Ryan Shuirman and Dan McLamb successfully defended a state-employed neurosurgeon in a medical malpractice trial in the North Carolina Industrial Commission. The plaintiff had been treated by the neurosurgeon in the distant past for a cerebral AVM after which residual AVM remained. Fifteen years later, the plaintiff was again seen by the neurosurgeon following an alleged traumatic head injury at work. The plaintiff alleged that the neurosurgeon should have suspected that the residual AVM was the source of his latest hemorrhage and that surgical or radiosurgical intervention would have prevented a subsequent hemorrhage and further deterioration in his functioning. The defense was able to establish that the neurosurgeon had complied with accepted standards of practice in trusting the detailed trauma history provided by the plaintiff and his plan for monitoring the patient’s brain through serial imaging following a negative, but life-threatening, four-vessel angiogram showing no AVM. The deputy commissioner additionally found that the plaintiff had failed to prove that his outcome was made worse by his last intracerebral hemorrhage as his medical records and testimony demonstrated far better objective functioning than the plaintiff otherwise contended. After trial testimony and a lengthy briefing process in which both sides thoroughly argued their positions, the deputy commissioner found that the neurosurgeon was not negligent and awarded nothing to the plaintiff.