Tales from the Claims Vault

Jury spends less than four hours deliberating before returning a $900,000 verdict against DC on September 15, 2017.

Posted in Risk Management on Monday, October 7, 2019

From the Desk of Justin Brown, NCMIC Claims Representative

The Situation

Samantha Wilcox, age 27, presented to David Reuter, DC, on January 12, 2015, with subjective complaints including pain in her scalp, left ear and head lasting three weeks.

Dr. Reuter treated Ms. Wilcox with a toggle adjustment and an instrument adjustment. Immediately afterward, Ms. Wilcox experienced numbness on her left side. She said Dr. Reuter explained this reaction was caused by toxins released during the adjustments.

Two days later, on January 14, Ms. Wilcox presented to a hospital emergency room with neck pain and left side tingling. When the attending physician and resident arrived to examine her, Ms. Wilcox was screaming, “Somebody help me!” while writhing on the waiting room floor.

The ER physicians found Ms. Wilcox’s cranial nerves to be intact and her reflexes normal. A CT scan of her cervical spine was taken and determined to be essentially normal. Ms. Wilcox was discharged with a diagnosis of a neck soft tissue injury; she was instructed to follow up with her primary care physician the following week.

Later that evening, Ms. Wilcox presented to a different hospital’s ER. After a number of tests, she was diagnosed with a left vertebral artery dissection. She was admitted to the hospital and remained there through January 20, 2015.

At that time, she was transferred to the hospital’s inpatient rehabilitation unit, where she stayed through January 23, 2015. Ms. Wilcox made a solid recovery.

The Trial

On June 13, 2015, Ms. Wilcox, now the plaintiff, sued Dr. Reuter, alleging that his treatment caused the vertebral artery dissection. NCMIC retained Gregory Sessions, Esq., to defend Dr. Reuter.

First up in the allegation against Dr. Reuter was Aaron Remington, DC. This chiropractic expert testified that Dr. Reuter deviated from the standard of care because he failed to take or order imaging studies during his history and exam.  

However, defense attorney Sessions was able to call into question Dr. Remington’s credibility as an expert due to the fact that his license was suspended. Attorney Sessions pointed out that Dr. Remington lost his license because he billed for services not performed and took unnecessary X-rays. Consequently, he had to take courses in how to properly take and read X-rays.

The plaintiff’s allegations against Dr. Reuter concluded with testimony from Ms. Wilcox’s treating neurologist who opined that Dr. Reuter caused the dissection and the stroke that occurred two days later.

Defense Weighs in

The NCMIC defense team retained a chiropractic expert who testified that he believed Dr. Reuter met the standard of care, although he had concerns about Dr. Reuter’s documentation. This expert noted the cranial nerve exam taken at the hospital was normal, which meant Dr. Reuter’s cranial nerve exam two days earlier was also normal.

The causation expert retained by NCMIC was a Harvard-trained neurologist who worked at a hospital stroke clinic and taught at Harvard. This expert worked closely with defense counsel to animate blood flowing through the vertebral artery, and show how a dissection could lead to a TIA when a clot broke off. Defense counsel described this causation expert’s testimony as the best he had ever heard.

The Outcome

The case went to trial on September 11, 2017, taking five days. Eight of the 12 jurors selected were college educated, and expectations were high for a defense verdict. However, the jury spent less than four hours in deliberations before returning a verdict of $900,000 for Ms. Wilcox.

Defense counsel spoke with the jurors after the verdict to identify why they came to this decision. In short, the jury said they believed that Ms. Wilcox presented to Dr. Reuter with a pre-existing condition, but they thought the DC should have referred her to a medical provider before treating her.

The judge privately told defense counsel that he was shocked by the verdict; he expected a defense verdict. He also said that the defense causation expert was one of the strongest he had ever seen.

^{Although this report is based on a real case, all names are fictitious to protect patient and doctor privacy.}