Litigation Support: Case Examples

    With nearly seventeen (17) years of experience in the courtroom, APS has a proven track record of winning cases at a rate far in excess of the industry average.

    In fact, where other insurers have realized significant losses, APS has helped influence verdicts for the defense team or assisted in achieving case dismissals. Please review this featured case to learn more about our process and our results.

    Figure 1. Article from Boston Globe

    Figure 2. Roux-en-Y Bypass

    Figure 3. Letter from Defense attorney

    Post-operative complications with gastric bypass lead to lawsuit.

    Case Details

    This suit was filed by Charlie Weis, head coach of the football team at the University of Notre Dame, in the wake of a laparoscopic roux-en-Y gastric bypass performed on 6/14/2002. In this case, two well-known complications, intra-abdominal bleeding and leakage, occurred in the postoperative period.

    During a contrast upper GI series, a leak was revealed at the site of the gastrojejunostomy. Two days after the initial surgery, a second surgery was performed. An exploratory jejunostomy revealed that the roux limb was filled with clotted blood, which caused increased pressure in the gastric pouch, in turn leading to leakage of the anastomosis. The physicians irrigated the blood and repaired the leakage. Then, by inserting an endoscope and filling the peritoneal cavity with fluid, the surgeon insured that the anastomosis was intact.

    Defense Verdict

    Intra-abdominal bleeding and leakage are common postoperative complications of this procedure, so it was not surprising that they occurred in the Weis case. The complications were diagnosed in timely fashion, and further surgery was required to repair the leakage. The second surgery was successful.

    APS provides medical exhibits to explain complicated procedures and recognized complications to the lay jury. In this case, we provided a normal-anatomy medical illustration of the digestive system, identifying structures and organs to assist the defendants and experts in educating the jury. We then provided a case-specific medical illustration to explain the roux-en-Y gastric bypass that was performed. We illustrated the laparoscopic ports and the techniques that define a normal Roux-en Y gastric bypass. The doctor could then educate the jury on the details of the case with the assistance of a clear and accurate visual representation of the relevant anatomy.

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Other Case Examples

United States v. Kristen Gilbert

APS provided all demonstrative evidence for the prosecution in the case against Nurse Gilbert, the notorious Angel of Death convicted of the murder of four patients she was supposed to be tending.
The judge who presided over the case described our contribution as follows: "This equipment, still rare in most courtrooms, made presentation of medical records, all of which had been electronically scanned, enormously easier. Direct testimony of the government's lead cardiologist unfolded with multicolored, animated diagrams of the heart, a tour de force presentation of expert testimony."

Reginald Lewis Estate v. Gilbert Mudge, M.D., et al

APS provided an interactive presentation bolstering the defense and helping the jury find for Dr. Mudge, the defendant in the case filed by the widow of the former Boston Celtics star.

Vaskas: Pulmonary Surgery with Complications

APS provided demonstrative evidence for the defense in a case of complicated anatomic anomalies. Through medical illustrations created directly with physicians, the defense attorneys were able to walk through the series of events that led to an unpredictable and unpreventable post-op complication of a necessary surgery. APS showed that post-op bleeding after a V.A.T.S. (video assisted thoracic surgery) procedure to remove a sequestration in the lung tissue was a well-known complication and that every attempt was made for the patient. APS successfully described complicated terms, such as P.E.E.P. (positive end-expiratory pressure), atelectasis, and fibronolysis, to assist the jury in understanding what surgeries were performed and the clinical rationale behind them. APS was pleased to be of assistance in the defense verdict for a very talented thoracic surgeon.

Lindor: Shoulder dystocia

APS provided demonstrative evidence for the defense in a case involving shoulder dystocia that resulted in the child developing Erb's Palsy. The plaintiff’s claim rested on the use of a vacuum extractor. Plaintiff attorneys claimed the device was used when the baby was too high in the maternal pelvis for safe delivery. The resulting child was born with Erb's Palsy, a form of brachial plexus injury. Through records and feedback from physicians, APS was able to create medical illustrations to educate the jury on proper placement of the vacuum and the optimal stations for its use. We also created illustrations to demonstrate how a brachial plexus injury could occur in utero, and to show that the different maneuvers used during delivery were accepted as the standard of care at that time.  APS was pleased to be of assistance in the defense verdict for a well-respected obstetrician.