Vaagelaw.com - Case Histories

Disposition: (Settlement/Arbitration/Trial)	Settlement
Date:	4/11/2008
Type of Case:	Medical Malpractice
Allegation(s):	Failure to timely acknowledge and treat coronary artery disease resulting in mycoradial infarct
Result:	$1,175,000.00
Case Name:	MARY DOE AND JOHN DOE v ROE HEALTH CARE PLAN, et al.
Facts:
This was an action for damages brought by the claimants against Mrs. DOE�s health care plan providers following an MI and an above-the-knee amputation of Mrs. DOE�s right leg which claimants alleged was a direct result of the negligence and failure to meet the standards of care and practice, as well as its own internal policies and procedures, of ROE HEALTH CARE PLAN, and its medical care providers. As early as November of 2001, Mrs. DOE�s primary healthcare provider at ROE HEALTH PLAN diagnosed her with hypertension. The HEALTH PLAN�s records also indicate her family history of coronary artery bypass. In early January of 2006, Mrs. DOE was 50 years old. She and Mr. DOE had been married for 33 years. Although she was a smoker, her overall health was good. Over the course of the next six months, she made multiple presentations to ROE medical facilities, in the emergency room, to primary care, to vascular surgery and to Urgent Care, with multiple signs, symptoms and risk factors for coronary artery disease. Despite an abnormal EKG, multiple risk factors and symptoms commonly associated with coronary artery ischemia, even with a confirmed diagnosis of atherosclerotic vascular disease in her legs, ROE physicians and healthcare providers never worked Mrs. DOE up for coronary artery disease. In failing to do so, they not only violated accepted standards of practice and care but they also violated their own written guidelines. As a result, on June 11, 2006, Mrs. DOE suffered a major myocardial infarction, causing permanent damage to the functioning of her heart. In addition, complications associated with an intra-aortic balloon pump that was required for the emergency bypass procedure she had to undergo, resulted in an above-the-knee amputation of her right leg.
Injury/Injuries:
Until the events giving rise to this action, Mrs. DOE had worked for many years side-by-side with her husband in several of their own businesses, providing services ranging from simple clerical tasks to complicated accounting and managerial skills. As a result of the MI and amputation, along with the emotional trauma she suffered, Mrs. DOE is now permanently and totally disabled. Mr. DOE must not only deal with the physical and psychological changes to his lifelong partner, he has had to take over or hire out all of his wife�s previous job duties � and attempt to be her full-time caretaker and emotional support provider at home, along with trying to manage his personal struggles that come as a result of the injuries inflicted upon his wife.
Contentions:
Plaintiffs� experts in the areas of family practice, cardiology and cardiovascular surgery testified that ROE HEALTH PLAN�s personnel violated the standard of care in failing to timely ensure that Mrs. DOE underwent proper testing to diagnose the nature and extent of her coronary artery disease, including EKG, stress testing, cardiac echo, a nuclear study if needed, and ultimately angiography. The standard of practice required such a workup on several occasions, as follows: 1. Following Mrs. DOE�s emergency room visit on January 5, 2006, the standard of care required primary care physicians who saw her in January and February, including her primary healthcare provider, to work her up for coronary artery disease as she was at extremely high risk based on the fact she was a long-time smoker, had a family history of coronary artery disease, suffered from hypertension and had elevated cholesterol and lipids. Further, physical examination indicated that Mrs. DOE had atherosclerotic vascular disease in the peripheral arteries in her legs � and the EKG done in the ER on 1/5/06 was abnormal, even according to ROE�s expert. 2. Mrs. DOE was seen in Primary Care a total of five times: January 9th, January 16th, January 31st, February 7th, and February 9th. At each visit, the standard of care required the physician to work her up for coronary artery disease, and at each visit, no such workup was done or even ordered. 3. The standard of care required a coronary artery disease workup for Mrs. DOE following the studies done on February 16th and 17th. Those studies showed that Mrs. DOE had at least moderate atherosclerotic disease in her legs, one of which was significant enough to require the placement of a stent in her left leg. Given the confirmation of this disease process which is always systemic, the standard of care again warranted a workup for coronary artery disease. 4. The ROE healthcare providers had yet another bite at the apple on May 30th, when she was seen with a new symptom in Primary Care. At that time, according to the examining physician, Mrs. DOE�s primary complaint was �heartburn� and �epigastric pain and upward� into her chest. The physician diagnosed her with gastro-esophageal reflux disease. The doctor admitted in deposition that this new symptom is consistent with angina pain caused by coronary artery disease. She also admitted that the ROE guideline on GERD indicates that under these circumstances, coronary artery disease should be ruled out as to the cause of the symptom. She even conceded that she was unaware of the pre-existing abnormal EKG. Plaintiffs alleged that the medical personnel at ROE HEALTH CARE PLAN facilities should have known that she was at risk for a heart attack, and should have taken steps to prevent her from having the MI long before it occurred. Their failure to follow their own written policies and procedures on working up coronary artery disease was a direct cause of the eventual loss of her leg, and her ensuing damages. Defendants alleged that at all times they complied with the standards of practice.
Special Notes:
Shortly before the matter went to Arbitration, the parties settled the matter for $1,175,000.00.