Dozens of attorneys handle medical malpractice cases in L.A. County, but only a relative few specialize full-time. Some of the best, based on Business Journal research and conversations with their peers, are listed below.


Richard Carroll
Partner
Carroll Kelly Trotter Franzen & McKenna
Specialty: Defense in cases related to anesthesia, heart problems and brain damage, particularly of babies.
Notable Cases: Gathers v. Loyola Marymount University (1990): Represented Kerlan-Jobe Orthopedic Group and Dr. Benjamin Shaffer, the doctor on duty when Loyola Marymount University basketball player Hank Gathers died after collapsing during a game. Filed for $32.5 million, the case against his clients was dismissed at trial. Ochoa v. Goldstein (1992): Represented the cardiac surgeon of a diabetic man who lost both his legs due to an infection following heart surgery. "Over the course of the trial, I became good friends with the plaintiff himself," Carroll said. "You don't often develop a friendship with the guy you're against."
Most Challenging Aspect of Practice: Quickly learning the medical intricacies of each case in a way that allows him to explain doctors' decisions to juries. "You represent someone who spends four years in medical school and nine years in practice, and in seven to eight days you have to convey to the jury why the judgment they made was appropriate under the circumstances," he said.
On the Nature of the Business: "I have little kids. So when you're trying a case for a doctor against parents of a child with profound brain damage, and a victory for you is sending that child home with no money, it tugs at your heartstrings," he said. "When you have little kids they want to know what you did all day. And you have to tell them in a way that characterizes you as a good guy."
Amanda Bronstad


Michael Trotter
Partner
Carroll Kelly Trotter Franzen & McKenna
Specialty:
Defense in cases involving necrotizing fasciitis (flesh eating bacteria), AFP (alpha-fetoprotein) blood tests that detect problems in unborn babies, and failure to diagnose cancer.
Notable Cases: Yanes v. Wood (1997): Defense in a wrongful birth lawsuit alleging a radiologist failed to detect dwarfism in an unborn baby during an ultrasound test. Ramirez v. Flores (2004): Defended a surgeon in the case of a 30-year-old man who died from necrotizing fasciitis. Defense of Dr. Ernest Carlsen in an investigation by the state Attorney General (1993): Carlsen was the subject of allegations he sexually molested dozens of patients during breast exams. The case settled out of court.
Most Challenging Aspect of Practice: Seeing "sad, sad" cases. "It's seeing how there are bad diseases out there, bad conditions, that even the best doctor can't fix. You have to be sensitive to it or you don't do a good job."
On the Nature of the Business: "You come to learn that there are really some bad outcomes that have nothing to do with the care that was provided. We learn that it happens in spite of the doctor's best efforts. A lot of people think a bad outcome means somebody did something wrong. That's the biggest fundamental flaw people have when judging care. What makes it easier is when you get to know the doctor you're representing, and then you find out about the success stories where somebody is cured. Thankfully, we do get exposed to that a little bit."
Amanda Bronstad


Louis 'Duke' De Haas
Shareholder
La Follette Johnson De Hass
Fesler & Ames
Specialty:
Defending malpractice claims, with emphasis on cases involving brain-damaged babies.
Notable Cases: O'Rourke v. Kaiser (1988): Heather O'Rourke, who appeared in three "Poltergeist" films, died of intestinal stenosis, a congenital obstruction of the digestive tract, a few weeks after her 12th birthday. Her mother alleged Kaiser Permanente doctors misdiagnosed the condition and that a simple surgical procedure could have saved the child. The case went to arbitration and was settled for an undisclosed sum. Pierce v. Summit Medical Center (2005): Successfully defended the medical center in a case brought by a 24-year-old woman who was left paralyzed from the neck down. He also defended Daniel Freeman Memorial Hospital in litigation that resulted from the death of Loyola Marymount University basketball star Hank Gathers in 1990.
Most Challenging Aspect of Practice: The realization that risk is inherent in all medical procedures. "Everyone thinks having a baby is all dandy, but you have a surgery. Things can be tenuous and in a flash, you can have a catastrophic injury." Facing the parents of a child in the wake of such an event is especially hard. "I can relate to them personally because I had a sister who suffered brain damage," he said. "It is always painful."
On the Nature of the Business: "No matter how much we improve medicine, or how sophisticated it becomes, like any endeavor in human life, it will be fraught with human error. So we will always have medical malpractice litigation. When you have a parent of a brain-damaged child filing a lawsuit, either outcome is a no-win situation for them."
Aarthi Sivaraman


Steven C. Glickman
Partner
Glickman & Glickman
Specialty:
Representing plaintiffs in personal injury/medical malpractice cases.
Notable Cases: Garstang v. UCLA (2000). Glickman's client developed an infection following breast reconstruction surgery. The defendant, chief of plastic surgery at UCLA, refused to settle for an amount below $30,000. The jury awarded $455,000. Also, obtained a confidential settlement agreement in 2004 for a client who suffered a lack of oxygen to the brain after heart bypass surgery, after he was taken off a respirator. Though nothing in the records indicated negligence, Glickman established that the hospital and the doctor in charge failed to follow correct procedures. The case settled for about $1 million.
Most Challenging Aspect of Practice: The state's Medical Injury Compensation Reform Act, which limits non-economic damages to $250,000. "We look for cases with high medical expenses, loss of earnings and other readily quantifiable damages. Because of this, we turn down 97 out of 100 cases that come to us," Glickman said. Plus, there are roadblocks being put up in the name of tort reform. "There is no relationship between a 'frivolous case' as the president puts it, and caps on damages," he said. "A 'frivolous case,' by its very nature, has no value."
On the Nature of the Business: "There are fewer lawyers handling medical malpractice cases on a regular basis now because of the economics," he said. "For each case, you have to be prepared to advance costs of at least $50,000 for experts, depositions, trial expenses and exhibits. So with a $250,000 cap on non-economic damages it often doesn't make sense to advance this much money. Juries understand that when you have a significant injury that was caused by a preventable medical mistake, the plaintiff should be compensated. But juries for these kinds of cases need to be educated in general, and by the lawyers in particular, because the issues are often so complicated. And getting to a jury can be expensive."
Eric Berkowitz


Shirley K. Watkins
Senior Associate
Michels & Watkins
Specialty:
Representing malpractice plaintiffs, mostly infants with significant injuries.
Notable Cases: Jane Doe v. Roe Hospital (2000): Secured a $1 million confidential settlement with an area hospital after it failed to diagnose a brain tumor in a teenage girl who later died. Helen Patchen v. County of Riverside (1995): A jury trial resulted in a $300,000 verdict in favor of a teenage girl with schizophrenia who died in county custody after a reaction to an anti-psychotic drug. Bernard Rosenzweig v. Mohammed Gharavi (1997): Jury trial resulted in a $1 million verdict on behalf of a man who had unnecessary bypass surgery because of a misread angiogram.
Most Challenging Aspect of Practice: Overcoming the biases that jurors have when they walk into the courtroom. "The public has been inundated with media representations of this so-called malpractice insurance crisis," Watkins said. Another challenge: dealing with the most severely disabled children, many of whom are very poor. "We have to serve not only as their lawyers but as de facto case managers," she said.
On the Nature of the Business: "A lot of people who have been victims of malpractice don't have health insurance. Who has to bear the expense of providing care to people who are victims of malpractice? The taxpayers. We are basically holding the doctors and the hospital responsible and making them pay for what they did wrong instead of having the government pay for it. It's a fundamental fairness issue. It shifts the cost of care back to the person responsible for causing it."
Laurence Darmiento


Philip Michels
President
Michels & Watkins
Specialty:
Representing malpractice plaintiffs, mostly infants with significant injuries.
Notable Cases: Marquez v. Community Hospital of San Bernardino (2002): Litigated for a $7 million verdict in favor of an infant brain damaged during birth after his mother was allowed to have a vaginal delivery without a doctor present even though she had two previous Caesarian sections. Rodriguez v. Community Hospital of San Bernardino and Muhtasub (2000): Represented plaintiff who received an $11 million verdict in a case in which an infant suffered brain damage when the umbilical chord was squeezed during a risky delivery and there was difficulty finding the attending physician.
Most Challenging Aspect of Practice: California's Medical Injury Compensation Reform Act, which caps pain and suffering awards at $250,000. The 30-year-old law "is not indexed to inflation" and has changed the nature of the business, including the kind of cases lawyers can take. The result is that fewer people are knowledgeable and resourceful in the practice and some cases, like the death of an older son who is not a wage earner, are often not taken on.
On the Nature of the Business:
"One thing that stands out is the inequities in medical care out there. People who are the least advantaged are pushed more into health care systems with less sophisticated doctors and hospitals that cut corners. Not only do they get poorer care in general, but they have less ability to deal with the problems. I think we try to help people who have either been abused by the system or neglected or don't even realize what is happening to them."
Laurence Darmiento


Robert Reback
Partner
Reback McAndrews & Kjar
Specialty:
Defending health care providers in cases involving major neurological injuries, brain or spinal cord damage, or wrongful death.
Notable Cases: Byrd v. Inglewood Women's Hospital, Morton Barke and Steven Pine (1989): Defended the doctors and the hospital against claims by the family of Belinda Byrd, who died after an abortion. Trial resulted in a hung jury, and the case was subsequently settled. Terms were confidential. Garrett v. Young (2002): Defended Dr. William Young in 2002 against claims by Eufala Garrett that he violated the California Medical Information Act. Judgment for defendant was upheld on appeal, clarifying the reading of the law.
Most Challenging Aspect of Practice: The cases tend to be very complex. Malpractice lawyers have to learn medicine while juggling the legal issues presented and trying to put everything together in a way that will be persuasive to the jury. "The business side of malpractice law is a matter of developing a sufficient reputation and a sufficient amount of experience so people will want you to represent them and their interests," he said. "Insurance carriers are very specific about who they pick because they have to satisfy shareholders."
On the Nature of the Business: "It's a low form of improvisation. The jury is the audience and they judge your performance with their verdict. For me, with every case that comes in, I'm working it up as though it's going to trial because doctors must consent to a settlement. Being accused of malpractice is something our clients take very seriously."
Christopher Keough


James D. Nichols
Vice President & Managing Shareholder
Bonne Bridges Mueller O'Keefe & Nichols
Specialty:
Medical malpractice defense of doctors, hospitals, nurses, technicians and other health care providers.
Notable Cases: Chacone v. Mendoz (1990): Successfully defended a doctor whose patient got an infection after her knuckles were injected with vitamin K despite it being an unrecognized practice. Bucholtz v. Drachenberg (1991): Successfully defended a pediatric neurologist in a case involving an infant whose neck was fractured in delivery and who was left a quadriplegic as a result. The neurologist died during trial and Nichols defended the estate (one of the toughest of his career). Woo v. Capuya (2002): Successfully defended a cardiac surgeon who left behind a guide wire in a patient's heart; the jury found negligence but decided it caused no harm.
Most Challenging Aspect of Practice: Making people understand that a physician is not necessarily negligent when he makes a mistake. "When somebody is treated by a health care professional and they have a bad outcome, all too often they think somebody violated the standard of care," Nichols said. "The practice of medicine is an art. It's not an exact science." He sees his job as getting the jury to look at a case through the eyes of the physician at the time the patient is being treated.
On the Nature of the Business: "It's my job to take the facts and present them as honestly and with the best verbal skills I have," he said. "What I do is lay it on the jury. I win most of the cases I try, but sometime when you lose you say it was meant to be lost. I am a churchgoing guy. That gives me a lot of comfort. You have to get up the next day and look at yourself in the mirror. I don't want my children to think I am a shyster, crooked, sleazy lawyer."
Laurence Darmiento


David J. O'Keefe
President & Senior Shareholder
Bonne Bridges Mueller O'Keefe & Nichols
Specialty:
Medical malpractice defense of doctors, hospitals and other health care providers.
Notable Cases: Looney et al. v. Birds (1994): Jury awarded $800,000 to three AIDS patients who claimed they were harmed by taking an experimental, non-FDA approved drug (a lower amount than the original $10 million demand by five initial plaintiffs). Anderson v. Regents (1989): Verdict for defense in a case involving patient who hallucinated and jumped out of a window at UCLA Medical Center while taking an experimental anti-seizure medication. O'Keefe argued there was proper informed consent and the jump could not have been prevented.
Most Challenging Aspect of Practice:
Patients who have sustained catastrophic injury and present an empathetic appearance to a jury. "I had a case with a child born with no arms and two deformed legs, which had not been picked up with ultrasound testing and genetic testing," he said. "The child was in court scooting around in a four-wheeled little cart that she would try to push with her legs. Then she would be up in the cafeteria feeding herself with one foot. The jury saw all this, yet the jury in that case elected to find in favor of my client and not award any damages." There are occasions, he said, when it's better to have the injured plaintiff in court. "The jury becomes too acclimated to seeing them and the emotional edge wears off," he said.
On the Nature of the Business: "A competent plaintiff's attorney looks for catastrophic injury, and then they look to see whether or not they can link that injury causally to what a doctor or a health care institution did. What I am always trying to do is persuade a jury that whatever the complication, it is something that is a recognized risk of whatever procedure the patient underwent and it occurs in a certain percentage of cases irrespective of how careful a health care provider is."
Laurence Darmiento


Steven A. Heimberg
Partner
Heimberg & Zohar
Specialty:
Cases that change or challenge existing laws.
Notable Cases: Allen v. HealthCare Partners Medical Group (2002): Represented a man who died of an undiagnosed infection and obtained a $1.5 million jury verdict, including $800,000 in non-economic damages. The case carved out a legal exception for health care providers to the state's $250,000 cap on non-economic damages under the Medical Injury Compensation Reform Act of 1975. Akins v. Women's Medical Group of Santa Monica (1999): Represented a toddler who suffered brain damage after doctors failed to perform a Caesarian section. He got a $16 million verdict award, the largest in Los Angeles County.
Most Challenging Aspect of Practice: Limits on recoveries and fees make the margin for profit razor thin. Compounding that, the $250,000 MICRA cap allows the defense to hire "lots and lots of experts," making it hard for a plaintiff to match if the potential award is capped. Another problem for plaintiffs' lawyers is that juries tend to favor doctors and hospitals to start with because the plaintiff has the greater burden of proving that negligence occurred and that it caused the injury.
On the Nature of the Business: "It's a tremendous toll on one's life. In an auto accident case, the jury knows that it is not standard to drive at 100 miles per hour and drink a bottle of scotch. But when they bring in a (doctor) with a thick resume willing to protect his or her brethren, it's essentially so much techno-babble. You have this enormous burden to de-assemble these concocted defenses. That amount of work takes a toll, and with the profit margins that are left, it makes it a difficult lifestyle that very few attorneys want to pursue."
Amanda Bronstad

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