Gould liable in malpractice suit Modesto widow awarded $878,257 for missed diagnosis of heart trouble By KEN CARLSON BEE STAFF WRITER Last Updated: June 3, 2006, 06:37:29 AM PDT Daniel Bettencourt was 49 when he suffered a fatal heart attack while working as a manual laborer at E.&J. Gallo Winery on Jan. 15, 2003. An autopsy determined that the Modesto man had more than 90 percent blockage in an artery that supplies blood to the left side of the heart. Last week, a jury found that Gould Medical Group doctors had failed to diagnose Bettencourt's heart condition. The verdict, supported by 11 of the 12 jurors following a civil trial in Stanislaus County Superior Court, awarded $878,257 to his widow, Peggy Bettencourt. Because Gould turned down a settlement offer last year, the medical group may have to pay interest and legal costs, bringing the judgment to almost $1 million. Stockton attorney Stewart Tabak, who represents Bettencourt, said there were two key issues in the case: A Gould cardiologist failed to order a coronary angiograph test for Daniel Bettencourt to look for artery blockage and disregarded a family history of heart disease. Bettencourt's mother had bypass surgery in her 50s, Tabak said. "This young man gave repeated red flags that something serious was going on," he said. "Regrettably, he fell through the cracks and he was allowed to die." Gould has until late July to decide whether to appeal. Gould representatives referred questions to attorney James Nelson of Walnut Creek. He was unavailable for comment Friday. The defense argued that the Gould doctors complied with the standard of care. In court statements, the defense's expert witnesses said a cardiac catheterization is not ordered for every patient with chest pains. The procedure, considered somewhat invasive, involves inserting a catheter into the patient's leg or arm and threading it through arteries to inject dye into the coronary arteries. The dye gives doctors a clearer picture of the arteries. The defense also contended that Bettencourt had a long history of gastric distress and that other test results were consistent with gastric reflux disease. Most medical malpractice lawsuits never reach the trial stage, and in those cases tried in California, only about one in five are decided in favor of the patient, according to a Rand Institute for Civil Justice report in 2004. Peggy Bettencourt's initial suit named the Sutter Gould Medical Foundation, physician's assistant Denise Wofford and doctors Calvin E. Olson, Lisa Masson and Peter Lai. The practitioners are part of the Gould Medical Group, which contracts with the Sutter Gould foundation. Gould is liable for the damages, according to the verdict. Sought help in 1998 The lawsuit said Bettencourt initially went to Gould's urgent care clinic in Modesto with chest pains and what Tabak called other textbook symptoms of heart disease in mid-1998. He was examined, given nitroglycerin to reduce heart attack risk and referred to a cardiologist, the lawsuit says. Lai, a cardiologist, put Bettencourt through a treadmill test and interpreted the results as negative. The pains gradually went away but returned in 2002, according to the lawsuit. Bettencourt sought primary care several times for the symptoms, including angina, occasional shortness of breath and pains radiating to his left arm and neck. At times, the symptoms occurred when he exerted himself, Tabak said. In 2002, Lai ran Bettencourt through a second stress test, which again was negative. Gould doctors then tried to pinpoint a gastric cause for the symptoms. Olson, a gastroenterologist, evaluated Bettencourt and concluded that test results were consistent with gastric reflux disease. According to court records, Olson performed a colonoscopy that ruled out an intestinal cause on Jan. 13, 2003. Bettencourt died two days later. During the trial, Tabak put a medical expert on the stand who testified that negative results from electrocardiograph stress tests can be erroneous 10 percent to 25 percent of the time. 'Ultimate test' never given Tabak argued in court that catheterization is almost foolproof in detecting diseased coronary arteries. "He was never given the option of the ultimate test," the attorney said. The jury awarded Peggy Bettencourt $250,000 for emotional pain and suffering, the maximum allowed in medical malpractice cases in California. The lion's share of the damages were for loss of earnings and financial support. Gould can choose to spread the payments over several years, although it would have to pay 10 percent annual interest on the damages.