A St. Clair County jury returned a verdict in favor of all four defendant medical professionals on Wednesday in Chief Judge Andrew Gleeson's courtroom in a suit alleging they failed to recognize the severity of a patient's spinal injury. 

After deliberating roughly two hours, the jury reached verdicts in favor of defendants Dr. Rachelle Leach, Stephanie Armstrong, PA-C, Elizabeth Kraus and Midwest Emergency Department Services. 

Plaintiff Donald Santel was represented in the case by Amy Gunn of The Simon Law Firm PC in St. Louis.

Leach and Armstrong were represented in the case by Ted Harvey of Freeark Harvey & Mendillo PC. 

Kraus and Midwest were represented by Kenneth Burke of Brown & James PC. 

During closing arguments Wednesday morning, Gunn told jurors that the case arises out of the defendants’ alleged failure to order a CT scan to fully investigate the plaintiff’s neck pain.

“Ordering a CT scan, that is not herculean effort,” Gunn said. “That is not overly above what someone would do.”

She argued that had a CT scan been done earlier, the defendants could have prevented Santel's worsening condition.

Gunn asked the jury to award Santel more than $532,000 for medical expenses and anywhere from $315,000 to $600,000 for lost wages. She also asked for an unspecified amount in loss of a normal life, which she said is Santel’s “greatest expense.”

“That is the largest harm in this case,” Gunn said. “You all decide what that is.”

Presenting closing arguments for Leach and Armstrong, Harvey reminded jurors that they cannot base their verdict on speculation, prejudice or sympathy.

“It’s easy to be sympathetic to Mr. Santel,” Harvey said.

He added that jurors should decide the case on credibility and believability.

“I don’t think any of the experts, the witnesses, for the plaintiffs are believable at all,” Harvey said.

Harvey argued that Leach and Armstrong were not negligent in their care of Santel as they performed thorough physical examinations that did not reveal any neurological symptoms that would lead them to believe a CT scan was necessary. He added that medical professionals don’t order CT scans unless they feel it is necessary because it exposes the patient to radiation.

Harvey also argued that the defendants used the Nexus system as a guideline to determine the appropriate treatment, but “in the end, it’s your clinical judgment.”

During closing arguments for Kraus and Midwest, Burke said Gunn’s arguments were based on speculation, assuming things would have gone differently had the defendants ordered a CT scan earlier.

Burke added that Santel allegedly reported a pain level of four out of 10 and showed no signs of neurological symptoms when he saw Kraus. She also allegedly performed a physical examination in an attempt to produce symptoms.

Gunn countered by arguing that if the defendants suspected a more serious injury, then they should have ordered a CT scan.

“The clinical judgment of these providers is that they suspected a cervical spinal injury,” Gunn said. “If you suspect that, you don’t get to leave it on the table.”

She told jurors that if they consider it acceptable care to mask pain with medication instead of fully investigating an injury, then “say so in your verdict.”

Santel filed his medical malpractice complaint on March 21, 2014. He claimed that he developed right shoulder and neck pain after he slipped and fell onto a concrete surface on Feb. 26, 2013.

The pain allegedly persisted and increased in severity until he went to the emergency department at St. Elizabeth’s Hospital in Belleville on Feb. 27, 2013.

Leach and Armstrong, a physician’s assistant, ordered an x-ray but did not order a CT scan or MRI, the suit states. They allegedly diagnosed Santel with a shoulder sprain and discharged him with pain medication.

Santel alleged his neck pain became worse in the following days.

He returned to the emergency room on March 3, 2013, seeking treatment for his worsening neck and shoulder pain.

Kraus, a nurse practitioner, allegedly examined Santel without ordering a CT scan and diagnosed him with a trapezius sprain. He was again discharged with muscle relaxers and pain medication.

Two days later, Santel claimed he collapsed while trying to get out of his bed from intense pain in his neck and numbness and spasms throughout his limbs. An ambulance took him to St. Elizabeth’s emergency room for a third time.

Santel alleged that by the time he arrived at the hospital, he was “extremely weak, unable to move his arms and presented signs of jaundice, renal failure and multisystem organ failure.”

Santel was admitted to the intensive care unit and underwent an MRI of his C-spine, which allegedly revealed thecal sac narrowing, asymmetric disc protrusion and cord flatting.

Santel then underwent urgent neurosurgery, which allegedly revealed purulent drainage, C5-C6 diskitis and a spinal infection.

Santel underwent a fusion of his spine and an incision and drainage during the surgery, the suit states.

Santel was transferred to Barnes Jewish Hospital’s ICU for more care.

According to his complaint, he was suffering from a spinal infection, acute quadriparesis, sepsis, septicemia, multisystem organ failure, acute renal failure, acute liver failure and acute postoperative respiratory failure when he was transferred to Barnes.

St. Clair County Circuit Court case number 14-L-235

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Organizations in this Story

St. Clair County Circuit Court
10 Public Square
Belleville, IL 62220-1623

Brown & James P.C.
525 W Main St
Belleville, IL 62220

The Simon Law Firm PC
800 Market St
St. Louis, MO 63101

Freeark, Harvey and Mendillo, P.C.
115 W Washington St
Belleville, Ill. 62220

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