Kenton County Jury Awards $8.27 Million After ER Doctor and Radiologist Miss a Brain Aneurysm's Warning Bleed

On September 15, 2010, Melanie Robbins, then 35, went to the emergency room at St. Elizabeth Medical Center in Kentucky with a headache she rated 10 out of 10 and called the worst of her life. It had begun days to a week earlier and got worse when she coughed or bent over. She also had nausea, vomiting and sensitivity to light and sound.

Emergency physician Dr. Dianna Perazzo ordered a CT scan of her head. Radiologist Dr. Kirk Doerger read it as normal. The jury later heard that the scan in fact showed a sentinel bleed, a small warning hemorrhage that signals a larger one may follow. Dr. Perazzo ordered no further testing, including a lumbar puncture, which can detect blood in the spinal fluid when a CT scan does not. Robbins stayed until midnight, said her headache had eased, and was sent home with a short supply of pain medication.

Twelve days later, on September 27, she returned to the ER after an aneurysm in a brain artery ruptured and caused a stroke. Imaging showed extensive bleeding around the brain and a dissecting aneurysm, a rare type in which blood tears between layers of the vessel wall, in the right middle cerebral artery. She was transferred to the University of Cincinnati Hospital, where a neurosurgeon operated to rebuild the vessel. The aneurysm bled again when a temporary clip came off, and a second surgery on September 30 followed as her brain swelled and bled into the temporal lobe. Robbins was left with almost total paralysis and needs round-the-clock care.

She sued the hospital and both physicians and their practices in Kenton Circuit Court. The hospital settled before trial. The case against Dr. Perazzo and Dr. Doerger was tried over fifteen days in March 2017. Robbins' side argued that her symptoms were signs of a subarachnoid hemorrhage and that Dr. Perazzo should have ordered a lumbar puncture even after a normal CT report. Dr. Perazzo countered that Robbins had not described a sudden thunderclap headache, and Dr. Doerger's expert testified that the outcome stemmed from the nature of the aneurysm and its repair. Robbins was represented at trial by Robert and Delana Sanders of Covington, with James Leventhal of the Denver firm then known as Leventhal, Brown & Puga as co-counsel.

The jury awarded $1,268,621.67 for medical expenses, $6 million for future care and treatment, and $1 million for pain and suffering, a total of $8.27 million. It assigned fault equally: 50 percent to Dr. Perazzo and 50 percent to Dr. Doerger. The trial court denied both doctors' motions for a new trial. Dr. Doerger resolved his share after trial and did not appeal.

Dr. Perazzo appealed alone, challenging evidentiary rulings, limits on a defense expert's testimony, the exclusion of evidence about alleged drug and alcohol use, and cumulative error. On December 23, 2020, the Kentucky Court of Appeals affirmed, leaving in place her half of the judgment, a sum of more than $4 million. The firm reports that the Kentucky Supreme Court declined to review the case in August 2021.