In Luppold v. Hanlon, the Massachusetts Supreme Judicial Court upheld a $28.8 million medical malpractice verdict, offering valuable insights for litigators navigating complex claims involving emergency care failures and multi-defendant liability. The ruling not only confirms the trial court’s handling of legal standards but also highlights the decisive impact of expert medical testimony in proving causation and damages in catastrophic injury cases.
Clinical Timeline: Failure to Diagnose Critical Ischemia
Steven Luppold sought care at Lowell General Hospital’s emergency department on March 7 and March 13, 2015, with complaints of severe foot pain and discoloration. These symptoms were early indicators of a vascular emergency. Despite the potential seriousness, no diagnostic imaging or vascular consult was initiated during either visit. On March 12, he contacted his primary care physician regarding worsening symptoms, but still, no definitive diagnostic steps were taken.
It wasn’t until March 17—ten days after the first ER visit—that Luppold underwent imaging at a different hospital. He was found to have both arterial and venous thrombosis. The vascular damage was by then irreversible, and an above-the-knee amputation of his left leg was performed on March 18.
Litigation Strategy and the Role of Expert Testimony
Attorneys at Lubin & Meyer represented Luppold in a case that named several providers, ultimately focusing on RN Susan Hanlon, PA Charles Loucraft, and NP Carlos Flores. The plaintiff’s legal team successfully argued that the defendants deviated from the standard of care, causing a preventable loss of limb.
Expert testimony played a central role. Medical experts reconstructed the clinical timeline, demonstrated what actions were medically indicated but omitted, and explained how each missed step compounded the harm. They tied the delay in diagnosis directly to the loss of treatment opportunity—key in overcoming defense arguments about shared or attenuated liability.
The jury awarded $20 million in damages and $8.9 million in prejudgment interest. The defense appealed, raising issues around the exclusion of evidence regarding a high-low settlement agreement with one co-defendant, alleged errors in the jury instructions on causation, and the applicability of prejudgment interest to future damages.
Massachusetts High Court Upholds Trial Court’s Rulings
The Supreme Judicial Court affirmed the trial court’s decisions. On causation, the justices confirmed that the jury instructions aligned with the “but-for” standard outlined in Doull v. Foster. Regarding the high-low agreement, the court agreed that revealing its existence could have unfairly biased the jury. On interest, the court reaffirmed Massachusetts precedent that prejudgment interest applies to the full award, including future damages—a crucial point for attorneys managing settlement strategy and case valuation.
For attorneys, Luppold v. Hanlon offers multiple takeaways:
- Expert Testimony as a Case Cornerstone: The strength of your expert can be the difference between merely alleging negligence and proving it to a jury. Experts must do more than explain—they must persuade.
- Navigating Multi-Defendant Claims: When multiple providers are involved, a tightly constructed narrative and timeline—anchored in expert insight—become essential in assigning responsibility.
- Understanding Procedural Strategy: Knowing when and how to challenge or defend settlement agreements, jury instructions, and interest rulings can significantly influence appeal outcomes.
How Cambridge Medical Experts Can Support Your Next Case
At Cambridge Medical Experts, we work closely with trial attorneys to provide the clinical clarity needed to win. Our services include:
- Detailed, timeline-driven case reviews by board-certified physicians
- Strategic expert reports tailored to litigation objectives
- Testimony that survives scrutiny and connects with juries
Whether you’re building a claim from the ground up or reinforcing a complex theory of liability, our experts help translate medicine into legal success.
