Michael A. Haggard and Todd J. Michaels of the Haggard Law Firm in Coral Gables won a $4.8 million jury verdict for the family of RIchard Puchalski, a 70-year-old former lawyer who died onboard a ship owned by Royal Caribbean Cruises Ltd.

Wisconsin resident Laura Goodloe claimed medical malpractice cut her father's life short, as the ship's doctor gave Puchalski medication that made his condition worse.

“It was a preventable tragedy,” Haggard said. “Cruise lines cater to older folks and they cater to families, and it's just really unfortunate that they don't start taking seriously that when you have 4,000, (or) 5,000 souls on board you need to take care of them.”

Royal Caribbean's lawyer, Jerry D. Hamilton of Hamilton, Miller & Birthisel in Miami, did not respond to requests for comment.

Puchalski began practicing in 1970s Chicago, specializing in immigration and employment law, often representing labor unions for police and firefighters. He served in the Department of Labor and as general counsel to the Illinois Human Rights Commission, and founded a number of firms. Before his death, Puchalski enjoyed semi-retirement, doing pro bono work and mentoring his daughter and son-in-law, who were his law partners.

Puchalski was en route to Alaska to celebrate his 70th birthday on the morning of July 31, 2016, when he went to the ship's infirmary to report he was experiencing shortness of breath.

According to the federal lawsuit, Dr. Amanda Saunders had correctly diagnosed Puchalski with acute congestive heart failure, meaning his heart was having a hard time doing its job, causing fluid to build and back up into his lungs.

Todd Michaels of the Haggard Law Firm in Coral Gables. Todd Michaels, the Haggard Law Firm. Courtesy photo.

“Congestive heart failure obviously sounds scary and it is serious, but someone shouldn't die at that point,” Michaels said. “It's a situation where a doctor has to get somebody through the acute stage, and then they're treated and they can live long term.”

The plaintiff claimed the doctor should have kept Puchalski for further evaluation, or transferred him to hospital as the ship approached port. But instead Saunders discharged Puchalski, instructing him to return for a check-up and giving him Metoprolol, a beta blocker used to treat high blood pressure, chest pain and heart failure.

Though the medication is used on patients with long-term congestive heart failure, it works by slowing down the heart, according to Michaels. That means it's not ideal for a patient in the acute, or urgent, stage like Puchalski.

“Because in those moments, the heart is having enough trouble pumping blood to begin with, and then you put medication on top of that, which slows the heart down,” Michaels said.

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Click here to read the complaint

The doctor also gave Puchalski a diuretic to reduce the built-up fluid in his body by dilating his blood vessels, which Michaels argued was a recipe for disaster. While the first medication reduced Puchalski's blood pressure, the second exacerbated its effects.

“You've got the heart that's already weakened, then you've got the medicine to slow it down, then you expand the blood vessels, and what you get is a heart that can't beat,” Michaels said.

Puchalski was in his cabin about 39 minutes later when his son arrived and he quickly stood up. As Michaels tells it, the doctor never warned Puchalski that such a movement could cause a sudden drop in blood pressure. He collapsed, suffering a pulseless electrical activity cardiac arrest — meaning his heart received the brain's instruction to beat but was too weak to do it.

Puchalski was taken to hospital, then an intensive-care unit in Anchorage, where he died.

His family sued Royal Caribbean in March 2018, claiming negligent medical care, vicarious liability and negligent hiring, retention and training. They also argued that because the ship had docked when Puchalski was discharged, the doctor should have called an ambulance.

Royal Caribbean denied the allegations and moved to dismiss for failure to state a claim —arguing the complaint lacked enough facts and amounted to a shotgun pleading, lumping various theories of liability into a single count. It also claimed it had no duty to evacuate Puchalski.

Michael Haggard, of the Haggard Law Firm. Courtesy photo. Michael Haggard, of the Haggard Law Firm. Courtesy photo.

When Haggard picked the jury, he looked for people who wouldn't apply a lesser standard of care to a cruise ship doctor, as opposed to a doctor at a hospital on land.

“I didn't want them to say, 'Oh there's not much they can do,' ” Haggard said. “ Because [the doctor] certainly had everything available to her and she was right there in port.”

In an unusual move, Haggard and Michaels called defendant and doctor, Saunders, as their first witness, which worked in their favor.

The litigation leading up to the trial had “played out in a funny way,” as Michaels put it, and it had been hard to get hold of the doctor for a deposition as she was from South Africa, lived in Belgium and worked on the high seas. But when they did, Saunders claimed she didn't discharge Puchalski and that he'd left despite her objections.

Haggard said he immediately doubted that version of events as there was nothing to back it up.

“[Saunders] never amended any report to say, 'My gosh, the guy who left by ambulance, he tried to leave my clinic,' ” Haggard said. “ You don't think there'd be something documented from one of the biggest cruise lines in the world?”

As the case progressed, that story changed as even the defendants' experts acknowledged  Puchalski was discharged, according to Haggard and Michaels, who had only to relay that to the jury to help cast doubt on the defense's version of events.

“It was sort of strange in the path that it took to get there, but I think in the end the facts that had always been the real facts, if you looked at the records, if you looked at every other witness than this doctor, came to light through the jury,” Michaels said.

Jurors awarded the plaintiff $4.8 million in damages and about $34,400 in medical expenses, which U.S. District Judge Cecilia M. Altonaga adjusted to $3.3 million as jurors found the defense 70 percent liable. It's possible jurors agreed with some of the defense's claims that Puchalski had a preexisting condition, and often didn't go for checkups.

Attorneys say it hasn't been easy for Puchalski's family, who all saw him passed out on the floor, but Haggard and Michaels said the verdict served its purpose.

“They've all just been so thoroughly hurt and their lives have been so thoroughly damaged by losing [Puchalski] in the way they did,” Michaels said. “What they would have liked us to be able to give them, we couldn't give them. We couldn't go back and undo what had happened, but I think there's a sense of relief that Royal Caribbean has been held responsible.”

Read the full jury verdict: [falcon-embed src="embed_1"]

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Case: Laura Goodloe, personal representative of the estate of Richard Puchalski v. Royal Caribbean Cruises Ltd.

Case nN.: 18-21125

Description: Maritime medical malpractice; wrongful death

Filing date: March 23, 2018

Verdict date: March 8, 2019

Judge: U.S. District Judge Cecilia Altonaga

Plaintiffs attorneys: Michael Haggard and Todd Michaels, the Haggard Law Firm, Coral Gables; and Philip D. Parrish, Philip Parrish P.A., Miami

Defense attorneys: Jerry Hamilton, Hamilton, Miller Birthisel, Miami

Verdict amount: $4,834,390.20

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