- I'm about to dissect the case of "Grey's Anatomy".
But I think I want to do it,
not just medically.
We should do it legally.
Welcome to the channel, Legal Eagle!
(cheers)
- Hey, Legal Eagle's!
- Bewop!
(air whooshing)
(loud crash)
- Crap.
- [Narrator] Doctors never mean to screw up
- Crap, crap, crap, crap. (machines beeping)
- "Crap, crap, crap, crap" is the last thing you want
to hear in a surgical room.
- If I saw a transcript that said "crap, crap, crap."
I would see dollar sign, (Dr. Mike laughs)
dollar sign, dollar sign. (cash register dinging)
- It's not like we want to hurt anyone, but sometimes we do.
Sometimes we make mistakes.
- And then the lawyers make it right.
- I'm looking for Dr. Torres.
- Yes. Hi.
Great. You're being sued.
(both laugh)
- Is that how it happens?
- Sort of.
In a medical malpractice situation like this,
you obviously have to start the lawsuit somehow.
And the way you do that is called process of service.
And if you didn't know where the person was
or where they worked
or you didn't know who their lawyer was,
then you would have to hire someone called
the process server to actually physically hand you--
- Is that the person that like throws it at you
and says "You got served"?
- It can.
'Cause I've seen that in movies.
They throw it and it's like,
"Oh I got served!"
What does that mean?
- You need have a competent adult who was able
to verify that this is the person who is being sued.
- So throwing it in a door...
- That is not best practices, no.
- [Travis] Ready to build me a new hip?
- [Man] He needs to be able to do this...
see, right there.
Can a new hip do that?
- More importantly,
will he be doing it by December?
He's got Olympic qualifiers coming up.
- You mentioned a crash last year.
- They said it gave me arthritis.
- [Man] You can't win the gold with arthritis.
- I want the Peterson hip.
- Would one hard crash cause arthritis
for the rest of his young career?
- It sounds off.
The only thing I can imagine is
if you have a significant loss of cartilage
or potentially a labral tear,
but there's other procedures that you can go
about from an orthopedic standpoint
rather than just replacing the hip.
Also, what they're asking
of the doctors is not practical, at all.
To make promises that he's going to be able
to do a move,
that promise on recovery time,
none of this is ever guaranteed
because in medicine you don't even know what's gonna happen
until you open a patient up.
Especially in a specific case like this.
This is hyper-specific.
He's not a run of the mill joint replacement patient.
- It's funny you say that
because one of the first cases you learn about
in law school is called Hawkins vs. McGee.
You might have heard of it colloquially 'cause it's called
the "hairy hand" case. - Ooh.
- Where in the turn of the century,
a doctor
had a patient who had a hand condition,
I think his hand was burned,
and the doctor promised
that not only would he have a fully functional hand
but it would be a hundred percent recovered.
- Okay. - And he had a skin graft.
And as a result
he was not given the a hundred percent normal hand
but a hand that was functional, but hairy.
(Dr. Mike laughs) And so, the lawsuit was,
can you recover damages for the breach
of the promise that was given
when he was promised a hundred percent normal hand
and given a hairy hand?
And the answer is, yes.
You have to value whatever the difference is in money
between a normal hand and a hairy hand.
- Buddy of mine got this one,
he was back on the mountain in no time.
This is what I need.
- Okay.
Even if I did agree
that a hip replacement is the right course of treatment
I've never even used the Peterson resurfacing hip joint.
I doubt you or your team want you to be my first.
- Yes!
No experience whatsoever.
Barreling forward without doing the research
and making specific promises.
This is...
- A lot of patients in general,
treat medicine as if it's like a shopping thing.
"I want X."
When in reality sometimes "X" isn't what's best
for the patient.
And sometimes it puts you
in this murky position
where the patient feels like they're not
getting what they want.
You're not giving it to them
because you think it's not in their best interest.
And then they do something like,
leave a review for you on one of these websites.
And as a result, you can't even comment on that
'cause legally you're breaking patient privacy
if you comment on that.
- Oh, I never thought about that.
- Yeah. - That's absolutely right.
- I'll research the joint.
I'll learn what I can.
I'm not making any promises.
- [Travis] I'm not worried.
- Despite the fact that she appears
to have been actually making some promises,
it is obviously good that she is going
to do some research here.
It's not necessarily dispositive
that a doctor hasn't done a procedure before
- Sure and is therefore negligent
based whatever outcome happens.
But often in cases like this,
at least the manufacturer has an interest
in making sure that their own products
are installed correctly.
So, to my knowledge,
medical manufacturers will give doctors extensive training
so that things are done correctly on the user end.
- They will send in a rep
during the time of the procedure to be with us
and guide us with the questions that we may have.
And they're really well-trained
because a lot of the stuff, tech wise,
comes out so soon.
You just have to have them on the same page.
- I'm not settling.
Okay. (Dr. Mike chuckles)
- Okay, you've convinced me.
- I tried.
- And there are things to remember tomorrow.
Let the jury see your face.
- Wait, tomorrow? What? - That's... how fast is that?
- That's ridiculous.
This is a conversation that they would be having
on day one, on day two, on day three,
this would be a multi-year process.
- Let the jury see your face.
You wear a suit.
Dark, not bright.
Skirt, pants, minimal jewelry,
heels, pantyhose--
- Pantyhose?
- Professional but feminine.
You still have your wedding ring?
- Yes.
- Wear it.
Juries respond better to marry women with families.
- Ooh, that's a little misogynistic there.
I mean, so there is,
there's a whole science
to presenting yourself in front of the jury.
This is going a little bit crazy
in terms of the specifics.
I mean, you want to dress nicely.
There are whole memes
on the internet about Tekashi 69 showing
up to court with like tattoos all over his face,
his tie like down to here
and like his shirt out and stuff.
So you don't want to show up to court looking like that.
Being so specific about what you're wearing.
She's a doctor, she's--
- The colors, does it matter?
I can't imagine... - Not really.
Maybe on the extreme margins.
- You ready?
- Sure.
- Okay. Okay.
As someone who knows a fair bit about men's fashion,
what do you notice
about the shirt that this guy is wearing.
- It's a different color collar and probably cuffs.
- Yeah.
So, he's wearing what's called a contrast collar
and French cuffs. - Yes.
- Which is, if I had to choose...
the most pretentious thing
you could possibly wear with a suit,
I would say contrast collars.
Now, there's nothing wrong with that.
You know, if you're a tobacco tycoon maybe
and you're drinking a mint julep on a patio,
contrast collar's great.
I believe that there's only one proper color for a shirt,
which is white. But that-- - White, okay. (laughs)
It makes shopping a lot easier, right?
(dramatic music)
An above the knee amputation
is usually a more aggressive one.
If you can, you always try and go below the knee
for stability purposes.
Also, there's a lot of blood vessels here
that are really dangerous.
So, most patients that I see who have amputations,
usually to like diabetes complications, gangrene,
are below the knee amputations.
It's rare for me, at least in primary care,
to see above the knee amputations.
- I imagine you want to save something below the knees
so that the prosthesis is more functional that way.
- Yep, exactly.
(door closes)
(dramatic music)
- Okay, you do rise when the judge comes in.
- Would if I could.
- So that is great.
There's a whole science and pseudoscience
to making your client presentable and human
in front of the jury. - Okay.
- And you're technically not allowed to talk
to the jury,
except in opening statement and closing argument.
- Okay. - So, anything you can do
to humanize your clients, - Wow.
the better.
- And notice he's not wearing a tie.. makes sense
and he's a young guy...
humanizes him a little bit.
But to kinda get that jab in and say,
"Oh gosh, I can't stand up
"because of this horrible thing
"that the doctor did to me."
That's really smart. - Driving home the point.
- Driving home the point.
It's not gonna show up on any transcript, anywhere.
- Now, serving as a juror
in a medical malpractice case, isn't easy.
I don't know about y'all, but I'm no doctor.
Hell, I barely made it
through high school biology. (jury laughs softly)
- Okay, fine.
- But you are going to get a crash course education
in orthopedic medicine and postoperative infections.
And you're going to hear words like "pseudomonas"
and "emboli".
Don't let that intimidate you.
- So, the sort of "aw shucks" thing.
Like, "I'm not a doctor."
Blah, blah, blah.
That can be good.
But you want to pair that with making the defense seem
like they're the ones that are trying
to overly complicate things. - Got it.
And that you're the speaker of truth.
You're going to tell them exactly what happened
'cause you're not hiding anything.
In an opening statement like this,
what you would want to say is,
"You're gonna hear a lot of medical jargon.
The defense wants you to be confused
about these things",
but you want to transition to your theme.
The one thing you want the jury to remember
throughout the entire case.
The lone star that they can hold onto.
And you say,
"Despite all this complicated stuff,
and we're gonna explain it to you,
the one thing you need to remember is... this."
- Dr. Torres agreed to perform a surgery
she did not fully understand.
We will establish that Dr. Torres
made a series of faulty decisions.
Eventually costing Mr. Travis Reed,
a thriving, healthy Olympic athlete,
his legs.
And we will establish that all
of this started because of one careless mistake.
- So, that's not bad.
It's a little argumentative.
An opening statement is not like a closing argument,
where you're allowed to make whatever
arguments you want. - Okay.
An opening statement is there
so that you can tell the jury
what is going to happen.
What evidence is going to come out
based on your extensive discovery,
that you have done. - Sure.
- What I don't like about this is that he has
put the stakes too high.
"This doctor made one huge mistake.
"And this doctor did something she didn't understand."
If I was the defense counsel--
- You would just disprove that, he loses.
Exactly.
In my closing argument I would say,
"Remember when the plaintiff's attorney said,
"'The doctor didn't understand that'?
"Well, you heard from the doctor that she did
"a hundred hours of research,
"corresponded with the manufacturer
"and brought the manufacturing rep
"out to participate in surgery.
"She knew what she was doing."
Is it true that in medical malpractice cases,
unlike the burden of proof
being beyond a reasonable doubt,
it just has to be more likely than not?
- That's exactly correct. - Okay.
- And that is the case with all civil cases.
It's called the preponderance of the evidence
standard.
- All right, let's start closing. Irrigation, please.
- Wait, the sponge count is off,
we're missing one sponge.
- Are you kidding me?
- You can't close until we find it.
- So this is true.
We do a very careful sponge count
before and after the procedure prior to closing
because there have been cases,
as you're well aware,
of sponges being left in patients,
tools being left in patients.
In fact, I remember when we were operating
we would have on the wall all the sponges that we've,
were gonna use for that case.
So there would be like 30 sponges on the wall
in little pockets,
almost like the shoe things, you know?
- Right, yeah that makes sense.
- And then as we take them out,
we put them back in.
And we've made certain adjustments where
before we would just use sponges by themselves.
Now, they have an attached plastic ring
that makes them easier to spot.
You could also leave that plastic ring outside of the body
so you know to take the sponge out.
- Oh!
- So, there's been a lot of adjustments
to improve here
but clearly it's still happens sometimes.
- Are you saying that Dr. Torres
knew she left a sponge in Mr. Reed's body
and she didn't care?
- [Jo] No, of course she cared but--
- No, but still she knowingly left--
- What?! - Who is this on the stand?
- Exactly!
This is one of the nurses or doctors
in the hospital.
So, the plaintiff as apparently his first witness,
has called a hostile witness.
(Dr. Mike laughs)
That is insane.
Juries, like all humans
have the primacy and latency effect.
So, they're gonna remember what they heard first
and they're gonna remember what they heard last.
- Yes.
- So, using that to your advantage
at this point to the stand,
you would call either the plaintiff himself
to tell the entire sad story of what happened to him.
Or you call your expert,
who is going to explain, - On your side.
on your side, all of the medical stuff,
from the secondary material.
You would never call a witness
that is basically
on the other side. - Yeah.
- The patient was running out of time.
He would have--
- Hun, hun. It's a yes or no question.
- (both exclaim in shock) Hun hun?
(laughs loud)
- I've got a boy in college, good kid.
And I went to visit him last month
and you would not believe the sponge I found
in his sink. I mean there's no tellin'--
- Ask a question.
- Objection, irrelevant.
- Yes, that was irrelevant.
But that's like the fifth most important objection
to make here? (Dr. Mike laughs)
He's just telling a story.
"I got this kid in college.
"He's a real mess.
"He left a sponge in the sink."
The only thing you're allowed to do, during examination,
is ask questions. That's it.
- Well, let's fast forward
to the next time you saw Mr. Reed.
- About two weeks later.
- And how was he then?
Was he... good?
Happy?
Recovering well?
- He had an infection. (whoosh)
- Hi there.
Travis, I hear you got quite the fever.
- [Jo] Temp's 103, I'm just starting his workup.
- He's burning up.
- And she said this is weeks later?
- Apparently.
- But weeks later,
she's just seeing him for the first time?
Like, she would see him the next day.
- That sounds negligent.
- [Girlfriend] I had to force him to come in.
- [Callie] How are you feeling Travis?
- Wait, he went home with a fever?
- No!
- Post-surgical fever can happen.
And there's like, a thing that we remember
in medical school called the five W's.
Wind, water, walking, wonder drugs...
and they all mean something different.
Like UTI's, pulmonary embolism is one of them,
wind being pneumonia.
Medications that you could be taking can cause a fever
and you try and rule things out.
But the fact that he went home with a fever
and he's 103,
that's a really high fever.
That should be thoroughly investigated.
- Is that a murmur?
- Okay, so they are listening to the heart.
- Did they listen to the right side?
- Well, it's funny when you listen
for heart sounds,
you actually listen starting
on the right side of the body.
And a lot of people,
patients that are medically in tuned
from watching shows or have some curiosity
they'll say,
"Doctor, you know, the heart's
"on the left side." (laughs)
I'm like,
"Well, there are blood vessels that come
off the heart that are on the right side
that we listen to as well."
The pulmonary artery.
So you want to listen there
and then move your way, make your way,
aorta, listen to the chambers of the heart.
So, yeah we do listen on the right side
to hear the heart.
- That looks bad. (Jo in the background) Oh wow.
- That looks like an infected wound.
- What does "oh wow" mean?
Yeah so, when we give medical feedback,
when we listen to a patient's lungs,
when we look at wounds,
we tend not to exclaim our feelings.
(laughs)
So, we don't say,
"That sounds scary.
That's good. That's bad..."
It's either normal or abnormal
and you keep it at that.
- I don't want you to worry.
The wound looks a little infected--
- A little infected?!
- Okay? - Yeah
- I mean, he looks like a zombie from my eyes.
What I'm seeing right here is all kinds
of reasons why the hospital could have not only contributed
to the initial negligence
but committed its own malpractice, as well.
Which is, that this patient is being sent home
too early. - Yes.
- This patient is not being checked
on regularly. - Yeah.
- And to the extent that they are checking
on this patient,
they're not examining the wound
where the surgery took place. - (laughs) Yeah, exactly.
That wound did not get infected today.
(both laugh)
That's been an infection that's been festering.
And generally speaking, after you have surgery
you have not only follow-ups with the surgeon,
you have follow-ups with your primary care doctor.
All of which times we do vitals,
we check a wound.
In fact, anytime a patient now is hospitalized.
We have one of our nurses call the patient the next day
to make sure they understand the medicines
they should be taking,
what symptoms are they experiencing?
And if anything is off, they come right back.
- What about the murmur?
Could the infection have traveled to his heart?
- His vitals were stable.
So, first we gotta clean out that joint, okay?
We can't afford any delay.
- See? Another thing that's untrue.
How does she know the wound is not just infected
versus the joint is infected?
- Well, at this point,
they might as well just paint a dollar sign
on top of the hospital. - Exactly.
- And this doctor might as well be
just taking wads of cash
and lighting it on fire. - Honestly, I think if,
you can probably create your own law firm
that just targets their patients,
'cause you'd be very well off.
- Post-op infections are very common.
They happen all the time.
- Is that your professional opinion?
- It is. - I see.
And in your professional opinion,
is it also common for a post-op infection
to result in a double amputation?
Does that happen all the time too?
- You don't know what she's going to say right there.
She might say, - Yes.
"In a situation like this,
"where this went wrong,
"his heart blew up, he had a lung problem.
"Yeah. That's exactly what I would expect to see.
"And these doctors did a fantastic job.
"That's completely impeccable."
- What would he have done in that case?
- Thank you, Your Honor. I have no further questions.
(both laugh loud)
- Why didn't you page me sooner?
We just heard the murmur this morning.
- This morning?
- Yeah.
- Look at this growth.
You knew he was a heart patient.
This didn't concern you?
- Of course it did. That's why you're here.
So what did we do?
- The infection is eating away at his graft.
- So, not only is having a fever
'cause his joint is infected,
which she knew somehow without doing any diagnosis,
but his heart valve also has an infection on it.
Vegetations means it has actual bacterial growth on it.
And she's only performing the surgery on his leg,
but not on the heart?
- Dr. Torres? You need to see this.
- I was changing his compression socks and I saw this.
His leg's gray, cold.
I can't find a pulse.
- Why aren't you checking all the time!
- Yeah, exactly.
So, when a patient is laying in a hospital
they're not just passively laying there.
The reason they're in the hospital is
because there are wound checks every few hours,
neuro checks, the residents come in
and round on the patient every morning.
Look at the wound, look at the leg.
- And it seems like,
an area where there's already been some problems,
you probably don't want to hide them
behind compression socks.
- Yes, exactly.
- Okay. Where's Whitney?
- I told her she had time to grab lunch
before Travis woke up.
All right? You need to go find her and tell her--
- That's an ultrasound,
portable ultrasound machine that we use
to hear blood flow.
And the reality of it...
you don't need that for his leg.
You can see that it's not getting circulation.
- Okay. I've got to go in
and do an embolectomy on the spot.
- Yep there's a problem.
- So an embolectomy,
like they're saying that a blood clot has now traveled
to his arteries.
I can't, I can't even follow this.
There's nothing, there's no medical sense
or rhyme or reason. - Doesn't that presume
that a blood clot has flown down to his...
- Arterial system now.
- in his legs.
- Yeah, which means it did a full circle.
(laughs)
- If I don't try this embolectomy
he could lose his leg.
- Well he can live without a leg.
He can't live without a functioning heart.
- Look, if you do the heart tomorrow,
it gives him an extra day on antibiotics.
Right? He'll be more stable.
And the heart surgery will be less risky.
Christina, this is Travis Reed we're talking about!
Let me try to save his leg.
- Does the course of treatment change if you're dealing
with a famous person?
- It doesn't change that.
But it does depend on patient need.
Like if a patient's job is...
intimately tied to a specific function of their body,
we will work harder
to save that body part. - Ah, I see.
- Yeah. So there is some truth to that.
You may have seen musicians play their instruments
during brain surgery.
'Cause they want to make sure they don't do any damage
to something that's really important to that person.
- Whoa! That is cool. - Yeah, yeah.
- What's his temp?
- Oh, he was febrile over night,
but his white count's stable.
- What's going on? - Travis?
- What aren't you telling me?
- What's wrong?
(loud whoosh)
- That's full on necrosis.
So, here's the weird situation.
- Why aren't checking on him?
- Why is he the one pointing that out?
And why are they so casually strolling in
like in the middle of the day?
He's basically throwing more clots
and the fact that they waited to do his heart
(stutters) it's obviously,
she's guilty.
This is a civil suit.
She's not guilty, she's liable.
- Liable - And I think so is
the hospital here. - Yeah, agreed.
And notice where his necrosis was starting from,
below the knee below. - Below the knee.
- Why did they go above?
- Oh man... that's unfortunate.
If you want to see the rest of our analysis,
click here for part two on Legal Eagle's channel.
Check out Legal Eagle.
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