On a brisk and biting January morning in 2018, a woman walked through the doors of Michel & Ward’s downtown Chattanooga office wearing a surgical mask. This was more than two years before COVID-19 made face coverings common. When she sat down across from Alix Michel and David Ward – the firm’s only two attorneys – she removed the mask.
What they saw stunned them.
“There was an open wound on her cheek,” Michel recalls. “It was a gaping, horrific crater.”
She hadn’t come to sue anyone – at least not yet. She didn’t even know if she still had cancer. That’s all she wanted to find out.
“She told us a doctor had removed what was supposed to be a small skin cancer,” Ward adds. “But he left her with a crater, and then wouldn’t return her calls.”
That moment launched a six-year odyssey – a David-versus-Goliath legal battle that would become the most papered case in the history of the Hamilton County Courthouse. What Michel and Ward uncovered along the way was a shifting maze of questionable medical decisions, disappearing records, contradictory testimony and a behemoth legal defense that stretched from a multi-suite “war room” at SpringHill Suites and included a carousel of experts brought in to dismantle their case.
They won anyway.
A wound and a question
The story began – medically speaking – Nov. 27, 2017, when a nurse practitioner performed a biopsy on the woman’s cheek. The pathology report came back “nodular and superficial basal cell carcinoma,” a type of slow-growing skin cancer. One of the preferred treatments for such cancers, especially on the face, is Mohs surgery, a technique known for removing tumors while preserving as much healthy tissue as possible.
The woman underwent Mohs surgery Dec. 20, 2017, at the same dermatology practice.
“She left with a baseball-sized hole in her face,” Michel says. “She had to go to the ER the same night because she was bleeding and struggling to breathe. Home health took care of her. It was a mess.”
Still, her first concern when she walked into Michel & Ward wasn’t legal redress. She wanted answers. “She said, ‘I just want to know if I have cancer or not,’” Michel continues. “She hadn’t heard a word from the doctor since the surgery.”
Trail of breadcrumbs
The attorneys say they requested her medical records that very day. A week or so later, she began receiving phone calls. First from the facility. Then from an unidentified number – 423 648-0707. That one she answered. It was the doctor.
“He said, ‘Come back in. See only me. We’ll fix this,’” Michel recounts. “That spooked her.”
The doctor told her she still had residual cancer. That prompted her to seek a second opinion at Tennessee Oncology, where she’d been seen two years earlier about a different matter. That physician promised to obtain her records. A week later, he told her the records indicated there was still cancer present.
At his advice, she consulted another local dermatologist. During her appointment, the office faxed a request to the original doctor for the surgical records. She waited for hours, hoping they would arrive – but they never did while she was there. (They didn’t arrive until the following day.)
Finally, in May, she traveled to Emory in Atlanta. By the first week of June, Emory’s dermatopathologists reviewed the records and concluded there was no cancer.
The case unfolds
“That’s when we filed the suit,” Ward says. “It was a straightforward malpractice case: the doctor misdiagnosed her and performed an unnecessarily invasive surgery.”
But nothing about the case would prove simple.
The central problem: Mohs surgery requires the surgeon to excise tissue and immediately examine it under a microscope to determine whether cancer remains. If the margins are clear, they stop.
In this case, the maps – drawings created after each of seven cuts – showed inconsistencies. Michel and Ward requested the original chart. When they finally received it, they saw red felt markings showing where the surgeon had allegedly seen cancer. But the markings bled through to the backs of the maps – creating patterns that didn’t align with the originals.
“You couldn’t make the front and back match up, no matter how you twisted them,” Ward says. “Something was off.”
Worse still, the identity of who had taken the cuts became murky. Initially, the doctor claimed to have taken all of them. Then, under deposition, he admitted the nurse practitioner might have taken one cut – the second one.
That would be a violation of CMS rules. Under federal guidelines, the same person must serve as surgeon and pathologist for every cut in a Mohs procedure. Yet no record showed the nurse practitioner’s involvement, and the doctor’s testimony kept shifting.
Michel sums it up bluntly: “This was either a Mohs surgery or it wasn’t. And if it wasn’t, then why bill it as such?”
The missing map
To clarify the record, the attorneys hired Gerald LaPorte, a forensic document examiner and former Secret Service analyst. His conclusion stunned them: the surgical map was not the original map; there had been another map.
The defense hired its own expert, reputed to be the second-best examiner in the country. He reluctantly agreed with LaPorte’s technical findings but attempted to downplay them. The maps, he argued, were “substantially similar.”
“That became their defense,” Ward says. “It was a word game. Not ‘accurate,’ not ‘authentic’ – just ‘substantially similar.’”
The most explosive moment during trial came when a pathology expert for the defense testified that a slide in question was a benign lesion called a trichoepithelioma, not cancer. He spent nearly three hours explaining it to the jury, slide by slide.
But during cross-examination, Ward pounced.
“I showed him the same slide with his handwriting on it from his deposition, where he called it basal cell carcinoma,” Ward says. “His credibility was shot.”
The expert had testified that he reviewed all slides “in the blind” – without knowing who they belonged to – to ensure objectivity. But Ward wasn’t finished.
He revealed a letter that had accompanied the slides: “We represent the defendant. If you can do this, you’ll be helping out a colleague.”
“So much for reading the slides in the blind,” Ward says. “He admitted, ‘Yes, I’m helping a colleague today.’”
Goliath v. David
The defense came armed: Multiple lawyers. A support team. Several rooms at SpringHill Suites for the duration of trial. A barrage of 5,000 pages of pretrial motions designed to whittle away claims.
Michel and Ward had no paralegals, no secretaries. Just each other – and stacks of documents so high they covered a conference room table that seats 10 people and spilled onto another.
“There were nights we left the office at 3 a.m.,” Michel says. “We worked every weekend for months before trial. This table was our war room.”
The case had 30 hearings. “Each time, a different lawyer would show up for the defense,” Ward says. “They had specialists for everything – billing, appellate issues, medical standards.”
Faith and fortitude
Michel credits something else for their success: faith.
“I had an army of people praying for us,” he says. “A friend came to the courthouse every morning to start us off with a prayer in the corner.”
Some days were grueling. “In the morning, we’d be sitting in that courtroom thinking, ‘We’re done,’” Michel says. “But by the afternoon, the defense would be in shambles. We had two people; they had an army. But we had an army of prayer warriors.”
That conviction sustained them – along with a belief in the truth of their case.
“We had one paid expert – a dermatologist from Brentwood,” Michel says. “She’d never testified before. But she withstood cross-examination like a pro.”
A physician from Emory served as a treating expert. The defense, by contrast, leaned on a multitude of paid witnesses.
A rare win
The jury returned a verdict in favor of Michel and Ward’s client and awarded her $3.3 million for medical negligence.
It was one of the largest health care liability verdicts in Chattanooga in more than a decade. And it stunned many in the legal community, where such outcomes are rare.
“We’ve had so many calls from plaintiff lawyers saying, ‘You did the impossible,’” Michel says.
The verdict was subject to statutory caps. A second trial to determine punitive damages was scheduled – but the case settled confidentially before it went forward.
A systemic hurdle
Ward and Michel say their win underscored how stacked the system is against injured patients.
“Almost every physician in Tennessee is insured by the same physician-owned mutual insurance company,” Ward says. “If you’re a plaintiff’s lawyer, you can’t find experts. We’d get people who’d say, ‘That’s an egregious case. I’ll testify.’ But when we called them back, they’d say, ‘I can’t.’ Clearly, the insurer had reached out to them.”
Their client, Michel says, is finally moving forward.
“She had her moment. She had her day of justice. She told her story.”
It was a story her doctor wanted buried. But Michel and Ward dug until they found the truth – and then exposed it.
Michel says it took everything – every evening and weekend for months, every ounce of energy for preparation, and every prayer they could call in.
Ward adds, “That’s the strength of our firm. Either of us could have done it. We both knew every inch of that case.”
And in the end, David didn’t just survive his battle against Goliath – he won.