Medical Malpractice
This is an example failure to diagnose a potential heart attack case against Kaiser Permanente and its healthcare providers.
Summary of Plaintiff’s Allegations
A 63-year-old man presents to the Defendant Kaiser Permanente’s Gaithersburg Medical Center with complaints of chest pain. Rather than evaluate the man’s chest pain, Kaiser Permanente instructs him to return to the office in two days. When he returns, still complaining of chest pain, his primary care physician orders an electrocardiogram (ECG) study. The primary care physician determines that the study is normal and sends him home without further instructions or interventions regarding his chest pain.
The man returns to the Defendants’ office two months later. He is still complaining of chest pain, which he says now radiates up to his neck. An ECG is ordered and performed the same day. The doctor thought it was normal. Hs is sent home after scheduling a nuclear stress test (NST), a diagnostic test used to evaluate blood flow to the heart, for two days later.
The man returns to the office for his nuclear stress test two days later. He is discharged that morning after the test. That afternoon, the doctors interpret his test results to be abnormal. Later in the day, the man receives a telephone call informing him that his results are abnormal and that he should follow up with a cardiologist. He schedules an appointment for six days later.
That same evening, the man is transported emergently from his home in Germantown, Maryland, to Shady Grove Adventist Hospital Emergency Room. Upon his arrival, he is diagnosed with acute coronary syndrome, shock, respiratory failure, and unstable cardiac rhythm. Efforts made to stabilize him in the emergency room prove unsuccessful; he is pronounced dead later that night.
The man’s family files a survival action and a wrongful death claim in Montgomery County, alleging that the Defendants violated the standard of care by failing to recognize the seriousness of the man’s condition and properly treat it. The family alleges that had the Defendants complied with the standard of care, this man would have avoided all of his injuries, including his tragic and untimely death.
Failure to Diagnose Heart Attack Lawsuits
Failure to diagnose a heart attack, also known as myocardial infarction, is a common and serious theme of medical malpractice lawsuits.
These cases typically arise when a healthcare provider, usually the primary care doctor, fails to recognize the signs and symptoms of a heart attack, delays diagnostic testing, or misinterprets test results, leading to a lack of timely treatment.
Like any malpractice lawsuit, the plaintiff must prove that the healthcare provider breached the standard of care – failing to do what a reasonable doctor would – in diagnosing and treating the heart condition and that this breach directly caused the patient’s injury or death.
The difference between success and failure in these lawsuits often boils down to what is found in the patient’s medical history, the symptoms presented, the timeliness and accuracy of diagnostic tests like ECGs or blood tests, and the actions or inactions of the medical staff.
The cases that see jury verdicts or high settlement amounts have strong evidence that the doctor’s negligence led to a preventable bad outcome, supported by convincing expert testimony to establish the standard of care and how it was violated.
Strengths of the Case
- Repeated Complaints of Chest Pain: The patient consistently reported chest pain, which is a classic symptom of a heart issue. This should have prompted more aggressive diagnostics and treatment earlier.
- Failure to Properly Interpret ECG: The primary care physician determined the ECG was normal twice despite the ongoing symptoms. This could be seen as a clear deviation from the standard of care.
- Delay in Diagnosis and Treatment: There was a significant delay from the first presentation to the nuclear stress test and follow-up, which is critical in cardiac cases. The delayed follow-up could be argued as negligence.
- Abnormal NST Results: The NST results were abnormal, indicating a serious issue, yet the patient was only advised to follow up with a cardiologist six days later, showing a lack of urgency in treatment. This has jury appeal.
- Acute Coronary Syndrome and Death: The final diagnosis of acute coronary syndrome and subsequent death supports the plaintiff’s theory of the case that the earlier mismanagement led to the fatal outcome.
Weaknesses of the Case
- Initial Normal ECGs: If the initial ECGs were reasonably interpreted as normal by reasonable standards, it will be challenging to prove negligence during the initial visits. So that is a big issue: what would a reasonable doctor presume from that ECG?
- Complexity of Cardiac Diagnoses: Cardiac conditions can be difficult to diagnose, and sometimes, symptoms might not be apparent immediately. The defense attorney will argue that the medical staff acted within reasonable bounds given the information at each stage.
- Patient’s Age and Health: At 63, other underlying health conditions might have contributed to the severity of the situation, potentially complicating causation arguments.
Relevant in Discovery or Trial
- Medical Records: Detailed examination of all medical records, including ECG results, notes from visits, and the nuclear stress test report, will be crucial, obviously.
- Expert Testimonies: Cardiologists and other medical experts will need to testify about the standard of care for patients presenting with chest pain and whether the actions of the defendants were appropriate. It will be interested to see how the defendant expert’s defend some of these allegations.
- Communication Records: Any communication between the patient and healthcare providers, including phone calls and follow-up instructions, will be relevant to establish timelines and responses. If the patient was told to do something and he did not do it, that would give the defendant a leg to stand on.
- Hospital Protocols: Examination of Kaiser Permanente’s protocols for handling chest pain and cardiac symptoms will help determine if the staff followed or deviated from established procedures.
- Witness Statements: Statements from nurses, doctors, and other healthcare staff involved in the patient’s care will provide insights into the decision-making process and potential lapses.
Additional Comments
- The most critical issue in the case is likely to be whether the abnormal stress test warranted a trip to the emergency room. The most effective medical approach to preventing the patient’s death in a case like this is early detection and treatment. The primary tool used to detect acute coronary disease is a stress test followed by confirmation with coronary arteriography which is what the family’s lawyers are going to argue at trial.
- Heart attack is leading killer of Americans. Approximately 1.5 million of us have heart attacks. One-third of those heart attacks end in death, and most cannot be avoided. Still, too many people with had chest pain and other warning symptoms and could have been saved with prompt attention, diagnosis, and treatment.
- The failure to diagnose a heart attack accounts for one-fifth of all malpractice payouts against emergency rooms. While this is not an ER case, the target defendants are internists and cardiologists which is very typical.
Jurisdiction
- Montgomery County
Defendants
- Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
- Kaiser Foundation Health Plan, Inc.
- Mid-Atlantic Permanente Medical Group, P.C.
- Two internists
- A cardiologist
- Carol Cardinale, M.D. – Cardiology
- A nurse practitioner
- Two CNMTs
Hospital Where Patient Was Treated
- Shady Grove Adventist Hospital
Negligence
- Failure to timely and adequately realize, diagnose, and appropriately treat the man’s true and serious medical condition
Specific Counts Pled
- Medical Negligence- Survival Action
- Medical Negligence- Wrongful Death
Plaintiff’s Experts and Areas of Specialty
- Gary W. Crooks, M.D. – board certified in internal medicine; licensed to practice in Pennsylvania,
- Joel K. Kahn, M.D. – board certified in internal medicine, cardiovascular medicine, and interventional cardiology; licensed to practice in Michigan; head of a cardiology center
Getting a Lawyer for Your Malpractice Claim
If you have suffered as a result of the negligence of a doctor, nurse or another healthcare provider, our law firm can help you. You are entitled to justice and monetary compensation for the needless harm that has been done to you. Miller & Zois has a very long history of results in medical malpractice and nursing home cases in Maryland, earning large verdicts and settlements. Call today to speak with a caring medical negligence attorney who can help you at 800-553-8082 or get a free online case review.
More Malpractice Claim Information
- Looking for co-counsel for your malpractice claim? Learn more about what Miller & Zois can deliver to you and your client to increase the settlement and trial value of your case. Our firm will split attorneys’ fees with co-counsel consistent with the Maryland Rules
- Heart attack misdiagnosis claims
- Similar case against Franklin Square
- Heart attack misdiagnosis in the emergency room lawsuit in Baltimore against St. Agnes Hospital
- Failure to treat heart attack symptoms claim against St. Joseph’s/UMMS in Baltimore
- CALL 800-553-8082 or get a free online medical negligence serious injury and wrongful death claims. Miller & Zois handles medical mistake claims throughout the entire state of Maryland and in Washington, D.C.