Sample Medical Malpractice Closing Statement Transcript

Below is an example of a medical malpractice closing statement given by Rod Gaston in a brain aneurism misdiagnosis case.

Laura Zois’ opening and rebuttal close in the same case

P R O C E E D I N G S
THE COURT: Folks, thank you. Please have a seat.
Have a seat. Madam Clerk, good afternoon. Shall we continue,
please? Sir?
CLOSING ARGUMENT BY RODNEY M. GASTON, ESQ.
ON BEHALF OF THE PLAINTIFF
May it please the Court, good afternoon to the jury.
As you look over to the trial table, you’ll notice that Ms.
White is not here. She’s out of the courtroom, because she
did not necessarily want to hear lawyers talking again about
her child’s death and she did not want her emotions to
interfere with the job that you have to do.
In our society, we place a very high value on human
life. And when that human life is taken away by the negligence
of someone else in our society, the community as a whole is
responsible for fully compensating that person for the losses.
And that’s Jonathan and his mother. In this case, what
happened to Jonathan during the week of July 2, 2015 is
inexcusable. And you as members of the jury are the only
persons in our society who can right the wrong and provide
justice in this case.
There is absolutely no defense to what happened to
this child. Ms. White, all she and Jonathan wanted was for
his medical providers to do their job. That’s all any of us
expect of any person, to do their job. And she only asked them

to do one thing. She asked one question. What is wrong with
my son? That’s it. They couldn’t even answer that question.
That’s what cost this child’s life.
Now, I’m going to explain to you by using the
evidence in this case to give you a roadmap how you can reach
the correct and just verdict in this case so that Ms. Jones
and her son can obtain justice. Brady is no longer with us.
That means that you are his voice. You will speak for him in
the verdict that you render in this case.
Before I talk, I’m going to have to go over some of
the evidence and I know we’ve been here for a couple of weeks.
But the evidence is important. And before I get to each of the
individual defendants and what they did wrong, there is one
thing that’s very important. When evaluating this child, we
learned of the red flag. The red flag in this case we heard
from Dr. Duncan, who was the very last witness.
The red flag is this — and red flag means danger.
The question is, was this headache waking this child up at
night? That was one of the most important questions for all of
these doctors and medical providers to answer, because if the
answer to that question is yes, then something is really wrong
and this isn’t just a child who has another headache.
Dr. Valderrama — we know the child couldn’t sleep.
He was unable to sleep. Dr. Valderrama never asked that
question. Dr. Martin never asked that question. Dr. Mitchell

— and this is interesting. This is how important the answer
to that question was. I asked Dr. Mitchell — was it important
for you to know if these headaches were waking this boy up? I
asked her that question three times. Every time she avoided
the answer. Then I needed help from the judge to get the
answer to that question. And the judge said, “ma’am, answer
the question.” She knew the answer to that question would be
devastating for their side, because the answer to that question
was very important, because then you look somewhere else. They
never asked. They never got the answer to the question which
they needed. And it’s very important.
Now, let’s talk a little bit about what the
obligation was. This is the obligation of all these medical
providers. They had to rule out the life threatening
conditions. And keep in mind, we’re not saying that they had
to know specifically that this was a rare condition of sentinel
bleed and they had to focus on that and that was the only thing
they had to do and the only thing they had to rule out. That’s
not it. That’s not it, folks. They had to rule out the life
threatening conditions.
One of those life threatening conditions is what
killed this child. All they had to do was look for them, and
they had all the signs and symptoms that this child had life
threatening conditions. So we’re not claiming that they had to
think specifically, okay, this is the one, this is the only one

we’ve got to find. It’s the only one. That’s not it.
Globally, the child presented with symptoms of what’s called
secondary source of headaches. And they had to be aware of
that and rule out those life threatening conditions and they
would have found the life threatening condition that killed
this child.
The standard of care. The judge told you — it’s
pretty simple. It’s just what a reasonably competent medical
provider would do under similar circumstances. That’s all
that’s required. Bare minimum. Reasonably competent. That’s
all we ask for. That’s all any of us ask for in our society.
And who was reasonably competent? Two medical providers were.
Nurse Practitioner Tanner. She’s the first person that saw
this child. She recognized that his condition was so ominous
that she sent him right to the hospital. She got it right.
That’s why she’s not a defendant in this case. She got it
right. She did exactly what she was supposed to do. A nurse
figured this out. From the very first visit. But none of the
other doctors did.
Children’s Hospital, unfortunately, and it was too
late at that time, but they did what they were supposed to do.
They took the right history. They knew what was going on with
this child. This was a complete system failure. Complete from
beginning to end. They only had one job, rule out the life
threatening conditions. When in doubt, rule it out. Better

safe than sorry. It doesn’t do any good to be sorry when the
child is dead. It’s too late. Safety. It’s all about patient
safety. That’s the complete medical system. Life threatening
conditions. Okay? Aneurysm is a life threatening condition.
Nobody disputes that. A lesion is a life threatening
condition. Nobody disputes that. A tumor, absolutely. Nobody
disputes that. And a bleed, which is what the child had.
Nobody disputes that these are life threatening conditions.
And guess what? He had all of these symptoms for these life
threatening conditions.
Inaccurate history. Examine the evidence. You heard
all these different doctors explain the history that they had
taken. None of them had the exact history right. They picked
different drop down menus. They didn’t ask the right
questions. Or I asked the questions, but I didn’t document the
answer. Really? Aren’t you supposed to document the answers
if you’re a medical doctor? Because when someone else looks
behind you
, you can say, I did what I was supposed to do.
Okay, if it’s in the chart, you did. If it’s not, how do you
know what you did? Just trust me. Trust me. I did
everything. Well, that’s why there’s medical documentation.
And that’s what our society requires.
Be thorough. Be thorough. I heard one doctor say, I
don’t have time to write two paragraphs. If you choose the
profession of a doctor — nobody forced you to do that — and

you don’t have time to write two paragraphs for a child that
you’re entrusted to care for? And you’re being paid to do
that. We’re not asking you to do something that you weren’t
trained to do. We’re asking you to do something that you were
trained to do. And when you go back in the jury room, there’s
a document that we introduced that we didn’t talk much about.
You may or may not look at it — but if you want to
know how many patients these doctors were in charge of seeing
on the second, for that four hour window, it was 18. How much
time do you think Dr. Valderrama and Dr. Martin spent with this
child? It’s no excuse that they have to see 18 patients. You
can’t rush a patient through because you have another patient
that’s waiting. It’s like we’re going to do a thorough job.
The corporation that hired these doctors put them in
charge. And the action of the Gunson (phonetic sp.)
Corporation too, for their negligence — to take their time.
You expect the doctors — we all expect the doctors to spend an
equal and fair amount of time with each of our “children.”
Each child is entitled to equal care under the law. You can’t
shortchange a child.
It’s obvious that Ms. White, who was born in another
country, came to this country lawfully and got a job as a
productive citizen. English isn’t her first language. Spanish
is. They never asked her if she wanted a translator. Why not?
Come on, now. This community is diverse. We have people from

Asia, people from Vietnam, people from India, people from South
America — all in our great community here. And when you go to
a hospital, the hospital should recognize, okay, if this
patient does not speak fluent English, how about asking them?
Dr. Valderrama speaks the same language as Ms.
White, but she decided, I’m not going to speak to her in
Spanish. We’re just going to try to get through in English.
If there’s a problem with communication, it is the provider’s
responsibility to ensure adequate communication. That’s their
job. That’s what they’re trained to do. They never asked for
a translator.
Did these providers talk to each other? Nowhere in
the chart is there a statement of Dr. Martin — I spoke to Dr.
Valderrama. I reviewed with Dr. Valderrama her plan, her
initial mental impression. It was migraine. That’s wrong. I
corrected her. Now we’ve got the right diagnosis. Right
diagnosis. We know there was no real communication, because
what papers was this child discharged with? Migraine
headaches. How do you give a mother discharge instructions for
a condition the child does not have? Does that make any common
sense? Does that make any medical sense? Does that make any
sense? It’s up for you to decide that.
Medical records. Missing information. Where’s all
the answers to all the important questions? They’re not there.
They’re supposed to be there. Wrong information. There’s

information in the chart that’s wrong. Flat out wrong. We
know there’s information in the chart that’s wrong, because
International Pediatrics simply cut and pasted the medicine
that they had given the child way before, and they kept going
through the chart and sticking with the chart. Wrong
information. And it’s their own chart.
False information and mistakes. How many mistakes
are we going to allow for the care of a child? Jonathan’s
symptoms — here we go — nausea, vomiting ten times. In your
everyday life, have you ever heard of a child vomiting ten
times in one day that didn’t have a stomach virus and wasn’t
suffering from food poisoning? What’s causing this? This is a
big deal. Parents want the answer to this question. She never
got the answer.
Severe headache, eight out of ten. It’s not a one
out of ten. It’s eight. Neck pain. All these symptoms match
a brain bleed. Everyone said they did. No doubt about it.
They do. Tanner’s note page 139 — it’s in the record. You
can look at it. She did the right thing. “I saw no reason for
him to have such severe vomiting.” No reason. She is a nurse
practitioner in a pediatric office that sees hundreds and
hundreds and hundreds of children.
In fact, the doctors there staff their offices with
this nurse practitioner, because they believe she’s competent
enough to do the evaluation. And she was. And she figured

out, okay, what is the reason for the severe vomiting? She saw
none. In all of her experience, she can’t figure it out.
Which means something else is going on with this child.
Something serious. He appeared very ill.
If you look at her note, he had normal vital signs.
Normal. But he is ill. That tells you that a child can have
normal vital signs and still be very, very ill. So when they
tell you the reason we didn’t do anything else is because he
had normal vital signs, whoa, whoa — back up. Back up. She
knew the child had vital signs. He appeared ill, and she knew
what to do. And none of these other doctors could figure it
out.
And you don’t have to look any further to understand
what the standard of care requires in this case, because the
nurse has it right here. The reason she sent this child to the
hospital was to rule out serious causes for the headaches.
Those are the life threatening conditions. She knew what had
to be done. All of these other doctors — more training than
the nurse, more experienced than the nurse — emergency room,
board-certified doctors, fellowship trained doctors — they
couldn’t know to rule out the more serious causes. That’s why
this child is dead.
Dr. Valderrama, third year resident. I understand
she’s a third year resident. She’s still a medical doctor.
She’s still licensed by the State of Maryland to take care of

patients. She doesn’t have the training of a board certified
doctor. But remember, she went through her pediatric neurology
rotation already. She knows what to look for in children,
because she worked side by side with a pediatric neurologist to
know what to look for, the danger signs to look for. She
already knew that. So she says, I’m just a third year
resident. Well, wait a minute. Hold on a second. You don’t
get a pass because you’re a third year resident. The judge
didn’t say the standard of care applies to all doctors except
for third year residents. It applies to everybody.
Now, no prior episodes. Drop down menu. This was a
big deal. She put no prior episodes. Why is that important?
Because of the child didn’t have any prior episodes, this was a
huge, huge, huge deal, a big red flag that required more
evaluation. They had to do something to change that. Because
that didn’t match the defense the lawyer came up with. And
what did they do to change that?
She also failed to ask the important questions. She
failed to recommend CT. She changed her deposition testimony.
If yo
u recall — and I know you’ve got to remember back, she
said this was accurate. And on the witness stand, oh, now,
it’s a mistake. Now it’s a mistake. I didn’t mean to do that.
So she’s changed it. No, that’s a mistake. And she changed the
medical chart. No, the drop down menu was wrong. I picked the
wrong thing. I didn’t know what I was doing.

Interesting enough, what she picked to change is
exactly what matches the defense they’re presenting to you in
this case. Isn’t that convenient, that the one thing she
picked to change matched the defense.
And if you know anything about investigations, if you
watch any type of police show, what you look for is did someone
change the story? When you change the story, there’s a reason
why. Why did she change her story in this case? That’s for
you to decide, why did it change? She gave the patient the
wrong information.
Dr. Martin, the doctor who is supposed to be
supervising Dr. Valderrama, no documented discussion of the
conversation. None. I mean, if you’re supervising someone,
don’t you want to put in the record I supervised this doctor, I
did this, I did that, I did this, I did that — because that’s
your job. Her employer who hired her to do this job, doesn’t
she want to show her employer, I’m doing the right thing —
here’s my documentation.
I’m properly supervising this younger doctor, because
I’ve got more experience. No detailed documentation of her own
exam. Two sentences. There wasn’t a detailed history and
physical that Dr. Valderrama did. Just a couple of sentences.
And she thinks that’s adequate. You have to decide whether
that’s adequate or not. No CT scan.
Okay. That’s a problem. This child had signs and

symptoms of life threatening conditions, and they didn’t even
order a CT scan. How easy is it to do a CT scan? It’s right
down the hall. Same hospital, same floor. Have the entire
results back within an hour. The child was there for three and
a half hours. Plenty of time to order it. They just didn’t
feel like it. Approved a discharged with migraine headache
papers.
Was she really paying attention when she approved
migraine headache papers to give to this child, when as we all
know, they didn’t diagnose migraines in the emergency room?
Why are you giving papers for migraine headaches? Come on.
What’s going on here? Are you paying attention to this child
or not? She signed the note five days later.
Now, I understand that sometimes doctors get busy. I
get that. But she was going away for four days. She had four
days off. And she couldn’t spend five minutes at the computer
before she left the hospital to put her note in the record?
She knows how important her notes are, because other doctors
read them, especially if the child comes back to the hospital.
She knew that. And she left.
And how does she remember what she did five days
later? This is kind of interesting. Oh, I’ve got specialized
training for my brain. I’ve got specialized training so I can
remember things better than anybody else, because I’m a doctor,
and I can do it, I can remember six patients. Well, what

training did you have? Well, not really any school training,
just from being a doctor and working here. Is that right?
Okay. That’s why you can remember things better than anybody
else? It’s up to you whether you decide to give any
credibility to that.
Dr. Mitchell — her drop down menu — character of
symptoms unknown. It’s missing. That’s missing information.
Degree at onset. Unknown. Isn’t it important to know these
facts for this child? Headache waking Jonathan up. Unknown.
This is the red flag I was telling you about. That’s why I
spent so much time getting the answer from her, because I knew
how important it was. She knew how important it was. Now you
know how important it is.
This is something that is really unexplainable. Dr.
Mitchell knew the exact treatment plan this child had three
days before. Remember what it was. They gave him an IV of
Toradol. It’s pain medicine. The child felt better. Well,
you can shoot pain medication into the child’s vein — anybody
is going to feel better for a while. Two hours later, the
headache came back. She knew that because she read that. She
knew that treatment plan didn’t work for this child. And what
did she do? The exact same treatment again.
So she expected that the same treatment plan that the
doctors used three days before but failed was going to work for
this child. Why? There’s a thing in our lives that we’ve

learned that if you do the same thing over and over again and
expect a different result, what is that called? You all know
what’s that’s called. That’s what she did. That’s what she
did.
The thing about Dr. Mitchell, though, she considered
the CT. She almost got it right. She considered it. She
said, oh, nope, not for this child. Not for this child. Why?
Why? Why not for this child? He’s been to the ER twice. Now
he’s not sleeping. He’s not getting better, folks. He’s
getting worse. He’s getting worse. The judge told you about
foreseeability. When the danger increases, a reasonable doctor
acts more carefully.
We’ve already had this child in the emergency room
once. The doctors already evaluated his entire condition once.
He’s back again with worse conditions. She said when she
pulled up her chart that note came up from before and she was
on heightened alert status. But she didn’t do anything.
You’ve got to think of something else. You have to think of
something else.
And here’s what’s definitive. You can determine
whether this is important or not. But she testified falsely in
her deposition. And this is important. Dr. Martin’s note
wasn’t in the chart when she saw it. Dr. Martin’s note was put
in the day after. She said at her deposition, I read that note
and I considered everything that day. Then she realized what

she said was false. You have to determine the weight to give
that with respect to everything she said. That’s for you to
determine. I’m not going to tell you what weight to give it.
That’s your job.
Longely, physician’s assistant. Where’s the pain
score? The first thing you ask someone — you hurting? What’s
your level of pain on a one to ten? Doesn’t every doctor —
any time in the community, think in your own lives, when you go
to a doctor and you’re hurting, what’s your level of pain? She
never asked. That is probably something that is important for
this job. Differential diagnosis, she — give her credit for
this. And she deserves a great amount of credit for this —
she got the right differential. She got the right
differential, and she deserves great credit for that, because
she figured it out.
But the problem is she didn’t act on it. She knew
it. And she got it right, but she just didn’t act on it. If
you know it and you get it right, you act on it. And if she
had simply acted on it, this child would not have died. And
the way that she was supposed to act on it was to rule it out.
You rule it out by a CT. You heard Dr. Bates say
of the
responsibility she had — get this child to the ER for a CT
now. You can’t wait with a hemorrhage. You wait with a
hemorrhage, you’re going to have a bursting aneurism and the
child is going to die. Why wait?

Did anyone on the defense give you a reasonable
explanation why you wait? Why are you waiting? What harm
would have it done for this child to have done the CT that day?
No harm. What benefit? It would have prevented the child’s
death. All she had to do was call the neurologist. Think in
your everyday life — hypothetical question. Physician
Assistant Longely called Dr. Edelstein. That’s who they’re
referred to. Dr. Edelstein, I have your patient because
Jonathan was her patient.
He’s been to the ER twice with horrible headaches.
He’s gotten treatment from the ER twice that’s not working.
Now he’s not sleeping. He’s here again. I have in my
differential a diagnosis of aneurism and hemorrhage. I need
your help. Could I send this child over today? Can you
squeeze this child in on what is a potentially life threatening
situation among all the other children who are there for a
regular visit? Can you squeeze him in, please? What do you
think Dr. Edelstein would have said? Sure. I’ll take a look
at that child. But she never made the call. Never made the
call.
And the cut and paste — we know that there was wrong
information cut and pasted into this chart. And we also know
she never signed her note. She was supposed to sign it. She
was out of town. Someone else got in there and signed it. She
didn’t sign it — the supervisor didn’t sign it either. You

can determine what weight to give that failure. Remember, it’s
a system failure all the way down the line.
Dr. Edelstein, the neurologist, cut and paste. Now,
you have to determine — and it’s up to you, based upon the
evidence — is what Dr. Edelstein did is simply take the
information from the 2009 note and paste it into this note?
That’s up for you. These two documents will be there for you
to review.
And what we’re talking about is a neurological exam.
It is word for word. Word for word. Is this just a
coincidence or is it something that Dr. Edelstein said — we’re
just going to cut and paste. It’s up for you to decide. Use
your common sense. How can two evaluations six years apart be
exactly identical, word for word? It’s up to you. You have to
decide that.
Now, with respect to Dr. Edelstein. Do you remember
how long Dr. Younkins (phonetic sp.), who was here today, told
you that he takes to evaluate a child like this? Three hours.
He does a thorough evaluation to rule out any life threatening
conditions for children that come to his office. Three hours.
How long did Dr. Edelstein take with this patient? She already
knew the history. Two visits to the ER. Two visits to the
primary care. They still haven’t figured out what’s causing
the child’s headaches. Do you think she took three hours or
not?

Dr. Edelstein did on the witness stand admit, you
know, when you have a child like this, it’s her job to reach a
correct diagnosis. And what did we hear Dr. Younkins say? You
don’t have to do that. You’re a doctor, aren’t you? You don’t
have to reach a correct diagnosis? Can you imagine if you’re a
member of this community and you into the pediatrician’s office
and you ask the pediatrician, doc, what’s the diagnosis, and
the doctor says, I don’t have to reach a correct diagnosis.
Would you ever go back to see that doctor again? That doesn’t
make a whole lot of sense from what’s going on on the defense
side.
She did think Jonathan had a brain lesion, to her
credit. She did. That was the right thing for her to be
thinking for this child. To her credit, she ordered a CT of
the brain. Exactly what should have been done days before.
Here’s the order. And what I couldn’t understand — and you
have to determine whether you understand it — why does she say
I didn’t order the CT when we have her order signed by her on
the 8th?
She made the correct differential diagnosis which was
one of the life threatening conditions. She ordered the right
test. But she — like Physician’s Assistant Longely, didn’t
take it to the next step. The next step is get the test done
now. Why wait? Why wait? The answer to that question has
never been explained by any doctor.

And she kept the truth from the patient. This is a
little disturbing, or maybe it’s a lot disturbing. She thought
that this boy had a brain tumor. She’s ordering a CT for the
brain tumor. The parent is sitting in the office. What do you
expect a doctor to tell a parent of a child when the doctor
thinks the child has a brain tumor? You expect the truth. Why
did Dr. Edelstein withhold the truth from this parent? It’s
unexplainable, because it’s indefensible. And she failed to
rule out the life threatening condition, and we know, a couple
of days later, this child suffered that main burst in his head
and died.
Now, let’s talk about Dr. Oakley, the defense
witness. One thing he said was so important. It cuts right
through everything in this case. If two weeks into this trial
you don’t remember anything but one thing, remember this. And
it’s a book that he had. He wrote the book. It’s on his
resume. Secondary Etiology. That’s the secondary cause, the
more life threatening causes — requires urgent imaging.
That’s him. That’s their expert saying this. It’s
not me saying it. Their expert says secondary etiology
requires urgent imaging. That’s exactly what should have
happened in this case. It didn’t happen. And that’s their
expert telling you this. You don’t have to go any further than
this to get to a verdict in this case. It’s right here.
Dr. Kuhn (phonetic sp.), the defense witness — he’s

not a pediatric neurosurgeon. He’s not a radiologist.
Remember him? He doesn’t know what causes a headache. Come
on, now, that’s why we’re here. What caused this child’s
headache? And he didn’t know whether he made $50,000 or
$300,000. Does that make any sense to you? It doesn’t make
any sense.
Dr. Nelson, defense witness. He’s a pediatrician.
He said something — maybe it’s strange, it’s a little strange
to me. He only asked to diagnose a sick child. Well, when you
take the child to the pediatrician, you already know your child
is sick. You don’t need a doctor to tell you your child is
sick. You need a doctor to tell you why your child is sick.
He said no, we just determine whether they’re sick and we send
them out to somebody else. He has no experience with sentinel
bleeds.
He had never diagnosed a child with a small bleed
that then turned into a rupture. Never had. And he never
orders the imaging. He’ll order a simple x-ray. But if it’s a
CT scan, now, he won’t do that. I mean, he’s a board certified
pediatrician for years. Why doesn’t he order CT scans? Does
that make sense to you? You figure that out if it makes sense.
He didn’t read the hospital chart.
He said, well, when you came in to see Ms. Longley on
the 6th — did he read the hospital chart from the 5th? Well,
not really. Well, how do you know the symptoms are the same?

1. Uh, uh — can you refer me to the chart? No, I want you to

know from your memory. You just told the members of the jury

it’s the same thing. Why did you tell them that if you didn’t
know. I need my chart. No you didn’t. So you don’t know?
Dr. Sparrow — defense witness. I’m not an expert.
She’s never seen this condition before. Never has. I’m not an
expert. Why didn’t you call me? You have to determine why
they called her. She’s not an expert in the issues that are
involved in this case. “I get confused reading depositions.”
Well, you’re a paid expert. Shouldn’t you really be paying
careful attention to what sworn testimony is of the doctors who
you were coming in to this Court to support? Unaware that Dr.
Mitchell gave false testimony. Nobody told her that Dr.
Mitchell changed her testimony and gave false testimony. I’m
not an expert. Okay, I believe you. I believe you’re not an
expert. We’ll believe you.
Dr. Bates. He is an expert ER pediatrician that Ms.
White had. Dr. Valderrama breached the standard of care. Dr.
Martin breached the standard of care. Dr. Mitchell breached
the standard of care. And he also said that Physician
Assistant Longley breached the standard of care. And the
breaches are not doing the thorough history, not doing the
complete evaluation, not considering ruling out the life
threatening causes, and not getting this child to the CT scan
right away. That’s what this case boils down to. It’s not

hard to figure out what the breach of the standard of care was.
Dr. Kelly, a pediatric neurologist — he commented on
Dr. Edelstein’s care. Dr. Edelstein breached the standard of
care. Failed to obtain informed consent. Informed consent is
something that every doctor has to obtain from a patient.
Informed consent means you inform the patient what’s going on
with their condition. You explain the treatment options. You
give them the options. And you get their consent. She didn’t
tell the mom why she was ordering the CT. Didn’t tell the mom
the difference between waiting a week to see how the child does
and getting the CT now.
Dr. Edelstein implemented the same failed treatment
plan that was implemented by Dr. Valderrama and Dr. Mitchell.
Same failed treatment plan. The radiologist — what would show
up on a CT? Okay? A bleed can show up. And it did. An
aneurism showed up. And the hole showed up. This is the hole
from the initial bleed that clotted over. Remember, the
initial bleed, it clots over, and then there’s a big burst. He
saw that. He is at Children’s Hospital Pennsylvania. The
defendant’s radiologist — what did the defendant’s radiologist
tell us about what the CT showed? This is a case about what
can be shown on a CT and what can be seen on the CT. What did
their expert radiologist say to you? They never called me.
The key issue in this case is what can be seen upon
the CT study. They never called the radiologist. Now, Dr.

Kuhn says, I read these. Dr. Kuhn can’t see an aneurism unless
it’s four times bigger than the one Jonathan had. Well, good,
Doctor, then you don’t have to be reading CTs. We’ll let the
board certified radiologists read that, because they can figure
it out. I don’t blame him that he can’t see it. Because he’s
not trained like a board certified radiologist. We have no
board certified radiologist in this case.
Vasospasm. This a concept that may or may not be
difficult to understand. It’s how they time the bleed.
Vasospasm is you have little sausage links that appear in the
arteries. Dr. Buchanis (phonetic sp.) explained this. And you
saw this video. It will be back there if you want. But
basically it is those little sausage links. They look like
sausage links. Remember, the tree goes from big branches to
little. This artery went from big, little, big, little, big.
Not supposed to do that.
When it does that, you know there’s been a prior
bleed. And that’s representing vasospasm. And here it is.
You see this sausage link? And it goes to small. Big to
small. All along here, big to small, big to small. It’s
segmented. And that’s what we showed you. And he measured
them, too. They go from big to small, big to small. I’m
sorry, small to big. I got it backwards. But the measurements
are there.
Was the death preventable? This is an easy question.

Answer it. You’ll have to answer it, which is the cause, it’s
the proximate cause question that the judge says you’ll have to
answer. Was it preventable? It was. There’s only two things
you have to know. The time from the CT to a lifesaving
treatment is 12 hours.
That’s all the time they needed to save this child’s
life. A CT anywhere from July 2nd all the way up through
July 9th, because he had the hemorrhage on the 10th, any CT in
that seven day window, 12 hours this child would not have died.
Because doctors can save children’s lives if they just do the
right thing. That’s what doctors are supposed to do.
Dr. Bend, the pediatric neurosurgeon,
remember, she said she took the national exams — I think she
scored number two and I think she said her husband scored
number one. What do you know about her? She’s a smart doctor.
She treats these children. She operates on them. And she
saves their lives.
How long would she have needed to save this child’s
life? Time from the CT to life saving treatment, you only need
24 hours. If Dr. Edelstein had ordered that CT on the 8th, the
operation would have been over at the end of the night. He
wouldn’t have died, because the hemorrhage wouldn’t have burst.
The aneurism would not have burst. He would not have died.
And there was a timeline of events. You can see all
the care this child had. Day after day after day after day.

And not one of these doctors ordered a CT scan. Does that make
any sense?
A mother loss. Now we’re coming to the reason we’re
here. We’ve spent all of this time on medicine. All of this
time arguing who did what, who did what. Let’s not forget the
real reason why we’re here. We’re here because a mother
suffered the loss of a child. And what does that mean? You’ve
heard the phrase children are my life. You’ve heard parents
say that over and over again. That’s because it’s true. And
when you have a child whose life is so intertwined with the
mother, when that child’s life is taken through negligence, not
only does the child die, a portion of the parent dies with the
child.
And how do you know how much this child meant to her?
She saves his Halloween costumes. She saves his shoes. She
saves the pencils that he took to school. And she has his
ashes in her room. That means she can’t let him go. Because
if she lets him go, she’ll be gone, too. And how do we know
how much fun the mother and child had? Look at the pictures.
This is a happy child. He had a loving mother and
loving siblings. Birthday parties. Christmas. New Year’s
Eve. And then when you see the mom, you see the children.
That’s what tells you about how close his family was. Ice
skating. There’s a birthday party with a sombrero. This
picture is more than anything that I can describe about the

relationship between the mother and the son.
And it’s the last memory she has of her son. And for
the next 46 years, which the judge told you that she has on
this earth, I counte
d up the number of waking minutes. It’s 16
million. 16 million more minutes in her life she has to suffer
through the grief.
The burden of proof in this case. When the judge
told you the plaintiff had the burden of proof, it’s just by 51
percent. That’s it. If you go back in the jury room and you
say, you know what? If you hear one of the jurors say, I’m
not sure — well folks, you don’t have to be sure. The law
doesn’t require that you be sure. This isn’t beyond a
reasonable doubt. You can have some doubt.
The law doesn’t put that heavy burden of proof on a
mother or a son in this case. It’s just 51 percent. So if one
of you say I’m not sure, remind each other what the judge says
about the burden. It’s only 51 percent. It’s more sure than
not, more right than wrong. That’s it. 51 percent. That’s
all we have to do. That’s a very low burden. But I think the
evidence in this case is that we’ve proven it much higher than
that.
The verdict sheet. The judge is going to go over the
verdict sheet with you shortly. There’s like 10 or 15
questions. There’s a question for each of the doctors. There’
a question for the physician’s assistant. Did they breach the

standard of care? Yes. Was that breach a cause of the injury?
Yes. For the doctor and the physician’s assistant for informed
consent, did they fail to obtain informed consent? Yes. Was
it a breach? Was it a cause of death?
The evidence requires you to answer yes to every
question. It’s that simple. Jonathan White’s last week
on this earth. I can’t ask you to step into a 12-year-old
child’s shoes, but you can appreciate the evidence. The worst
week of his life was the last week of his life. Headaches,
pain, can’t sleep. One image is really vivid for me. When he
saw Dr. Edelstein, he has his hands on his head. His eyes are
closed. He’s not moving his neck.
What does that tell you about this child’s suffering?
It was immense. And can you imagine and appreciate what’s
going through the child’s mind? He’s asking his mom for help,
like every child would. His mom is reaching out to the doctors
for help, like every mom would do, and this mom did every
single thing that every doctor ever asked her to. Everything.
And they couldn’t answer one simple question.
And they saddle him and her with a quarter million
dollar medical bill. This is the easy part. That’s the easy
party. You can fix this real quick. And for Jonathan
Valladaras, for everything this child went through, the worst
week of his entire life before his death, medical expenses are
here. And now you understand at the beginning of the trial why

my colleague, Ms. Zois, she’s going to be asking for a
substantial amount of money, now you understand why and the
reasons why. That’s why we’re asking for that verdict sheet,
that whatever the number is, $1 million and not a penny less
because we place a high value on human life in our society.
With respect to the mother, not a day goes by that
she doesn’t cry. It’s not going to get any better. It’s not.
She can’t get over this loss. She never will. We’re going to
ask for $4 million. Remember, it’s 16 million minutes that she
has to suffer through this. That’s not even a dollar a minute.
It’s much less than that. Thank you very much.