Meghan Jackson was on the junior high basketball team with aspirations of earning a scholarship to play college ball.
Posted in Case Studies on Tuesday, December 27, 2022
Her low back pain started in August during pre-season basketball practice, which consisted of conditioning exercises, running and free weights. Nothing in particular caused the pain, but it progressively worsened over time. By the start of the season, Meghan’s parents decided to have her examined.
Dr. Kenneth Stacy advertised himself as a specialist in sports medicine. Meghan’s first treatment with Dr. Stacy occurred on Oct. 15, 2017. As no specific trauma caused her complaints and because of her young age, Dr. Stacy made a clinical decision to not X-ray her lumbar spine at the initial visit. He treated her with conventional manipulations and adjunctive therapies which helped, but Meghan’s low back pain persisted.
On Nov. 15, 2017, Meghan’s team had an away game and she saw considerable playing time. During the drive home and throughout the night, Meghan’s low back pain progressively worsened and now extended bilaterally into the tops of her thighs.
The next morning, Meghan’s parents called Dr. Stacy’s office and made an appointment for later that day. Both of her parents accompanied her to the visit. Meghan’s father, Travis Jackson, asked Dr. Stacy to take an X-ray of Meghan’s lower back during the visit. Dr. Stacy replied that he did not think it was necessary, since there was no specific traumatic event that caused the pain or progression of new symptoms.
At the time, Dr. Stacy was using a software package for office notes, but during that visit, supplemented his “canned” notes with a detailed narrative describing the history of Meghan’s onset of pain after the game, noting the new complaints of pain into her thighs. Dr. Stacy’s diagnosis for the Nov. 16, 2017, visit did not include lumbar pars defect fractures.
When Dr. Stacy manipulated Meghan’s low back that afternoon, she felt a sudden sharp pain and cried out. Her father, shaken by her scream, walked out of the treatment room for a few seconds. When he returned, he stopped the treatment and said, “Let’s go.” With that, he and his wife, Colleen, left the office and drove Meghan directly to a nearby hospital where she was seen in the emergency room. X-rays taken at the ER confirmed the presence of bilateral pars defect fractures at the L4 level.
Meghan was discharged from the ER with a referral to a pediatric orthopedist. He placed her in a full hard body cast for six weeks followed by a soft body cast for another six weeks. While Meghan was in the hard cast, she could not attend school and required her mother’s help with her personal hygiene needs, including bathing and using the toilet. Meghan was, however, able to keep up with her schoolwork and socialized with her friends at her home.
A Lawsuit is Filed
The basic allegations against Dr. Stacy were that he negligently failed to take an X-ray before treating the plaintiff on Nov. 16, 2017, and, as a result, failed to diagnose Meghan’s pars defects fractures. Also, the excessively forceful manipulation he performed during that visit either caused the bilateral fractures in Meghan’s spine or substantially aggravated any pre-existing bony pathology in her spine which adversely affected her treatment.
The defense team retained a chiropractor and a pediatric orthopedist as experts. Both defense experts agreed that the bilateral L4 pars defect fractures probably existed by the time Dr. Stacy saw Meghan on Nov. 16, 2017, and were not caused by any adjustments he performed that day. They admitted that had Dr. Stacy X-rayed Meghan’s lumbar spine before treating her, he would have discovered the fractures and, at that point, he should have referred plaintiff out for orthopedic evaluation and care.
However, Dr. Stacy’s decision not to take pretreatment X-rays was reasonable and within the standards of care since there was no traumatic event in Meghan’s history to account for her symptoms and her prior treatment for similar symptoms was successful. They further agreed that, at worst, the Nov. 16 adjustments only caused a temporary short-term increase in her sensation of pain but did not alter the treatment Meghan eventually received or adversely affect her recovery.
Meghan’s expert opined that Dr. Stacy negligently failed to take pretreatment X-rays and the excessively forceful adjustments he performed that day either caused the fractures or aggravated pre-existing pathology in Meghan’s lumbar spine. Either way, his negligence adversely affected her treatment.
Fortunately, Meghan made a full recovery from her L4 pars fractures without any permanent restrictions on her physical activity.
The trial lasted four days. Eventually, the jury returned a defense verdict in favor of Dr. Stacy on all counts.
What Can We Learn?
The successful outcome at trial was attributable to three things. First, Dr. Stacy was committed to going to trial and vindicating his professional reputation. Although he was not a gifted speaker by nature, he committed himself to working with the defense team to prepare himself for both his pretrial deposition and trial testimony. At the trial, Dr. Stacy gave a professional performance, which impressed the jury.
Second, NCMIC committed the resources that enabled the defense team to retain highly qualified experts whose trial testimony was persuasive to the jury.
Third, and equally important, on Nov. 16, 2017, Dr. Stacy took the time to supplement his “canned” software office notes with a written history of what happened and when it happened.
The jury found his supplemental notes to be credible. Often, the failure to fully and adequately document the patient’s chart can create doubt in jurors’ minds when they try to piece together the true factual chronology of the case. A lack of adequate records leads to a classic “he said, she said” dilemma for a jury trying to resolve conflicting testimony regarding pivotal facts in a case. However, the jurors in this case placed a high degree of credibility on Dr. Stacy’s office notes that enabled them to conclude that his treatment did not cause the plaintiff’s pars defect or aggravate any pre-existing disc pathology.
About the Author
Charles J. Davis Esq. is a trial attorney practicing in the Cincinnati, Ohio, area since 1977. He is licensed in both Ohio and Kentucky. Since 1990, he has focused on professional liability and has tried numerous cases for NCMIC insureds over the years. Last year, he successfully argued cases before both the Ohio and Kentucky Supreme Courts that favorably impacted insureds and their liability carriers in both states.