The Delaware Supreme Court affirmed a Superior Court judgment in favor of Delaware Neurosurgical Group and Dr. Paul T. Boulos, M.D., in a medical malpractice case involving brain aneurysm surgery complications. The decision, issued Feb. 2, rejected patient Deanna McKeehan's appeal challenging jury instructions about how to evaluate expert testimony on surgical risks.
McKeehan filed the malpractice lawsuit after complications from an aneurysm clipping procedure performed by Dr. Boulos in 2019. The case centered on whether the trial court properly instructed jurors on how to consider medical experts' testimony about the risks inherent in neurosurgical procedures.
The legal dispute arose from a motor vehicle collision in August 2019 that led to McKeehan being transported to Christiana Care Hospital. A CT scan of her brain revealed two unruptured brain aneurysms—one in her middle cerebral artery and another in her internal carotid artery bifurcation. These findings prompted McKeehan to seek specialized neurological care.
Dr. Boulos, a neurosurgeon with Delaware Neurosurgical Group, recommended that McKeehan undergo an aneurysm clipping procedure. This surgical intervention involves placing small ligation clips across the entry point of each aneurysm to block blood flow and prevent potential rupture. The procedure is considered a standard treatment for brain aneurysms but carries inherent surgical risks.
Following the surgery, McKeehan experienced complications that formed the basis of her medical malpractice claim. The case proceeded to trial in Delaware Superior Court, where a jury heard testimony from medical experts about the risks associated with neurosurgical procedures and the standard of care required from surgeons.
The central issue on appeal concerned the trial court's handling of jury instructions regarding expert testimony. McKeehan argued that the court erred by failing to provide adequate guidance on how jurors should evaluate medical experts' testimony about procedural risks. Specifically, she contended that the court should have accepted her proposed limiting instruction clarifying that a known risk of surgery could still result from a surgeon's negligence.
McKeehan's proposed jury instruction sought to distinguish between unavoidable complications inherent to surgical procedures and those resulting from medical negligence. Her legal team argued that without this clarification, jurors might incorrectly assume that any complication falling within the known risks of surgery automatically absolves the surgeon of liability.
The defense successfully opposed McKeehan's proposed limiting instruction, and the trial court declined to include it in the final jury instructions. The jury ultimately returned a unanimous verdict in favor of Dr. Boulos and Delaware Neurosurgical Group, finding no malpractice had occurred.
On appeal, McKeehan maintained that the absence of her proposed instruction prejudiced her case by allowing defense counsel to argue that complications were merely known risks without adequate judicial guidance on how such testimony should be evaluated. She claimed this created confusion about the relationship between surgical risks and potential negligence.
The Delaware Supreme Court, in an order signed by Justices Traynor, Legrow, and Griffiths, rejected McKeehan's arguments after reviewing the parties' briefs, the trial record, and conducting oral arguments. The court determined that the trial court's jury instructions were adequate and that no error occurred in rejecting the proposed limiting instruction.
The decision reinforces the principle that trial courts have broad discretion in crafting jury instructions, provided they adequately convey the applicable law. Courts are not required to give every instruction requested by parties, particularly when existing instructions sufficiently address the relevant legal concepts.
This case highlights the ongoing challenge in medical malpractice litigation of helping juries understand the distinction between unavoidable surgical complications and those resulting from negligent care. While all medical procedures carry inherent risks, patients may still recover damages when complications result from a healthcare provider's failure to meet the appropriate standard of care.
The ruling may influence how Delaware courts approach similar jury instruction disputes in future medical malpractice cases. Defense attorneys will likely point to this decision when opposing proposed limiting instructions that seek to clarify the relationship between surgical risks and potential negligence.
For healthcare providers, the decision affirms that thorough informed consent processes and expert testimony explaining procedural risks remain important components of malpractice defense strategies. The case underscores the importance of clearly documenting patient communications about surgical risks and potential complications.
The original Superior Court case was designated C.A. No. N21C-11-174, and the Supreme Court appeal was numbered No. 56, 2025. The case was submitted to the Supreme Court on Nov. 12, 2025, and decided on Feb. 2, 2026, following oral arguments before the three-justice panel.