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$46.5 Million Verdict Entered for Infant in Medical Malpractice Case

Elizabeth DiNardo, Esq. | Associate Counsel


On March 9, 2017, after a two-week trial, an Arkansas jury entered a verdict in favor of two-year-old Kara Smalls and her parents in the amount of $46.5 million in a trial against the Arkansas hospital and doctor who delivered the infant.

Kara Smalls was born on June 4, 2014 at the Ouachita County Medical Center, delivered by Dr. Jonathan Lewis. At the time of her birth, Kara had abnormally high bilirubin levels and therefore was at risk of extreme jaundice, but the defendants misread the results as normal. Doctors also noted that the infant and her mother had different blood types, which is also a warning sign for the potential for extreme jaundice. However, despite the multiple warning signs, including the nurses’ finding of jaundice in the first 24 hours of the newborn baby’s life, and five other instances of jaundice over the following 24 hours, the Ouachita County Medical Center and Dr. Lewis released Kara 48 hours after birth without repeating the bilirubin test, and without warning her parents to be on alert for signs of extreme jaundice. According to the complaint, jaundice in infants is relatively simple to treat and the national standard of treatment, for decades, has been phototherapy lights.

Just days after bringing Kara home, Karl and Candice Smalls realized that their daughter’s health was failing and it was soon discovered that the baby’s bilirubin level had gotten so high that the substance had penetrated her brain which caused irreversible brain damage. Her untreated jaundice has consigned Kara to a very difficult life. Kara is unable to walk, talk or feed herself, and will likely never be able to care for herself. However, Kara’s cognitive function is normal for a child her age.

At trial, the defendants argued that while a blood test for jaundice is the national standard of care, doctors and hospitals in South Arkansas are held to a lower standard of care than the rest of the country. Fortunately for those receiving medical care in South Arkansas, the jury did not agree with the defendants’ arguments. Plaintiff’s attorney, Stuart Ratzan, commented on the verdict saying, “I think it could be a reminder to people that when it’s a national standard of care, you have to follow it.”

The case is: Karl Smalls et al. vs. Ouachita County Medical Center et al., case number 70CV-16-364-4, in the Circuit Court of Union County, Civil Division, Fourth Division.


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