Case Name: Tahani Spearman, individually and as guardian ad litem for Taylor Ivory, a minor v. Prasad V. Gourineni, M.D., Prasad Gourineni, M.D., S.C. d/b/a Pediatric & Young Adult Orthopedics, No. 2016-L-000626
Case Types: Medical Malpractice – Orthopedist; Misdiagnosis; Failure to Test; Informed Consent; Orthopedic Surgeon; Orthopedic Surgery; X-ray Interpretation; Unnecessary Procedure
- Hip – hip replacement
- Leg – scar and/or disfigurement
- Other – physical therapy; steroid injection; decreased range of motion; cartilage/chondral, damage
- David R. Barry Jr.; Corboy & Demetrio; for Tahani Spearman, Taylor Ivory
- Michael D. Ditore; Corboy & Demetrio; for Tahani Spearman, Taylor Ivory
- Charles F. Redden; Cunningham Meyer & Vedrine, P.C.; Chicago, IL for Prasad V. Gourineni
- Joseph C. Sheahan; Cunningham Meyer & Vedrine, P.C.; Chicago, IL for Prasad V. Gourineni
Case Outcome: Verdict – Plaintiff
Award Amount: $2,600,000.00
On July 3, 2012, Taylor Ivory, a promising 13-year-old basketball player on a nationally ranked high school team, went to see Dr. Gourineni for a left kneecap problem. Taylor’s pediatrician had diagnosed the young girl with patellar subluxation –a partially dislocated left kneecap. X-rays of Ms. Ivory’s left knee and hip were both negative. Dr. Gourineni, an orthopedic surgeon, prescribed physical therapy (PT). Taylor did PT from July through August of 2012. The young athlete’s knee pain improved but did not completely go away.
With the continuing knee pain, Ms. Ivory saw Gourineni again in October 2012. After his examinations, the doctor diagnosed Taylor with left hip impingement. Hip impingement happens when the head of the femur bone (ball of the hip socket) pinches against the acetabulum (hip socket).
To determine if she had hip impingement, Gourineni gave Taylor an intra-articular local anesthetic injection aimed at the hip capsule on November 16th. The doctor’s theory was that if the hip joint injection relieved Taylor’s knee pain it would prove that her knee pain was referred from the hip. Gourineni asserted that the injection relieved Taylor’s knee pain, demonstrating that she had hip impingement.
Gourineni determined that Taylor’s hip impingement required surgery to shave off some of the acetabulum bone. Notably, Dr. Gourineni did not order an MRI at any time during his treatment of Taylor.
Hip Surgeries on a Teenager
On Nov. 23, 2012, Taylor Ivory underwent hip surgery at the age of thirteen. Dr. Prasad Gourineni performed the surgery at Advocate Children’s Hospital in Oak Lawn, Illinois. After the surgery, Taylor suffered from cartilage damage in her hip. She received treatment from a physical therapist and worked with an athletic trainer throughout 2013.
However, by September 2013 Taylor’s hip pain was increasing and she had limited hip mobility. Gourineni recommended and performed surgery to address Taylor’s hip joint space narrowing and bone spurs. Bony growths called spurs arise from the surface of bones when they rub together when the cartilage no longer effectively buffers the two bones. This second surgery was unsuccessful.
Taylor sought care from another orthopedic surgeon after the mounting problems in her hip under Gourineni’s care. Her new doctor gave her a steroid injection in her hip to try to alleviate her pain. However, he also recommended hip replacement for the teenager. Additional orthopedic surgeons she consulted confirmed the hip replacement recommendation.
In June 2015, Taylor Ivory underwent hip replacement when she was about 15 years old. Her surgeon consulted with her after the procedure, and Taylor did months of more physical therapy. Ms. Ivory received no more treatment for her hip.
Allegations and Testimony
Taylor Ivory’s mother, Tahani Spearman, acting individually and as Taylor’s parent and natural guardian, sued Gourineni, his practice, and the hospital. The plaintiffs alleged that Gourineni failed to meet the accepted standard of care in his treatment of Taylor, constituting medical malpractice. Prior to the trial, the hospital was dismissed from the action.
Faulty Hip Impingement Diagnosis and Cartilage Damage
During the trial, an orthopedic surgery expert for the plaintiffs testified that Taylor did not have left hip impingement, nor did she require surgery. This orthopedic expert stated that Taylor did not meet the criteria for a hip impingement diagnosis. The principal symptoms for this condition are hip or groin pain and Taylor had neither. In the expert’s opinion, Gourineni erroneously relied on a normal X-ray rather than ordering an advanced imaging study, like an MRI (magnetic resonance imaging diagnostic) before the first surgery. The expert also faulted Gourineni for failing to account for the fact that Taylor was a growing 13-year-old girl.
The plaintiffs’ expert in orthopedic surgery also disputed Gourineni’s hip impingement diagnosis based on the intra-articular local anesthetic injection. The expert testified that other areas of the leg can become numb with this kind of injection in the absence of any hip impingement.
The expert also asserted that during the procedure Gourineni damaged Taylor’s hip cartilage when he drilled into her hip socket, breaching the cartilage. Although this is a known complication of the surgery, in the expert’s view, the cartilage will wear away over time due to the natural movement of the hip.
The plaintiffs also offered the testimony of a radiology expert. This expert said that Doctor Gourineni improperly relied upon an X-ray that showed no abnormalities when he diagnosed hip impingement. This radiology expert’s read of the X-ray was that Ms. Ivory had a normal hip, with no impingement.
Defense Said Diagnosis Was Correct and Met the Standard
The defense asserted that Doctor Gourineni met the standard of care in his diagnosis of hip impingement. In addition, they maintained that his recommendation and the performance of the surgery also met the standard.
Doctor Gourineni’s orthopedic surgery expert testified that the diagnostic injection approach Gourineni used provided conclusive evidence of hip impingement. Ms. Ivory’s subsequent treating physicians agreed with this defense expert’s view on this point.
The expert maintained that Gourineni’s diagnosis was correct and that an MRI was not necessary. Gourineni’s orthopedic expert added that during the surgery the doctor’s diagnosis of hip impingement was confirmed. This expert also pointed out that Taylor’s medical records showed that her knee pain complaints ended after the surgery.
The defense also called one of Taylor’s treating surgeons to testify. The physician stated that Ms. Ivory’s cartilage damage was not due to Gourineni’s surgical technique. Instead, the damage was the result of chondrolysis, according to this surgeon. The expert added that there is no known cause for this condition. Chondrolysis is the acute destruction of the cartilage in the femoral head.
Taylor was a sophomore in college when the trial happened. She sought $4 million for past and future pain and suffering and an additional $5 million for past and future loss of normal life. She also sought damages for past and future disfigurement based on the 6-inch vertical scar on her left hip.
Taylor’s orthopedic surgery expert testified that this young woman would have to get a hip replacement every 15 to 20 years.
Once a promising basketball player, Ms. Ivory alleged that, after Gourineni’s care, she’ll never be able to play basketball again.
Was There Proper Informed Consent?
The plaintiffs’ counsel also alleged that there was a lack of informed consent for the Gourineni surgeries. Counsel argued that Doctor Gourineni failed to advise Taylor’s mother that Taylor’s cartilage was at risk for damage during the first procedure. The plaintiffs also asserted that Gourineni did not advise Taylor’s mother of the MRI findings that he ordered prior to the second procedure.
The defense asserted that the consent form Taylor’s mother signed before the first surgery explained the cartilage damage risk. Gourineni’s lawyer also said the doctor refers patients to his website which also explained the surgery risks. The defense countered that before the second surgery, Gourineni had informed Taylor and her mother that an MRI showed chondrolysis in her hip.
Taylor’s mother flat-out denied that there was an MRI conversation before the second surgery.
Who Won the Case?
After a five-day trial, the jury found in favor of Ms. Ivory. Jurors awarded Ms. Ivory a total of $2.6 million in damages. The damages were:
- $1,000,000 for pain and suffering
- $1,500,000 for loss of normal life
- $100,000 for disfigurement
In this sad case, where a teenage girl who loved to play basketball ended up with a hip replacement, widely divergent expert opinions on her diagnoses and the standard of care were presented. Although she sought north of $9 million in damages for a lifelong affliction, the jury awarded $2.6 million. This may indicate that jury wrestled with who to believe.
Certainly, juror doubts about Ms. Ivory’s allegations may have surfaced when her other doctors agreed with some of the defense experts’ testimony. In the end, however, the plaintiff’s counsel was able to overcome any uncertainties in the jurors’ minds to secure a significant verdict for their client.