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Mom: Drug caused movement disorder in autistic teenager








Cook County


Cook County Circuit Court

Injury Type(s):

other-tongue; other-dyskinesia; mental/psychological-behavioral disorder

Case Type:

Medical Malpractice – Failure to Monitor, Negligent Treatment, Prescription and Medication

Case Name:

Lorrie Angel, mother and next friend to Michael Angel, a minor v. Michael Segal, M.D., Howard Klapman, M.D., and Howard Klapman, M.D., Ltd.,
No. 09-L-003496


February 11, 2014



Lorrie Angel (Female), 

Michael Angel (Male, 14 Years)

Plaintiff Attorney(s):

Francis P. Morrissey;
Burke Wise Morrissey & Kaveny, LLC;
Michael Angel ■ Brian T. Monico;
Burke Wise Morrissey & Kaveny, LLC;
Michael Angel

Plaintiff Expert(s):

Emma Cabusao;
IL called by
Francis P. Morrissey, Brian T. Monico ■ David Larsen;
IL called by
Francis P. Morrissey, Brian T. Monico ■ Peter Breggin;
NY called by
Francis P. Morrissey, Brian T. Monico


Michael Segal, M.D., 

Howard Klapman, M.D., 

Howard Klapman, M.D., Ltd.

Defense Attorney(s):

Stephen C. Veltman;
Pretzel & Stouffer, Chartered;
Michael Segal, M.D. ■ James J. Stamos;
Stamos & Trucco LLP;
Howard Klapman, M.D., Howard Klapman, M.D., Ltd. ■ Scott L. Anderson;
Pretzel & Stouffer, Chartered;
Michael Segal, M.D.

Defendant Expert(s):

Louis Kraus;
Adolescent Psychiatry;
IL called by
Stephen C. Veltman, Scott L. Anderson ■ Thomas DiMatteo;
Adolescent Psychiatry;
IL called by
Stephen C. Veltman, Scott L. Anderson ■ Bennett Leventhal;
Adolescent Psychiatry;
IL called by
Stephen C. Veltman, Scott L. Anderson


Allied for Segal ($1 million policy)


In the early 1990s, plaintiff Michael Angel, 3, was diagnosed with autism. At age 10, Michael began seeing Dr. Howard Klapman, a pediatric psychiatrist. On Feb. 4, 2004, at age 14, he began to visit Dr. Michael Segal, another child psychiatrist, in Chicago. Segal diagnosed Michael with obsessive compulsive disorder, which made him experience agitation. In May 2004. Segal prescribed Zyprexa, which is normally prescribed for psychotic mental disorders such as schizophrenia, for "off-label use." Segal believed that this medication would be helpful in dealing with Michael’s agitation, and began him on 20 mg, before increasing the dosage to 30 mg, a full adult dosage. Michael continued to take the Zyprexa, and returned to Segal approximately once per year, which continued until his last visit, on Aug. 22, 2007. In his 2007 visit he presented with facial tics, as well as tongue thrusting. According to Michael, these were symptoms of tardive dyskinesia (TD), a disorder characterized by involuntary and repetitive body movements. Believing that Michael was experiencing dystonia rather than TD, Segal nonetheless lowered the dosage of Zyprexa to determine whether or not Michael was experiencing TD. However, when the dosage was lowered, Michael’s symptoms worsened. Lorrie Angel, on behalf of her son, sued Segal, Klapman, and Klapman’s practice, Howard Klapman, M.D., Ltd., for medical malpractice. When Michael reached the age of majority, 21, Lorrie Angel’s role was changed to "plenary guardian" from "mother and next friend." Prior to the conclusion of the litigation, Klapman and his practice were dismissed from the case, leaving Segal as the only remaining defendant. According to plaintiff’s counsel, Segal was negligent in failing to monitor Michael after prescribing him the Zyprexa, violating the standard of care in not doing enough to check if he was developing any adverse side effects as a result of starting the medication. They contended that this was despite the known risk that patients taking psychotic medication such as Zyprexa could develop TD. They alleged that the standard of care required Segal to closely monitor Michael, especially since he had prescribed a full adult dosage to a teenager. According to testimony from the plaintiff’s non-treating psychiatric expert, despite only seeing Michael roughly once per year, Segal missed the signs of TD that Michael showed during each of the visits. The expert opined that the TD that he developed was solely due to the anti-psychotic medicine that Segal was prescribing. Defense counsel contended that the standard of care was not violated, that the standard of care permitted off-label use of Zyprexa. They contended that psychiatrists often engage in off-label prescribing of anti-psychotic medications, and that there was nothing wrong with Segal prescribing the medication to Michael. Defense counsel also alleged that Michael never had or developed TD, nor does he have TD now. They argued that the involuntary movements he experienced were the stereotypical movements associated with autism, not any other disorder. The defense’s non-treating child psychiatric expert opined that it was appropriate for Segal to see Michael once per year, and that Segal did not violate the standard of care in the way he treated him. The expert also opined that Michael did not have TD.


Michael resumed taking the full dose of Zyprexa, which served to mask the symptoms of TD that he showed, according to plaintiff’s counsel. Another medication, Invega, was also added to his regimen, to further suppress his involuntary movements. Plaintiff’s counsel argued that Michael’s personality was sapped as a result of the anti-psychotic medication, and his normal life was negatively affected in that he was uninterested in any activities that he once took part in. They also alleged that the TD took a toll on his body, as the involuntary movements of his body caused him to collide with objects. Two treating doctors opined that Michael’s condition was anti-psychotic- induced. Plaintiff’s counsel asked the jury for a recovery of approximately $1.7 million, which included past and future loss of normal life, future increased risk of harm, pain and suffering, and medical costs for Lonnie Angel under the Illinois Family Medical Leave Act. Defense counsel disputed the sought damages, contending that Michael was on anti-psychotics for his behavior, not his movements. They argued that this fell into his normal life as an autistic child, and did not constitute a loss of normal life for Michael, if he did develop TD.


The jury rendered a verdict, finding in favor of Michael Angel. It determined that his damages totaled $1,532,000. During jury deliberations, the parties had agreed to a high-low agreement, with a high of the $1 million insurance policy limits for Segal and a low of $250,000. The jury award was then reduced to $1 million. The high-low agreement precluded the possibility of any post-trial motions being filed.

Lorrie Angel: $72,000 Personal Injury: Past Medical Cost; Michael Angel: $685,000 Personal Injury: Future Medical Cost; $550,000 Personal Injury: past loss of normal life; $100,000 Personal Injury: future loss of normal life; $125,000 Personal Injury: future increased risk of harm

Actual Award:


Trial Information:


Elizabeth M. Budzinski


$1 million (policy)



Trial Length:


Trial Deliberations:


Jury Composition:

5 male/ 7 female

Editor’s Comment:

This report is based on information that was provided by plaintiff’s counsel and defense counsel for Klapman. Defense counsel for Segal did not respond to the reporter’s phone calls.