hospital, SC14CV882.

Sandra Williams suffered permanent brain damage after going without sufficient oxygen for at least 20 minutes while being treated for a hematoma, or blood clot, that had closed off her trachea, just days after a successful neck surgery.

Williams’s attorney, the Bell Law Firm’s Lloyd Bell, argued Dr. Erick Westerlund, the on-call doctor when Williams arrived at the hospital, failed to promptly report to the hospital, review her imaging results, or treat her while her condition was still stable enough to prevent her collapse.

Westerlund countered he was monitoring Williams’ condition, through the staff,  and that surgical intervention wasn’t necessary until she began to develop breathing problems.

Bell opened the trial’s testimony with Dr. Thomas Walsh, the surgeon who performed the neck surgery on Williams, and a colleague of Westerlund's.

During direct examination, Walsh initially maintained Westerlund’s treatment of Williams—delaying any surgical intervention until she had trouble breathing—was appropriate.

But Bell responded by introducing evidence of Walsh’s testimony in another trial, in Alabama, involving a man who suffered oxygen deprivation from a neck hematoma. In that case, testifying for the plaintiff, Walsh had described the Alabama patient’s hematoma as “massive.” Bell read Walsh’s testimony in the case:

“That goes straight to the operating room now, with or without any breathing complaint. Call the ENT. Call Anesthesia,” Walsh had testified in the Alabama case. “Because anybody with our training… knows that this is a case that’s going to go bad. And you’ve got to take it to the operating room, get them intubated, and prevent the stroke. There’s just no variance in that situation.”

At the witness stand, Bell asked Walsh to compare the X-ray of the Alabama patient’s hematoma to the X-ray of Williams.

“Which hematoma’s bigger? Can you tell?” Bell asked.

“I think they’re comparable,” Walsh said.

Bell dug deeper, going back to Walsh’s testimony in the Alabama case:

“At this point right here, he’s a ticking time bomb. And it’s ticking slowly. And you can’t see the clock, and at some point the ticking is going to speed up. And when it speeds up, you’ve got a matter of minutes, and you’d rather get this bomb defused while it’s ticking slowly, before the ticking picks up and it crashes or explodes.”

“That was on a different case,” Walsh responded after Bell read the passage.

But Bell countered by noting Walsh, in his Alabama testimony, had specifically noted Williams’ case was “similar” to the Alabama matter.

Bell cut further into Walsh's Alabama testimony, highlighting inaccuracies in Walsh’s description of Williams’ treatment, including Walsh’s claim that Westerlund had promptly seen Williams and admitted her to the ICU after she had arrived at the hospital.

“Now you know, the truth is, Dr. Westerlund did not come and see her and promptly admit her to the intensive care unit,“ Bell said. “You know that’s not true?”

“I agree that’s not true,” Walsh acknowledged on the stand. “I was in error in that, but my defense would be that I hadn’t reviewed Ms. Williams’ case prior to [giving] this testimony [in the Alabama case], so that was an error.”

“So your defense to giving testimony under oath, twice, that was inaccurate, was that you hadn’t reviewed your patient’s medical records?” Bell asked.

“Well, the case I was testifying about, wasn’t about Ms. Williams,” Walsh answered. “But I agree, that’s an error.”

Bell then read a portion of the Alabama transcript in which Walsh described Williams’ resulting brain damage and blindness in detail. “Where’d you get that from, Dr. Walsh?” Bell asks.

“I don’t remember.”

“Did you just make that up?”

“I might have,” Walsh says.  

After a jury verdict finding Westerlund negligent and awarding Williams $26 million, Bell told CVN he believed his questioning of Walsh critically undermined the defense’s credibility from the first day of trial.

“I think the jury quickly concluded that these doctors were all about protecting themselves, and twisting the facts to do so,” Bell said, “and not at all about telling the truth and being straightforward.”