Francis A. Howell III

Paul Karp (Partner-New York, NY) and Francis Howell (Associate-White Plains, NY) obtained a defense verdict on behalf of their neurologist client following a jury trial in the Supreme Court of the State of New York, Rockland County. The plaintiff, a police officer, alleged that the neurologist failed to timely diagnose and treat myasthenia gravis, a neuromuscular disorder that causes muscle weakness in the voluntary muscles. He claimed that the alleged delay in diagnosis and treatment resulted in a “myasthenic crisis,” causing respiratory failure and admission to an intensive care unit, and negatively affected his ability to be a father and carry out normal daily activities. The plaintiff had missed more than one year of work following his ultimate diagnosis. At trial, the plaintiff’s expert testified to 17 alleged departures from the standard of care and that the failure to promptly diagnose myasthenia gravis worsened disease progression and diminished responsiveness to treatment.

Using meticulously detailed demonstrative exhibits, Paul guided the jury through the plaintiff’s course of treatment during the 6 months of alleged negligence, during which 11 medical professionals across 9 specialties evaluated him. Through expert testimony, Paul challenged the plaintiff’s claim that he suffered a myasthenic crisis, establishing that the plaintiff’s Negative Inspiratory Force (NIF) score never met the clinical threshold for such a diagnosis, despite repeated references to a "myasthenic crisis" in the non-party hospital records. Paul also undermined the plaintiff’s neurology expert’s credibility through cross-examination regarding the expert’s extensive work on behalf of petitioners in the U.S. Court of Federal Claims.

Frank drafted a successful memorandum of law arguing that the verdict sheet should be limited to a single liability question, despite the plaintiff’s numerous alleged departures from the standard of care, and only one liability question was submitted to the jury for consideration. He also filed a memorandum of law to preclude the plaintiff from making an improper argument to the jury on summation. In closing, Paul argued that the plaintiff failed to meet his burden of proving liability because his symptoms were diffuse, vague, and inconsistent with a diagnosis of myasthenia gravis during the relevant period. He further argued that the plaintiff failed to establish that any alleged delay in diagnosis caused a worsened prognosis or the claimed myasthenic crisis.

After deliberating for less than one hour, the jury returned a defense verdict in favor of Wilson Elser’s neurologist client. 

Michael E. Gallay (Partner-White Plains, NY) and Francis A. Howell (Associate-White Plains, NY) obtained summary judgment in the Supreme Court of the State of New York, Westchester County, on behalf of a large hospital system, a pediatric ENT surgeon, and an anesthesiologist. The plaintiffs alleged the improper prescription of oxycodone for pain relief following a tonsillectomy, resulting in the overdose death of the 5-year-old patient five days after the surgery. The summary judgment motion was supported by the expert affirmations of a pediatric ENT, a toxicologist, and a pharmacologist who had done years of research on the effects of oxycodone on pediatric patients. The experts agreed that the medication was prescribed within the standard of care for ENT surgery, the dosage was appropriate, and the post-mortem oxycodone levels indicated the child must have received significantly more than prescribed. In opposition, plaintiffs’ counsel submitted only the affirmation of a retired pediatrician who never performed a tonsillectomy, never prescribed oxycodone to a pediatric post-operative patient, and lacked training in pharmacology or toxicology. The court adopted Michael and Francis’s reply argument, finding that the plaintiffs’ purported expert merely cited out-of-context medical literature, constituting inadmissible hearsay, and failed to demonstrate sufficient knowledge of the applicable standard of care for prescription of oxycodone or pertinent pharmacological factors of pediatric oxycodone use. Accordingly, the court held that Wilson Elser met the burden of demonstrating a prima facie right to summary judgment and that the plaintiff expert’s affirmation was insufficient to create an issue of fact.

Paul Karp (Partner-New York, NY) and Francis Howell (Associate-White Plains, NY) defended a hospital, treating neurosurgeon, and treating neuro-intensivist (an internationally recognized expert in the field of Neuro Critical Care Medicine) in a case venued in Westchester County Supreme Court that involved claims of pain and suffering as well as wrongful death after the decedent suffered an intracerebral hemorrhage. The plaintiff claimed that the decedent was suffering from life-threatening intracranial pressure, which put her in danger of an imminent brain stem herniation, and that surgery should have been performed to place an extra-ventricular drain and intracranial pressure monitor. Paul was able to prove through his witnesses that the decedent had significant preexisting cerebral atrophy with enlarged Sulci, which provided the room within her brain to accommodate the edema caused by her severe stroke. Paul’s witnesses, using the evidence graphics we created, were able to definitively show that even without the placement of the intracranial pressure monitor, the pressure within her skull was stable and she was never in danger of developing the life-threatening brainstem herniation. Therefore, no surgical intervention, nor the administration of last-ditch effort pharmacological interventions (Hypertonic Saline or Mannitol) to reduce brain edema were warranted. Frank filed a motion in limine to preclude the plaintiff from offering testimony analogous to that of an expert and the motion was granted by the court. After a week of trial, the co-defendant, a skilled nursing center, settled out with the plaintiff. Rather than continue the case, the plaintiff discontinued the action as to the hospital and the two named physicians.