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Catastrophic Medical Injury

The Catastrophic Medical Injury Practice consists of a core group of attorneys with experience handling high exposure cases in the Mid-Atlantic and Northeastern states. We understand the complex and sensitive nature of these types of cases, and possess the knowledge and resources necessary to achieve results for our clients.  

The group operates primarily in three areas of litigation: birth injury, non-birth medical malpractice catastrophic injury, and non-medical malpractice catastrophic injury.

Birth Injury Litigation
In this context, we defend directly, assist as a consultant, or serve as a resource or as co-counsel for pre-trial and trial matters. We help develop standard of care, causation and damage defenses, assist in selecting reputable, qualified experts, and preparing to defend against plaintiff experts.

Non-Birth Medical Malpractice Catastrophic Injury Litigation
We serve in the same capacities as in birth injury litigation, with an additional focus on damage defenses in cases involving large claims for future medical expenses.

Non-Medical Malpractice Catastrophic Injury Litigation
Future care costs are high, and scientific or medical issues, causation and damages predominate, or are substantial. We collaborate with other attorneys within our firm who are knowledgeable about the underlying liability issues. Our experience includes helping to defend several claims where a MVA involving a pregnant woman is blamed for a premature baby with complications.

We also offer limited services in selected cases, including the selection, retention and cultivation of experts, jury research, and focus group services, often serving as plaintiff's counsel in mock trials and mock depositions to test the readiness of a defendant or nurse-witness.

Our attorneys keep abreast of the latest trial tactics and trends in medicine. They are often called upon to speak at events hosted by clients and various industry groups. We have access to the country's top experts on:

  • Obstetrics and maternal fetal medicine;
  • Pediatrics, including neonatology, neurology, infectious diseases, genetics, neuroradiology and placental pathology;
  • Life expectancy;
  • Economic loss, including the Affordable Care Act and other damage mitigation techniques;
  • Biostatistics and epidemiology; and
  • Many other scientific and medical subspecialties.

Results

Defense Verdict Received in Traumatic Brain Injury Case

We received a defense verdict after a two-day arbitration hearing in a traumatic brain injury case. With an initial $5.25 million demand, the plaintiff alleged overmedication led to cardiac arrest and a traumatic brain injury resulting in permanent neurocognitive impairment. Through testimony from our providers and experts across internal medicine, pulmonology, toxicology, and neuropsychology, we demonstrated that the care met the standard, did not cause the arrest, and that any deficits could have been pre-existing.

Won Unanimous Defense Verdict in High-Exposure Birth Injury Case

We secured a unanimous defense verdict in a high-exposure birth injury case, successfully proving that our client’s obstetric care met accepted standards despite claims of negligence and lasting injury. The plaintiff, the mother, alleged the obstetrician defendant was negligent in failing to identify her baby as large for gestational age in the prenatal period, in failing to proceed with a cesarean section during the labor, and in negligently performing a forceps delivery. The plaintiff alleged, as a result of her injuries from the delivery, she suffered pelvic organ prolapse, incontinence, and ongoing pain and suffering. The plaintiff underwent two subsequent gynecologic surgeries and alleged, as result of her ongoing pain, she would never be able to return to work for the remainder of her life. Through the testimony of our client and experts, we were able to establish the care provided by the obstetrician was within accepted standards of care and the decision to proceed with the delivery as performed was the safest option for the mother and baby. The jury returned a unanimous verdict in favor of our client.   

Thought Leadership

The Quarterly Dose

Catastrophic Medical Injury Practice

August 26, 2026

Attorneys in our Catastrophic Medical Injury Practice are focused on defending complex, high-exposure matters in litigation, including birth injury claims, catastrophic medical malpractice cases and other significant injury cases involving substantial future care costs and damages exposure. Combining deep legal knowledge with access to leading medical, scientific and economic experts, our team partners with clients to develop effective defense strategies, manage risk, and achieve favorable outcomes in challenging cases. According to practice co-chairs, Joan Orsini Ford and Kathleen Kramer, “Catastrophic injury cases demand a unique combination of legal experience, medical understanding and strategic vision. Our team is committed to helping clients navigate these high-stakes matters with thoughtful advocacy, trusted resources and a results-driven approach.” In select cases, we also provide litigation support related to the selection, retention and cultivation of experts; jury research; and focus group services in the form of mock trials and mock depositions to test the readiness of a defendant or nurse-witness.

The Quarterly Dose

ALL RISE: Recent Victories and Success Stories

November 1, 2025

Gary Samms (Philadelphia and King of Prussia) obtained a defense verdict on behalf of a Philadelphia hospital and two Emergency Department physicians after a six-day jury trial in a complex and extremely emotional case involving the death of 7-year-old child. Allegations of negligence surrounded the failure to admit and perform a urine drug screen on an 18-year-old who presented high on synthetic marijuana or K2. Gary argued that the doctors appropriately performed numerous exams, tested and monitored the patient until he achieved clinical sobriety. The patient was discharged, then 22 hours later smoked more K2 and within two hours strangled his 7-year-old sister to death. Paralegal Nancy Farnen (Philadelphia) was instrumental in the result. In another matter, Gary obtained a dismissal in the middle of trial after cross-examining the plaintiff’s witnesses in a case involving a former NFL player and opera singer who contended they had permanent injuries after knee surgery and the failure to diagnose a pseudoaneurysm. Plaintiff’s counsel agreed to dismiss Gary and his client prior to the end of their case to prevent him from participating in the trial further and decided to limit their recovery to the other defendants due to Gary’s successful cross-examination. Gary also obtained a defense verdict after an 11-day trial on behalf of four physicians and a major teaching hospital in Philadelphia. The medical malpractice action involved the labor and delivery of a baby later alleged to have a hypoxic birth injury that caused developmental delays and permanent brain damage, among other issues. The plaintiffs’ experts boarded $21 million in future medical costs to take care of the child and the demand in the pretrial was commensurate with those numbers. In another matter, Gary obtained a non-suit in a wrongful death case in Delaware County. The court found upon motion that there was no link to causation after an extensive, nuanced argument. With tremendous support from Adam Fulginiti and paralegal Nancy Farnen (both of Philadelphia), Gary also secured a unanimous defense verdict in Philadelphia on behalf of a prominent orthopedic surgeon accused of inappropriate touching of a patient. The plaintiff alleged that the physician inappropriately touched her during a preoperative examination for bilateral hip surgery. Through meticulous cross-examination and persuasive argument, the defense team achieved a complete victory. Adam, working closely with Bobbi Lewis, Ryan Harvie and paralegal Dorien Belle (all of Philadelphia) also obtained summary judgment on behalf of their nursing home client. The case involved allegations that the facility failed to prevent various conditions and injuries during the resident’s admission, such as UTI/sepsis, acute kidney injury/metabolic encephalopathy, dehydration and failure to thrive/weight loss, and skin breakdown. The plaintiff alleged these developments resulted in numerous damages including, but not limited to, death. Our motion for summary judgment sought dismissal under the grounds that the facility held immunity pursuant to the Pennsylvania Tort Claims Act and included numerous supporting documents, ranging from public entity reimbursement agreements, personnel information, corporate bylaws and other materials. Melissa Dziak and Robert Aldrich (both in Scranton) received a defense verdict after a two-day arbitration hearing in a traumatic brain injury case. With an initial $5.25 million demand, the plaintiff alleged overmedication led to cardiac arrest and a traumatic brain injury, resulting in permanent neurocognitive impairment. Through testimony from our providers and experts across internal medicine, pulmonology, toxicology and neuropsychology, Missy and Rob demonstrated that the care met the standard, did not cause the arrest and any deficits could have been pre-existing. Kevin Hexstall (Philadelphia) and Michael Mongiello (Harrisburg) were successful on appeal of a child abuse determination levied against a home health nurse. The three-day hearing was litigated before the PA Department of Human Services. As a result of the court’s order, the nurse’s record of child abuse is being expunged. The matter arose out of the alleged attack of a child-patient by a family pit bull dog during home nursing care. It was asserted that the nurse failed to properly supervise and protect the child and failed to properly respond to the incident when it occurred. Kevin and Mike established a lack of definitive proof that the nurse negligently left the child unsupervised. They also called into question the circumstances surrounding the alleged attack, including whether the dog had a known history of aggression, which led to credibility issues on the part of the family member witnesses. Medical experts also testified on the appellant’s behalf to address possible alternate explanations for the child’s injuries. Ultimately, Kevin and Mike established that the prosecution failed to meet its burden of proof, highlighting multiple errors and inconsistencies relating to the investigation and the reporting processes. This is a significant outcome in a difficult jurisdiction with many problematic underlying facts (which led to the decision to not call the nurse to testify in her defense). Kevin and Mike’s efforts in this regard were also instrumental in allowing for achievement of a very favorable resolution of the civil claim. Michael also obtained partial summary judgment for an obstetrician in a medical professional liability action, significantly curtailing his client’s exposure. The case arose out of the alleged negligent delivery of a baby, resulting in a shoulder dystocia, right brachial plexus injury and Erb’s palsy. Michael argued that there was a lack of evidence that his client improperly applied traction during the delivery. The judge agreed and granted partial summary judgment on the plaintiff’s gravamen claim of direct negligence. The court also granted summary judgment on claims for res ipsa loquitur and failure to obtain informed consent and also as to the plaintiff’s claim for past medical expenses, due to a lack of proper evidence in support of these claims. Jeffrey Bates and Travis Talbot, with the help of paralegal Jennifer Cicchetti (all in Philadelphia), received a defense verdict in a dental malpractice action before the Luzerne County Court of Common Pleas. The plaintiff had a history of issues with his third molars (wisdom teeth) beginning in 2012. In 2013 he was referred to have one of them extracted by a prior dentist. In October 2015, the plaintiff presented to our client for a broken tooth. During the exam, our client advised him that he needed to have all four of his third molars removed. He even suggested it needed to be done at the next visit. However, the plaintiff did not schedule any further appointments. On January 10, 2017, the plaintiff presented with an infected third molar on the lower right, and our client suggested extracting both third molars on the right, as all of his third molars were broken down and sources of infection. However, the plaintiff would only allow extraction of the lower tooth. Our client extracted the tooth, gave a prescription of amoxicillin and administered two loading doses to get the antibiotic to therapeutic levels more quickly. He also told the plaintiff to call if the swelling in his face did not improve or if it got worse. Over the next four days, as the plaintiff testified, his swelling got worse every day, but he did not call the doctor. Finally, on January 14, 2017, his swelling had progressed into his neck, and he called our client, who saw him and immediately sent him to the emergency department. He was admitted to the hospital for 40 days, was intubated, underwent 11 procedures, including multiple incision and drainage procedures, placement of a PEG tube and a tracheostomy. The plaintiff’s experts agreed that a patient has responsibility for his own care, and failing to have his teeth extracted, or calling the doctor when the situation got worse, contributed to his injury. Although contributory negligence was on the verdict slip, the jury never got to the question as they found our client was not negligent. Justin Johnson and Nataliana Guida, with assistance from paralegal Elina Sheldon (all in Roseland), secured a wrongful birth verdict well below the pre-trial settlement offer, which the plaintiffs rejected. Despite being brought into the case just seven months prior to the trial, Justin and Talia delivered compelling arguments that led to a total verdict that was less than the original offer made before the trial, with our client responsible for only 65%. Megan Nelson (Orlando) was successful in having her Florida Rule 5.900 Petition for Expedited Judicial Intervention Concerning Medical Treatment Procedure granted. The alleged incapacitated person had been medically cleared for discharge to a skilled nursing facility. However, his brother, who had been appointed as the health care surrogate and power of attorney, had refused to consent to his brother’s transfer to any skilled nursing facility. After numerous unsuccessful attempts by the hospital case management team to transfer the patient, Megan was retained to file a Florida Rule 5.900 Petition for Expedited Judicial Intervention Concerning Medical Treatment Procedures. After the emergency evidentiary hearing, the court granted the petition and ordered the brother to consent to the transfer of the patient to a skilled nursing facility. Michael Roberts and David Williamson (both of Cincinnati) successfully secured a dismissal on behalf of our client, a leading provider of complex specialty pharmacy services, via a Motion to Dismiss. At oral argument, Michael successfully argued that the plaintiff’s claim was a medical claim under R.C. 2305.113 and, thus, subject to the affidavit of merit requirement in Civil Rule 10(D)(2). In addition, he argued that the plaintiff’s cause of action should be dismissed since she could not establish the adequacy of her complaint without a proper affidavit of merit. The court agreed and dismissed the plaintiff’s Complaint in its entirety.  *Results do not guarantee a similar result. The Quarterly Dose – November 2025, has been prepared for our readers by Marshall Dennehey. It is solely intended to provide information on recent legal developments and is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We welcome the opportunity to provide such legal assistance as you require on this and other subjects. If you receive the alerts in error, please send a note to tamontemuro@mdwcg.com. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2025 Marshall Dennehey. All Rights Reserved.

Firm Highlights

Thought Leadership

Commonwealth Court Reaffirms the Constitutionality of Act 111's IRE Provisions

In this case, the claimant sustained a work injury of January 6, 1994, which was acknowledged by Notice of Compensation Payable (NCP). After the claimant’s receipt of 104 weeks of temporary total disability benefits, the employer filed a Request for an Impairment Rating Examination (IRE). The IRE was performed in May 2023 and the IRE physician found that the claimant had a 5% whole person impairment, under the AMA Guides. The employer filed a Petition based on the IRE results, and the Petition was granted by the WCJ. During litigation, the claimant argued that the IRE provisions of Act 111 (Section 306(a.3) of the Act) were not applicable to her injury, since it predated June 24, 1996, the date Act 57 went into effect, and that the IRE provisions were unconstitutional. The Workers’ Compensation Judge (WCJ)) granted the Petition and the Board affirmed. On appeal to the Commonwealth Court, the claimant argued that Act 111 violated the nondelegation doctrine and that its retroactive application to the claimant’s injury was unconstitutional. The court rejected the arguments on the basis that they had already found the same arguments without merit in multiple, prior cases. The court also addressed an argument made by the claimant that Act 111 was procedurally defective under the Pennsylvania Constitution because it was only considered on two days in each House after having undergone amendments and reassignments. The court noted that the Pennsylvania Constitution requires every bill to be considered on three different days in each House. The claimant maintained that, according to the legislative history, the bill did not receive three separate days of consideration from each House when it was assigned a new bill number. The court pointed out, however, that the bill number, H.B. 1840 remained constant and was considered on three occasions by the House. Further, the court concluded that minor amendments to the bill were germane to its original subject, which was to modify the Act’s IRE process, in accordance with Protz II.

Thought Leadership

Appellate Division Reversed Trial Judge's Orders Granting a Plaintiff's Section 40 Summary Judgement Motion

In Haskins v. Casey, et al., the plaintiff Dane Haskins worked for defendant Ekornes, Inc. (Ekornes) as a material handler. In June 2021, he filed a workers’ compensation claim petition for benefits due to a left shoulder injury in December 2020. He then resolved his workers’ compensation claim in November 2022 under an Order Approving Settlement. In January 2023, he filed a lawsuit against Ekornes and later amended to add additional claims and name other defendants, including the Ekornes president, chief financial officer, and director of human resources. In May 2025, a second amended complaint alleged that after he filed the workers compensation claim, Ekornes placed him on leave under the Family and Medical Leave Act (FMLA), denied his request for a work accommodation, and ultimately terminated him from employment in December 2021. He pleaded several causes of action asserting violations of the New Jersey Law Against Discrimination (LAD) as well as fraudulent concealment and wrongful discharge. The plaintiff then moved for partial summary judgment, seeking an order enforcing Section 40 of the Workers’ Compensation Act (WCA) as well as summary judgment on his FMLA claims. The defendants opposed the motions and cross-moved for summary judgment on the FMLA claims. After arguments, the court entered an order in December 2025, denying the FMLA motion and cross motion and granting the plaintiff’s Section 40 motion. In the order, the court permitted the plaintiff to pursue compensatory damages at trial in connection with the bodily injury claim. The court also allowed the plaintiff to present evidence of any workers’ compensation benefits to support his claim. The court then denied the defendant's subsequent reconsideration motion in February 2026. The defendants that appealed the Section 40 aspect of the orders. In reviewing the appeal de novo, the Appellate Division rejected the plaintiff's argument that the work-related injury arose out of his discrimination claims under the LAD. The plaintiff argued that he should be able to pursue a personal injury claim as a part of his LAD claim, noting that the employer’s compensation carrier would be able to assert a lien against any recovery against his LAD claims. In distinguishing between the Richter vs. Oakland Board of Education, 246 N.J. 507 (2021) case, in which the Court found that any recovery would be subject to a Section 40 lien as the allegation was that the defendants failed to accommodate her pre-existing diabetic condition, which resulted in bodily injury. In this case, the Appellate Division indicated that there was no bodily injury caused by Ekornes’ failure to accommodate a pre-existing disability. Rather, the shoulder injury was a result of a workers compensation claim, for which he received appropriate benefits previously. The Appellate Division noted that if the plaintiff was successful in proving his LAD claims, he would be entitled to damages caused by the discriminatory discriminatory conduct such as lost wages and emotional distress damages and that there will be no Section 40 lien. In addition, the Appellate Division disagreed that the petitioner could present evidence about and seek damages for his shoulder injury at trial. Although the petitioner argued that a defendant who retaliated against an employee for filing a workers’ compensation claim should not benefit from the exclusivity provision of the WCA, the Appellate Division noted that the Legislature did not include this type of scenario in the statue nor did any of the case law recognize this type of claim as a remedy. As such, the Appellate Division reversed the December 2025 order granting the the plaintiff’s Section 40 summary judgment motion as well as the February 2026 reconsideration motion order. The Appellate Division noted that they did not intend to limit the plaintiff in his pursuit of his other claims on under the LAD, FMLA, and workers’ compensation retaliation causes of action.

Thought Leadership

WCJ Improperly Refused to Conduct C&R Hearing and Erroneously Required Settlement of All Pending Petitions

In this case, the claimant sustained injuries in the course and scope of her employment as a registered nurse. The employer acknowledged the injury by a Notice of Compensation Payable (NCP).  Subsequently, a Workers’ Compensation Judge (WCJ) expanded the description of injury. The employer then filed a Termination Petition, alleging the claimant was fully recovered from the injuries. Providers filed Utilization Review (UR) Petitions, challenging UR determinations finding their chiropractic treatment to be not reasonable and necessary. A settlement of the claim was eventually reached, and the employer filed a Petition to Seek Approval of a Compromise and Release (C&R) Agreement. The C&R outlined that the agreement fully resolved all future workers’ compensation claims except for the termination and UR Petitions. Briefs were filed and one day later, the WCJ issued an Interlocutory Order which stated if instructions were not followed regarding filing of a C&R, a settlement hearing date would not be given. The employer complied with the order, and filed the C&R. Subsequently, the WCJ notified the parties that the C&R must resolve all issues in the petitions, or would not be entertained. A settlement hearing was never held, and the WCJ then issued a decision, granting the Termination Petition and dismissing the UR Petitions. The WCJ also said that the Petition for Approval of a C&R was dismissed without prejudice, as the issues in the Termination and UR Petitions went to a decision. The claimant appealed to the Workers’ Compensation Appeal Board (Board). The Board granted the claimant’s appeal, finding that the WCJ violated the requirement of Section 449 that an expedited hearing be held when a Petition for Approval of a C&R is filed.  The Board further held that it was legally incorrect for the WCJ to insist that the C&R resolve all issues raised by the pending Petitions. The Board remanded the case to a new WCJ, and Employer appealed to the Commonwealth Court. The court affirmed the Board and held that the WCJ erred, as a matter of law, by refusing to hold an expedited hearing within 30 days, once the Petition for Approval of a C&R was filed.  The court noted that the language of Section 449(b) is mandatory, and a settlement hearing is not discretionary or dependent on a party’s separate request for a stay, or whether the record has been closed. The court further rejected Employer’s argument that the case should not be remanded to a new WCJ for a new decision on the termination and and UR Petitions, as the Board passed no judgment on whether the C&R Agreement resolved the termination and UR Petitions, and left it for the WCJ to decide in connection with the Petition for Approval of a C&R.