Medical Malpractice - The Ryan Speed Story

Steve Murphy (Voiceover): On July 31, 2007, a bright, young, 25 year old athlete and new dad, Ryan Speed checked into the Advanced Dermatology and Cosmetic Surgery clinic in Orlando, FL to seek treatment for a simple case of skin rash. The treatment that Ryan received from the Advanced Dermatology and Cosmetic Surgery clinics, over the next 2 years, has nearly destroyed him. The clinic gave Ryan massive injections and oral prescriptions of corticosteroids like Prednisone, Kenalog, and Depo-Medrol- the unbelievable result: in less than 2 years, Ryan's hips were destroyed at the young age of 26. He had to have both of them replaced with artificial hips. An MRI of Ryan's hips revealed he had Osteonecrosis or the"... death of a segment of bone caused by an impaired blood supply." This disorder occurs most commonly among people between the ages of 30 and 50. It often affects both hips and/or both shoulders. The most common cause is high doses of corticosteroids especially when given for long periods of time. And as fate would have it, to add insult to injury, Ryan's artificial hips had to be replaced repeatedly because they were the Depuy artificial hips recalled by FDA and the manufacturer Johnson and Johnson.

Today, the Insider Exclusive presents the true story of the miraculous courage of Ryan Speed and how his lawyers, Stewart Greenberg and Mark Stone, partners at the law firm of Greenberg, Stone & Urbano, are getting justice for Ryan earning them the highest respect from citizens and lawyers alike as one of the best plaintiff trial lawyers in Florida and in the nation.

Hi, I'm Steve Murphy and this is the Insider Exclusive live from Miami, Florida at the law firm of Greenberg, Stone & Urbano

ONSCREEN TEXT: Insider Exclusive presents: Medical Malpractice - The Ryan Speed Story

Steve Murphy: It is my great pleasure to introduce Stewart Greenberg and Mark Stone. Welcome to the show guys.

Mark: Nice to be here.

Stewart: Thank you Steve.

Steve: Today we're going to be talking about a young man, Ryan Speed, and his case. Give us a little background on who Ryan is and how this whole thing happened.

Stewart: Ryan, at the age of 25, developed a skin condition and he went to his dermatologist. And it's a dermatological center that has over 50 offices throughout many states in the country. And they treated him with injections and oral medications called corticosteroids and they over-treated him to the point where he developed a condition called avascular necrosis; basically, where the bone in his hip died from the lack of blood flow...and as a result, he's had six operations including 2 total hip replacements.

Steve: And he's now 29

Stewart: Now he's 29 years old.

Steve: Advanced Dermatology and Cosmetic Surgery clinics, that's the name of the organization, isn't it?

Stewart: Yes it is.

Steve: They're pretty big, aren't they?

Stewart: Yes, as I said, they have over 50 locations in many states.

Steve: Now, when he initially went there they gave him a bunch of corticosteroids, correct? Is that the normal type of treatment that you would have for a skin rash?

Stewart: Well, I think that they could have done other things before they gave him steroids and even when you administer steroids you're supposed to administer a certain amount. They went way above and beyond the amount of steroids which anyone should be administered.

Steve: The doctors that are at the dermatology clinic, they're medical doctors, dermatologists?

Stewart: Yes, and also there are physician's assistants who administer the medications as well.

Steve: Now, he's also, as a result of having artificial hips, he had them replaced, didn't he?

Mark: Sure, and Steve that's such a difficult procedure especially, even for a guy Ryan's age. And to have that more than one time and he may be facing future hip replacements. I think the difficult thing for Ryan to accept is this was so easily preventable. Corticosteroids are prescribed everyday by doctors. If they are prescribed in a safe amount you're not going to typically...

Steve: Is there a way that a doctor can monitor the amount of steroids in your body. There must be some residue. It just doesn't expel it all at once. So, they can see if they're reaching at a dangerous level.

Stewart: They should know by the amount that they're administering how much is proper and how much is improper. They administered far too many steroids to Ryan.

Steve: Stewart, you have with you a replica of a hip. Show our audience a little bit about what happens when a hip is replaced.

Stewart: Sure. This is the femur bone, the big bone of the leg and this area, right here, is the socket that goes into the joint, the hip joint.

Steve: ...the natural one?

Stewart: The natural one. What happens, in this case, is this part of the bone wore away and died because of the avascular necrosis. And what happens is that they put in an artificial - in this case, a piece of metal manufactured by Depuy. What had happened in Ryan's case is there is a receptor that kind of moves around like this, and there is a piece of metal that gets screwed in here and down into the femur and that allows him to have movement. In this case, not only did he have to have his hip replaced but this particular hip has been recalled because the metal on it has failed and Ryan had metal toxicity in his system. So, he's had to have 2 replacements in addition to the initial insult of the AVN.

Steve: What are they replacing it with?

Stewart: They're replacing it with another hip that's not completely metal but has plastic in it.

Steve: ...made by the same manufacturer?

Stewart: Yes, it is.

Steve: ...and there's thousands of these going on, aren't there?

Stewart: Yes, there are, all over the country.

Steve: Okay, tell us a little bit about how this has affected Ryan's life.

Stewart: Well, having a hip replacement surgery is very painful. The recovery is long. He's going through physical therapy. It's affected his ability to interact with his children, to enjoy the daily activities of life. Even sitting is a problem, walking is a problem, sleeping is a problem, bending, stooping, you name it. Anything that you can think of that anyone does on a daily basis, Ryan is affected.

Steve: And he's such a young man. He's 29, right?

Stewart: Yes.

Steve: This case is pending?

Stewart: That's correct.

Steve: What's your legal strategy to win this case?

Mark: Well Steve, as in any case, we've hired experts. Those experts have reviewed all of the medical evidence in the case and we will put together a case based on the expert medical opinion of these doctors primarily stating that had the defendants exercised reasonable care they would have early on discovered that they were using levels of corticosteroids that were simply greater than should've been administered.

Steve: ...and basically poisoning the body.

Stewart: Correct.

Steve: We have Ryan with us today and we're going to bring him on now so he can tell the story from his point of view. It is my great pleasure to introduce Ryan Speed to the show. Welcome to the show, Ryan.

Ryan: Thank you.

Steve: Thanks for coming here today. I know you had to travel all the way from Orlando, right?

Ryan: Yes.

Steve: This has been a nightmare for you... 25 years old and you had a rash on your back, on your skin, where?

Ryan: Yes, I had it on my back, on my neck, and some spots on my arms.

Steve: You decided that you were going to go to a dermatologist; kind of a natural thing to do, right?

Ryan: Yes.

Steve: You went to this clinic...they're doctors, you trusted them. Tell us what happened.

Ryan: I went to Advanced Dermatology and Cosmetic Surgery thinking they had my best interest at hand to treat my condition. I put all my trust in her thinking she had my best interest at hand and, as a result of that, I got diagnosed with avascular necrosis which is deterioration of the bone.

Steve: Now, only in your hips?

Ryan: Yes, in both my hips. On my left hip, I had a total hip replacement and on my right hip I had a core decompression, at 27 years old. That's a lot to take in.

Steve: What was going through your mind when you came here because you had a rash on your skin and now your hips are destroyed. I mean what went through your mind?

Ryan: I was devastated. I didn't know what to think. When I got the results of the X-ray they told me that if I didn't catch it when I caught it I could have had a prosthetic limb. Now, who was telling you, '...if you didn't catch it at the right time, ' the same doctors?

Ryan: No. Advanced Dermatology never tested for any of those symptoms, side effects, or anything. I went to Dr. Phillips' hospital.

Steve: And what prompted you to go to another doctor to find this out?

Ryan: Hip pains. I was having hip pains when I was skating with my kids.

Steve: When you first had the hip pains, you called up the dermatology clinic, correct?

Ryan: No.

Steve: You didn't talk to those doctors to ask them what's going on?

Ryan: No.

Steve: You didn't know that was related to that.

Ryan: No, not at all. I had hip pains so I said, "you know what, I have to get this looked at." So me being precautious I went to the hospital immediately because I was having hip pains periodically. I said, "This just doesn't feel right." When I got the X-ray, they told me, I literally was floored. I felt betrayed.

Steve: When you found that information out did you call the dermatologist? Did the new doctor say to you that it's because of the steroid shots that you've been getting, the injections you were getting caused this? Did he say that?

Ryan: Yes.

Steve: He did.

Ryan: Yes.

Steve: Did you call them up?

Ryan: No. I had stopped treatment with that clinic.

Steve: Immediately?

Ryan: Immediately.

Steve: Did they contact you as to why you weren't going back there?

Ryan: No.

Steve: They just didn't care?

Ryan: They didn't.

Steve: How has this affected you and your regular daily activities? Are you working?

Ryan: No.

Steve: Were you working before?

Ryan: Yes.

Steve: But you cannot go to a job now.

Ryan: No.

Steve: This is ongoing, and to add insult to injury, I understand, as Stewart had said, you had to have your hip replaced.

Ryan: Yes.

Steve: The artificial hip replaced.

Ryan: Yes.

Steve: That's pretty painful.

Ryan: Very, excruciating pain...I wouldn't suggest it to anyone.

Steve: Who is paying for all of this while this is ongoing, while your lawsuit is pending?

Stewart: Well the last hip replacement was paid for by the manufacturer but they even gave him trouble about paying for his pain medication at the end. I mean he had to spend an extra day at the hospital and we had to argue with people because they didn't provide for any of that care.

Steve: What do you think justice for you is, right now?

Ryan: Justice? They affected my life, for the rest of life. They've taken my youth, my enjoyment of life in the prime of my life. I can't go outside to play with my kids. I can't enjoy shooting a basketball. I can't even kick a ball. So, this is life challenging and this is an uphill battle for me...and justice? I don't even know. I don't have words...I would say how can someone like that still be in business?

Steve: If you could say one thing to Advanced Dermatology and Cosmetic Surgery clinics, what would you say? What would you say to them? Why did you do this to me?

Ryan: Why me? Why me? I mean what did I do to deserve this? I really don't understand why my life has to be taken from me at such a young age.

Steve: How do the prospects look for his legal action?

Stewart: We're very confident that we're going to be successful.

Steve: Good, good, you deserve it because you know your whole life has been taken away basically.

Ryan: Yes.

Steve: Well I really appreciate having you come on the show and we wish you the best of luck. It is my great pleasure to introduce Ryan's mom, Lucille. Welcome to the show.

Lucille: Thank you.

Steve: What an ordeal, right?

Lucille: Yes.

Steve: You have a 25 year old son. He has a skin rash. He goes to a dermatologist clinic. They start giving him medicine, corticosteroids and what, about a year and a half later, he starts having hip pains, correct?

Lucille: Yes.

Steve: How has this whole thing affected him, and you, as well as your husband because everybody lives in the same house now....?

Lucille: Well actually it's a parent's worst nightmare because we never imagine that at this time in Ryan's life that Ryan would have to go through something like this. Ryan has gone through surgery that he should have never have gone through for someone his age. And it has changed all our lives. To be told that he would be ok, that he would have just minor, limited activities, but that is not true. All our lives have been changed. We have become Ryan's total caregivers. His dad and I have for him and his children. Ryan had gotten a home for him and his children but he had to move back home because we became his total caregivers. And not at one moment have we ever regretted that but it breaks our heart that our son, at this age in his life should be enjoying his life. And now we know it's never going to be over for Ryan. Ryan has undergone 3 hip surgeries and we've all come to the conclusion that he's probably going to have more hip surgeries.

Steve: Yeah, because he's only 29.

Lucille: He's only 29. He just turned 29. Ryan can't do the things he used to do with his children. Ryan can't work. Ryan can't actually sit for very long. Ryan can't stand for long periods of time. I, on the other hand, his mother, I love him very much, I am a mother, and I'm a nurse - I've been one for 30 years, I'm going to do what a mom does: I'll see that Ryan gets his meals, make Ryan comfortable, the medication... Ryan has had sleepless nights. I've been up with Ryan like rubbing him, making sure that he gets to sleep and stuff, and his kids, when his children...what really breaks our hearts is when his kids comes to us and ask me, "Nani, is this daddy's last surgery?" I mean his daughter's going out for basketball and she wants her dad to teach her but Ryan can't jump like he used to. He use to play basketball in high school and he wants to be there. He tries. He used to work but he can't do that as much as he did.

Steve: And this could've been avoided, right?

Mark: Oh, sure, absolutely. It's a complication of...not even necessarily a complication; it's a direct result of the administration of too many steroids. It just should never have happened.

Steve: What do think justice is in this case?

Lucille: That's a kind of tough one. Justice would be...actually...I'm trying to think. I look at Ryan and think that justice to me is that this should of never have happened to Ryan, at his age. I just think that justice would be if my son could have one day without pain. One day without suffering or hearing "you know momma, my hip hurts," again or he's itching to the point where he makes himself bleed. You know the justice is that I think in the medical field, just speaking because I'm a medical professional that we need to open our eyes; we need to be more in tune to what our patients are saying to us and listening to what their complaints really are.

Steve: Well thank you very much for being there for Ryan.

Lucille: You're welcome.

Steve: You're his mom....he's lucky you're his nurse and you know, you've really risen to the challenge. Your law firm is doing a great job for you guys. That's why we're doing this show - because it's very unfair to Ryan.

Lucille: Yes, it is.

Steve: Thank you for being on the program. Today, we are very fortunate to have one of the leading hip experts on our show, Dr. Mauricio Herrera. Welcome to the show.

Dr. Herrera: Thank you.

Steve: Explain to our audience a little bit about hip replacements, why they're needed, etc...with your model of the pelvis there.

Dr. Herrera: Well, the basics of the hip are that the hip is a joint. A joint is a ball inside of a socket and in this model you can see what a general hip would look like. This is what a normal hip would look like. The ball is nice and smooth. You have a cartilage layer. The cartilage covers the bone and the fits in the socket quite nicely. But what can happen is, such as in a situation when a patient does take corticosteroids, by mouth or by injection, the blood supply to the ball portion can actually die and the bone can die and term for that is avascular necrosis. And unfortunately when that happens, when the blood supply gets distorted to the ball portion of the hip, this will die and the joint won't work like a normal joint anymore and the patient will have a lot of pain, and discomfort, and disability because of that.

Steve: Therefore, it has to be replaced with a mechanical type.

Dr. Herrera: Correct, and so when something bad happens to the hip joint then we are able to do an artificial hip replacement which is called a total hip replacement when you change the socket and you change the ball. The ball fits in the socket and that's what the new joint looks like and that's what a total hip replacement is.

Steve: Now this is the hip that Depuy manufactures but this is the one that was recalled, right?

Dr. Herrera: Correct.

Steve: Because it has too much...

Dr. Herrera: You can actually see all the erosion of the metal on the implant.

Steve: What kind of metal is that?

Dr. Herrera: It's called cobalt chrome which is just a combination of different metals melted together.

Steve: Now let me ask you when the FDA approved this, there was no way for them to determine over a period of time that it would end up with this kind of result?

Dr. Herrera: Correct. Many times companies, when they put forth an implant, really won't know till a 20, 30, 40 year follow-up how a hip is going to do. Unfortunately, this particular hip had a high rate of failure.

Steve: Is Ryan's case a typical case where you have too much corticosteroids injected into the hip?

Dr. Herrera: Yes. Actually, it's a very common occurrence. This avascular necrosis, or when the bone's blood supply gets distorted unfortunately many patients do take corticosteroids for various reasons, especially asthma. Asthma is the number one reason why someone would have to take corticosteroids for treatment. So, avascular necrosis is more common than you would think.

Steve: Okay, great. Well thank you very much for being on the program. You provided a lot of valuable information.

This case is of tragic proportions here. How do you decide which cases to handle, which cases to represent?

Stewart: We look at each case individually. We look at the client. We look at what their injuries are and we try to help people who need access to justice in the court room. These are people who can't afford to fight major corporations such as Johnson and Johnson or this dermatological clinic on their own. We invest our time, we invest our money. And we try to help them. We get justice.

Steve: When you look're talking about know often times and I've heard this many times, the defendant may offer a meager, measly, little settlement you know ...10,000 dollars or something like that. Now in Ryan's case it's going to require a lot of money to do these hip replacements for the rest of his life. How do you know whether you want to take a case to trial or whether you want to settle the case?

Mark: Sure. Well Steve, Stewart and I, between us, have about 50 years collectively of experience. We have what we feel is a good understanding of the relative value of cases. So, what we do is we sit down with the client. Once we feel an offer is reasonable compensation we'll sit down with the client and advise the client.

Steve: ...based on other cases of a similar nature?

Mark: Absolutely, based on other cases of a similar nature. Ultimately Steve it's up to the client. Our job is to council the client and advise the client whether or not we think it's a fair and reasonable settlement.

Steve: Okay, great. I hope that in Ryan's case you reach a fair and reasonable settlement because he certainly deserves it. I want to thank both of you for spending time with us today.

Steve Murphy (Voiceover): Thanks for joining us. You can find more information about our guest and the issues at

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