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Healthcare
8 min read
Areas of Expertise :
Healthcare, Emergency Medicine, Neurology, Medical Malpractice, Stroke
Published Date:
Last Modified Date:
Jurisdiction:
Georgia State
Court:
In October 2015, 32-year-old Jonathan Buckelew was taken to North Fulton Hospital after collapsing during a chiropractic neck adjustment and showing seizure-like symptoms. Although he arrived at a certified primary stroke center, signs of a brain stem stroke, including vertebral artery dissection, were either missed or not clearly communicated by emergency physician Dr. Matthew Womack and the hospital’s radiologist. Dr. Womack did not relay key clinical details to the on-call neurologist, including Buckelew’s second seizure-like episode and imaging findings showing dissection. By the time an MRI confirmed the stroke the next day, the window for effective intervention had passed. Buckelew was left with locked-in syndrome, conscious but almost completely paralyzed. In 2022, a jury awarded $75 million in damages, including $9 million for past medical costs and $46 million for pain and suffering.
In March 2025, the Georgia Court of Appeals upheld the full verdict and rejected defense arguments involving jury instructions, causation, and expert witness impeachment. The court concluded that jurors could reasonably find gross negligence under Georgia’s emergency medical care statute based on the failure to follow basic clinical steps during an emergency. The case shows how delayed stroke recognition and provider miscommunication can lead to catastrophic neurological injury in a time-sensitive hospital setting. At its center, the dispute concerned a breakdown in urgent stroke assessment, diagnosis, and consultation during a rapidly progressing medical emergency.
Jonathan Buckelew, then 32, was taken by ambulance to North Fulton Hospital after collapsing and becoming unresponsive during a chiropractic neck adjustment. When he arrived, he showed seizure-like activity and clear signs of neurological distress. Even though the hospital was a certified primary stroke center, the underlying brain stem stroke was not diagnosed during the critical treatment window.
Dr. Matthew Womack, the attending emergency physician, ordered a CT scan and CT angiogram that showed signs of vertebral artery dissection. He consulted the on-call neurologist but did not relay key clinical details, including the recent chiropractic adjustment, seizure activity during a lumbar puncture, and the imaging findings. That failure limited the neurologist’s ability to assess the situation and act on the full picture.
Later that evening, ICU physician assistant Christopher Nickum admitted Buckelew to the intensive care unit. Despite his worsening condition, the stroke was not definitively diagnosed that evening, and he remained in critical condition overnight. An MRI the next morning confirmed the brain stem stroke, by which point the window for effective intervention had passed.
The next morning, an MRI confirmed that Buckelew had suffered a brain stem stroke. By then, the opportunity to perform a mechanical thrombectomy or provide other effective treatment had passed. The stroke caused permanent damage and left him with locked-in syndrome, conscious but unable to move or speak.
Buckelew sued Dr. Womack, the hospital, the radiologist, and other healthcare providers. A jury found Dr. Womack and the radiologist grossly negligent and awarded $75 million in damages, including $9 million for past medical costs, $20 million for future care, and $46 million for pain and suffering. The jury apportioned fault at 60% to Dr. Womack and 40% to the radiologist.
The Georgia Court of Appeals affirmed the jury’s decision and rejected both the defense and plaintiff appeals. The court held that the gross negligence standard was properly applied and that the jury instructions were valid. It also stated that jurors could reasonably find that the defendant physician failed to exercise even slight diligence under Georgia’s emergency medical care statute.
The Supreme Court of Georgia’s 2025 denied-review list includes S25C0923. Womack v. Buckelew (A24A1642) under June 10, 2025, indicating that further review was denied after the Court of Appeals decision.
Superior Court of Fulton County, Georgia
Case Name:
Buckelew v. Womack et al.
Hospital Malpractice
Critical Care Nursing
Intensive Care Unit (ICU)
Medical Imaging
Neuroimaging
Nursing
Hospital Liability
Acute Care Hospitals
Thrombosis
Lifetime Medical Costs
In October 2015, 32-year-old Jonathan Buckelew was taken to North Fulton Hospital after collapsing during a chiropractic neck adjustment and showing seizure-like symptoms. Although he arrived at a certified primary stroke center, signs of a brain stem stroke, including vertebral artery dissection, were either missed or not clearly communicated by emergency physician Dr. Matthew Womack and the hospital’s radiologist. Dr. Womack did not relay key clinical details to the on-call neurologist, including Buckelew’s second seizure-like episode and imaging findings showing dissection. By the time an MRI confirmed the stroke the next day, the window for effective intervention had passed. Buckelew was left with locked-in syndrome, conscious but almost completely paralyzed. In 2022, a jury awarded $75 million in damages, including $9 million for past medical costs and $46 million for pain and suffering.
In March 2025, the Georgia Court of Appeals upheld the full verdict and rejected defense arguments involving jury instructions, causation, and expert witness impeachment. The court concluded that jurors could reasonably find gross negligence under Georgia’s emergency medical care statute based on the failure to follow basic clinical steps during an emergency. The case shows how delayed stroke recognition and provider miscommunication can lead to catastrophic neurological injury in a time-sensitive hospital setting. At its center, the dispute concerned a breakdown in urgent stroke assessment, diagnosis, and consultation during a rapidly progressing medical emergency.
Jonathan Buckelew, then 32, was taken by ambulance to North Fulton Hospital after collapsing and becoming unresponsive during a chiropractic neck adjustment. When he arrived, he showed seizure-like activity and clear signs of neurological distress. Even though the hospital was a certified primary stroke center, the underlying brain stem stroke was not diagnosed during the critical treatment window.
Dr. Matthew Womack, the attending emergency physician, ordered a CT scan and CT angiogram that showed signs of vertebral artery dissection. He consulted the on-call neurologist but did not relay key clinical details, including the recent chiropractic adjustment, seizure activity during a lumbar puncture, and the imaging findings. That failure limited the neurologist’s ability to assess the situation and act on the full picture.
Later that evening, ICU physician assistant Christopher Nickum admitted Buckelew to the intensive care unit. Despite his worsening condition, the stroke was not definitively diagnosed that evening, and he remained in critical condition overnight. An MRI the next morning confirmed the brain stem stroke, by which point the window for effective intervention had passed.
The next morning, an MRI confirmed that Buckelew had suffered a brain stem stroke. By then, the opportunity to perform a mechanical thrombectomy or provide other effective treatment had passed. The stroke caused permanent damage and left him with locked-in syndrome, conscious but unable to move or speak.
Buckelew sued Dr. Womack, the hospital, the radiologist, and other healthcare providers. A jury found Dr. Womack and the radiologist grossly negligent and awarded $75 million in damages, including $9 million for past medical costs, $20 million for future care, and $46 million for pain and suffering. The jury apportioned fault at 60% to Dr. Womack and 40% to the radiologist.
The Georgia Court of Appeals affirmed the jury’s decision and rejected both the defense and plaintiff appeals. The court held that the gross negligence standard was properly applied and that the jury instructions were valid. It also stated that jurors could reasonably find that the defendant physician failed to exercise even slight diligence under Georgia’s emergency medical care statute.
The Supreme Court of Georgia’s 2025 denied-review list includes S25C0923. Womack v. Buckelew (A24A1642) under June 10, 2025, indicating that further review was denied after the Court of Appeals decision.
Emergency Medicine Expert Witness
Dr. Martin Lutz, an emergency medicine expert who testified that Dr. Womack grossly deviated from the applicable standard of care by omitting critical clinical information during a neurological consult. Emergency medicine experts are commonly called to assess whether ER protocols were followed in time-sensitive conditions such as stroke. These experts often provide insight into triage decisions, diagnostic orders, and provider communication standards in emergency settings.
Neurology Expert Witness
Dr. Raul Nogueira, a specialist in interventional and general neurology, testified that earlier intervention could have significantly reduced the severity of Buckelew’s stroke. Neurology expert witnesses are typically engaged in cases involving brain function, vascular injury, or diagnostic delays in neurologic emergencies. Their testimony can be critical in evaluating causation, long-term neurological outcomes, and whether specialist consultation met clinical expectations.
Nursing Expert Witness
Jennifer Adamski, PhD, testified as a nursing expert regarding ICU staff conduct, including the failure to notify a physician despite repeated family requests. Nursing experts are often brought in to assess whether nursing documentation, monitoring, and escalation protocols aligned with professional standards. These witnesses help courts evaluate whether care coordination and patient communication contributed to adverse outcomes.
Radiology Expert Witness
Radiology expert witnesses are typically engaged to review imaging interpretations, identify diagnostic errors, and determine whether communication of findings met professional standards. In litigation involving stroke or missed diagnoses, their evaluations often center on timing and accuracy of radiological reports.
Hospital Administration Expert Witness
Given allegations about ICU policies, nurse responsibilities, and hospital protocol enforcement, experts in hospital operations are often engaged in such cases. These experts assess institutional policies, staff training, and compliance with emergency protocols. Their role may also include reviewing whether systemic issues contributed to the failure to activate stroke alerts or follow established procedures.
Proving Gross Negligence Under Georgia’s Emergency Medical Care Statute
Georgia’s emergency medical care statute, OCGA § 51-1-29.5, required Buckelew to prove gross negligence rather than ordinary negligence. Plaintiff’s counsel met that burden by using expert testimony to show an absence of even slight diligence in the defendants’ clinical decisions and provider communication. In emergency-care cases governed by elevated liability standards, the most effective approach is to connect specific omissions to avoidable harm in a clear and fact-driven way.
Using Neurology Testimony to Prove Time-Sensitive Causation
Neurology testimony helped the jury understand how the delay in stroke intervention affected the severity of Buckelew’s outcome. In stroke cases and other neurological injury claims, causation often turns on narrow treatment windows and the medical significance of each missed step. A well-structured expert timeline can help show how early failures in diagnosis, consultation, or escalation contributed to permanent neurological damage.
Treating Provider Miscommunication as a Separate Breach of Care
The failure to relay key clinical information, including imaging results and Buckelew’s chiropractic history, played a central role in the jury’s findings. In cases like this, provider miscommunication can be framed as its own breach of care rather than as a side issue attached to the missed diagnosis. That approach is especially important where testing was ordered but the right information was not communicated in time to guide treatment.
Vetting Expert Witnesses for Impeachment Risks Before Trial
The defense expert was impeached with a prior podcast statement concerning altered medical records, and the appellate court upheld that use of the statement. That part of the case shows why counsel should closely review an expert’s prior public comments, publications, recorded interviews, and other impeachment material before trial. Careful vetting can reduce avoidable credibility damage and help counsel prepare for cross-examination more effectively.
Using Pretrial Orders to Preserve Hospital Liability Theories
The court limited some arguments against the hospital because the pretrial order did not fully preserve those theories of institutional negligence. That ruling shows how much can turn on precision in pretrial filings, especially when a party intends to pursue claims tied to staffing, policies, escalation failures, or protocol enforcement. In complex medical negligence cases, pretrial orders should be drafted with enough clarity to preserve each theory the party may need to present at trial.
Buckelew v. Womack became a major Georgia medical malpractice case after a delayed brain stem stroke diagnosis left Jonathan Buckelew with permanent locked-in syndrome and led to a $75 million verdict that the Georgia Court of Appeals later affirmed. The jury found that miscommunication and omitted clinical information by the emergency physician and radiologist supported a finding of gross negligence, placing the case at the center of disputes over provider communication, timely stroke diagnosis, and emergency care standards. The litigation also showed how expert testimony in neurology, emergency medicine, and nursing helped explain causation, treatment timing, and departures from accepted care. As a result, the case remains a strong reference point for lawyers handling stroke malpractice claims, emergency medical care statute issues, and cases where delayed escalation leads to catastrophic neurological injury.
What happened in the Buckelew stroke misdiagnosis case?
Jonathan Buckelew collapsed during a chiropractic neck adjustment in October 2015 and was taken to North Fulton Hospital. Although he arrived at a certified primary stroke center, his brain stem stroke was not promptly diagnosed, and key findings tied to vertebral artery dissection were not fully communicated. By the time the stroke was confirmed, the treatment window had passed, and Buckelew was left with locked-in syndrome. A jury later awarded $75 million in damages.
Why did the jury find Dr. Womack and the radiologist grossly negligent?
The jury found gross negligence because critical clinical information and imaging findings pointing to stroke were not properly communicated during an emergency. According to the case, those omissions affected the neurologist’s ability to assess the situation and intervene within the limited treatment window. Under Georgia’s emergency medical care statute, the jury could find that this conduct showed a lack of even slight diligence.
What is locked-in syndrome, and why was it central to the case?
Locked-in syndrome is a severe neurological condition in which a person remains conscious but is almost completely paralyzed and unable to speak. It is commonly associated with serious brain stem injury, including stroke. In Buckelew’s case, the condition was central because it reflected the permanent harm that followed the delayed diagnosis and loss of timely treatment.
How much was awarded in the Buckelew v. Womack verdict?
The jury awarded $75 million in total damages. That amount included $9 million for past medical costs, $20 million for future care, and $46 million for pain and suffering. The Georgia Court of Appeals later upheld the verdict.
Was North Fulton Hospital found directly liable in the case?
The jury did not find North Fulton Hospital directly liable for gross negligence. Even so, hospital staff conduct and the handling of Buckelew’s care were examined closely during the litigation. The jury’s gross-negligence findings focused on the emergency physician and the radiologist.
Emergency Medicine Expert Witness
Dr. Martin Lutz, an emergency medicine expert who testified that Dr. Womack grossly deviated from the applicable standard of care by omitting critical clinical information during a neurological consult. Emergency medicine experts are commonly called to assess whether ER protocols were followed in time-sensitive conditions such as stroke. These experts often provide insight into triage decisions, diagnostic orders, and provider communication standards in emergency settings.
Neurology Expert Witness
Dr. Raul Nogueira, a specialist in interventional and general neurology, testified that earlier intervention could have significantly reduced the severity of Buckelew’s stroke. Neurology expert witnesses are typically engaged in cases involving brain function, vascular injury, or diagnostic delays in neurologic emergencies. Their testimony can be critical in evaluating causation, long-term neurological outcomes, and whether specialist consultation met clinical expectations.
Nursing Expert Witness
Jennifer Adamski, PhD, testified as a nursing expert regarding ICU staff conduct, including the failure to notify a physician despite repeated family requests. Nursing experts are often brought in to assess whether nursing documentation, monitoring, and escalation protocols aligned with professional standards. These witnesses help courts evaluate whether care coordination and patient communication contributed to adverse outcomes.
Radiology Expert Witness
Radiology expert witnesses are typically engaged to review imaging interpretations, identify diagnostic errors, and determine whether communication of findings met professional standards. In litigation involving stroke or missed diagnoses, their evaluations often center on timing and accuracy of radiological reports.
Hospital Administration Expert Witness
Given allegations about ICU policies, nurse responsibilities, and hospital protocol enforcement, experts in hospital operations are often engaged in such cases. These experts assess institutional policies, staff training, and compliance with emergency protocols. Their role may also include reviewing whether systemic issues contributed to the failure to activate stroke alerts or follow established procedures.
Proving Gross Negligence Under Georgia’s Emergency Medical Care Statute
Georgia’s emergency medical care statute, OCGA § 51-1-29.5, required Buckelew to prove gross negligence rather than ordinary negligence. Plaintiff’s counsel met that burden by using expert testimony to show an absence of even slight diligence in the defendants’ clinical decisions and provider communication. In emergency-care cases governed by elevated liability standards, the most effective approach is to connect specific omissions to avoidable harm in a clear and fact-driven way.
Using Neurology Testimony to Prove Time-Sensitive Causation
Neurology testimony helped the jury understand how the delay in stroke intervention affected the severity of Buckelew’s outcome. In stroke cases and other neurological injury claims, causation often turns on narrow treatment windows and the medical significance of each missed step. A well-structured expert timeline can help show how early failures in diagnosis, consultation, or escalation contributed to permanent neurological damage.
Treating Provider Miscommunication as a Separate Breach of Care
The failure to relay key clinical information, including imaging results and Buckelew’s chiropractic history, played a central role in the jury’s findings. In cases like this, provider miscommunication can be framed as its own breach of care rather than as a side issue attached to the missed diagnosis. That approach is especially important where testing was ordered but the right information was not communicated in time to guide treatment.
Vetting Expert Witnesses for Impeachment Risks Before Trial
The defense expert was impeached with a prior podcast statement concerning altered medical records, and the appellate court upheld that use of the statement. That part of the case shows why counsel should closely review an expert’s prior public comments, publications, recorded interviews, and other impeachment material before trial. Careful vetting can reduce avoidable credibility damage and help counsel prepare for cross-examination more effectively.
Using Pretrial Orders to Preserve Hospital Liability Theories
The court limited some arguments against the hospital because the pretrial order did not fully preserve those theories of institutional negligence. That ruling shows how much can turn on precision in pretrial filings, especially when a party intends to pursue claims tied to staffing, policies, escalation failures, or protocol enforcement. In complex medical negligence cases, pretrial orders should be drafted with enough clarity to preserve each theory the party may need to present at trial.
Buckelew v. Womack became a major Georgia medical malpractice case after a delayed brain stem stroke diagnosis left Jonathan Buckelew with permanent locked-in syndrome and led to a $75 million verdict that the Georgia Court of Appeals later affirmed. The jury found that miscommunication and omitted clinical information by the emergency physician and radiologist supported a finding of gross negligence, placing the case at the center of disputes over provider communication, timely stroke diagnosis, and emergency care standards. The litigation also showed how expert testimony in neurology, emergency medicine, and nursing helped explain causation, treatment timing, and departures from accepted care. As a result, the case remains a strong reference point for lawyers handling stroke malpractice claims, emergency medical care statute issues, and cases where delayed escalation leads to catastrophic neurological injury.
What happened in the Buckelew stroke misdiagnosis case?
Jonathan Buckelew collapsed during a chiropractic neck adjustment in October 2015 and was taken to North Fulton Hospital. Although he arrived at a certified primary stroke center, his brain stem stroke was not promptly diagnosed, and key findings tied to vertebral artery dissection were not fully communicated. By the time the stroke was confirmed, the treatment window had passed, and Buckelew was left with locked-in syndrome. A jury later awarded $75 million in damages.
Why did the jury find Dr. Womack and the radiologist grossly negligent?
The jury found gross negligence because critical clinical information and imaging findings pointing to stroke were not properly communicated during an emergency. According to the case, those omissions affected the neurologist’s ability to assess the situation and intervene within the limited treatment window. Under Georgia’s emergency medical care statute, the jury could find that this conduct showed a lack of even slight diligence.
What is locked-in syndrome, and why was it central to the case?
Locked-in syndrome is a severe neurological condition in which a person remains conscious but is almost completely paralyzed and unable to speak. It is commonly associated with serious brain stem injury, including stroke. In Buckelew’s case, the condition was central because it reflected the permanent harm that followed the delayed diagnosis and loss of timely treatment.
How much was awarded in the Buckelew v. Womack verdict?
The jury awarded $75 million in total damages. That amount included $9 million for past medical costs, $20 million for future care, and $46 million for pain and suffering. The Georgia Court of Appeals later upheld the verdict.
Was North Fulton Hospital found directly liable in the case?
The jury did not find North Fulton Hospital directly liable for gross negligence. Even so, hospital staff conduct and the handling of Buckelew’s care were examined closely during the litigation. The jury’s gross-negligence findings focused on the emergency physician and the radiologist.
Why did the Georgia Court of Appeals uphold the $75 million verdict in Buckelew v. Womack?
The Georgia Court of Appeals upheld the verdict after rejecting challenges to the jury instructions, causation findings, and impeachment of expert testimony. The court concluded that the evidence allowed jurors to find gross negligence under Georgia’s emergency medical care statute, especially given the failure to relay key clinical facts and imaging results during a time-sensitive stroke emergency. That ruling left the full $75 million award in place.
Hospital Malpractice
Critical Care Nursing
Intensive Care Unit (ICU)
Medical Imaging
Neuroimaging
Nursing
Hospital Liability
Acute Care Hospitals
Thrombosis
Lifetime Medical Costs
Medical Devices, +4
Healthcare
Healthcare, +4
Healthcare
Why did the Georgia Court of Appeals uphold the $75 million verdict in Buckelew v. Womack?
The Georgia Court of Appeals upheld the verdict after rejecting challenges to the jury instructions, causation findings, and impeachment of expert testimony. The court concluded that the evidence allowed jurors to find gross negligence under Georgia’s emergency medical care statute, especially given the failure to relay key clinical facts and imaging results during a time-sensitive stroke emergency. That ruling left the full $75 million award in place.