Case: Felix Cantore v. West Boca Medical Center

Case no: 502010CA 024815XXXX MB

Description: Medical malpractice

Filing date: Oct. 1, 2010

Trial dates: Jan. 18-Feb. 22, 2013

Judge: Palm Beach Circuit Judge Lucy Chernow Brown

Plaintiff attorneys: Crane Johnstone and Linda Alley, Schlesinger Law Offices, Fort Lauderdale

Defense attorney: Michael Mittelmark and Scott Michaud, Michaud, Mittelmark, Marowitz & Asrani, Boca Raton; Scott Solomon and Norman Waas, Falk, Waas, Hernandez, Cortina, Solomon & Bonner, Coral Gables

Jury verdict: For the defense

Details: Alexis Cantore, who suffered from chronic hydroencephalus, or water on the brain, had a third endoscopic ventriculostomy, a surgical procedure creating an opening in the brain’s third ventricle using an endoscope placed through a hole in the skull in 2006.

On July 3, 2008, at age 13, Alexis was rushed by ambulance to West Boca Medical Center with increasing intracranial pressure and complaints of headache, nausea and vomiting.

Emergency room physician Jaqueline Freyre-Cubano contacted Miami Children’s Hospital, the nearest facility with a pediatric neurosurgeon and also where Alexis was a regular patient. The teen arrived at West Boca at 4:36 p.m. The helicopter left with her for a 21-minute flight to Miami at 8:09 p.m.

"She was getting off the helicopter, and she herniated her brain," said Solomon, who with firm managing partner Waas defended the Life Flight air ambulance service Miami Children’s Hospital operates.

Her parents, Felix and Barbara Cantore of Parkland, sued West Boca, Freyre, her affiliated Emergency Pediatric Services P.A. and Life Flight, claiming negligence and failure to render appropriate care and treatment, arrange for timely transfer, protect Alexis from neurological harm and recognize signs of her true condition.

Alexis was scheduled for a repeat ventriculostomy to improve fluid drainage the month of the emergency.

Plaintiff case: The Cantores complained the staff at both medical facilities should have communicated better and should have chosen the Palm Beach County-operated Trauma Hawk helicopter or regular ambulance, which were under contract to arrive at West Boca within 30 minutes.

"We alleged there was a lack of communication between the hospitals on when the helicopter was going to arrive," Johnstone said, noting the father could have driven Alexis the 51 miles to Miami Children’s in much less time. "It was outrageous for this child to be waiting in an emergency room for four hours for treatment that this hospital could not provide."

The Cantores asked for nearly $60 million in damages, including $39 million for past and future economic costs and the rest for pain and suffering.

Defense case: Freyre settled her portion of the complaint, but West Boca Medical Center and Life Flight went to trial.

"All of the allegations brought by the plaintiffs were obviously contested," Waas said.

A. Scott Lundeen, a partner at the Coral Gables office of Wicker Smith O’Hara McCoy & Ford, defended Freyre. Firm partners Lynn Audie and Oscar Cabanas represented Emergency Pediatric Services.

Waas and Solomon said the clock that day was the most important aspect of the case.

"All of the experts agreed that there is no national standard regarding time of transport," Waas said of the more than four hours that elapsed between Alexis arriving at West Boca and reaching Miami Children’s.

Mittelmark, who represented the hospital with partner Michaud, said, "From the moment she walked in the door she was triaged immediately."

The neurosurgeon who gave Alexis an emergency ventriculostomy in Miami testified in deposition that her rapid deterioration was not foreseeable.

"Had she come in earlier, the same thing would have occurred but in the hospital," Solomon said the neurosurgeon testified.

Outcome: Jurors weighed the testimony of 43 witnesses presented over five weeks and deliberated five hours before finding no reckless disregard by West Boca’s employees, Life Flight’s staff or Freyre as a Fabre defendant.

Mittelmark called it "a devastating injury" to the child and "a horrible thing" for her parents to experience but said that did not add up to malpractice by his client. "As far as West Boca goes, they did everything they should," he said.

Johnstone said Alexis, now 18, takes high school classes via telephone and requires 24-hour care. "This girl has not swallowed food or drink for 4½ years," he said.

Comments: "She went from a long-standing, chronic condition to an acute condition, and that does not generally occur," Waas said.

Post-verdict: Johnstone said he will file post-trial motions and is considering an appeal.

The Cantores rejected a pretrial settlement offer, giving the defense the right to seek attorney fees and costs based on the verdict in its favor, Solomon said.