DOWNERS GROVE — Timothy Ashe has been on both sides of the courtroom.

After 20 years as a defense lawyer working for doctors and hospitals in medical cases, the Downers Grove lawyer moved over to the plaintiff side a little more than a decade ago.

It gave him a perspective of both sides of the coin — and helped him secure one of the largest settlements in Cook County's history.

Last month, the Cook County Board approved a $20 million settlement in a malpractice lawsuit after a surgery at a county hospital went awry, leaving a Chicago toddler with severe persistent brain damage.

The malpractice suit was brought by Justine Francique, whose now-3-year-old son, Keith, underwent a routine surgery in 2011 at Stroger Hospital in Chicago.

But during recovery, Keith suffered cardiac arrest and, according to court documents, a delay in resuscitation left him with permanent brain injury. Ashe, who as a defense attorney had experience particularly in instances of brain damage, represented the family.

"There are a few key documents in the medical records which showed nobody was monitoring this child," Ashe said. "There was a significant amount of time where he was not breathing."

According to the suit, Keith was a typical healthy child when he underwent surgery to repair an undescended testicle. When he suffered cardiac arrest after, about five minutes elapsed before medical personnel took action to perform CPR, according to reports. The resulting lack of oxygen left the toddler with irreversible brain damage.

The settlement was designed to ensure that the child could receive care for the rest of his life.

Regardless of his medical issues, doctors expect Keith to have a normal life expectancy, and the family is looking at considerable expenses.

"He has round-the-clock nursing needs," Ashe said. "He's tube-fed. He's incontinent. He can't walk. He can't talk. He has to be carried up and down stairs."

Ashe said that often in tort cases where there is a large payout, people will assume it is a lottery windfall for the family, but that's not the case, Ashe said. A probate court judge will monitor the funds to ensure it is spent properly.

For instance, the family is looking to move from their southside Chicago apartment into a modified home that will allow Keith to receive care. That transaction must be approved by the judge, Ashe said.

"Since it's a minor and since it's brain damage, they watch this like a hawk," he said.

Ashe also gave credit to county and hospital officials for approving the settlement almost within a year of the incident. In his 34 years as an attorney, he has seen plenty of lawsuits drag out out in court.

"The hospital was clearly negligent in this case. That being said, I do have to give the hospital a lot of credit because unlike most of the cases we see, they stepped up and took responsibility, and they made a very prompt payment," he said. "I think this was really a shining example of how hospitals and doctors should deal with cases like this."

In settling the lawsuit, county officials admitted no wrongdoing. But several hospital employees were reportedly disciplined after the incident, County Board President Toni Preckwinkle told reporters last month.

The settlement will come out of a taxpayer fund. It is one of the largest public settlements in the county's history, the Chicago Sun-Times reported.