approximately fifteen months after her surgery and because she was the verdict in the case was were during june of two thousand and fifteen in the amount of about two point eight nine million dollars of which  million seven fifty was for non economic damages and one million dollars was for passed after medical bills in the case results or in a word were one hundred forty seven thousand dollars for lost and come thirty seven past thirty seven thousand  went over the years she had our surgery in august of two thousand and twelve she had a fluid accumulation just a few days later it became her memorial hospital she had then i gallbladder surgery  our motion for a better basic difference between the technique which the plaintiff claims we should have done and what we did is that with the technique that the plaintiff believes we should have done you basically preserve the rectum and then you tack the upper part of the  record into the spinal column so that it remains in place and then make their cut from the intestines further up in the patient's body place experts in this case are both surgeons who began their career after two thousand both young surgeons emergency circumstances the plaintiff in this case basically contends that it was a departure from the standard of care for my client to this surgery removing most of the rectum and the claim is that we should have  the plaintiff's two young surgeons who are experts who are of that view the problem we have here is that there are literally many hundreds of training programs for certain surround the country i have no doubt that dr healy and dr  surgeons and they know what they know as a result of their training and i think that's the way they were trained exactly but it is the fact that many people are trained otherwise for example we had a an expert from the color rectal surgeon from fort events involving the plaintiffs health after our surgery is that she suffered in confidence and that began shortly after the surgery and went on into two thousand and thirteen it is clear from the testimony of of the surgeons in this case plaintiff's experts as well as ours that all of the different approaches and there are some six or seven or eight different technical approaches to this can result in confidence and typically when the approach is used that we use this particular instance there are other factors that affect incontinence sphincter tone of the patient squeeze pressure strain the patient history of gallbladder surgery all of these things are factors that go into  the sum total of the intestinal of struction charges for this lady were two hundred twenty two thousand dollars dr fealy is of the view and clearly testified that imagine your others have had this from time to time cases there are a huge ns one and every one and they get that they develop in varying degrees depending on the patient but they develop those things dr thing really in this case says that those evens this lady developed were not the result of anything they claim in this case that we did wrong dr mueller testifies truthfully that there's no way to know which surgery that this lady had and there were many produce which had he which this lady might have developed which produce the obstruction the point is that i believe both the plaintiff's experts as well as ours will tell us has to have testified that no negligent act of art or they were charged with caused these intestinal obstruction it's rather the insult to the body plaintiff philip pneumonia it appears likely it's a type of pneumonia the can get from being in the hospital the charges for that were about eighty four thousand dollars the f think that nobody connects with any wrongdoing on the part that's i think approximately thirty thirty two thousand dollars so a substantial part of these medical bills that were awarded well that were claimed in the case that were put in evidence five ninety thousand dollars were things which we think under the high contradicted evidence were not responsible for so the plaintiff so the jury returned a verdict of the million dollars it was not broken down it was i think past past medical bills apart from future medical bills we know at the most past medical bills would have been five hundred ninety seven thousand dollars if the jury did that then it means they gave the words for medical expenses that we did not cause and we think they are sensitive there's a claim in this case also income we believe the un contradicted testimony is that mrs jackson fortunately can work could work she was unable to find a job that she was fully results in our having weight because those cases not stand for that proposition and they were also we did object specifically on the grounds that we're now saying which is many of these bills are not things that under any question relates to the connection between you said surgery surgery and insulted by right what if you insult the body is the wrong insult i e that we are there things that follow from right here you don't concede that it was the wrong surgery but if it was the wrong surgery is it more likely true than not some of these things would have followed the more yes and i don't know that it's accurate to say that what your client did was more is it accurate to say it was more just don't know which of these surgeries and there's no way to know which of the surgery she had she had a surgery when she was a teenager well it seems a kind of a stretch the doctors all say that could be the culprit in this case it could have been our surgery that we did it could have know the surgery on the intestinal obstruction in december that we could have been any of these and there's no way the plaintiffs experts will say we can know which it is so they didn't really connect that t a as a basis for saying that under the circumstances you must object twice to medical bills when they're offered and then when you discuss where they go back to the jury or not i do not believe cam unself stands for that this is the facts of the case  different it was a situation where we knew that there would be further proceedings before the judge outside the presence of the jury to discuss that and in the rush to get to the jury we simply didn't do it that's not the case here we were very detailed level in going through these medical bills the  in the case and she simply can't use some of these injuries the other point that we have is that an intestinal obstruction is not reasonably perceivable to work as a result of the surgery we did th there seems to be a tendency in more plaintiff's lawyers to try to inject into medical negligence cases the concept of secrecy rules later sawyer in this case talked about rules we objected first time she ever that she was make your statement again we hear rules and then we do object and it would be sustained and they'd say it again a few minutes later they certainly pounded it hard enough i have to think it would have had some effect and she was doing it for some reason i don't think rules apply it's almost like the old days time impeaching him with other instances in other cases where his testimony was just allowed but the unfortunate thing for the plaintiff is that they didn't follow up they didn't complete it so we don't know we had just told the cases where for one reason or another his testimony was not allowed we don't know what the subject matter was we don't know what the test was in that respect and that's what our limited motion went to but yet she went on and she did that with this particular  closing argument service but opt for the defendant had to go they must be a fall because they had to go all the way to the boondocks they had to go all the way to texas to find a seventy year old surgeon who would say what they want him to say well as we point out i think there are four judges on our illinois supreme court who maybe wouldn't qualify of seventy as a is the decider i shouldn't be here if seventy is a problem i mean yeah so  were and there was also a suggestion along the way that there were doing this procedure that our client got a bigger fee for doing this procedure as opposed to the way the plaintiff suggests the truth is she didn't prove that in the case but she did argue that as well and that's improper certainly the financial interest of a witness is relevant to a witness but not it is not relevant to the conduct of the doctor she has ruled with it and so i think i know the answer to this but we have raised that we think we should be entitled to the right off so to speak and i think that was directly vested in the miller case that we should have a credit against i one that she does have some evidence is that we chose this procedure the low entry resection rather than the records she does claim that and there was testimony from people that they thought that was improper and caused injury in so far as the patient in underwent developed and convents and underwent for the surgery so we believe under these circumstances  it's clear to us i don't know if the jury gave five hundred ninety thousand dollars for medical bills or not passed future we don't know on your medical bills we don't know where the sleaze ever again developed intestinal obstructions weeks we can't know that no doctor said that no doctor can predict the other i want to go back that they offered instruction you did not object to instruction how do you how do you get some understanding of if you know that's going to be an issue and you need it's an issue that you think cuts in your favor right don't you have to offer an instruction or offer a means by which to thousand dollars which means there will be four hundred thousand to what there may not happen in the future it could be as little stu hundred fifty thousand they gave the slate for medical bills which they have seven hundred fifty thousand for the future we don't know but it's something that we can't that was going to happen nine of the civil practice code that requires that verdict forms be itemized and the march cesky case which i cited my brief says that if counsel that in my brief and defense counsel did not respond to it at all in their reply brief but clearly marked chassis that case and section two dash eleven zero nine require that  a verdict form be itemized and if you don't itemize it you lose if you want to calculate specific items of damages by the same token i would have lost two if i were challenging the inadequacy of damages because both parties have to do it i didn't do it they didn't do it they didn't object to the verdict form and so there is a  the outcome of this case is controlled by the standard review defense counsel did not mention the standard review the standard of review is the pederast standard on judgment and  standard we all know says that when all of the evidence viewed in the light most favorable to the opposing party so overwhelmingly favors move it that note that no contrary verdict based on that ever heard evidence could ever seen but clearly the overwhelming weight of the evidence in this case is not in favor of the defendant another version of the of the standard  review was the supreme court in the york case which said a total failure or lack of evidence to prove any necessary element of the plaintiff's case that's a very high standard in their brief defense counsel acknowledged that it is rarely granted and in this case there simply was not proof the main issues that counsel raised in their in their reply brief was their intention that we did not show evidence of a standard of care and that in a patient like barbara jackson he answered well a procedure like this cures the prolapse have to salute but it typically results in incontinence so if the goal of the patient is to fi the prolapse but also remain constant then the rector paxi is the standard of care now that question furnishes both the answer to standard of care as well as standard of care for what standard of care means what reasonably careful doctors do in the same or similar circumstances one other example question this is an age ten forty two but for example this is jackson anything other than direct c would have been a law the standard of care and she was desiring the best functional outcome possible so then i think yes in that case the expert testified not only just what he was her personal practice was but he affirmatively stated that he could not testify as to what the this question does the training in all of retinal surgery the basic standards of doing a low interior reception or direct effect does that vary from place to place answer as i know from talking with other colorectal surgeon and being a part of a training program it is pretty standard there is a core set of things that we are required to teach every call o rectal fellow and they plaintiff's other expert dr mueller testify as to the standard of care he said favorable obviously means a violation of the standard of care dr mueller also said i asked him a question about his written report and i said if you clue in my professional opinion dr weber deviated from the standard of care by not performing correct effects and also by resetting the majority of mrs jackson's practice and dr mueller answered yes that is what i wrote and i agree with that now contentions that that mr hart says that well dr mueller didn't have that much experience that goes to wait that was decided in snelson versus hand and that was decided in the heading your purses will make it's if an expert doesn't have much experience that's fine that's something the jury can take into account but ultimately it's a jury question with regard to the foreseeability there that argument really floors me because dr healy is only office you know that he wrote in the ordinary course of business the first time he saw this is jackson as a patient two that the rectum sends out progressive warning signals as it begins to fill at first you only feel a slight urgency but as it fills more and more it becomes obvious to you you need to get to the bathroom on the other hand dr feely pointed out that the the hook colon is just a conduit it takes material from point a to point b so there is no warning sign consequently you have the incontinence dr mueller also testified that the practice parameters indicated that anterior resection may cause complete loss of control again that's an indication that if you take out the rectum problems may occur that is certainly some evidence of foreseeability the fact that not everyone becomes after having a wreck after having a low anterior resection is irrelevant plaintiff is not obligated to prove prove that the foreseeable outcome occurs in every case i mean that's like saying that a collision is not a forseeable result of driving too fast because not everyone who goes over the speed limit gets into an accident in martial versus burger the supreme court said it was foreseeable that an out of control car would hit a plate thus window certainly that doesn't happen every day with regard to damages hot they argued in their reply brief we had to show that every aspect was forseeable i don't think that they have no authority once we show that some injury might occur we don't have to show also there was abundant evidence see that that ballot struction might occur from surgery and with regard to their question there the suggestion that plaintiff did not have evidence that the power of struction were related to what dr weber did is simply incorrect you only have to look at testimony at page thirteen eighty one of the record where he said i asked this question he said that the next surgery that barbara jackson had was on december sixth of two thousand and twelve do you have an opinion to reasonable degree of medical certainty as to whether the extensive surgery that dr weber did on august twenty seventh contributed to the development of the balance structure answer my opinion is that the surgery that dr bailey had to was more than likely related to the previous surgery that dr weber did because he went so low into the rectum area to divide that area that creates even more  reason to my medical opinion i can say is that dr bailey's operative report clearly describes that's where all the youth heaton's he had to deal with there they were all down in low in the p hadn't done that extensive surgery removing her rectum she wouldn't have the power obstruction in two thousand and twelve she would've had this surgery in two thousand and thirteen to do the cost me so that's what led to all  the in the later bow of structures but it never would have started if it hadn't been for dr weber getting the train started  with regard to again with regard to manifest weight of the evidence again the standard review is important not only kind of a verdict not be reverbs for manifest weight unless it unless the jury's findings were on reasonable arbitrary and not based on any of the evidence this court would also have would have to find that judge little abused his discretion in denying the motion with regard to the issues of while here every single instance just about every single instance of trial error that defense counsel has raised in this point was forfeit they never objected they simply did not object they did jack to two issues the issues of  there the other thing about reversible error is reversible error only occurs if the defendant meets the burden of showing it was substantially prejudicial and would of standards of care are defined as reasonably careful doctors do in similar situations now this concept of reasonably careful doctor may sound murky but the basic rules of surgical practice are well known and they are set forth haven't shown how that mention of rules because every time i mention it with all it boys rolls correct it standards of care and then of course at the end of the trial the judge instructs the jury on what the standard of  er versus sara bush lincoln case is dispositive of the issue because of the fact well there are two aspects to the medical bills there is approximately because the write offs were not paid by anyone and only allows a reduction for benefits that were either paid by sure or are payable to the fighter that in fact there can be no the benefit because of the fact that there's no language in twelve o five that allows for an extension of time and a court has no no leeway to grant an extension for what is in essence  but there's something very basic these are young surgeons here and i have no doubt they purposely believed in this procedure they were taught in this trial counsel brought up the fact that the former head of the sight of school of medicine here moved to saying well you know it can't be perhaps that obvious because someone who teaches my method is now in dallas fort worth but it was clear there was testimony as the surgeon says that's not the way we do it i think there are differences i think there are differences in terms of when you were trained they have two young surgeons here we have to with vast experience in the case you can't explain away the fact that there's an entire that's a good like dallas fort worth but there are people  it and they and they're being trained it all over the country and do it these two young surgeons cannot know what started every single one of these hundreds and hundreds of medical centers around the country they can't go  this nobody says that it was her surgery and they need to prove that in order to to rebuild us on the financial interest question when she asked about cost of the procedure i didn't object during  during the trial i objected to some of those however she made on a player to complete the impeachment of these people