Given the defense bar's typical embrace of the understated, it's not surprising that H. Andrew Owen Jr. describes his Georgia firm's role in three medical malpractice victories in two weeks as "a little unusual."

The Owen, Gleaton, Egan, Jones & Sweeney partner is quick to downplay his role in one of those cases, but he is eager to heap praise on his colleagues who helped beat back the suits and nearly as effusive for his opponents in the most recent trial, a Clarke County case decided Oct. 9.

The first case involved a woman who suffered a rare reaction to an anti-seizure medication that left her with rashes and permanent vision problems.

Sharon Stenson was 47 when she visited Dr. Dennis M. Lacey in June 2005; Lacey had been treating Stenson since an auto accident in 1994 caused headaches due to post-concussive syndrome, according to the pretrial order.

In the latest visit, "Stenson reported that her headaches were stable, but she had a change in her condition in that she was having significant and different memory problems," it said.

Lacey performed an electroencephalogram that seemed to indicate abnormal activity and prescribed Lamictal, an anti-seizure medication.

Two weeks later, she developed painful rashes and was admitted to Emory Dunwoody Medical Center, where she was diagnosed with Stevens-Johnson Syndrome. It is a reaction to drugs that can cause blistering of the skin and mucous membranes and eye disorders including conjunctivitis and corneal perforation, according to the Stevens-Johnson Syndrome Foundation.

There is no cure for the syndrome, only treatment for the symptoms.

In 2006, Stenson sued the doctor and his clinic, Drs. Lacey and Freschi, PC. Her complaint, filed by Atlanta sole practitioner Erik H. Olson, asserted that the doctor was negligent in prescribing an anti-seizure drug with the potential for such side effects to a patient with no known history of seizures.

Owen Gleaton partner Amy J. Kolczak, who handled the defense along with firm associate Richard J. Baker, said test results from an EEG and an MRI, among others, suggested the patient was developing a seizure problem.

The defense did not dispute that the drug caused Stenson's condition, said Kolczak.

"Our presentation was all centered around the standard of care, that Dr. Lacey was trying to do the best thing to protect Ms. Stenson, and also the public," she said. "If she had had a seizure while driving, she could cause a wreck."

Stenson turned down a $150,000 pretrial offer of settlement, Kolczak said, and on Sept. 28, after a one-week trial before Fulton County Superior Court Judge Kimberly M. Esmond Adams, the jury took about an hour and a half to find for the defense.

Olson said his client is "considering her post-trial options" but declined to comment further on the case. He noted, however, that the case was his first medical-malpractice loss in 11 years of practice.

The case is Stenson v. Drs. Lacey and Freschi P.C., No. 2006CV115091

THE SECOND WIN

Four days after the Lacey verdict, another Fulton County jury declined to hold three doctors responsible for the complications suffered by a woman who underwent gastric-bypass surgery and whose subsequent bowel leakage into her stomach cavity went undetected for several days.

Kathy Shackelford, 50, underwent the surgery by Dr. Larry L. Hobson at Atlanta Medical Center on March 19, 2004, according to trial documents.

Shackelford remained in the hospital and by March 24 "was gravely ill with intra-abdominal sepsis and peritonitis," which her attorneys blamed on Hobson's accidental puncturing of her bowel during the surgery.

Her complications included respiratory and organ failure and aggravation of a preexisting degenerative spine condition. She eventually needed surgeries for a hernia and digestive disorders, according to the pretrial order.

In 2005, Chambers, Aholt & Rickard partners Eugene P. "Bo" Chambers Jr. and Dale C. Ray Jr. filed a medical malpractice suit against Hobson and several other doctors involved in Shackelford's care.

"She was basically in a coma for about two-and-a-half months," said Chambers. "When she came around, she had to basically learn to talk again, walk again, as a result of being stationary so long."

Shackelford still walks with a cane, he said, and the injuries ended her plans to open a restaurant.

By the time the case came to trial, the defendants included Hobson; Dr. David Norman, a recent resident and fellowship participant whose rounds included Shackelford; and Dr. Kimberly Spencer, a radiologist who performed a CT scan the day after the surgery and was alleged to have missed signs of fluid and air in the patient's stomach cavity.

Hobson was represented by Paul E. Weathington and Weathington Firm associate Allison M. Richardson. Weathington was unavailable for comment.

Thomas S. Carlock of Carlock, Copeland & Stair, who represented Norman with firm partner Asha F. Jackson, said that despite efforts by the plaintiff's side to divide the defendants, they generally maintained a solid front as they fought the case.

"There was never any claim [among the defense counsel] that the surgery was inappropriate or technically incorrect," said Carlock, other than "a little bit of discussion over whether there was a scuff on the intestine that could have indicated a puncture."

Owen Gleaton partner Rolfe M. Martin, who represented Spencer along with associate Mark D. Meliski, agreed.

"It certainly was case that the plaintiffs could have tried to pit the defendants against each other," said Martin. "But, because the doctors all felt their colleagues provided good, quality care they stayed away from criticizing each other."

"Yes, they were all singing from the same song book," said Chambers with a laugh.

After a two-week trial before Fulton County Superior Court Judge Melvin K. Westmoreland, the jury took about four-and-a-half hours to find in favor of all three defendants.

"We were up against six lawyers and three defendants," Chambers added. "It was David and Goliath, and this time Goliath won."

He said he did not anticipate an appeal.

The case is Shackelford v. Hobson, No. 2005CV108303.

THE THIRD WIN

On Oct. 9, an Athens, Ga., jury returned a defense verdict in the case of a man who died of cryptococcal meningitis after several doctors failed to detect the disease over a span of more than three weeks.

Norman Echols was 55 when he first went to the emergency room at Cobb Memorial Hospital on Oct. 16, 2006, complaining that he had a headache for two weeks, plus body aches, coughing and shortness of breath, according to the original complaint.

The ER doctor ordered a chest X-ray and CT scan that didn't reveal anything out of the ordinary, according to the pretrial order, and Echols was diagnosed with bronchitis, prescribed an antibiotic, told to stop smoking and sent home.

Two days later, he went to see his primary care physician, Dr. T. Andrew McElhannon in Athens, who changed his antibiotic. Two days after that, he was at the ER at Athens Regional Medical Center, still complaining of a headache and other ailments.

That ER doctor diagnosed a probable tension headache and prescribed Xanax, which didn't help, and he soon returned to the ER.

Over the course of several days, McElhannon and several other doctors at the hospital who saw Echols attributed his condition to a migraine headache, depression or other possible causes.

On Nov. 8, Echols' wife again brought him to the hospital. His condition had worsened to the point of "complete blindness and altered mental status," according to the complaint.

On Nov. 12, another doctor ordered a lumbar puncture, during which "Echol's intracranial pressure was so high that cerebrospinal fluid shot out the upper end of the lumbar puncture tube," it said.

Echols was diagnosed with cryptococcal meningitis, a fungal infection; after being hospitalized until January, he was ultimately released to a long-term facility for the permanently disabled, where he died on Aug. 13, 2007.

"Mr. Echols never recovered his sight or his cognitive abilities," said the complaint filed on behalf of Echols' wife, Janice Marie Echols, by Ragland & Jones partner Evan W. Jones, Dennis T. Cathey of Cornelia, Ga.'s Cathey & Strain and Hartwell, Ga., attorney Jeffery S. Malcom.

The suit accused McElhannon; Dr. Eric Wilson, who was covering McElhannon's calls; and neurologist Terry L. Wimpey of negligence for having failed to diagnose Echols' meningitis sooner. The suit faulted them particularly for not ordering a lumbar puncture early in his treatment.

The circumstances of the case were "terrible," said Owen, who handled Wilson's defense along with Owen Gleaton associate Melissa P. Reading.

The defense's position, he said, was that "this is a very rare illness that had a very unusual presentation.

"Usually," he said, "the symptoms of meningitis are headache, fever, stiff neck. [But] Mr. Echols had previously complained of headaches, and he didn't present any of the others."

Weymon H. Forrester of Gainesville, Ga.'s Forrester & Brim, who represented McElhannon, agreed that the lack of the usual symptoms was a key factor in Echols treatment.

In addition, he noted, "cryptococcal meningitis in a non-HIV patient is very rare. My client had diagnosed cryptococcal meningitis in other patients, but it was repeatedly noted that there was a lack of meningial signs."

"Our argument was that, in retrospect, [McElhannon] was being confronted with something he had never seen before."

The defense was particularly aided by the testimony of Dr. Charles W. Stratton IV, an infectious disease expert from the Vanderbilt University School of Medicine, said Forrester. Stratton testified that even if the cryptococcal meningitis had been diagnosed the first day Echols was examined, that type of infection is very difficult to treat."

That testimony helped defeat the plaintiff's claim that the delayed diagnosis caused Echols' death, he said

John A. Dickerson of Toccoa, Ga.'s McClure, Ramsay, Dickerson & Escoe, who represented Wimpey, did not respond to a request for comment.

Cathey and Jones, who represented the plaintiff, did not respond to inquiries.

After a two-week trial before Clarke County State Court Judge N. Kent Lawrence, the jury took about six hours to deliver a defense verdict on all counts, said Owen.

"This was really a textbook case of how a civil trial should proceed," he said. "We had an excellent judge, two of the best med-mal plaintiff's lawyers, and two of the best defense lawyers in Georgia representing my co-defendants."

"There was no acrimony, no nastiness. ... I'll bet there were no more than five objections in the course of a two-week trial," he said.

The case is Echols v. McElhannon, No. ST07CV1373.

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