ER Twice Dismissed Blood Clot as Sciatica. The Patient Lost His Leg. A Jury Awarded $20 Million.

On March 7, 2015, Steven Luppold walked into the emergency department at Lowell General Hospital with back pain, a cool left foot, and noticeable purple discoloration in his toes. Nurses charted what they observed. The physician assistant who saw him did not review those nursing notes before concluding the problem was sciatica. Luppold was sent home with pain medication.

Six days later he returned. His foot was still discolored and cool. He now had severe left ankle pain on top of the original complaints. A nurse practitioner saw him on the second visit but, according to trial testimony, asked no questions about the foot or ankle and issued the same diagnosis: sciatica. No ultrasound was ordered on either visit.

Four days after that second discharge, Luppold's primary care physician at Lahey Hospital ordered a simple ultrasound. It revealed deep vein thrombosis and arterial thrombosis in the left leg. The tissue had been starved of blood long enough that necrosis had set in. Surgeons amputated his left leg above the knee. Luppold was in his mid-thirties at the time.

Robert Higgins of Lubin and Meyer took the case to trial in Middlesex Superior Court in Lowell. The central argument was straightforward: had either ER visit included a basic ultrasound, the clot would have been caught in time and the leg could have been saved. The jury heard from three defendants, including nurse Susan Hanlon, physician assistant Charles Loucraft, and nurse practitioner Carlos Flores. Defense counsel represented them on grounds that the presentations were consistent with sciatica.

After nine and a half hours of deliberations over two days, the jury returned a verdict of $20 million, divided equally between compensation for pain and suffering and compensation for lifetime loss of the leg. The award exceeded the $16 million Higgins had requested. With pre-judgment interest, the total judgment came to $28.8 million. Massachusetts Lawyers Weekly identified it as the largest medical malpractice verdict in the state for 2023.

Defendant Hanlon moved for remittitur and judgment notwithstanding the verdict, then appealed when the trial judge denied both motions. On January 3, 2025, the Massachusetts Supreme Judicial Court affirmed the verdict in full, finding no error in the trial judge's evidentiary rulings or in the jury instructions on causation.