Case #1010: Cardiology Errors
On December 10, the Plaintiff presented to a hospital with complaints of chest pain. Subsequently, a nuclear medicine stress test was completed revealing an area suggestive of ischemia. Additionally, cardiac perfusion studies confirmed that the Plaintiff’s ventricular ejection fraction was 61% — within normal limits for a man of his age. With these findings, he was transferred to another hospital for definitive treatment.
On December 12, the Defendant cardiologist performed a cardiac catheterization. At that time, he found stenosis in the right coronary artery, placed a stent at that site, and returned the Plaintiff to the coronary care unit for ongoing care. Shortly after the procedure, the Plaintiff complained of left chest pain. His signs and symptoms were such that the Defendant was notified by nursing and the Plaintiff was taken back to the laboratory for a second catheterization.
Thereafter, the Plaintiff was again returned to the coronary care unit where he alleged that he continued to complain of chest pain. Subsequently, at approximately 5:30 a.m. on December 13, a twelve-lead EKG was completed which the Plaintiff alleged confirmed an evolving cardiac process which required immediate intervention. The nursing staff at the hospital did not immediately inform the Defendant cardiologist of the abnormalities present on the EKG. Moreover, when the Defendant cardiologist was informed at approximately 9:00 a.m. of new EKG changes, he nevertheless discharged the Plaintiff to home. As a result, the Plaintiff was discharged with none of the required intervention provided. In essence, he was a walking time bomb for a myocardial infarction.
The following year, the Plaintiff alleged that he suffered with shortness of breath and fatigue such that he saw his primary care physician on March 4. That physician referred him back to the cardiology group on March 5, at which time the Plaintiff was seen by a partner of the Defendant. That cardiologist noted abnormal changes on his EKG taken that day. As a result, the Plaintiff was referred for exercise tolerance testing on March 14, and, during the test, developed ventricular tachycardia, requiring discontinuation. The Plaintiff was then transferred to the hospital for repeat cardiac catheterization, which confirmed the fact that the Plaintiff had suffered a severe myocardial infarction. The Plaintiff claimed this was the result of the Defendant’s failure to recognize the evolving process and treat the Plaintiff prior discharge from the prior hospitalization.
The Plaintiff suffered a severe myocardial infarction reducing his ejection fraction from normal limits to 30% — in essence, rendering him a cardiac cripple. The Plaintiff required implantation of a pacemaker in an effort to help stabilize his heart, and was discharged on March 19.
The Defendant denied all allegations of negligence, causation and harm, contending that the Plaintiff was asymptomatic at the time of discharge and that the post-catheterization EKG did not demonstrate acute signs of an evolving myocardial infarction. Moreover, the Defendant argued that, in any event, the Plaintiff failed to follow up with the cardiologist as instructed and that there was no opportunity to provide treatment which would have avoided myocardial damage.