Seeing the invisible injury

Using neuro-visual experts to prove mild traumatic brain injury

Courtney Rowley

Marianna Samuels

2026 August, Advocate Magazine

When it comes to Mild Traumatic Brain Injury (mTBI) cases, the defense playbook is almost always the same: No objective evidence. CT/MRI normal. Symptoms are subjective. 

It’s effective but untrue. It’s effective because it is built on a half-truth: standard CT and conventional MRI often, more than 90% of the time, miss mild TBI. It’s untrue because there is objective evidence available to us, if we are willing to look. Specifically, we need to take a closer look at the visual system. 

Thirty to fifty percent of the brain is devoted to seeing. When the brain is injured, the seeing breaks down in ways that produce numbers, charts, prescriptions, and follow-up appointments – not just patient complaints. Our job is to find those numbers and put them in front of a jury.

Why mTBI is so hard to prove 

The definition

The World Health Organization Collaborating Task Force and the Centers for Disease Control define mTBI as an acute brain injury resulting from mechanical energy to the head from external physical forces. Operational criteria include one or more of the following: confusion, disorientation, or loss of consciousness for 30 minutes or less; post-traumatic amnesia of less than 24 hours; or transient neurological abnormalities such as focal signs, seizure, or intracranial lesions not requiring surgery – with a Glasgow Coma Scale of 13 to 15 at 30 minutes post-injury or later.

The peer-reviewed literature is in consensus that people with mTBI have a high degree of disruption of both visual input to the brain (the afferent visual system) and the brain’s control of ocular motor systems (the efferent visual system), with both objective and subjective findings. A careful neuro-ophthalmic assessment is the road map; for a detailed treatment of these systems, see the Trial Guides volume Brain Injuries: A Multidisciplinary, Illustrated Guide.

The Defense Health Agency (DHA) has framed the term Ocular Motor Rehabilitation (OMR) for Ocular Motor Dysfunction (OMD) as a deficit to Ocular Motor Function (OMF), to address symptoms such as blurry vision, double vision, tracking issues, headaches, dizziness, photosensitivity, and imbalance in patients who have suffered mTBI/concussion, within the Department of War (DOW) and Veterans Affairs (VA) systems of care, for the purpose of developing shared interprofessional definitions. OMDs include dysfunction of ocular alignment (tropias and phorias), movement (pursuit and saccade), binocular coordination (version and vergence), and accommodation. They impact balance, spatial orientation, proprioception, and visual-motor coordination – even when the eyes themselves are structurally normal. 

The classic symptoms

The classic mTBI symptom list is familiar: headache, brain fog, irritability, photophobia, fatigue, sleep disruption, slowed processing, memory problems, cognitive impairment. Every one of them is patient-reported. None of them shows up on a scan. That is the whole architecture of the defense.

The defense script

We all hear different variations on the same theme: “self-reported,” “symptom magnification,” “litigation-driven,” “Grade 1 concussion,”  “should have resolved in seven to ten days,” “no objective basis for ongoing complaints.” These are not effective. The defense is banking on the fact that when most people imagine “brain injury,” they picture a coma, a brain bleed, etc. They do not picture a software engineering manager who has difficulty scrolling a screen or a surgical ophthalmologist who needs prism glasses and can no longer perform surgery. Our job, along with our experts, is to teach the jurors that brain injury is much broader than common misconceptions. 

CACI 3903 allows recovery for the loss of “physical, mental, and emotional well-being” once we prove causation. Causation is where these cases live or die. Neuro-visual evidence can help prove causation in brain injury cases, including mild traumatic brain injury. 

mTBI is a process, not an event

The defense wants the jury to believe an mTBI is a single moment that resolves in days, maybe weeks. However, brain injury is a process. That process is called a neurological cascade. 

The primary injury is mechanical – acceleration, deceleration, rotation. When the brain, suspended in fluid inside a hard skull, moves, it strikes the inside of the skull at the point of impact (coup), then rebounds and strikes the opposite side (contrecoup). Rotational and shear forces stretch and tear axons – the brain’s wiring – at the microscopic level. This is diffuse axonal injury, which cannot be detected by standard CT and conventional MRI.

The secondary injury unfolds over hours, days, and weeks: glutamate excitotoxicity, calcium influx, mitochondrial failure, oxidative stress, neuroinflammation. The neurons that survived the first hit are now sitting in a hostile environment. Some recover; some don’t. The defense narrative of “seven to ten days and gone” assumes a degree of cellular forgiveness the brain does not actually have.

The “mild” in mild traumatic brain injury is a Glasgow Coma Scale category, not a measure of how the injury impacts a person’s life. Mild means the injury hides better, not that the injury is small.

Why the visual system is uniquely vulnerable

Vision is not something the eyes do. It’s something the brain does. The eyes are hardware. The brain is software. Changes in the brain’s connectivity or function are routinely expressed through the eye’s machinery, which is why the visual system is uniquely positioned as an objective biomarker for brain dysfunction.

Thirty to fifty percent of the cerebral cortex is involved in visual processing: primary visual cortex (occipital lobe), parietal and temporal lobes, frontal eye fields in the frontal cortex, the brainstem, thalamus, basal ganglia, cranial nerves, cerebellum, and the visual tracts). Because mTBI generates rotational acceleration forces that stretch the brain’s long white-matter tracts, the visual pathway – optic nerve, optic tract, optic radiations, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, etc. – is a natural target.

Walk through the visual pathway

Light enters the eye through the pupil and strikes the retina (an extension of the central nervous system), where photoreceptors convert light into neural signals. Those signals travel through the optic nerve (CN II) toward the brain. At the optic chiasm, nasal fibers from each retina cross to the opposite side; temporal fibers stay on the same side. The combined fibers continue as the optic tracts. Most synapse in the lateral geniculate nucleus of the thalamus, where input is organized and relayed to the visual cortex in the occipital lobe for processing of form, color, and motion. Some fibers diverge to the Edinger-Westphal nuclei in the midbrain, adjacent to CN III, controlling pupillary constriction and accommodation.

From the occipital lobe, higher-order processing proceeds to the parietal lobe for spatial orientation, the frontal lobe for ocular motor response, and the temporal lobe for object recognition. Supranuclear pathways – brainstem, cerebellum, basal ganglia, and cortex – generate saccadic and smooth-pursuit eye movements; the cerebellum fine-tunes them. Infranuclear pathways from the CN III, IV, and VI nuclei in the midbrain and pons control the extraocular muscles. The medial longitudinal fasciculus coordinates CN III and CN VI activity and, together with the infranuclear pathways, produces the vestibulo-ocular reflex (VOR). 

Neuro-visual experts

Neuro-ophthalmologists are medical doctors (M.D.) who diagnose and treat neurological diseases with ophthalmic manifestations. They are trained in medicine, general ophthalmology, and neurology, with a focus on the brain disease rather than the eye itself. Neuro-optometrists hold a doctorate in vision science (O.D.). They are experts in ocular motor function, primary eye care, and the medical, non-surgical, management of ocular disease.

Both produce incontrovertible evidence including dated, repeated, numerically scored examinations performed in the ordinary course of clinical care, often beginning long before any lawyer is involved.

The neuro-visual exam – What gets measured objectively

A neuro-ophthalmic exam evaluates the afferent and efferent visual pathways. Findings include both objective measurements and patient-reported symptoms. When the two corroborate one another – and corroborate the clinical history, the clinical exam, and the neuroimaging – the diagnosis of mTBI is established to a reasonable degree of medical probability. It is a multidisciplinary process: neurologists, optometrists, neuro-ophthalmologists, occupational and physical therapists, audiologists, speech pathologists, and neuropsychologists each opine, and the diagnosis is built from the convergence of their findings.

Objective findings

• Pupillary findings: dilated or poorly reactive pupils; afferent pupillary defect (APD).

• Optic nerve pallor and traumatic optic neuropathy on optical coherence tomography (OCT) and posterior segment exam.

• Strabismus (tropia) and phorias documented on cover/uncover, Hirschberg corneal light reflex, and version testing in nine cardinal positions of gaze.

• Cranial nerve III, IV, or VI palsies and paresis, with measured prism diopters of misalignment.

• Saccadic intrusions, deficient pursuit, reduced positive fusional vergences, abnormal near point of convergence (NPC).

• Visual field defects on threshold perimetry, often localizing the lesion within the brain.

Photosensitivity

Photosensitivity is common in mTBI and remains largely subjective on direct testing – the workup is to rule out anterior and posterior segment causes (dry eye, meibomian gland dysfunction, neurotrophic keratitis, conjunctivochalasis, iris atrophy, retinal pathology). The literature implicates central sensitization of the trigeminothalamic pathway. The trigeminal nerve (CN V) communicates with the thalamus, the brain’s sensory gatekeeper. When the thalamus is under assault in mTBI, it becomes hyperexcitable. Normal light becomes overwhelming. The patient who walks into the deposition wearing sunglasses indoors is not performing for the camera. The trigeminothalamic pathway is doing its job badly.

Every meaningful test in a neuro-visual workup produces a number or an image. Near point of convergence is centimeters. Stereopsis is seconds of arc. Phorias and tropias are prism diopters. Visual fields and OCTs are printed images. 

This is the antidote to the “it’s all subjective” defense.

Suplizio v. Proliance Surgeons

Jason Suplizio was a 50-year-old senior software engineering manager at Adobe, a mountain biker, master’s-degreed, and a qualified pilot candidate. On June 24, 2021, he was dropped on his head while under general anesthesia for a routine shoulder surgery. The CT and MRI were normal. The defense argued that Mr. Suplizio’s complaints were ‘entirely subjective.’ 

We were able to show the chart of his treating optometrist, Dr. Lisa Dok, F.A.A.O. Over more than two years, Dr. Dok saw Jason 61 times. She measured his near point of convergence and watched it move. She measured stereopsis and watched it move. She prescribed prism glasses and vision therapy. She paused therapy when she suspected an auditory processing component was holding back his visual recovery, referred him out, and resumed treatment. Most of this was objective evidence of Mr. Suplizio’s brain injury. 

Dr. Dok told the jury that approximately 80% of concussion patients develop convergence insufficiency. She told them Jason’s findings were “more along the lines of someone who has post-concussion syndrome with visual findings, rather than just someone who just has a pure convergence insufficiency.” She told them his injuries were permanent. 

The defense argued pre-existing convergence insufficiency from age 16. Dr. Dok answered with a 33-year asymptomatic interval, during which Jason passed a pilot medical, earned a master’s degree, and read 20 books a year. She told the jury, based on objective medical evidence, that the fall created a new injury.

Tong v. American Auto Auction Group

Dr. Ly Ti Tong was a practicing surgical ophthalmologist. In April 2021 she was rear-ended. The CT was normal. The conventional MRI was normal.

After the collision, for the first time in her life, Dr. Tong needed a prism prescription. Her treating optometrist examined her in March 2022 and wrote the prism.

The defense neurologist was hired to tell the jury that his neurological exam was ‘normal.’ We were able to show through cross-exam that the general neurologist’s acute neurological exam is not designed to find convergence insufficiency, saccadic intrusions, or accommodative dysfunction. 

Dr. Samuels: A pilot who cannot fly

A 49-year-old commercial airline pilot was involved in a rear-end motor vehicle collision. He hit his head against the window on the left side, with possible loss of consciousness, and was diagnosed in the emergency department with mTBI and orthopedic injuries. He then developed accommodative insufficiency (worse in the left eye), convergence insufficiency, intermittent strabismus, deficient saccadic eye movements, and diplopia. His ocular motor system was under siege. He was no longer fit for duty. Federal Aviation Administration standards automatically remove pilots with ocular motor dysfunction from the cockpit. He lost his career, which was devastating both financially and emotionally. He will likely never return to aviation. The case is ongoing.

Cross-examining the defense neurologist with neuro-visual evidence

1. Establish the limits of the screening exam. A routine cranial nerve check tests gross function. It is not a substitute for a neuro-ophthalmic evaluation, an OCT, a threshold visual field, or measured prism cover testing. 

2. Establish what the witness did not review. Most defense neurologists have not read the treating optometrist’s records. 

3. Establish what those records show. Numbers. Dates. Diagnoses. Prescriptions. Get the witness to agree that none of this is patient self-report.

4. Close the loop on causation. Establish that the patient had no pre-injury visual symptoms and that the post-injury records are objective. This proves that something between point A and point B caused the change. The trauma is more likely that cause. 

5. The ‘invisible injury’ is a defense frame. Stop accepting it.

Brain injury is not invisible – it’s connected to one of its most measurable functions: the visual system. When we build our cases on charts, visits, measurable convergence, a prism prescription, a visual field printout, etc., the defense’s ‘subjective’ and ‘invisible’ themes fall flat. 

Of course, we don’t stop there. Brain injury is visible in the people it affects, which includes the plaintiff, of course, but also includes the people around them: their family, co-workers, friends, neighbors. Lay witnesses make brain injury visible and visceral and are powerful evidence in the courtroom. 

Practical tips

• Retain a neuro-visual expert early. 

• Use the treating chart as an exhibit. 

• Make a measurements timeline

• Take treaters’ depositions for use at trial and emphasize the patient physician relationship.

• Cross the defense neurologist with the treating optometrist’s records.

• Gather lay witnesses who have direct experience with the ‘before’ and ‘after.’ 

Courtney Rowley is a national trial lawyer, published author, and mother. She represents clients in catastrophic injury, medical malpractice, toxic tort, and wrongful death cases. She is CAALA Trial Lawyer of the Year 2025. She and her husband, Nick, have spent their careers trying cases together as equal partners, and have been politically active in defending the civil justice system – helping reform California’s MICRA caps on medical malpractice damages and, this year, fighting to protect civil rights against the Uber ballot initiative. She has taught trial skills across the country for more than 15 years, including several years teaching at Gerry Spence’s Trial Lawyers College.

Marianna Samuels, O.D., is a board-certified optometrist and clinical researcher based in San Diego. A Diplomate of the American Board of Optometry, she practices medical optometry at North County Eye Center, where she also serves as Medical Director of the Refractive Surgery Clinic. Dr. Samuels earned her Doctor of Optometry from the University of California, Berkeley, School of Optometry, graduating magna cum laude. Dr. Samuels is a recognized authority on traumatic brain injury and its effects on the visual system. She authored the chapter on neuro-ophthalmologic assessment in TBI for Brain Injuries: A Multidisciplinary, Illustrated Guide, and she serves as an expert witness on TBI-related eye and visual-pathway injuries, primarily for plaintiffs. 

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Courtney Rowley

Courtney Rowley is a national trial lawyer, published author, and mother. She represents only people – never corporations, insurers, or institutions – in catastrophic injury, medical malpractice, toxic tort, and wrongful death cases. She is CAALA Trial Lawyer of the Year 2025.

Most recently, Courtney co-led the civil prosecution of Monsanto on behalf of more than 150 teachers, students, and parents poisoned by PCBs at the Sky Valley Education Center in Monroe, Washington. After three years of litigation and multiple trials, Monsanto settled the entire inventory of pending Sky Valley cases.

Courtney's work extends beyond the courtroom. She and her husband, Nick, have spent their careers trying cases together as equal partners, and have been politically active in defending the civil justice system – helping reform California's MICRA caps on medical malpractice damages and, this year, fighting to protect civil rights against the Uber ballot initiative.

Closest to her is Trial By Woman, the nonprofit she co-founded with Theresa Hatch. What began as a small effort to teach and support women trial lawyers has grown into a national community of powerful attorneys.

Courtney has authored four books: Trial By Woman; Voir Dire and Opening Statement; Running with the Bulls: How to Win Top Dollar Settlements; and Damages Evolving, with David Ball and Artemis Malekpour. She has taught trial skills across the country for more than 15 years, including several years teaching at Gerry Spence's Trial Lawyers College.

She grew up in Oxnard, California, and studied at USC and Loyola Law School. She and Nick live in Montana with their children.

Marianna Samuels

Marianna Samuels, O.D., is a board-certified optometrist and clinical researcher based in San Diego. A Diplomate of the American Board of Optometry, she practices medical optometry at North County Eye Center, where she also serves as Medical Director of the Refractive Surgery Clinic. Dr. Samuels earned her Doctor of Optometry from the University of California, Berkeley, School of Optometry, graduating magna cum laude. Dr. Samuels is a recognized authority on traumatic brain injury and its effects on the visual system. She authored the chapter on neuro-ophthalmologic assessment in TBI for Brain Injuries: A Multidisciplinary, Illustrated Guide, and she serves as an expert witness on TBI-related eye and visual-pathway injuries, primarily for plaintiffs. 

Connection and civil justice in the age of fragmented truth

Take 12 people who have been living in fragmented, personalized information environments and guide them to a shared understanding of the truth

Courtney Rowley

2026 April, Advocate Magazine

The courtroom is one of democracy’s last spaces where shared truth can be established, free from algorithmic distortion. Trial lawyers must use this power to combat corporate disinformation, protect civil jury rights, and reconnect with communities – because civil justice is democracy in action.

We are living in a crisis of information overwhelm. News cycles have collapsed to hours, sometimes minutes. Events that in the past would have dominated a week of public attention quickly disappear, replaced by something more algorithmically optimized, more emotionally primed to direct us away from something different and often to hold us in place, keeping us from looking left, right or seeing what is right in front of us. 

Algorithms don’t select what we see based on truth or accuracy. What captures and holds our attention is all that matters – reshaping how we process reality. 

‘Silo’ doesn’t cover it anymore. We have not been in the same barn or even on the same farm or ranch for many years. We are living in radically different versions of reality. It used to be that we had the same information and could agree to disagree. Now, we live in a world of disorientation and consistent inconsistency. 

In our last brain-injury trial in Seattle, I told the parable about the blind men and an elephant – each man touches a different part of the animal and reports a different truth, each one convinced, each one genuinely experiencing what he believes. None of them is lying, but each of them believes that the tiny piece they are touching is the whole animal. In a lot of ways that is what life feels like now – many of us are blindfolded, holding a fragment of a vast, complex reality, with an algorithm specifically designed to make sure we never see the parts that don’t confirm what we already feel or believe. 

The consequence is distance and disconnect – between us and the full truth, between our experience and that of others, between what we feel certain about and what is actually happening. Many of us feel a creeping sense that truth and accountability are constant moving targets – that power moves too fast, that the story changes too quickly, that there is always another fragment demanding our attention before we’ve finished processing the last one. 

This is not accidental, it’s the result of billionaire industries and their calculated plans. The deliberate use of information and disinformation overwhelm as a political strategy – flood the zone, fragment attention, exhaust accountability – has been a documented feature of our current political climate.

“Flood the zone” –  Steve Bannon

In 2018, Steve Bannon, the 2016 CEO of President Trump’s presidential campaign and 2017 White House strategist coined the phrase “flood the zone.” He explained what he meant in an interview. “The Democrats don’t matter. The real opposition is the media. And the way to deal with them is to flood the zone with shit.” In 2019 he elaborated in a PBS Frontline interview: “The media can only – because they’re dumb and they’re lazy – they can only focus on one thing at a time. All we have to do is flood the zone. Every day we hit them with three things. They’ll bite on one, and we’ll get all of our stuff done, bang, bang, bang.” 

We have all combatted this tactic in the courtroom. The defense points to a test result here, a sentence from a deposition there, an alternative-causation theory, and often a hired courtroom expert with impressive credentials. The goal is not to win the argument on the merits. The goal is to make the truth feel uncertain, complicated, and exhausting – to create doubt and skepticism and thereby remove action from the intention of the jury. 

In Seattle, we tried a medical-malpractice case against a doctors’ group who dropped a patient on his head while he was still under anesthesia. They didn’t admit liability until the eve of trial, which meant tens of thousands of dollars in expert costs and hours of useless work and needless court time. The defense, in large part, was to show as many photographs as possible of the brain-injured man on vacation with his family. His wife worked for National Geographic and travel was their passion. Of course, our evidence showed that who he was and how he traveled had changed dramatically due to his traumatic brain injury, but it was clear that the intent was to show that our client “still has a good life” so his brain injury “isn’t that bad and isn’t worth as much.” 

In the Monsanto cases, the defense brought multiple experts who had little, if any, experience with Poly Chlorinated Biphenyls (PCBs), the forever chemicals that were the subject of the case. These hired guns testified in direct opposition to accepted, established science that has been relied on worldwide since the mid to late ’70s. They came in, one after the other, and told the jury that PCBs were not harmful to humans. Towards the end of the cases, it was clear that some of these experts were even working to publish “peer reviewed” journal articles to “challenge” established science in order to protect Monsanto. 

Confusion and distraction is a common defense strategy. But in a world where confusion and distraction overwhelming us has become the norm, the courtroom can still be our collective greenhouse for shared reality and discovery of the truth. 

The courtroom as our shared temple for reality and discovery of the truth 

Phones are turned off. Algorithms stop. The judge and jury are ready. A group of strangers are receiving the same information at the same time. They are governed by rules designed to ensure that all the information is received at the same time and that evidence meets standards of validity and relevance. Hearsay rules, foundation requirements, relevance standards – these are not just procedural technicalities. They are, in a world that has almost no information hygiene left, a system of enforced epistemological standards. There is one heuristic: Before a piece of evidence reaches a jury, someone has had to stand up and vouch for it. Someone on the other side has had the opportunity to challenge it. 

Being in trial during our last national election – a moment when public information felt particularly unhinged – I remember feeling deeply comforted by the rules of evidence, the judge, the jury. I am not naive about the imperfections of our system. But in that courtroom, the jury heard the truth. As trial lawyers we have the honor and privilege of being in some of the last rooms in our world where rules about presenting evidence and argument still exist. 

The civil jury trial is not just a mechanism for resolving disputes. It is a civic institution – a container for a shared reality of truth and justice, and genuine structural checks on concentrated power.

Our job, at the most fundamental level, is to take people who have been living in fragmented, personalized information environments and guide them to a shared understanding of the truth. 

Voire dire sets the container

Will you commit to putting your beliefs and bias aside and basing your decision in this case on the evidence and the law that the judge gives us? 

Corporations and the insurance industry have understood the power of misinformation for decades. The “frivolous lawsuit” narrative – the one that convinced a generation of Americans that injured people are the problem – and tort reform and corporate immunity as the solution – succeeded not because it was true but because it was simple, emotionally resonant, and spread easily in a fragmented information environment. 

The great American satirists understood the importance of truth and the power of doubt. Mark Twain wasn’t making jokes. He was holding power’s self-description up against power’s actual conduct and letting the gaps speak for themselves. In jury trials we take our opponents’ words and place them next to the evidence to expose the gaps, giving 12 people the power to speak the truth through their verdict. 

In a recent jury trial in Central California, a landowner threw his own private “burning man” party at the height of Covid. He provided drugs, alcohol, and ATVs, all within yards of a 30-foot ocean cliff. He allowed one of his guests to drive others, including himself, in the ATV at three a.m., high on illegal drugs and drunk on alcohol, resulting in a young woman’s death. 

The defense, naturally, was that one adult does not control the actions of another. But this man also happened to be a CEO of a national traffic-safety company as well as a commercial pilot. Our job was to expose the gap between who the defendant purported to be and his actions. Safety and appreciation for human life is something that requires good judgment and foresight and among all the adults at this man’s private party he was the one who knew that better than anyone else. 

In our recent Polaris trial in Seattle, the corporate narrative was sophisticated, well-funded, and had been circulating long before trial. Polaris: “Adventure vehicles.” This is not just a PR campaign. It is the fragments of the elephant that the defense wanted our juries to be holding when they walked into the room. 

In Monsanto the corporate narrative was that PCBs were “no more harmful than table salt.” The documents showed that they knew, since the 1940s, that PCBs caused endocrine disruption, neurological defects, gastrointestinal disorders, cancer, and other health problems. The gap between the party line and the truth was in the evidence. It was our job to show, over and over, that what Monsanto sold to the world was poison. Monsanto worked for decades to trick us into believing that the evidence and documents didn’t mean what they actually said. 

There is often a bigger story. It became clear through discovery and speaking with active environmental scientists and researchers that the government regulations Monsanto was hiding behind in its defense were the product of years of Monsanto’s own fraud and lobbying success. Monsanto convinced the U.S. government and military to bury a study in 1957 that conclusively established that PCBs can kill. How do U.S. Environmental Protection Agency regulations get set? Many times, using corporate-funded (and interested) research.

In the Mountain View School District child-molestation cases, the defense used a similar tactic. The school district’s lawyer got up in opening and expressed great disappointment in their “rogue” teacher. We had to bring in witness after witness to talk about how many district employees were told, warned, complained to, and beseeched over 19 years about the known child-sex predator. By the end of the case notice was no longer a theory, it was an established truth that was impossible to ignore. 

How to find the gap? Zoom out. Then zoom out again. We are looking for the why. Why did something like this happen? What had to be in place for it to happen and for how long? Who made the decisions that set this tragedy in motion? Who had the ability, and when, to stop or prevent it?

Reconnection: Focus groups

Overwhelm leads to inaction and disconnection. We feel it in our personal lives – the paralysis of too much information, too many demands on attention, the exhaustion of a world where accountability feels impossible. Our jurors feel it too. And if we are not careful, we feel it in our case preparation, buried in discovery, surrounded by our own team’s certainty about what the evidence means.

The antidote to disconnection and overwhelm – in our lives and in our case preparation – is reconnection. To human beings. This is why we should do everything we can to protect and preserve the right to a civil jury trial. Live focus groups are the best way to prepare. 

I have been a proponent of real, in-person focus groups my whole career. Not only is it the most enjoyable and engaging way to work up a case, I now see it as deliberate connection. We step outside of our echo chamber and sit across from humans who do not share our information environment, our assumptions, or our certainty/bias toward/about our case. And we are in fact asking for brutal honesty. 

We use focus groups in every case. They aren’t always impressive, sometimes they are a handful of people on Zoom if we cannot get it done in person. But they always teach us something – and not just about our cases. “We don’t ever rise to the occasion – we sink to the level of our training,” Archilochus wrote. A focus group is real life vulnerability, the closest thing I have found to trial. It takes whatever we can imagine at our desks about our discovery, our case, our presentation, and puts it in the fire. 

Here is what a well-run focus group actually does that no brief, no jury consultant’s report, and no AI can replicate:

It reveals which fragment of the elephant your case narrative assumes – and surfaces the fragments your mock jurors are holding that you haven’t accounted for. It puts the defense’s best arguments in the mouths of real people, where they are far more useful than on paper. It exposes the gap between what you find compelling and what someone who doesn’t share your information environment finds compelling. And if you are doing it right, it forces you to inhabit the defense’s perspective with enough seriousness to actually challenge your own case.

Discomfort

Our algorithm tries to convince us that we can avoid discomfort, that we should strive to avoid it. In doing so, we distance from one another and from reality. I hosted a coffee-and-donuts get-together in our neighborhood in Ojai last week. I read somewhere that the first step in anti-fascist organization is knowing your neighbors. It’s an important part of being a person, is what I also learned. I learned that we have good neighbors and that we can be there for and protect each other should tragedy ever strike. What a comforting discovery. 

AI has become an unavoidable part of our professional conversation, although my husband/law partner Nick Rowley (Trial Lawyers for Justice) refuses to have anything to do with it. Claude – or GPT, or whatever tool you favor – is genuinely useful for summarizing depositions, organizing research, finding patterns across thousands of documents. I use it. But when it comes to trial preparation, it has a fundamental limitation: AI will work hard not to cause you discomfort. It is optimized to be helpful in ways that feel good. Focus groups, interactions with human beings, are not. Shove the beeswax in your ears to resist the siren song of an AI that panders to your theories, and get in the room with strangers whose hearts are pumping hot blood through their veins. This is why I suggest that you buy the folding table and have coffee with your neighbors. Seek out that human connection as a revolutionary act. 

“Reversing Roles” is a Gestalt-based psycho-dramatic tool that helps one human experience the inner world, thoughts and feelings of another. It’s empathy in action. Put plainly, it is the act of putting oneself in the shoes of another. Our teacher, Gerry Spence, was once asked when it was that he used the tool. His answer, “always!”  

Civil justice under attack by Uber’s ballot measure 

The civil jury system has been under attack since the 1970s – through the expansion of tort reform, the “frivolous lawsuit” PR campaign, mandatory arbitration and the appointments of anti-civil plaintiff judges and justices. 

The 2026 Uber ballot initiative is one of the defense industry’s most dangerous weapons, and, in some ways, the most audacious: the use of democratic tools to undermine democratic rights. California’s Uber ballot measure, to effectively wipe out access to civil justice for the majority of injury victims, is the clearest recent example. 

Uber is seeking to limit citizens’ abilities to recover for Uber’s negligent acts by making it next to impossible to find a contingency-fee lawyer to match the lawyers Uber can easily afford with its limitless war chest. Uber has attempted this in multiple states, and their latest measure is set to be on the California ballot November 2026. 

The civil justice system will not defend itself. Corporations, with their virtually unlimited resources for public communication and manipulation, have no structural interest in protecting the institution that holds them accountable. What happens depends on all of us. 

The current cultural moment is demanding of structural patriotism – we must protect the structures that protect our democracy. And the first step is the same as anti-fascism – we have to meet our neighbors, we have to come together, we have to meet the friction of real-deal human interaction with empathy. It will be up to us to do what we do in the courtroom – present the evidence, show the truth, and inspire action. I hope to hear about thousands of fold-up coffee tables being put out in neighborhoods across California and people putting their phones away and learning the truth about the evil that Uber is trying to accomplish. If we leave the messaging to social media and algorithms, we are doing ourselves a disservice. People are longing for real connection and disconnection from the algorithm. 

The courtroom is one of the only places left where people get to look at the same elephant without blindfolds. It may be the most genuinely democratic space remaining in our society. Every jury verdict is an act of democratic recalibration: proof that the playing field can still be leveled, that ordinary citizens – not the two percent who generate 95% of the content – can achieve a shared understanding of truth and take meaningful action. 

We must take the skills we have – connecting with jurors, presenting evidence, advocating and putting our own resources at stake – and use them to protect the civil justice system and what it means for our democracy. 

The First Amendment and the Seventh Amendment are not coincidentally adjacent in the Bill of Rights. They are part of the same democratic architecture. Expression and accountability. Satire and verdict. The ability to name what power is doing, and the ability to make power answer for it, in front of a group of ordinary people from the community who have no stake in protecting power’s preferred narrative. That said, without us standing up and fighting for these rights with everything we have, they are just words on old parchment that will end up lost in the algorithm. Let’s not allow that to happen. 

Courtney Rowley is a trial lawyer dedicated to representing everyday people, with verdicts across personal injury, wrongful death, toxic exposure, and medical malpractice. She is the owner of the Rowley Law Firm. She is the 2025 CAALA Trial Lawyer of the Year. 

CAALA'S 2025 TRIAL LAWYER OF THE YEAR

The Consumer Attorneys Association of Los Angeles (CAALA) has named Courtney as its 2025 Trial Lawyer of the Year, recognizing outstanding achievement, integrity, and dedication to the pursuit of justice on behalf of consumers and injured individuals.

This prestigious honor is awarded annually to a trial attorney whose work exemplifies excellence in advocacy and a deep commitment to protecting the rights of others. Courtney was recognized for a series of significant verdicts and settlements over the past year, as well as for leadership within the legal community and unwavering dedication to clients.

Throughout her career, She has built a reputation as a compassionate, tenacious advocate for people who have faced life-changing harm due to negligence, corporate misconduct, or systemic injustice.

“This award is deeply humbling,” Courtney said. “CAALA represents the very best of our profession — lawyers who fight every day to protect the powerless and hold the powerful accountable. I’m grateful to my team, my colleagues, and especially to the clients who trust us to tell their stories and fight for their futures.”

She also expressed gratitude to CAALA for fostering a community dedicated to advancing consumer rights and mentoring the next generation of trial lawyers.

Congratulations, Courtney!

Jury Awards $48 Million to Former Students in California School Molestation Case

The Mountain View School District ignored countless warnings by other teachers and students about Joseph Baldenebro’s inappropriate behavior.

EL MONTE, Calif. — Six former students of the Mountain View School District were awarded $48 million in damages on Monday after a jury ruled against the district and a former teacher convicted of molesting them.

The 12-person jury found that the former teacher, Joseph Alfred Baldenebro, 62, was responsible for molesting six fourth- and fifth-grade students at Miramonte Elementary School on school grounds over several years. The jury also determined that the district was negligent in supervising and employing Baldenebro, leading to the abuse that occurred in the classroom and elsewhere on the campus.

Related Article: SchoolSafety.gov Shares Child Exploitation Resources for K-12 Schools

In 2018, Baldenebro pleaded no contest to one felony count of a lewd act upon a child and four misdemeanor counts of child molestation. He was initially sentenced to eight years in prison, but his sentence was later extended by 12 years when additional victims came forward. He was also required to register as a sex offender for life.

Jury Found Mountain View School District Negligent in Supervision of Baldenebro

Jurors found that the molestation occurred due to a pattern of negligence, as the district failed to properly supervise Baldenebro during his tenure at Miramonte Elementary.

Check out the full story here.

TL4J in Santa Barbara Magazine

TL4J in Santa Barbara Magazine

TL4J: Defending the Vulnerable and Holding the Powerful Accountable

BY TAYLOR OWENS

In a world where legal battles often feel like David versus Goliath, the team at Trial Lawyers for Justice has made it their mission to represent those who need it most: the everyday people, families and individuals who have been wronged and deserve justice. Led by a passionate and fearless team of trial lawyers, TL4J fights for what’s right, ensuring that the voiceless are heard, the overlooked are seen and justice is served—even when the odds are stacked against them.

While public perception of trial lawyers can sometimes skew negative, casting them as opportunists chasing settlements, the work done at TL4J tells a different story. It’s a story of sacrifice, of standing up for the vulnerable, and of transforming lives through the power of the law.

“We don’t just want to win cases; we want to change the world,” Nicholas Rowley, founder of TL4J, said. “It’s about standing up for the little guy when nobody else will.”

That ethos runs deep in the firm, whose mission goes beyond legal victories and into the realm of societal change. Every case they take on is not just about compensation for the wronged—it’s about holding powerful entities accountable, ensuring that no one is too big to face justice.

TL4J was co-founded by Nicholas and Courtney Rowley. Nicholas has achieved over $3 billion in verdicts and settlements, building his reputation as a leading national trial lawyer. His experiences have shaped him into a relentless advocate for injury victims. Courtney, equally passionate, champions the jury system and has authored several books on trial law, including Trial By Woman. She focuses on representing ordinary people in cases of personal injury, wrongful death, and other significant issues.

For those who come to TL4J, the legal system can often feel overwhelming. Clients aren’t just fighting for justice— they’re fighting for their lives, their families, and their future. Whether it’s a wrongful death case, catastrophic injury or corporate negligence, TL4J steps in as the last line of defense for people who have nowhere else to turn.

“There’s this perception that trial lawyers are greedy or manipulative,” Rowley said. “The truth is, we are the last line of defense for people who’ve been wronged and need a voice.”

Read the rest of the article here.

Trial Guides Authors Secure Record-Breaking $412 Million Verdict in Medical Malpractice Case

From Trial Guides:
Dec 09, 2024

Congratulations to Trial Guides authors Nicholas Rowley and Theresa Bowen Hatch, along with Keith Bruno and the Trial Lawyers for Justice team, for securing a $412 million medical malpractice verdict in a lawsuit against a men’s health clinic. 

In Sanchez v NuMale a jury returned a record $412 million verdict, including $375 million in punitive damages against the Las Vegas-based defendant, who was found 100 percent at fault in a botched penile injection procedure. Rowley called the defendant’s actions a "fraudulent scheme to make millions off of conning old men."

The case was brought by Bencoe & LaCour Law, PC, a New Mexico partner firm of Trial Lawyers for Justice, a national trial law firm founded by Trial Guides authors Nick and Courtney Rowley. According to Newsweek and other sources, this is the largest recorded medical malpractice payout for a single plaintiff.

Case: Sanchez v NuMale

Country: Bernalillo County, Albuquerque NM

Total Verdict: $412,005,149

The Case

The Defendant

NuMale is a multi-state men's health center, founded in 2013 and based in Las Vegas, Nevada, with a clinic in New Mexico. The company reportedly offers treatments for erectile dysfunction, hair loss, premature ejaculation, testosterone replacement therapy, and weight loss. 

Among their listed treatments for erectile dysfunction is Trimix injections: “a precise combination of three powerful vasodilators—papaverine, phentolamine, and prostaglandin E1—each targeting different aspects of the physiological process that leads to an erection.” The defendant claims that this treatment “not only increases blood flow but also enhances the duration and quality of an erection, making it suitable for sexual intercourse.”

The Plaintiff

The plaintiff, then a 66-year-old widower, first visited NuMale Medical Center in 2017 for fatigue and weight management. The clinic misdiagnosed him and instead treated him for erectile dysfunction (ED) in order to sell him invasive penile injections for “rehabilitation." The plaintiff had stated he only wanted testosterone for fatigue and weight loss. Evidence showed that he had left his entire sexual health history blank on his intake form.

Though the plaintiff disclosed multiple medical conditions and repeatedly told them he was widowed and not sexually active, the NuMale staff did not adjust their treatment to meet his lifestyle or goals. Instead, the physician's assistant (PA) injected him with the chemical, diagnosed him with ED, and told him that doing nothing would cause irreversible harm only their medicine could cure.

The plaintiff momentarily felt hope that he may have a love life again after losing his wife five years earlier. Instead, after an emergency surgery following a painful, 60-hour erection (priapism) just a few weeks later, the plaintiff was left with a completely scarred and nonfunctional penis. According to plaintiff attorney Lori Bencoe, these treatments left the plaintiff “permanently damaged, robbing him of the ability to share intimacy or even urinate normally for the rest of his life." 

Trial By Woman by Courtney Rowley and Theresa Bowen Hatch is available in paperback and ebook.

A Treatment Gone Wrong

After NuMale’s PA administered the unnecessary test, diagnosed him with ED, and prescribed a package of injections and testosterone, their nonmedical salesperson followed a marketing sales script written by the nonmedical owners. (At trial, the salesperson testified that NuMale was “just another sales job.” Before working for NuMale, he sold insurance, and he now sells HVAC systems.)

The plaintiff picked up his injection medicine about a week after his initial consult, and was “trained” in its use by a member of NuMale’s staff. On the same day, he also had testosterone pellets inserted and underwent a medically untested platelet-rich plasma procedure that the defendant claimed would heal damaged vessels in his penis (and increase size). At trial, the plaintiff’s expert called this false and stated that PRP was experimental at best.

The total cost of the procedure was $5,000, plus a $149 consultation fee. The defendant did not offer a single written discharge instruction to follow in case of emergency.

Just weeks later, on a Friday afternoon, the plaintiff returned to the clinic after having trouble with the injections he was instructed to self-administer twice weekly at home for therapy. Without assessing if he was doing them properly, the PA injected him with a 75% stronger dose of medication to induce another erection.

Then, contradicting NuMale’s own policy, the PA gave no antidote, but just instructed the plaintiff to “go home and show your friends.” The plaintiff signed no consent form and was offered no additional training for using the home antidote, which the plaintiff was unable to inject.

The plaintiff went home and attempted to inject the antidote multiple times without success. He spent a weekend in pain, not knowing what to do. Nobody told him that after six hours, irreversible tissue damage could occur inside his penis.

When he returned to NuMale on Monday morning, 60 hours into a sustained erection (priapism), the PA had to call his supervising doctor, who was running another clinic in Beverly Hills, to ask what to do. Procedures to reverse the priapism failed, and the NuMale staff told the plaintiff to drive himself to the ER, where the urologist performed an emergency surgery.

Instead of taking responsibility for medical fraud and unconscionable business practices, however, NuMale blamed the plaintiff for not going to the ER sooner. They also attempted to blame him for not calling the hotline number on the medical disclosure form, which he had not received, during the initial office visit more than three weeks prior. The jury heard testimony that Numale called the injury “self-inflicted.” 

“A Recklessly Negligent Twist”

In what plaintiff attorney Lori Bencoe called “a recklessly negligent twist,” the non-medical salesperson also had the job of training men how to self-inject the medicine, and administer the antidote in case of an emergency, on a dummy penis. He also admitted, under oath, that the 37 pages of consent and information forms NuMale had the plaintiff initial and sign usually just went into the file, and they only gave them a copy to their client when specifically requested.

The plaintiff was not proffered emergency care instructions or a hotline number. Moreover, a local urologist testified that another patient had called NuMale’s hotline number and got no response. 

Evidence showed that NuMale’s job description for the PA promised “no call, no after hours and no emergencies”—while offering bonuses based on sales and number of procedures.

The Mechanics of Medical Fraud

According to trial counsel Keith Bruno, NuMale falsely marketed itself and engaged in duplicitous business practices. For example, NuMale claimed that its injections would cure latent tissue disease in the penis, make the penis bigger, and if injected twice a week for a year, would cure ED in most men, allowing them to get off drugs altogether. None of these claims are medically true. But in order to convince the patient that there was a problem and NuMale offered the cure, NuMale staff would induce an erection by injecting a medicine into the penis, as a proof of concept and efficacy, and then “diagnose” ED to sell their treatment packages. Their marketing materials falsely informed patients that ED left untreated would cause irreversible damage, atrophy, and fibrosis to the penile tissue if they did not take two to three penile injections per week as rehabilitative therapy, regardless of sexual activity. (This is false.)

According to Bruno, while their ads never mention injections, the company’s principal owner has called testosterone the “gateway” to get men into their clinics. Once there, most patients end up on the “FDA-approved, 98% effective ED treatments” that the company claimed could cure ED after six to twelve months of regular use. (This is also false.)

Once in the clinic, men who asked for testosterone would be given a “test” that the defendant would say was “medically necessary to evaluate erectile function;” internal training materials called this injection test “mandatory.” This test promptly caused a chemical erection, which would encourage men to buy the product.

The Trial

Lori Bencoe, an attorney for the plaintiff, describes the experience of taking this case to trial with the team: “Our firm has been working with Nick Rowley, Theresa Hatch, and Trial Lawyers for Justice since 2019,” she says, “but this was our first opportunity to try a case with them. Theresa made tactical evidence decisions and took some great discovery depositions for use at trial. Keith [Bruno] and Nick are a lot of energy in a courtroom and total class acts. Nick’s jury selection was masterful—it was his 181st—and [the judge] permitted over a day to assure that we got a good fair and unbiased jury.” 

Voir Dire and Opening Statement by Nick Rowley, Courtney Rowley, and Wendy Saxon is available in paperback and ebook.

In the years of discovery and pretrial motions, the defense failed to respond to nine motions to compel. This resulted in the plaintiff team gaining access to all of internal training, marketing, sales, and hiring documents under a pretrial order. Shortly before trial, the plaintiff team successfully challenged the confidential status of those exhibits, which enabled them to prosecute NuMale from a perspective of transparency about its business practices. 

New Information about the Treating Physician Assistant

At trial, it was revealed that the treating PA was hired in spite of a worrisome work history. He had lost a job for taking drugs off a cart in the OR, for example, and he was a disaster witness for the defense. Nick Rowley held him to his prior testimony, even as the PA kept changing it. He admitted to telling the plaintiff to “go home and show your friends.” 

At trial, the PA admitted that all the forms NuMale had new patients sign were put in their file after initial consultation, and no later consents were given. He testified that when he was at NuMale, they had “lots” of priapisms but he could usually take care of them in the office. 

The PA also admitted to falsifying the plaintiff’s records after learning about the Board Complaint lodged against him; he added untrue things about the plaintiff that would help him, such as a lie that he had tried Viagra in the past without success. 

After an official Board Complaint, the PA entered into an Agreed Order and is no longer practicing. 

Pursuing Damages against the Parent Company

NuMale Albuquerque was run and managed by two subsidiary companies of NuMale Corporation, based out of Las Vegas Nevada. The plaintiff team presented evidence showing that NuMale Corp was responsible for all ads, staffing, and management decisions for all twelve clinics, and the parent and subsidiary companies were all owned and operated by the same four individual codefendants. 

Finding that Numale Corporation fully dominated its subsidiaries for an improper purpose, the trial judge acting in equity granted the plaintiff’s motion to pierce the corporate veil and hold the parent company responsible for all the conduct of its subsidiary companies in New Mexico. The jury’s verdict also found that the parent, its two subsidiaries, and all four of its principal owners-officers were civil co-conspirators.

Proving Inappropriate Medical Treatment

At trial, the plaintiff team explained that penile injections carry inherent risks; in accordance with medical guidelines, they require dose titration, patient training by a trained urologist, and ongoing monitoring for dangerous side effects. The FDA specifies that the use of psychotherapy and pills should be explored before this medical procedure, and even then, this procedure is only appropriate for patients who wish to be sexually active.

The plaintiff did not come to the clinic seeking treatment for ED, and had no partner. That did not dissuade NuMale from hawking and administering a product that was wholly inappropriate for their client. 

Internal training documents even mocked men who sought therapy for treatment for erectile dysfunction. In one shocking slide, the company even said that if psychotherapy works to treat his ED, “then the guy may be [a pussy].” When presented at trial, the jury was unimpressed with this crass machismo.

The Verdict

After three and a half hours of deliberation, the jury returned a unanimous verdict for the plaintiff. The jury found that NuMale engaged in fraud, negligence, and unconscionable UPA violations, awarding $375 million in punitive damages in addition to $37,005,149 in compensation for the plaintiff’s irreparable injuries. According to the foreperson, the jury hoped the compensatory verdict would care for the plaintiff’s lifetime medical needs, and also wanted him to get back every penny he paid NuMale: $5,149.

At over $412 million in total damages, this is the largest medical malpractice verdict in the U.S. to date.

Compensatory Damages: $37,005,149

Punitive Damages: $375,000,000

Total Verdict: $412,005,149

Keith Bruno hopes the verdict “sends a powerful message that medical providers cannot prioritize profits over patients' well-being without being held accountable."

Damages Evolving by David Ball, Artemis Malekpour, Courtney Rowley and Nicholas Rowle is available in paperpack, ebook and audiobook.

Monsanto PCB Jury Hears About Ex-Schoolchildren's Illness

By Cara Salvatore ·  Listen to article

Law360 (November 18, 2024, 11:24 PM EST) -- Four teenagers and a mother suing Monsanto over PCB damage at their former school took the stand Monday to testify, some tearfully, about physical and mental maladies they believe stem from exposure to decades-old light fixture fluid.

The jury in the trial heard from 16-year-old Rowin Grant, 13-year-old Mabry Grant, 19-year-old Hudson Snyder, 15-year-old Nolan Simmer, and Rowin and Mabry's mother, Donya Grant, in a trial now stretching into its fifth week over exposure to polychlorinated biphenyls at Sky Valley Education Center in Monroe, Washington.

The witnesses spoke of suffering from headaches, lack of appetite, skin conditions, memory loss, emotional outbursts, insomnia, inability to focus and fear about being able to maintain normal relationships or losing their faculties to a greater degree as they grow older.

"How often do you worry about what it'll be like later?" a lawyer for the plaintiffs asked Rowin Grant.

"Often," she said.

"Your sister Mabry, do you take care of her?" the lawyer asked. Rowin Grant's face crumpled, and tears welled up in her eyes as she looked down.

"That's all I have," the lawyer said.

A few hours later, when their mother, Donya Grant, was on the stand, she said her elder two children, Hadley and Kemper, had also experienced problems that started or restarted after their Sky Valley attendance.

Speaking calmly and clearly but rocking back and forth for the entirety of her testimony, Donya Grant said she had experienced "more headaches, more difficulty controlling my emotions," a newly unpredictable menstrual cycle and fatigue. "It was unusual for me to be at home in the middle of the day and feeling like I needed a nap, but I felt that more often," she said.

Meanwhile, Hudson Snyder said he and his younger brother Emmett — who is expected to testify Tuesday — both have serious problems with their appetites.

"It's kind of a graphic comparison, but both myself and Emmett have been compared to Holocaust survivors multiple times by doctors and other people," Hudson said. He also stated that he struggles seriously with decision-making and follow-through, even on things that he had been highly interested in.

Lawyers for Monsanto focused their cross-examination on what the plaintiffs do seem to be able to do. Rowin said she plays sports seriously and practices piano. The Grants are homeschooled and receive high grades.

And Hudson Snyder has taught himself figure drawing by studying textbooks — some of his highly detailed work was shown during his cross-examination. He also plays guitar in a band and snowboards, he said on cross-examination.

Monsanto's attorneys were also able to establish that many of the children were not at the school complex full-time, but spent a few hours a day there a few days a week.

In 2011, the multibuilding Sky Valley Educational Center, about 35 miles northeast of Seattle, took over a 1967 building complex in which old fluorescent light fixtures and classroom caulk were slowly releasing polychlorinated biphenyls, the plaintiffs claim.

The ongoing trial involves student Gunnar L.G. Rose and 14 other individuals who claim they developed a variety of health conditions due to the use of the school buildings.

Monsanto sold numerous formulations of the dielectric insulating liquids under the brand name Aroclor, producing 1.2 billion pounds of them from the 1930s to the 1970s, juries have heard. The fluid filled small capacitor ballast boxes in hundreds of fluorescent light fixtures at the complex. But the company knew for decades of the now-banned chemicals' extreme toxicity, lawyers said.

The case is the tenth Sky Valley case to go to trial; Washington's Supreme Court has agreed to take up the first of them, called Erickson, after three teachers' $185 million victory was overturned in May by the state's Court of Appeals.

Pharmacia LLC, a Monsanto spinoff that its once-parent is defending in litigation over PCBs made from the 1930s to 1977, faces an additional $1.1 billion-plus in verdicts from the trials but has appealed those losses. Monsanto was acquired by Bayer AG in 2018.

This jury recently heard from industrial hygienist Kevin Coghlan that Monsanto-made PCBs were "pervasive" at the school complex. Coghlan said different Aroclor formulas, identified by four-digit numbers, were in materials like caulk as well, not just ballast boxes.

The Rose plaintiffs are represented by Henry Jones, Sean Gamble, Richard Friedman, James Hertz and Ronald Park of Friedman Rubin PLLP, Colleen Peterson and Bridget Grotz of Pfau Cochran Vertetis Amala PLLC, and Nicholas Rowley, Courtney Rowley and Theresa Hatch of Trial Lawyers for Justice.

Monsanto is represented by Steven Fogg, Emily Harris and Lucio Maldonado of Corr Cronin LLP, Liz Blackwell and Darci Madden of Bryan Cave Leighton Paisner LLP, Kimberly Branscome of Paul Weiss Rifkind Wharton & Garrison LLP, Anthony Upshaw of McDermott Will & Emery LLP and Lindsey Boney IV of Bradley Arant Boult Cummings LLP.

The case is Gunnar L.G. Rose et al. v. Pharmacia LLC, case number 87281-8, in King County Superior Court.

--Editing by Kristen Becker.

Monsanto PCBs 'Pervasive' At School, Scientist Tells Jury

Monsanto PCBs 'Pervasive' At School, Scientist Tells Jury

By Cara Salvatore ·  Listen to article

Law360 (October 29, 2024, 11:14 PM EDT) -- Monsanto-made PCBs were "pervasive" at a Washington school, an industrial hygienist testified Tuesday in the latest trial over illnesses there before being grilled by defense counsel about the integrity of his material samples.

Scientist Kevin Coghlan walked a jury through the results of multiple rounds of testing by various environmental companies as well as by his own outfit concerning the multi-building Sky Valley Educational Center, about 35 miles northeast of Seattle, which in 2011 took over a 1967 building complex in which old fluorescent light fixtures and classroom caulk were slowly releasing polychlorinated biphenyls, plaintiffs claim.

"The PCB levels were pretty much scattered around the entire campus of Sky Valley. They were pervasive throughout the facility, either in bulk materials, or in the air in a number of cases, or certainly within light fixtures that were wipe-sampled," Coghlan told the jury, referring to sampling by swabbing a surface.

The ongoing trial involves student Gunnar L.G. Rose and 14 other individuals who claim they developed a variety of health conditions due to use of the school buildings. Monsanto sold numerous formulations of the dielectric insulating liquids under the brand name Aroclor, producing 1.2 billion pounds of them from the 1930s to the 1970s, juries have heard. The fluid filled small capacitor ballast boxes in hundreds of fluorescent light fixtures at the complex. But the company knew of the now-banned chemicals' extreme toxicity for decades, lawyers say.

Coghlan said different Aroclor formulas, identified by four-digit numbers, were in other materials as well, not just ballast boxes.

Aroclors "1016 and 1242 is fluid within metal capacitors," Coghlan told the jury. "The 1260 is actually in that brown or black material in the capacitor, [and] the caulking itself that's all around the building would have 1254 in it."

These chemicals are so good at spreading by air that, for example, 1016 was found in the caulk because the vapor spread and stuck there, Coghlan said.

From the various data available, he estimated that throughout the school, from the time it began being used by Sky Valley in 2011 until before the remediation in 2016, the PCB levels were anywhere from undetectable to 3,000 nanograms per cubic meter.

Various government agencies put the safe level much lower, Coghlan said.

Coghlan showed jurors documents explaining that an environmental company called PBS did testing in 2016; a company called ALS Environmental tested in 2016 as well; and a company called EHSI did some limited testing in 2014.

Years later, Coghlan himself also received samples of carpet that had been preserved by an educator at the school, a Dr. Yost.

On cross-examination, a defense lawyer for Monsanto suggested to Coghlan there was no way to be sure these samples were in good shape because of how they had been stored by the educator from 2016, when she collected them, until 2019.

She asked Coghlan whether Ziploc bags are porous when it comes to PCBs; Coghlan said they can be, and admitted that was how Yost stored them.

"But you don't have any idea what was going on in Dr. Yost's basement for the three years before?" the lawyer asked. Coghlan answered that Yost hadn't indicated there was anything notable about the storage environment.

"You didn't take air measurements, right?" the lawyer asked. Coghlan agreed he hadn't.

He also admitted Yost had stored the usable samples in the same room as a sample that was considered inappropriate for exposure testing because it had been so saturated with PCB oil residue from a leak. Coghlan agreed they were all stored in Ziplocs in the basement.

Cross-examination continues Wednesday.

The case is the tenth Sky Valley case to go to trial; Washington's Supreme Court this month agreed to take up the first of them, called Erickson, after three teachers' $185 million victory was overturned in May by the state's Court of Appeals.

Pharmacia LLC, a Monsanto spinoff that its once-parent is defending in litigation over PCBs made from the 1930s to 1977, so far faces an additional $1.1 billion-plus in verdicts from the trials but has appealed those losses. Monsanto was acquired by Bayer AG in 2018.

The Rose plaintiffs are represented by Henry Jones, Sean Gamble, Richard Friedman, James Hertz and Ronald Park of Friedman Rubin PLLP, Colleen Peterson and Bridget Grotz of Pfau Cochran Vertetis Amala PLLC and Nicholas Rowley, Courtney Rowley and Theresa Hatch of Trial Lawyers for Justice.

Monsanto is represented by Steven Fogg, Emily Harris and Lucio Maldonado of Corr Cronin LLP, Liz Blackwell and Darci Madden of Bryan Cave Leighton Paisner LLP, Kimberly Branscome of Paul Weiss Rifkind Wharton & Garrison LLP, Anthony Upshaw of McDermott Will & Emery LLP and Lindsey Boney IV of Bradley Arant Boult Cummings LLP.

The case is Gunnar L.G. Rose et al. v. Pharmacia LLC, case number 87281-8, in King County Superior Court.

--Editing by Emily Kokoll.

Rose et al. v. Pharmacia LLC Trial begins in Seattle

Law360 (October 17, 2024, 11:12 PM EDT) -- Monsanto is continuing its appellate bid to put off a chemical poisoning trial already underway in Washington state court as the plaintiffs told a Seattle jury on Thursday the company owes them more than $450 million, in the 10th such trial tied to an Evergreen State school.

Counsel for a group of families told the King County Superior Court jury Monsanto owes each of the 15 individuals a baseline $30 million to $50 million in compensatory damages, plus punitive damages to be requested at the end of the trial, for manufacturing the industrial chemicals that they say triggered brain damage and other lifelong health issues.

"Justifiably passing judgment against one of the largest chemical corporations in the world is what we hope you do at the end of this trial," Courtney E. Rowley of Trial Lawyers for Justice, representing the families, told jurors.

Led by former student Gunnar L.G. Rose, the families are among the nearly 200 people who claim they were sickened by polychlorinated biphenyls, or PCBs, from florescent light ballasts and building materials at the Sky Valley Education Center, 35 miles northeast of Seattle.

But on Wednesday, Monsanto filed motions urging the Washington Court of Appeals to rethink a commissioner's decision this week to let the trial go forward, saying again that the proceedings need to be paused until the Washington Supreme Court addresses overlapping issues in the case. The justices agreed last week to hear three teachers' request to reinstate their $185 million victory in Erickson v. Pharmacia that was overturned in May by the Court of Appeals.

Pharmacia LLC, the spinoff that Monsanto has agreed to defend in litigation stemming from its manufacture of PCBs from the 1930s to 1977, so far faces an additional $1.1 billion-plus in verdicts from the trials but has appealed those losses. Monsanto was acquired by Bayer AG in 2018.

Monsanto on Wednesday moved for the court to modify the ruling letting the trail proceed, citing the trial judge's recent decision to admit disputed testimony from an industrial hygienist for the families regarding the levels of PCBs at the school.

The trial court "has now indicated that it intends to allow the very expert opinions from plaintiffs' PCB exposure expert (Kevin Coghlan) that this court held in Erickson are not generally accepted in the scientific community and should have been excluded," the company told the Court of Appeals.

Monsanto said there was a "substantial risk" of reversal of any verdict in the case that would "render the current trial a colossal waste of resources — not only for Pharmacia, but also for the jurors, witnesses, and court personnel, including this court on review."

King County Superior Court Judge Michael Ryan has not yet issued an opinion explaining his reasoning for allowing Coghlan's opinions in the Rose trial, although when refusing Monsanto's recent request for a stay late last week he suggested the Rose case record includes more evidence supporting the legitimacy of the calculations than the record in the Erickson case.

Coghlan's methods weren't discussed in detail during opening arguments on Thursday, but Rowley told jurors the industrial hygienist is an "industry leader" and expert on PCBs in schools who would be providing estimates of the chemical levels at Sky Valley at the time the plaintiffs were there. There were no reliable monitors in place then, Rowley said, and the PCB-containing material had mostly been removed by the time testing was done in 2016.

"No one can precisely say how much — what our people were exposed to at the time they were going to Sky Valley school," Rowley said. "That's common in these school PCB cases, because no one knew anything about PCBs — or that they were breathing them."

As in past trials, the families plan to show that the company concealed its knowledge of PCBs' health effects from the public and manipulated the science to downplay the dangers. Monsanto will present evidence that it adequately studied the chemicals and warned of potential risks, and that the health conditions at issue can't be blamed on PCBs.

Kimberly O. Branscome of Paul Weiss Rifkind Wharton & Garrison LLP, representing Monsanto, told jurors they will get to see reliable testing results showing PCBs were mostly undetectable in the air and on surfaces inside the school at the time the plaintiffs were there, with a few samples indicating low levels that wouldn't pose a health risk.

"There is actual data about the PCB levels at Sky Valley Education Center, and you will get a chance to look at that data," Branscome said.

The trial, expected to last about two months, features the claims of three mothers and a dozen youth who spent time at the school as children between 2011 and 2016 while participating in hybrid programs for homeschooling families. They say their conditions include gastrointestinal problems, cognitive and emotional difficulties, hormonal abnormalities and reproductive system issues.

One mother was also hospitalized for two months after spending time at the school and has never regained full functioning of the right side of her body, Rowley told jurors.

Monsanto has contended that the trial court violated its due process rights by consolidating two groups of plaintiffs into one group of 15 in the Rose trial, saying jurors can't possibly determine whether PCBs are responsible for each of the injuries claimed by each person.

Branscome encouraged jurors to look for evidence in the medical records about whether the problems were diagnosed or treated by the families' doctors.

"It's important to remember that each individual and each claimed condition has to be looked at on its own to see if the evidence supports causation," Branscome said.

The Rose plaintiffs are represented by Henry G. Jones, Sean J. Gamble, Richard H. Friedman, James A. Hertz and Ronald J. Park of Friedman Rubin PLLP, Colleen Durkin Peterson and Bridget T. Grotz of Pfau Cochran Vertetis Amala PLLC and Nicholas C. Rowley, Courtney E. Rowley and Theresa Bowen Hatch of Trial Lawyers for Justice.

Monsanto is represented by Catherine W. Smith and Howard M. Goodfriend of Smith Goodfriend PS, Steven W. Fogg, Emily J. Harris and Lucio Maldonado of Corr Cronin LLP, Liz Blackwell and Darci F. Madden of Bryan Cave Leighton Paisner LLP, Kimberly O. Branscome of Paul Weiss Rifkind Wharton & Garrison LLP, Anthony N. Upshaw of McDermott Will & Emery LLP and Lindsey C. Boney IV of Bradley Arant Boult Cummings LLP.

The case is Gunnar L.G. Rose et al. v. Pharmacia LLC, case number 87281-8, in the Washington Court of Appeals, Division I, and case number 18-2-58239-3, in King County Superior Court.

--Editing by Brian Baresch.

For a reprint of this article, please contact reprints@law360.com.

Read more at: https://www.law360.com/washington/articles/1891187?nl_pk=42f6601c-4d65-4c9f-a129-b8603280e8a5&utm_source=newsletter&utm_medium=email&utm_campaign=washington&utm_content=2024-10-18&read_main=1&nlsidx=0&nlaidx=0&detected=1?copied=1

Monsanto hit with $857 mln verdict over PCBs in Washington state school

Dec 18 (Reuters) - A Washington state jury on Monday ordered Bayer's Monsanto to pay $857 million to seven former students and parent volunteers of a school northeast of Seattle who claimed that chemicals known as PCBs made by the company leaked from light fixtures and made them sick, according to court documents.

The jury in Seattle found the company liable for selling polychlorinated biphenyls (PCBs) used in the Sky Valley Education Center in Monroe, Washington that were not safe and did not contain adequate warnings. The verdict included $73 million in compensatory damages, and $784 million in punitive damages.

The plaintiffs included five former students and two parents who spent time at the school 7 to 18 years ago. They claimed exposure to PCBs at the school caused them to have neurological, endocrine system and other health concerns. Read the whole story here.

Monsanto ordered to pay $857 million over toxic PCB exposure

We could not be more proud of the work Theresa put into this case. The jury’s decision reflects the team’s dedication to bringing justice to their clients.

From MSN:

Monsanto on Monday was ordered to pay $857 million to a group of seven former students and parent volunteers at a Washington state school who claimed the company's chemicals sickened them. 

The judgment, which was reported by Bloomberg, AFP, Reuters and other news outlets, comes as Monsanto is facing thousands of lawsuits over its weed-killing chemical Roundup. Last month, the company was ordered to pay $332 million to a man who said Roundup caused his cancer.

Read the full article here.

How everyday people started a movement that's shaping climate action to this day

From NPR:

Deborah and Ken Ferruccio were driving in their red truck down a rural North Carolina highway one night in 1978 when they suddenly came upon big yellow signs reading: "Caution, PCB chemicals spilled along roadways." There was a three-foot swath of a brown substance along the sides of the road that was smelly and seemed toxic.

"I was very confused because I knew something about chemicals and I didn't know exactly the specifics on PCBs, but the signs indicated they were very serious," Ken says.

Immediately they wondered if the danger was airborne, and whether they should close the windows — or open them. Should they be worried about exposure at all, since they weren't in direct contact with the sludge?

Ken didn't know what to do.

"And it was literally like the awakening of our lives," Deborah says.

They were shaken by the experience. But it was just the beginning of their encounter with polychlorinated biphenyls, or PCBs — highly toxic human-made industrial chemicals used in factories. The more they learned about PCBs, the more concerned they got. And then they organized to fight back.

All around the world, there's a tragic history of industries dumping their waste or setting up their most hazardous facilities in communities viewed as politically powerless or less likely to protest their presence.

But the people of Warren County found that they were not powerless. Fueled by the spirit of the civil rights movement, they challenged their own political leaders over the toxic chemicals being dumped in their community. In the process, they helped birth a national movement, one that would eventually put environmental justice on the national agenda — and is shaping the fight for climate action today.

Read the entire article here.

Thoughts about AI by Theresa

Thoughts about AI by Theresa

I just attended a seminar put on by Filevine about AI. The speakers were:

• https://law.stanford.edu/directory/megan-ma/

• https://mtmp.com/speaker/cain-elliott/

I went into this with a  very open mind. My big picture takeaway is, this technology has not been harnessed or had boundaries applied. There are two types of AI that were discussed, largely: 1. chatgpt style that culls info from the internet at large and drafts something for you, and 2. AI technology that pulls only from the information you provide, ie a file in FV. 

My biggest takeaways re concerns:

AI doesn’t distinguish between what’s true on the internet and what’s not true. The source of information for your AI prompt is all of the information that’s available. Anyone can put anything on the internet. Like Wikipedia. 

There is a significant concern about bias. The historic bias against marginalized groups is part of what’s out there in the world. That will be incorporated into AI because it’s already out there. Then you start doubling down on bias and marginalization. 

There’s a significant concern about privacy in general. Any information you’ve put out there – address, phone, DOB, etc. can be culled by AI. 

The expectation is that the use of AI will affect malpractice (E&O) insurance. One carrier has submitted guidelines warning about using AI.  

Theft, fraud, stalking, hacking, terrorism are risks

Current AI: potential automated responses in gmail, yahoo emails. Suggestions from Amazon or other websites for other products. Chat bots.

“These are not decision-making tools.” “You can optimize for the outcome of your client. These tools can’t do that.”

How Filevine is using AI:

Demands: 48 hours, not final 

AI fields: use FV prompts to extract info based on documents in FV – “help you consume massive amounts of information”

                -depo questions

                - ICD10 codes

                -what is the drafter of RPD worried about

                -depo/depo summaries

                -objection logs

                -comes with page references so you can check

                -anything that can be OCR’d can be interpreted – not handwriting, diagrams, photos yet

 AI blocks: meant to accelerate composition of documents

AI Sidebar: conversation with your data, how do perform processes in Sidebar

Immigration AI: help with forms

My Impression:

Licensed legal work is required to be done by lawyers. All of this implicates our fiduciary duties, our duty of competence, our duty of confidentiality, etc.

In terms of briefing, demands, discovery, summaries – we have all of the resources available to do this and do it easily and quickly. My gut feeling is that it’s overwhelm that could lead to relying on AI as a short cut. The biggest risk to using AI is bypassing the thinking, issue spotting and planning that differentiates good lawyers from exceptional lawyers. This is the big danger spot I see in AI. FV’s AI can draft deposition questions, for example. But it can’t take into account what the needle moving issues are in my case, how I’m going to set up a particular witnesses, what case history I’m going to emphasize for leverage, whether I have all of the medical records, etc. That’s lawyer work. That’s what makes high value cases higher value cases. And a blunder there can impact trial, as we know.

Even using google, we have the option to evaluate the source before we click on the website link. With AI (outside of your file), there is no vetting of the source and no verification of the information whatsoever. That’s a huge concern when AI is used as a short cut for briefing. We have briefing templates in Westlaw for any CA motion/opposition imaginable, and it’s all correct and up to date. For other states, Westlaw has civil litigation guides or some other resource that gives you the rules of law and all you have to do is copy and paste and insert the facts of your case. It’s not difficult or time consuming at all. I’ve done this routinely in Iowa, Georgia, Florida, New Mexico, Washington, for example.

Where I can see value in case specific AI (within your file in FV, for example) is if the lawyer already knows the file and uses AI to create a document from a file that’s been uploaded into FV, for example, and then vets what’s in the document. The issue there is I’m not sure how much time you save since you have to vet the info regardless and make sure the document is what you wanted/needed it to be. 

Here are some other relevant articles and resources:

• https://www.reuters.com/legal/transactional/us-judge-orders-lawyers-sign-ai-pledge-warning-they-make-stuff-up-2023-05-31/

• https://www.reuters.com/legal/transactional/lawyer-used-chatgpt-cite-bogus-cases-what-are-ethics-2023-05-30/

• https://www.wired.com/story/italy-ban-chatgpt-privacy-gdpr/

• https://www.europarl.europa.eu/news/en/press-room/20230505IPR84904/ai-act-a-step-closer-to-the-first-rules-on-artificial-intelligence

Making A Killing

For too long, Californians who have been harmed instead of healed by our healthcare system have faced a formidable obstacle in seeking accountability in a court of law for medical negligence. It's called MICRA, Sacramento shorthand for the Medical Injury Compensation Reform Act of 1975. Over the course of four decades, MICRA has put an artificial cap of $250,000 on pain and suffering damages in cases involving medical malpractice, no matter the outcome - even death. IN all that time the MICRA limit has remained unchanged, despite decades of inflation that have reduced its economic effect by roughly 80%. Meanwhile, MICRA has yanked crucial economic decisions out of the hands of citizen juries, as they are not allowed to know of these caps during the course of the trial. It has done little to help doctors and nothing to improve patient care. Its main beneficiaries have been insurance companies. This issue of limits on damages in medical malpractice lawsuit is California's longest-running single-issue political battle.

Watch the new 2023 documentary on Apple TV+ by clicking here.

The She Said What Show

Courtney joins the She Said What Show to talk all things!

Ted Horn Memorial Award Acceptance

On January 28, 2023, Nick and Courtney accepted the Ted Horn Memorial Award at the CAALA Gala. This honors their outstanding service to the association and to the legal community. We are so proud of their work on the Fairness for Injured Patients Act and their dedication to human rights.

Courtney spoke at the event, “MICRA and laws that cap the value of life and quality of life damages are laws of inequity that not only curtail women’s rights but endanger their health.  Women are dying, unnecessarily, in America. Women take four years longer than men to be diagnosed with over 770 diseases. Women are 50% more likely to be misdiagnosed following a heart attack. Our maternal mortality rate is the highest of the developed countries. And what’s more--Black mothers die at a rate three times that of white women. These numbers don’t just reflect how women and people of color are treated in the healthcare industry, they are a direct reflection of how women are valued in the courtroom. 

But this inequity is not limited to CAPS on damages, it extends to our classrooms, our state rooms, and, still, our profession. 

This agreement with the CMA is a great beginning. The expansion of civil rights is progress. And, the work continues. In states across the country, caps designed to limit access to the courtroom and protect high donor insurance conglomerates are being introduced to legislation constantly. As we have seen geopolitically, democracy and human rights are fragile, and their protection cannot be limited to state lines or-- areas of practice. 

Our relationships, here, in this room, will be the anchor and the driving force of positive creativity and right direction in our laws, our country, and our profession. How we value and protect equity , dignity, and humanity in our laws, in our offices, will impact how we value all people in our society, now, and for the next seven generations.”

Watch acceptance speech here!

LA Hospital Sued for Racism

LOS ANGELES – The husband of a Black woman who died hours after childbirth in 2016 sued Cedars-Sinai Medical Center on Wednesday, saying she bled to death because of a culture of racism at the renowned Los Angeles hospital.

Charles Johnson IV said he discovered the disparity in care women of color receive at Cedars compared to white women during depositions in his wrongful death lawsuit that is scheduled to go to trial next week in Los Angeles Superior Court.

“There’s no doubt in my mind that my wife would be here today and be here Sunday celebrating Mother’s Day with her boys if she was a Caucasian woman,” Johnson said at a news conference outside the hospital. "The reality is that on April 12, 2016, when we walked into Cedars-Sinai hospital for what we expected to be the happiest day of our lives, the greatest risk factor that Kira Dixon Johnson faced was racism.”

Johnson died about 12 hours after having a scheduled cesarean section that was performed in 17 minutes to deliver the couple's second son, Langston.

“This is sloppy. It was butchery,” attorney Nicholas Rowley said. “It shocked everybody that we deposed, all the health care providers, even the head of (obstetrics) here, the head of labor and delivery, looked at it and said ‘No, I’ve never seen one done that fast.’”

Despite signs she was bleeding internally and over the desperate pleas of her husband, Kira Johnson languished for hours without being readmitted to the operating room until it was too late, the civil rights lawsuit said.

At one point, a nurse told Charles Johnson that his wife wasn't a priority, according to the lawsuit.

She died from internal bleeding — nearly 90% of her blood was later found in her stomach, Rowley said. Her bladder had been lacerated and she hadn’t been sutured properly.

The hospital, which has fought the malpractice lawsuit, said in a statement that it was founded on principles of diversity and health care for all and it rejected “any mischaracterization of our culture and values.”

“We are actively working to eradicate unconscious bias in health care and advance equity in health care more broadly,” the statement said. “We commend Mr. Johnson for the attention he has brought to the important issue of racial disparities in maternal outcomes.”

Kira Johnson's death led her husband on a crusade to advocate for reducing maternal mortality, which is especially high for Black women.

Before the pandemic, which increased deaths of women of color during childbirth, Black women died at 2.5 times the rate of white women, according to the National Center for Health Statistics.

Charles Johnson has testified before Congress and at the state Capitol in Sacramento in support of a variety of bills, including a 2019 state law that requires doctors and nurses to identify implicit bias at work, and a recent bill that would lift the cap on medical malpractice awards.

Johnson would not benefit from a change in the malpractice law that currently caps awards at $250,000. The case is scheduled to go to trial May 11, though recent court filings indicated the two sides were close to reaching a settlement.

The civil rights case would give Johnson another avenue to collect damages and hold Cedars-Sinai accountable. He's also seeking an injunction that would require the hospital to make changes to protect mothers and women of color.

But proving a civil rights violation in health care is difficult because most laws require showing discrimination was intentional, said Brietta Clark, a professor at Loyola Law School.

“Compared to when civil rights laws were enacted, a lot of the kind of unequal treatment that we see in health care today does not seem to be explicit,” Clark said. “It does not seem to be conscious.”

A judge had rejected Johnson's effort to change the malpractice case to add the civil rights action, partly because deposition excerpts did not show the hospital racially discriminated in the treatment it provided.

Dr. Kimberly Gregory, an obstetrician and gynecologist at the hospital, testified that she lives with “structural racism” every day and it prevents Black patients from receiving the same care as whites, according to court papers. She also said Kira Johnson should have gone back to the operating room sooner.

Dr. Sarah Kilpatrick, chair of the Obstetrics and Gynecology Department, testified that she told Charles Johnson: “I’m sorry. We failed your family. ... This shouldn’t have happened.”

Angelique Washington, a Black surgical technologist, said “patient safety was out the door” when Kira Johnson came into the operating room.

Washington, who has more than 30 years of experience, said she routinely witnessed different treatment of Black women but was afraid to speak up.

“When I see my Black ... patients come in, I say an extra prayer,” Washington said. “I say a silent prayer that all goes well. Because you do have racism very much so in the operating room.”

Clark said the evidence identified by the judge as weak were more general statements and not specifically about discrimination by the provider. She said the key thing for Johnson's legal team will be to show a pattern of discrimination.

Rowley said the effort to amend the case was a long shot. He has since gathered other evidence from additional depositions and will be able to seek data — such as the number of Black women that have died at Cedars — to support his claim in the new lawsuit.

“Kira died because she's Black,” he said. “Women of color don't get the same treatment as white women. That's a fact.” 

Read more here.

The Maternal Health Care Crisis

Congratulations to Charles Johnson, who was the advocate for the Fairness for Injured Patients Act and is a relentless and brilliant advocate for womens’ maternal health in America. He is moving the needle for maternal health.

USA women are dying unnecessarily from childbirth. We have one of the worst maternal mortality rates in the developed world; black women die three times the rate as white.

Equity in healthcare is a human right.

Read more here.

$275M verdict for toxic exposures at Monroe school, adding to swelling cost

Full story here.

The Seattle Times

By Taylor Blatchford Seattle Times engagement reporter

Ten students and parents who say they suffered serious neurological injuries from chemical exposure at a Monroe school have been awarded $275 million by a King County jury.

The lawsuit against Bayer Pharmaceuticals — which owns chemical giant Monsanto, the manufacturer of polychlorinated biphenyls, or PCBs — is the fourth to result in a multimillion-dollar verdict. The first three resulted in jury verdicts of $268 million distributed to 14 plaintiffs. One lawsuit is ongoing and 16 more lawsuits are awaiting trial.

In all, more than 200 students, parents and teachers from the Sky Valley Education Center, an alternative school in Snohomish County, have sued Monsanto over environmental contamination at the school.

They claim the Monroe School District knew as early as 2014 that PCBs were found on the campus, but, despite cleanup efforts, toxins were still being found into 2019.

A Seattle Times and ProPublica investigation this year found that the district was slow to respond to environmental hazards even while publicly reassuring staff, students and their parents that the school was safe.

Read the rest of the story here.