Jury Returns Verdict of $4.58 Million for Denial of Lifesaving Medications

CLEVELAND, May 31, 2016 /PRNewswire/ -- Nakeyia McMichael died from untreated brain swelling 24 hours after being discharged from the hospital with a diagnosis of a simple migraine headache.  A Summit County jury, in a case brought by the law firm of Spangenberg Shibley & Liber on behalf of Mrs. McMichael's family, sent a strong message about the duty of care physicians must follow and the safety that patients in this community deserve by returning a verdict of $4,580,000 for the Estate of Nakeyia McMichael. 

The verdict is intended to compensate the estate for the lost income and services of Nakeyia and the emotional harms and losses experienced by her family, including her husband, three young children, parents, and sister.

"The trauma that this family has endured was completely preventable, as it had been on two prior occasions," said Attorney Nick DiCello. "This close family has been irreparably harmed by this tragedy, and the community has lost a wonderful mother, nurse, and person."

When she was a teenager, Nakeyia was diagnosed with lupus, an inflammatory disease that occurs when the body's immune system attacks its own tissues.  Lupus is a disease that waxes and wanes in intensity with periods of increased disease activity called "flares."  Flares can affect the skin by creating rashes and cause joint pain and inflammation, and in more serious cases can cause organ inflammation, including of the kidneys, heart, or brain.  Despite having lupus, Nakeyia married, had three children, and was working full-time as a nurse.

In the late-fall of 2010, Nakeyia experienced severe headaches that were accompanied by vomiting and nausea.  She sought treatment at the Emergency Department at Akron General Medical Center on December 5, 2010.  The Emergency Department physicians quickly recognized that this was more than a run of the mill headache.  Nakeyia was seen by experts in neurology, neurosurgery, and rheumatology (specialists who treat lupus).  Nakeyia received a CT scan and MRI of her brain, which revealed inflammation, or swelling, of her brain. 

Progressive brain swelling is a medical emergency.  Unlike swelling in other locations of the body, the brain sits inside a fixed skull that allows little room for expansion.  If the brain continues to swell, the brain will eventually be pushed through the bottom of the skull in a process called herniation.  Herniation results in death.  There are medications, primarily mannitol and steroids administered intravenously to reduce brain swelling.  These medications are fast acting and lifesaving.

To treat her brain swelling, Nakeyia was given mannitol, a medication that reduces brain swelling by pulling excess fluid from the brain.  Following the administration of mannitol, Nakeyia's headache and nausea completely resolved.  Nakeyia was discharged from the hospital after four days of intense monitoring and observation by a team of physicians, receiving imaging studies of her brain, and receiving medications that reduced her brain swelling.

Following her discharge in December 2010, Nakeyia resumed her normal daily life as a wife, mother, and full-time nurse.  Nakeyia began seeing a neurologist who instructed her to go to the emergency department if she ever had headaches that were so severe that she could not manage them at home.

In April 2011, Nakeyia experienced another lupus flare that caused her to have a severe headache that was accompanied by vomiting.  Her husband brought her to the Emergency Department at the Cleveland Clinic Main Campus.  A neurology consult was ordered, a scan of Nakeyia's head was performed, and she was administered steroids by IV to reduce the brain swelling.  After receiving steroids by IV, Nakeyia's headache and nausea resolved.  She was discharged from the hospital.  Once again, she resumed her life as a wife, mother, and nurse.

On the morning of June 8, 2012, Nakeyia woke at 3:00 am with a severe headache.  She was nauseated and vomited. At around 5:00 am, Nakeyia and her husband went to the Emergency Department at Akron General Medical Center.  Nakeyia and her husband reported to the triage nurse that Nakeyia's headache was 10/10 on the pain scale, that she was nauseated, that she had a history of lupus, and that she was told that she has "swelling" in her head.  Nakeyia was placed in an examination room where she remained in 10/10 pain and vomited.  She was given a combination of IV medications called a "migraine cocktail."

Nakeyia received no pain relief from these medications and remained nauseated.  Nakeyia was then given Dilaudid, an opioid pain medication, by IV.  Her headache was mildly reduced from 10/10 to 7/10 after receiving this medication and she became sleepy.  She was woken by a physician who informed her that she was diagnosed with a migraine headache, that she should take Benadryl every few hours, and that she should follow-up with a primary care doctor within one week for her migraine headache.  She was given discharge paperwork confirming her diagnosis of a migraine headache. 

During the hospitalization on June 8, 2012, no one ordered any imaging of Nakeyia's brain, no one administered any medications to treat brain swelling, no one requested a neurology consult, no one contacted any physician who had treated Nakeyia previously for this condition, and no one looked at the medical records from Akron General 18 months earlier that documented how Nakeyia had successfully been treated for the same condition at the same hospital.

The Emergency Department of Akron General was operated by General Emergency Medical Specialists, Inc. ("GEMS"), a medical corporation that employs emergency room physicians.  John Pakiela, DO was the attending and supervising physician responsible for the medical decision-making and treatment Nakeyia received.

The next morning, June 9, 2012, Nakeyia woke with excruciating headache like she had the day before.  While her husband was attempting to retrieve pain medication, Nakeyia became unresponsive.  Nakeyia was rushed by ambulance back to the same Emergency Department at Akron General where she was seen 24 hours earlier.  Multiple tests were performed to confirm that Nakeyia was brain dead.  The cause of her brain death was herniation due to untreated brain swelling.  She was 33 years old.   

After more than two weeks of testimony and evidence, the jury found that Dr. Pakiela and GEMS were negligent and that their negligence caused Nakeyia McMichael's death.  The lawsuit was tried in the Summit County Court of Common Pleas in May 2016 by Spangenberg Shibley & Liber trial attorneys Michael A. Hill, Nicholas A. DiCello, and Peter H. Weinberger. 

Many of Spangenberg Shibley & Liber LLP's cases come via word-of-mouth, either from satisfied former clients or from other attorneys who know the firm is skilled at handling complex litigation and trying the most difficult cases.

The Cleveland attorneys of Spangenberg Shibley & Liber have devoted themselves to representing injured persons and aggrieved businesses for more than sixty-five years. Spangenberg Shibley & Liber, founded in 1946, has won more than one billion dollars in verdicts and settlements on behalf of clients. The firm maintains a "Best Law Firms" rating by U.S. News for Tier 1 Medical Malpractice Law and Personal Injury Litigation. For more information, you can contact the firm online or call (216) 600-0114.

SOURCE Spangenberg Shibley & Liber

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