New York Settles with Boxer Abdusalamov for $22 Million

The state of New York agreed on Friday to settle a lawsuit filed by former heavyweight boxer Magomed Abdusalamov for $22 million.  It is thought to be the largest amount ever paid by the state of New York in a settlement.

gavel-300x199Facts in Abdusalamov

Abdusalamov, now 33, fought at Madson Square Garden.  He lost the fight but was not knocked out.  He was evaluated by a New York State Athletic Commission (NYSAC) doctor after the fight.  Instead of sending him to the hospital after showing symptoms consistent with an acute blood clot in his brain, they released him. He took a cab later to the hospital himself.  The ER doctors immediately diagnosed his blood clot and he had immediate surgery.

Abdusalamov’s path after arriving at the hospital has been beyond awful.  He suffered several strokes.  He was in a coma for weeks.  He spent 10 months in the hospital. Today, paralyzed on one side.  He cannot walk or speak clearly.

The Malpractice Case

This case has generated a lot of media interest, obviously, but no one writing about the case is really talking about the medicine in granular detail.  But what appears to have happened is that this man developed a blood clot between his skull and his brain.

From the standpoint of a medical malpractice case, the question is whether the doctors should have seen the signs and symptoms of a blood clot that would warrant additional investigation.  First of all, the guy was a mess after the fight.  He had a laceration above his eye that needed to be sutured.  He had broken bones in his face and hand. More importantly, he complained of head pain.  Instead of simply sending him to the hospital for further evaluation, the doctors advised him to get to his primary care doctor in a day or two.

While time was passing, the pressure from the blood clot was building.   The pressure build-up is what ultimately causes the brain damage when a patient has a subdural hematoma. Unchecked with surgery, this pressure can cause irreparable to the brain stem.   The problem is blood flow to the brain is impeded because of this pressure on the intracranial cavity.  This case is fairly typical in its presentation.  Patients with an untreated blood clot usually have paralysis and speech problems.

The surgery to fix a blood clot can be extreme. In this case, given the delay, the doctors may have had to perform a hemispheric craniotomy which literally means you take off the whole side of the skull to decrease the pressure in the head.

Ultimately, the patient did get the surgery to evacuate the clot that saved his life.  But because it was not caught more quickly, it did not allow the patient to recover and be a functioning normal human being again because the damage to the brain was irreparable.

Why Settle for $22 Million?

Why was the settlement so high?   Three factors increased the settlement value of the case.  First, unlike many states, there is no cap on medical malpractice damages in New York.  If the jury is sufficiently outraged and/or feels great sympathy for the victim, there can be an extraordinary pain and suffering award in a case like this.  Second, the economic damages for a boxer in the prime of his career who would have a life of future earnings in and out of the boxing ring are significant.  On top of that, the economic costs of care for this man are also likely very significant.  So the damages and life care plan are probably (I’m guessing) more than double the ultimate settlement.  Finally, the state knows it mess up in this case.   These case can often be driven by the desire to do the right thing and put an awful (and high profile case) behind them.

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