The son of a cardiologist, Joseph Balesteri has always had a special interest in the medical profession. He was also a natural at the art of discourse, and relished the responsibility and potential impact he could have as an advocate. Combining these passions and talents led him to the field of medical malpractice and negligence.

He originally worked on the defense side, but found his true calling representing catastrophically injured plaintiffs. Two decades later, he has recovered nearly a billion dollars for his clients and their families, including many record-breaking verdicts and settlements. Balesteri is a partner at Power Rogers, based in Illinois.

Lawdragon: Can you describe for our readers the focus of your practice?

Joseph Balesteri: My concentration in the practice of law has been in the medical field. When medical care and treatment causes catastrophic life-altering consequences to the patient and/or family, I will determine if there was medical negligence. Experts from all over the United States will provide opinions and a civil lawsuit will be filed to obtain redress if appropriate. This focus has permitted me to obtain knowledge in all areas of medicine that parallel a medical school education, which instead of lasting four years, continues today — now for 25 years.

LD: Did you consider medical school originally?

JB: I always wanted to be a lawyer only because there is nothing comparable to being responsible for another person other than parenting. Being a lawyer is an unbelievable privilege that requires trust. Advocacy, arguing, and talking are oddly enjoyable to me, sometimes to the annoyance of my family.

My father is a cardiologist. Medicine was always interesting to me, but I didn’t want to answer the phone at all hours of the night and make sleep-interrupted decisions. I gravitated towards defending healthcare providers because of my dad. That lasted five years.

LD: Then you moved to the plaintiff side. What are some aspects about the work that you find professionally satisfying? What keeps you excited about it?

JB: The best part of my career choice is a lawyer must master medicine to talk about it. You have to be comfortable to ask complicated questions and smart enough to listen and follow-up without getting misled or off-track. You have to study every day or you will fail. That’s pressure I relish.

Our system isn’t eye for an eye, tooth for a tooth. A patient client can’t possibly understand, advocate, argue, and discuss medicine in a recorded session with doctors in their arena, their medical specialty. In a room of lawyers, it’s me versus the entire defense team. Unlike other injury cases, in medical malpractice it’s one against many.

I treat the occurrence like it happened to my family. I love the challenge of proving the merit of the case to the room. It’s an exhilarating adrenaline rush similar to success in sport. The David versus Goliath fight makes the work even more rewarding.

LD: Out of all the work you’ve done in your career, what would you say is the most interesting matter you’ve handled?

JB: Nguyen v. Bradley Allen, M.D. Dr. Allen was a world famous cardiovascular surgeon. He was married to Jaclyn Smith from the TV series “Charlie’s Angels.” He did a mitral valve repair in Chicago on a college student who had shortness of breath on exertion. He tried a new approach to the valve from a lateral incision so he consented her for permission to videotape the procedure. After the procedure, she suffered “locked-in-syndrome.” Records and videotapes were requested. Records were provided. No tapes. A lawsuit followed alleging failure to properly de-air the heart’s chambers before releasing the aortic cross-clamp permitting air embolus and devastating neurologic damage in a 19-year old.

An order of preservation was entered for all video footage. Dr. Allen had both a camera over the operating table and he had a camera on his head. Tapes were produced without sound. One of the tapes went black for hours and showed very little of the surgery. I watched the black tape for hours thinking that it was strange that there wasn’t static but rather blackness. Then, quickly and almost eerily, parts of two commercials appeared for 10 seconds. The first was “More Great Escapes of World War II.” The second, a commercial for Santa Monica BMW. All on a tape of a surgery done in Chicago. The commercials were run four days after the court ordered no modifications to the tapes and required their production.

I was in my early 30s. I brought the evidence to the partners. I wanted some advice on how to handle the deposition. One of the partners, Todd Smith, tried to take the deposition, instead of me, after hearing what was there. Joe Power overruled him. Joe told me to videotape the deposition and to scatter the relevant questions throughout the deposition so not to tip my hand. Dr. Allen admitted to living in Bel Air near Santa Monica. He acknowledge the court order and that he produced all tapes to defense counsel without difficulty. He admitted that the tapes were intact and without modification. The tapes were found at his office in Chicago. They never went on an airplane. He denied that his entire surgery was ever captured on video. He denied that there was audio. He testified that his de-airing technique was not captured nor the release of the cross-clamp on purpose and all recording had been stopped long before.

He was confronted with the commercials. He had no explanation. Later he produced more footage with audio. The tapes exposed the release of the cross-clamp while the patient’s head was level with her heart — not in Trendelenburg position as it should have been — shortly after a TEE image showed “a lot of air” in the heart chambers per the audio. I watched a real valve surgery to prepare. There were 10 defense experts defending everything done in the case including the current president and vice-president of the Society of Thoracic Surgeons who went to bat for Dr. Allen. I did all of the depositions of all experts for both sides except one. The case settled at trial for $20M.

My attention to detail paid big dividends for the client who could not speak. My expert, who is now a life-long friend, was brought up on charges for his testimony in front of the Society of Thoracic Surgeons. He refused their request to share all future depositions with the Society for their evaluation to escape censure. He and I spoke for someone who couldn’t. It was like a Hollywood movie from start to end.

LD: That’s incredible. How about recent matters, any standouts?

JB: A young lady, a minor, who got great grades and was a cheerleader, had a sore throat and problems with painful swallowing. Her labs showed she was dehydrated. She was admitted for days. No one imaged her neck. She had high fevers and was growing more and more tired by the day. Her labs showed a worsening infection. A decision was made not to transfer her to a Children’s Hospital. Thereafter, feeding her became the focus of her attendings. A nasogastric tube was placed in a very painful effort. An x-ray showed the tube remained coiled in her neck — it had not reached anywhere near her stomach. It was removed. Doctors next decided to lay her flat to get feeding access “comfortably.” No sedation assessment was done. The results were a cardiopulmonary arrest leading to catastrophic brain injury. No one identified the abscess in her neck even after the tube coiled due to obstruction. They couldn’t intubate. The case resolved for $40M, a record for brain injury to a minor.

LD: Wow. What challenges did you face in representing this young woman?

JB: Trying to provide for her future was the main challenge. Her parents obviously wanted her to have the best-of-the best to promote recovery. A hyperbaric chamber was purchased. Flights to intensive rehabilitation sessions outside Illinois have been occurring. An entire home has been modified for care and therapy to be provided daily. She needs the care for the rest of her life. Annuities were acquired as part of the settlement to pay for care guaranteed for her entire life.

Both sides — lawyers, doctors, and a hospital — figured out a way to get this beautiful young lady what she needed within two years of the occurrence in an adversarial legal system. It was a big relief to her parents who needed to work and help with 24-hour care needs for a growing young lady.

LD: Aside from the incredible result, is there something about this case that you will find especially memorable?

JB: I give a lot of credit to defense counsel Mike Slovis of Cunnigham Meyer & Vedrine, and his clients and their multiple excess insurers. They did what was right without unnecessary delay and treated my clients with dignity and respect. That says a lot about them. It is refreshing for all sides to move to help quickly and is forever memorable.

LD: It is always impressive and inspiring when both sides of the “v” are working together. Any other cases from your career that stand out? I’m sure there are many…

JB: Here’s one more. William Rooney was in his 70s when I tried to prove that a cervical epidural injection and delayed response to his post-injection symptoms left him a quadriplegic due to negligence. He lived alone in a bed in the center of his living room. He had a mastery of Chicago history and the lessons it taught. He shared stories about his family and upbringing. He had an interest in mine as a lawyer and a husband without a family of my own yet. We talked about life and family seemingly weekly. Partly it helped him pass the time. For me, I learned tons as we together tried to right the wrongs done to his life. We were friends during and following his lawsuit until he passed. No one witnessed that friendship but I spoke of it often to my friends, colleagues, and family.

LD: That’s beautiful. Backing up a bit if we may, what was your path to your current position at Power Rogers?

JB: I wanted to work for the best plaintiffs’ medical negligence firm in Chicago. I worked as a law clerk while attending law school to prepare me to be a defense lawyer. Joe Power was the top lawyer in the field in 1996 and remains so today. I got lucky getting hired as a clerk after my first year. Five years later I got luckier when the firm asked if I would return as a lawyer. I will always be loyal to this law firm.

LD: No doubt that makes you a strong advocate for the firm, when it comes to potential clients.

JB: The best advertisement are case results. I keep a list on the firm website of every successful case with a description of facts and court details from my first year at Power Rogers in 2000 until today. I don’t talk bad about our competitors, as there are many great lawyers. I just want the client to pick a lawyer they are conformable with, as this is the biggest decision of their lives. Being aggressive and over-selling are not honest and credible. If I don’t get the case, while disappointed, it’s not about me. The client is all that matters.

LD: Does your firm provide any professional development opportunities that you have found particularly valuable?

JB: My partner, Joe Power, invited all firm lawyers to attend conferences with the Inner Circle of Advocates during his two-year presidency. I watched the nation’s top plaintiff trial lawyers present cases and strategies for cases over each multi-day conference. This inclusion of what I call “The Outer Circle” at the meeting has had a major impact on my practice and focus. I have made friends and connections with some of the best of the best because of Joe’s generosity and guidance.

LD: Very cool. Did you have an early mentor who helped shape the course of your professional life?

JB: Robert E. Nora from Hinshaw & Culbertson when I was a defense lawyer, for those five years. He had advanced multiple sclerosis that was late onset. He took the train to work. He taught a group of us literally everything. He prepped with me for depositions, and watched me take them. He made me do so the first day I was licensed, totally solo. He read my depositions and gave feedback. He taught me the relevant case law and the medicine, as he came from a family of physicians. I still use his case law system today. He taught me about respect. About paying compliments forward. He was, and is, an example of hard work and perseverance. Luckily for him what his arms and legs didn’t permit, his brain and mouth did. He is one of the smartest and kindest people I have ever met. His remains inspirational and motivational to me. He was ultimately deprived of the practice of law through a disease he did not contribute to, but his practice of law does in fact still occur today, through those he taught and mentored. Definitely through me!

LD: I love that. He sounds like a real inspiration. How would you describe your style as a lawyer, Joe? Or, how do you think others see you?

JB: I would say I’m ready to challenge the defendant and his or her defenses as if the injury occurred to my family.

Others would say, I think, that I’m prepared, challenging, aggressive, condescending, and mocking.

LD: Do you have any advice for current law school students?

JB: Plan to work hard. Make your parents proud. Don’t expect to be catered to; do the catering to your clients and your law firm. Grind every day. Outwork your adversary. Don’t fight every battle. Get along with the other side. While trying to win is important, don’t scorch the earth with bickering and pettiness along the way. The world is round for a reason.

LD: What do you do for fun when you’re outside the office?

JB: I watch my sixth grader and high school freshman play and/or practice hockey which is like a full-time job. My wife and the boys enjoy attending sporting events, mostly Bears and Blackhawks games. We sneak away to Lake Geneva, Wisconsin in the summer weekends and at night enjoy Cabernet and Bourbon drinking.

LD: Do you have a favorite book or movie about the justice system?

JB: The 1982 movie “The Verdict” with Paul Newman. Reminds me of the stresses of law and how fighting for the underdog makes the stresses worth it. Great med-mal trial scenes makes it my favorite movie about the justice system.

LD: If you weren’t a lawyer, what would you be doing now?

JB: I would be unmarried, without kids, friendless, and unemployed as I don’t have any other skills except advocacy, arguing, and talking.