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Engleman v. McCullough

Court of Appeals of Arkansas, Division III

November 15, 2017

NATASHA ENGLEMAN APPELLANT
v.
CINDYE MCCULLOUGH; ST. JOHN'S CLINIC, INC., A/K/A MERCY CLINICS SPRINGFIELD COMMUNITIES; SISTERS OF MERCY HEALTH SYSTEM ST. LOUIS A/K/A MERCY HEALTH SYSTEMS OF ST. LOUIS APPELLEES

         APPEAL FROM THE CARROLL COUNTY CIRCUIT COURT, EASTERN DISTRICT [NO. 08ECV-12-154] HONORABLE SCOTT JACKSON, JUDGE

          Parker Law Firm, by: Tim S. Parker, for appellant.

          Malkmus Law Firm LLC, by: Brian D. Malkmus and Debra L. Gullett, for appellees.

          ROBERT J. GLADWIN, Judge

         Appellant Natasha Engleman appeals the judgment entered on February 10, 2016, by the Carroll County Circuit Court in favor of appellees Cindye McCullough, St. John's Clinic, Inc., a/k/a Mercy Clinics Springfield Communities, and John Does 1-3 following a jury trial in a nursing-negligence case. Appellant argues that the trial court erred in giving Arkansas Model Jury Instruction (AMI) 1501 over the objection of her counsel and, in effect, instructing the jury to consider only the testimony of the nurses and not to consider her testimony concerning the anatomic location where Nurse McCullough administered the intramuscular-steroid injection on March 3, 2011. She also argues that the trial court erred in refusing to give the modified version of AMI 1501 that she requested and proffered. We affirm.

         I. Facts

         On March 3, 2011, appellant presented to St. John's Clinic in Berryville, Arkansas, to receive an intramuscular-steroid injection to treat her allergies. The injection was administered by Nurse McCullough, a licensed practical nurse (LPN) employed by St. John's Clinic. Although appellant's chart reveals no complaints or complications immediately following the injection, appellant claims that just after the injection she experienced severe shooting pain down her leg that worsened over time. She further related that she was unable to walk out of the clinic and had to hobble out instead.

         Appellant's grandmother, Karon Richert, was present in the waiting room to pay for her granddaughter's shot. According to Ms. Richert, appellant was limping severely when she emerged from the room where the shot had been administered.

         When appellant returned to the clinic to see Dr. Craig Milam, he noted that her left knee was swollen and tender. He prescribed crutches and a knee brace and ordered a gout test, which came back negative. Dr. Milam testified that before March 3, 2011, the date of the injection, appellant had not complained about her leg.

         As appellant's severe leg pain and weakness continued and she developed a foot drop, she consulted informally with a friend, K.D. Zeit, who is a registered nurse (RN), and began to wonder whether her sciatic nerve had been injured as a result of the shot.

         She was subsequently seen at a clinic that referred her for EMG testing by neurologist Dr. Omar Al Khatib. The first EMG testing was suggestive, but inconclusive, for sciatic neuropathy, and the second EMG test results were normal.

         Through research, appellant learned of a California neurosurgeon, Dr. Aaron Filler, a former director of the Peripheral Nerve Surgery Program at Cedar Sinai Medical Center in Los Angeles, California. Dr. Filler is one of the inventors of the neurogram procedure, a specialized MRI procedure developed to visualize nerves. Appellant traveled to California to see Dr. Filler who ordered a neurogram study and interpreted the results. According to Dr. Filler's report, the study demonstrated an abnormality within her sciatic nerve consistent with mechanical injury to the sciatic nerve. Dr. Filler also diagnosed appellant with Reflex Sympathetic Dystrophy (RSD), or Chronic Regional Pain Syndrome (CRPS), and with foot drop.

         Dr. Filler performed surgery on appellant on August 26, 2011, during which he explored the area around the nerve and removed extensive scar tissue that had adhered to the nerve. Dr. Filler confirmed his earlier neurogram report of injury to appellant's sciatic nerve consistent with a needle-injection injury. Dr. Filler also observed adhesions to appellant's sciatic nerve along with fibrosis and scarring around the nerve. Appellant returned on June 28, 2013, for a second surgery performed by Dr. Filler to resection the piriformis muscle of her left hip at the level of the sciatic-nerve injury.

         Appellant's pain management for RSD or CRPS initially was conducted by Dr. Cathy Lou and subsequently by Dr. Jason Holt. Their treatment consisted of narcotic medications and nerve blocks, both of which failed to resolve appellant's pain.

         Appellant's leg has continued to deteriorate and atrophy. She remains in severe pain and has not walked unassisted since the incident and now uses a wheelchair. At the time of her injury, appellant was twenty-two years old and in excellent health. She was a dancer, and prior to her injury she ...


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