Teen Dies After Skull Surgery to Repair Fracture Sustained as an Infant

    Court: United States Court of Appeals for the Seventh Circuit
    Jurisdiction: Federal
    Case Name: Hall v. Flannery
    Citation: 840 F.3d 922


    When the plaintiff’s daughter was five months old, she was dropped and suffered a skull fracture. The fracture expanded over time and a cyst also formed in the area. The head injury and the cyst did not cause concern until, at the age of seventeen, the daughter was hit in the head and suffered blurred vision, dizziness, and a loss of consciousness. After CT and MRI scans revealed the severity of the fracture and the cyst, she underwent cranioplasty surgery to patch the split and the region of the dura (the thick membrane around the brain) where the cyst had developed. The day after the surgery, the daughter was released but she was found dead in her room three days later.

    Her mother filed a suit against the hospital and the doctors. She claimed that surgery led to her daughter suffering a seizure that led to her death. The plaintiff also asserted that the doctors treating her daughter should have administered anti-seizure medicine. In response, the defendants argued that no seizure had occurred and that a heart-related disease was the probable cause of death. A jury decided in favor of the defendants, and the plaintiff appealed. The appellate court examined the admissibility of the defendant’s pediatric surgery expert.

    The Pediatric Surgery Expert Witness

    The defendants’ pediatric surgery expert witness had been a practicing pediatric neurosurgeon for nearly 25 years. The expert worked as the director of pediatric neurosurgery for the Advocate Health Care program, which consisted of two large children’s hospitals and about ten other hospitals. He was also licensed in neurological surgery, affiliated with several scientific associations, and a former member of an editorial board for neurological publications. More prominently, he also worked on increasing fractures of the skulls, including the deceased’s and had written papers on numerous pediatric neurosurgery subjects, like epilepsy, cranial cysts, and severe head injuries.

    The pediatric surgery expert witness opined that the daughter’s cause of death was not a seizure but rather, a focal interstitial chronic inflammation of the heart. He arrived at his conclusions on the deceased’s based on his examination of the autopsy report, the deceased’s medical reports, including MRI and CT scans, reviewing the attending doctor’s report and post-surgery notes, and deposition testimony. The expert’s testimony was also based on his extensive professional experience, especially concerning pediatric neurosurgery.

    The plaintiff claimed that the trial judge erred in permitting the pediatric surgery expert witness to testify that the cause of death of the deceased was due to this underlying heart problem. The plaintiff further asserted that the expert had given his cause-of-death opinion without being qualified and without using a reliable methodology. The plaintiff argued that the expert did not have the necessary credentials since pathology was not his area of expertise, thus making his opinion on the alleged heart condition inadmissible.


    The appellate court stated that the pediatric surgery expert witness had ample qualifications to opine on the deceased’s surgical procedure and the probable risk of a seizure afterward. Moreover, the court concluded that the expert’s seizure-related findings were based on a reasonably accurate approach. However, the court noted that while the expert was qualified to analyze the surgery and the risk of seizures, this expertise did not apply to his belief that the child’s heart-related condition was the most probable cause of death. The court explained this was because the expert did not have any expertise related to focal interstitial chronic inflammation directly, or more generally, to cardiology.


    The plaintiff’s motion to exclude the pediatric surgery expert witness’s testimony was granted in part and denied in part.