Danae Ruth McGann v. Hannah J. Lilly

Court of Appeals of Texas·Decided August 14, 2023·No. 05-22-00455-CV·Published

Opinion

AFFIRMED AS MODIFIED; and Opinion Filed August 14, 2023

In the Court of Appeals Fifth District of Texas at Dallas No. 05-22-00455-CV

DANAE RUTH MCGANN, Appellant V. HANNAH J. LILLY, Appellee

On Appeal from the 366th Judicial District Court Collin County, Texas Trial Court Cause No. 366-04515-2017

MEMORANDUM OPINION Before Chief Justice Burns, Justice Molberg, and Justice Carlyle Opinion by Justice Carlyle Danae McGann appeals from the trial court’s judgment after a jury trial. We

affirm as modified in this memorandum opinion. See TEX. R. APP. P. 47.4.

Ms. McGann sued Hannah Lilly for negligence based on a car wreck, claiming

it caused a debilitating post-concussion syndrome. At trial, Ms. McGann introduced

expert testimony from several medical providers. Emergency medicine physician Dr.

Martha Grimm testified that she has expertise in concussions, treated Ms. McGann

after the accident, diagnosed her with concussion and post-concussion syndrome,

and referred her to a neurologist for further treatment. Neurologist Dr. Pedro Nosnik also treated Ms. McGann after the accident.

Based on his examination and a review of her post-accident records and imaging,

Dr. Nosnik opined that Ms. McGann suffers from post-concussion syndrome

attributed to the accident. He further testified that although most patients fully

recover from post-concussion syndrome, there is a small percentage of patients who

have lingering symptoms. And he explained that certain pre-existing conditions,

including depression and migraines, can make recovery from a brain injury more

difficult.

Optometrist Paul Kersjes testified that Ms. McGann sought treatment for

visual issues after the accident and reported suffering symptoms consistent with a

traumatic brain injury, including nausea, dizziness, and headaches. One of the

doctors at his practice diagnosed her with visual discomfort, spatial disorientation,

occulo motor dysfunction, and visual spatial deficiency, all of which are consistent

with brain injury.

Diagnostic radiologist Dr. Louis Schruff testified that he reviewed a SPECT

scan of Ms. McGann’s brain following the accident. He explained that a SPECT scan

is different from an MRI or CAT scan in that it measures blood flow to assess brain

function, whereas the other scans look at structural damage. Dr. Schruff opined that

Ms. McGann suffers from decreased brain function in her frontal, temporal, and

occipital lobes, which could affect her mood, memory, concentration, vision, and

ability to perform complicated tasks. He further opined that a traumatic brain injury

–2– was the most likely cause for Ms. McGann’s abnormal brain function, although he

could not say whether the accident caused her injury because he did not have a pre-

accident SPECT scan for comparison.

Neuropsychologist Dr. Richard Fulbright opined that Ms. McGann

demonstrated cognitive and emotional impairment, particularly in the area of coping

skills. Dr. Fulbright testified that Ms. McGann appeared to give her best efforts

during his examination, and he had no indication she was faking or exaggerating her

impairment. Dr. Fulbright attributed Ms. McGann’s impairment to the accident,

testifying that it affected multiple body systems and aggravated Ms. McGann’s

preexisting headaches. According to Dr. Fulbright, Ms. McGann can no longer work

and, although her biological recovery has plateaued, she will continue to need

medication and neuropsychotherapy in the future.

Both Ms. McGann and her daughter testified about how the accident has

affected Ms. McGann’s life. They testified that the accident was extremely

debilitating, that Ms. McGann is not the same person she was before the accident,

and that she can no longer participate in many of her pre-accident activities.

During her presentation of the case, Ms. Lilly elicited testimony establishing

that Ms. McGann had previously testified at least inconsistently. For example, in her

deposition, Ms. McGann testified that before the accident she had never received

treatment for depression, taken Prozac, or visited a psychiatrist, psychologist, or

neuropsychologist. Yet her medical records showed that she consistently received

–3– psychiatric treatment for depression in the years before the accident, which included

prescriptions for Prozac and Wellbutrin. In addition, her medical records showed that

she had previously received treatment from a neuropsychologist for memory loss

following an accident in 2011. Moreover, Ms. Lilly elicited testimony showing that,

despite denying as much during her deposition, Ms. McGann also sought treatment

before the accident for chronic headaches, dizziness, visual loss, visual changes,

vomiting, sensitivity to light, sensitivity to sound, fatigue, and concentration

difficulties—symptoms she claimed resulted from Ms. Lilly’s negligence.

Beyond that inconsistent testimony, evidence at trial established that Ms.

McGann withheld her relevant medical history from many of the providers from

whom she sought treatment after the accident, including her testifying expert Dr.

Nosnik. One such provider, neurologist Dr. Sunil Thummala, testified that, after

reviewing multiple MRIs and EEGs, he could find no objective evidence to support

Ms. Lilly’s claims that her symptoms resulted from a post-accident traumatic brain

injury. He noted both that the symptoms Ms. McGann reported did not match the

injury she claimed to suffer and that her symptoms likely would have resolved in the

months following the accident, if she had in fact suffered such an injury. Dr.

Thummala wrote after his exam:

Overwhelming majority of patients recover within a few months after accident. Certainly litigation is a major reason for symptom prolongation, and it is well-documented in literature. I believe her previous doctors perpetuated idea that her headaches are due to her brain damage, which at least I can’t see on exam today. Certainly, a

–4– secondary gain as potential cause for her symptoms cannot be definitively ruled out.

Dr. Thummala elaborated that it is well-documented in the medical literature

that “patients who have litigation pending and tend to file lawsuits, they tend to have

prolonged symptoms [compared to] an average patient who doesn’t go that route.”

He further explained that the term “secondary gain” refers to the patient “looking for

something else besides treatment,” which could include financial gain. He added

that, “[o]verall, looking at the records from past that we received and looking at the

exam and what she told us, the story was not making any -- much sense to me.” And

because there was “a disconnect, certainly we have to entertain the possibility that it

could be some secondary gain because I don’t want to treat somebody with [a] lot of

medications when the intent is not the medication but something else.”

Dr. Thummala recalled that Ms. McGann’s husband became angry when he

explained he found no evidence of a brain injury. Dr. Thummala responded: “You

are free to seek opinion from other doctors. You came to me for an opinion, I’m

giving you an honest opinion that I’m not seeing any brain damage. If you’re fixated

on that, basically I can’t do much there.”

Neuropsychologist Dr. Corwin Boake testified that his examination of Ms.

McGann revealed “invalid performance,” meaning that she did not give her best

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