Welcome to Trial Lawyer Talk. In this episode, Scott interviews Conroe, Texas-based lawyer Paula Estefan, who covers personal injury and medical malpractice cases all over the state of Texas. She shares a story of a compelling wrongful death case, as well as some of her insight into the world of medical malpractice cases, and how financial incentives that we never see affect the medical care that we receive.
Transcript for Trial Lawyer Talk, Episode 10, with Paula Estefan
Scott Glovsky: Welcome to Trial Lawyer Talk. I’m Scott Glovsky and I’m your host for this podcast, where we speak with some of the of the best trial lawyers in the United States. Today, we’re have with us Paula Estefan. Paula is an amazing medical malpractice lawyer and personal injury lawyer in the state of Texas. Her office is in Conroe, Texas, but she handles cases all over the state.
She’s going to share with us a very interesting story from a wrongful death case, in which she had a relationship with a young woman who passed away outside of the courtroom. She’s also going to share some of her insight into the world of medical malpractice cases, and how financial incentives that we never see affect the medical care that we get. Hope you enjoy it, let’s get started.
We are very fortunate today to have with us, Paul Estefan, who is a phenomenal, amazing, giving human being, and a wonderful trial lawyer from Houston, Texas. Paula is the go-to medical malpractice person in Texas. Thank you very much for being with us.
Paula Estefan: Thank you, Scott.
Scott Glovsky: Paula, is there a case that you’ve worked on that had profound impact on you?
Paula Estefan: Yes. First. I’d like to thank you for having me here, and for the nice words you said about me. But I’m more than willing to share a story with you about one of my clients. Chelsea came to me through her grandfather when she was about 16 years old. Her mother had died from an accidental overdose.
She’d gone to the hospital and they thought she had purposefully tried end her life. So they transported her out to another hospital, where she had recently been without any life support, and by the time she got to the second hospital she was gone.
Chelsea’s grandfather brought her and her brother, Chandler, into our office. We pursued that case for them, and got a settlement about the time that Chelsea was 18 years old. Chelsea didn’t have a mom and didn’t have a grandmother. Throughout the years of representing her and her grandfather, I became pretty close to her.
When she got the settlement, I took her to the bank, and we opened an account. We did a structure thing, and I was concerned about her. We were so close, that sometimes she would refer to me, teasingly, as her mother, because I would try to keep her in line.
Scott Glovsky: How did that feel?
Paula Estefan: Oh, it felt good in a way, and sad in a way. She stayed in touch with me throughout the years. She would come to me when she needed advice and that kind of thing. It was different, but a special relationship for me.
Then when Chelsea was about 25 years old, she was involved in a house fire. She was on Vicodin, and didn’t get out of the house and burnt to death. Her grandfather came to me, and was very upset, and wanted to know if there was anything that could be done for her brother who was younger than her. He was concerned because he was elderly and he was afraid Chandler would be left with nothing.
I looked into the case, it was pretty evident to me that a lot of it was her fault, for being on so much Vicodin, that she couldn’t get out of the house when everyone else did. I took the case anyway; my law partner thought I was crazy. I thought I was crazy too, but I was hoping somehow, maybe the stuff that I learned at TLC might help me get in touch with what actually happened, and why. Even though Chelsea may have had some responsibility, others did as well.
Scott Glovsky: Can you tell us a little bit about that fact that you’re taking a case for someone who you knew, someone who called you mom, who’s now dead?
Paula Estefan: It was heartbreaking. When I got the autopsy, it was more heartbreaking. This was not a sudden death, this was not a painless death. I started researching some of the things that I found in the autopsy that I just didn’t… Since I do a lot of medical malpractice I know that things put in medical records and autopsies, sometimes I call it kicking out of normal range, meaning they pique my attention, may mean something.
I noticed in her autopsy that she had bitten her tongue in two, that is what a person does when they experience the most extreme amount of pain that a person can suffer. The pictures were horrific. The thought of her dying in that manner in the corner. She finally found herself in the corner of the room because she couldn’t go any further, and she was trying to get down as low as she could to the ground. I can’t imagine anything much worse than that.
Scott Glovsky: Did you have a mental block? In other words, you’re representing some who you cared about.
Paula Estefan: I didn’t want to go there. I didn’t want to let myself actually know what she went through. No, I did not. Of course, there was a mental block. I don’t know if I would want anyone to go through that, much less someone that I cared about. I was afraid that that was going to keep me from being able to even look at the case objectively at all.
Scott Glovsky: Did it?
Paula Estefan: To some degree, yes. Until I realized that mediation was the next day. I’m thinking, I’m going to go in this room and I’m going to talk to an adjuster and a mediator, and her grandfather is going to be there. I care about him deeply, and this is going to be very difficult. I’m not sure that I’m the right person. I’m not sure I’m the right one to walk in that room on her behalf.
So I’m standing in my bathroom, that morning, and I’m worried. I’m up early because I’m panicking. I don’t want anybody to know that I may not be the right person, and I know I’m not. So I think about it for a few minutes and then I decide that the only way I’m going to be able to tell this story, is if I reenact her death.
I’m by myself, this group of lawyers working with me, or group of people, it’s not an involved reenactment like sometimes we do through TLC. It’s just me, and I let the heat begin. I start feeling what she’s feeling.
Scott Glovsky: Take us through that process.
Paula Estefan: Well, I wake up, I lay on the floor, and I realize that it’s dark and I can’t really see what’s going on, but I smell smoke. I can hear voices around me, and I know that something’s happening, and that it’s not making sense to me. I start realizing that it’s getting hotter and hotter, I’m disoriented, and I can’t figure out where to go.
The room is full of furniture, I’m sleeping in the spare room that’s full of furniture, and I can’t figure out what should be where. I’m crawling over couches, I’m crawling over the bed, under the bed, and I’m trying to figure out what to do and I’m panicking. I’m screaming out, “Ross, Ross, come get me. Ross, don’t leave me.” I know my boyfriend; I don’t hear his words anymore.
I’m starting to feel fire, and I have long brown hair and I’m starting to feel it burn. I start to feel my skin burn, and I’m on the floor trying to find the door. I know there’s a door here somewhere. I get over to where I can’t walk, I can’t crawl anymore, and I try to protect my face and my chest. I crouch down until I can feel my flesh burning off of me. I clench my teeth as tight as I can around my tongue, until I literally bite it in two.
I’m crying and screaming, and no one is coming. I know it’s over. I know this is the end. This is the way I go. Yeah, I might not have been the most perfect kid in the world, or the perfect woman, girl, granddaughter, daughter, but I didn’t have this coming. I know she didn’t have it coming.
I go to the mediation in a whole different frame of mind than I was 20 minutes earlier. I know that not only am I a person that can tell this story, I am the person that can tell this story. I knew her, at that point, better than anybody left in her life. I knew her better, and I knew what she went through. I knew what it was like, because I did that death, I lived that death, I died that death.
I knew when I went in that room, that probably the people in there were going to be incredibly uncomfortable with the presentation that I was going to give, that they had no idea was coming. I also knew that her grandfather couldn’t watch what I was fixing to do. So when the mediation began I asked him if he wouldn’t mind leaving the room, and he did.
For about 15 minutes, I reenacted something nobody in that room wanted to see, deal with, look at, or feel. My law partner was so incredibly uncomfortable, but not nearly as much as the adjustor, the defense attorney, who had just gotten a new grandbaby, and the mediator.
By the time I was done, nobody else wanted to give an opening statement, it was pretty much over. Everyone flew to their separate rooms after the mediation, because it was pretty uncomfortable.
Scott Glovsky: Can you share with us, what you did in that opening presentation?
Paula Estefan: Something extremely similar to what I did in my bathroom. I didn’t hold much back. But it was just getting into that emotion, doing that before I went into that room, and them knowing that any part of that might be in front of jury is not something they wanted to see. It was just very powerful and uncomfortable.
It was a short mediation, they pretty much just said, we really don’t think you could ever do that in a courtroom. But I could tell by the look on their face that they weren’t 100% sure I couldn’t, and they were willing to pay the policy to not have to take that risk, and they did.
Scott Glovsky: How did your connection with your client, knowing her before she passed away, make it harder and easier to handle that case?
Paula Estefan: It made it harder at first, because I didn’t really want to think that she was gone. I was out of town when she died, I didn’t know it, and I didn’t go to her funeral. So I never really had a chance to think about it. For that to be my focus for an hour, in a funeral, or that to be my focus and to go through a grieving process.
So I thought maybe I’m not the person. But because of the history I had with her, because of things she had shared with me, that she would have shared with her mother, like her graduation from high school, and her romances. She would call me for relationship advice.
She called her grandfather Pa. She said, “Pa is just not a girl. I need a girl in my life. I need a woman in my life. I need someone that is like me.” So we had that special connection. Just like I say, if you don’t have the family you need, you usually go and find the family you want, maybe that’s the other way around, either way it works. But she didn’t have what she needed, and she found what she needed in me to some degree. I think that made it difficult, and maybe the right person to do it.
Scott Glovsky: Did you have any guilt at all? Not that you had done anything wrong, but just that someone who you cared about, and who looked up to you, couldn’t solve her problems.
Paula Estefan: The part that really brought me guilt was the fear of giving her money, and what that might do to change her life in a not positive way. It’s always frightening for me as a lawyer to give, and I’m not going to limit it to young people – I will say all people, to change their life or lifestyle with money. Sometimes it feels like it’s really insufficient, it doesn’t replace the harms, the damages, that they have suffered.
I have seen it from time to time change people in a negative way. So I’m always concerned when a settlement comes through. I tell the people that I represent, do something with this that would honor whoever passed away. Do something with this that they would look down and go, had I lived, I would have seen that Chelsea had this or got this, or did this. So I always have concern, but that is the way or system works. I just try to make it the best that I can at that juncture.
Scott Glovsky: Do you think that the settlement of the earlier case gave her money that enabled her to continue in maybe a bad path, or making bad choices?
Paula Estefan: I think Chelsea had a lifestyle to begin with, that was a template from her upbringing, that was negative. So I’m not saying that a settlement made her do negative things, she was already on a negative path. I think I did see things that she did with that money that were very positive.
I went down to the bank with her and we figured out how to purchase her a home for herself. She had a job, and she was starting off on the right track. Part of the structured settlement gave her the ability to buy her own home at a young age, which was great. She was very proud. I was very proud of her for doing that. I think it’s something that would have honored her mother.
But I do think that Chelsea was left without parents at a very young age, and she had a tendency to get into trouble. I worry, and I sometimes feel guilty that additional money may have helped her down that path.
Scott Glovsky: That’s an interesting connection that her mother passed away earlier, which that sounds like that was what the first case was about. Would you share with us what happened, what her loss was?
Paula Estefan: Her mother?
Scott Glovsky: Yeah.
Paula Estefan: Her mother’s mother died four days before Chelsea’s mother died. Chelsea’s grandmother died four days before Chelsea’s mother died. Chelsea’s mother had a prescription to Vicodin, and she was over-medicating because of her loss.
She had been in another hospital for some stomach problems that was about 30 miles away. So when Pa took her to the hospital, he said she’s overdosed, and they just turned her pretty much away. They put her in a room. They didn’t even put a monitor on her.
They did an assessment, and asked her if she had been recently hospitalized, and she said yes. So they said we need to take you back to the hospital that you originally were at. In essence, patient dumping, because they thought she didn’t care enough about herself to live. Therefore, they didn’t care if she lived either.
Scott Glovsky: How old was Chelsea at that time?
Paula Estefan: She was 15.
Scott Glovsky: So would you have ever taken the case over Chelsea’s death, had you not had a connection with Chelsea?
Paula Estefan: No. No, I wouldn’t have. I wouldn’t have known Chelsea’s story.
Scott Glovsky: You took this case, and obviously did a phenomenal job, but it’s very thought-provoking that a client that you have a connection with, that you were there for her first, not first, but first significant tragedy in her life in losing her mom. Then had a relationship with her, and then after her passing are still helping her, still connected to her.
Paula Estefan: That’s not unusual for me to stay connected to clients like that. I have another one right now that I’m connected with, whose father passed away. He died probably in 2007, and I still correspond with her almost weekly. Went to her wedding, I’m sometimes the surrogate mom, even though it may be a dad. Those kids need guidance. They need mentoring. They need a wind beneath their wing. They need something that’s missing, and sometimes I get in that role.
Scott Glovsky: What do you say to all the law school professors that say, ‘don’t get connected to your clients, don’t get close to people, be analytical and objective, and a lawyer’?
Paula Estefan: I was fixing to say, ‘stay in law school,’ but really we don’t want them there, do we? I realize that this is not an easy job. There are sad stories that come in my office daily. At first I did distance myself from the heart of those stories, it’s difficult, it’s painful. But I can’t do this any other way.
I don’t know what to tell those law professors, other than maybe you need to come to a TLC event and see what the difference is, when you really care about people, and when you really want to change their lives. Not just hand them money, not just go down to the courthouse and be, what one of my clients called me early on, was their microphone.
If you want to be their microphone, you’re not changing their lives. You may change their bank account. You may change…well you won’t change how they view lawyers. But if you really want to change their lives you’ve got to let them in your heart. You don’t have any choice, you have to. If you can’t do that, then maybe you should go be in the oil and gas field. I don’t know.
Scott Glovsky: What are the ingredients to be a great trial lawyer? What are your secrets?
Paula Estefan: Thanks for calling me a great trial lawyer.
Scott Glovsky: Do you feel like a great trial lawyer?
Paula Estefan: I feel like a caring trial lawyer. I think great is defined in a lot of different ways. It’s like people talking about success. I feel successful, because I think I’ve changed lives. I know I’ve changed hospital policies and procedures. So I don’t have to have more people walk in my door. I have enough people walking in my door.
I would give anything to change the medical profession. I would give anything to change the system and what’s happening out there. If my door’s closed, because nobody else got hurt, I’m okay. I’m good with that. So that’s pretty much how I feel.
I do feel like a successful person, and then a successful lawyer, but that’s through relationships, that’s not through bank accounts. That’s not through associations that send me congratulations you’ve been chosen as the top whatever, that’s not success, that’s paper.
Scott Glovsky: I cut you off. I’d asked you about the ingredients to being, and I’ll change my question to being a successful trial lawyer.
Paula Estefan: Okay. Well, I think you have to, number one, care about your client. You have to know the real story, not the story that they tell you when they come in the door. Not the story you try to tell them when they come in the door, because I’ve been guilty of that. Once you find that real story, I think you’re unstoppable.
We can talk about the legal stuff and all that other mumbo jumbo, but once you know that story, and I mean you’ve reenacted it, you’ve lived it, and you’ve peeled back all those layers. It’s hard to stop a lawyer that knows that story and cares about that story. It’s extremely hard to stop that, I truly believe that.
Scott Glovsky: You mentioned earlier about all of the bad things that are happening in the medical profession. Can you share with us, from your view, what’s happening? What people don’t understand in the lay public?
Paula Estefan: Yeah. What’s going on right now is extremely complicated, complex, and it’s meant to be, and it’s purely financial. I talked to other med mal lawyers all the time, and I say, you’ve got to follow the money. There’s contracts underneath, I call it the tent, that are out there, that are directing medical care that you have no idea about.
They say, oh that’s fine if you have that case, but I don’t. I say, you do, you don’t know it. Because almost, I would say 85% of the medical decisions being made today, where you’re treated, how you’re treated, what you’re treated for, are strictly driven by money. Corporations, contracts between doctors and hospitals, that you have no idea about.
Doctors tell you that you can waive your deductible if you’ll go to a certain facility, because they get a 30% kickback from the hospital, for facility use fees. People have no idea. You can go to a hospital, if you go to a hospital that’s physician-owned, by law they have to tell you that, they’re not.
Obama said no more physician-owned hospitals would be built in the United States of America, because they’re dangerous. They look like spas, hotels, they’re beautiful. In fact, I call them a beautiful place to die, because they can’t support complications if they have them. They will take people in for surgery, and when they can’t keep their airway open, they call 911.
It’s unfathomable to me that people come in my office, and they go, I should have done something. I should have known he was not okay. I’m thinking, you shouldn’t have to dial 911 when you’re in the hospital. The hospitals are dialing 911. Physician-owned hospitals continue today, they’re still building them, they’re still dangerous, and people are driven to those hospitals through financial agreements with doctors, and it’s huge money.
I have one client now, that a day surgery was $300,000 and something. If they get you to agree to go in on an outpatient basis, then they don’t have to get pre-certification from your health insurance company. So the health insurance company can’t even know what’s going on, until it’s too late, and they’re faced with a $300,000 bill, and client who is either dead or severely injured. Because that hospital, the five bed facility, couldn’t support his or her complications.
Scott Glovsky: Wow. What advice do you have for patients to try to avoid, to be safe?
Paula Estefan: Keep up with what’s going on politically. The only place that nobody’s telling lies is on, believe it or not, the Congressional floor. Because the general hospitals, and the physician hospitals are tearing each other’s eyes out. They are jealous, it’s huge money. So they are giving sworn testimony against each other, about why they are so dangerous. It’s only place you’re going to find the truth.
Scott Glovsky: So how can people access that?
Paula Estefan: Internet, that’s how I do it. You go in, and that’s how I discovered it. I found an odd document in a medical record. I Googled ‘physician-owned hospital death,’ and all kinds of political information popped up. I’m like, ‘what is going on here?’ I had no idea. I just did tradition med mal like everybody else. That case changed everything for me.
Scott Glovsky: That sounds like you’re leading a crusade to spread the word, and stop the physician-owned hospitals.
Paula Estefan: That’s a huge crusade, there are many people on that crusade. Right now, the baby boomers are going through the medical services, they are needing more services. Because they’re getting to the years where they’re getting heart conditions, and things of that nature.
As they’re going through the glut of them, it’s going through the medical professions, it’s booming. The money is even bigger, and the bigger the money the harder the fight. They’re not going to give that up. This is retirement money for a lot of doctors and hospitals. The number of baby boomers is huge. So I’m always on a crusade, I’ve been on this crusade since 2009. I’ve gone to different places like TTLA, places like that –
Scott Glovsky: That’s the Texas Trial Lawyers Association?
Paula Estefan: Right, tried to get an ear. What I’m saying, it sounds unbelievable and complicated. I think as a person, it shocks our consciousness so that we don’t want to believe that is going on, because we can’t get sick. If that’s really going on, how do we walk into a hospital and trust them to actually take care of us, and not up-code us, because they want more money for high diagnosis than a cold. Then it becomes a flu or asthma, or COPD, they get paid more for that. So how do you trust them not to up-code you? You don’t know. At some point, it’s just trust.
Scott Glovsky: That’s incredibly scary.
Paula Estefan: It is scary. It’s very scary, and that’s just the tip, that’s just a piece.
Scott Glovsky: Wow. Paula, thank you very much for joining us today. Thank you for the tremendous gifts that you give to your clients every day, for the fight, for the caring, for the compassion, and for the help that you give people. Not to mention your wonderful role in teaching lawyers around the country how to be great trial lawyers, which you are.
Paula Estefan: Thank you. And thank you for what you’re doing. By what you’re doing, you help more of us get out the message of what we’re all trying to do at Trial Lawyers College, and you’re part of that too. I’m glad you’re here.
Scott Glovsky: Thank you for those kind words.
Paula Estefan: You’re welcome.
Scott Glovsky: Thank you.
Paula Estefan: Thanks.
Scott Glovsky: Thank you for joining us today for Trial Lawyer Talk. If you like the show, I’d really appreciate if you could give us a good review on iTunes, and I’d love to get your feedback. You can reach me at www.scottglovsky.com. That’s S-C-O-T-T-G-L-O-V-S-K-Y. com, and I would love to hear your feedback.
You can also check out the book that I published called Fighting Health Insurance Denials: A Primer for Lawyers, that’s on Amazon. I put the book together based on 20 years of suing health insurance companies for denying medical care to people. It provides a general outline of how to fight health insurance denials. Have a great week and we’ll talk to you in the next episode.
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