“The EKG is normal,” the cardiologist told the patient.
The patient had been having chest pain for days leading up to his decision to go to the local emergency room. In the evening before he decided to go to the emergency room, the pain was so severe he was unable to lie down or even try and go to sleep. He couldn't understand why he was having such bad pain. It felt like a truck was sitting on his chest. The pain was also radiating down his left arm. He developed really bad sweating. His skin was cold and clammy to the touch.
He finally told his wife he needed to go to the emergency room, immediately.
The emergency room they went to was a local community emergency room only a few minutes from their home by car. He had never been there before. He had never been a patient before. He did not know what to expect. His beautiful wife told the triage nurse that her husband was having massive chest pain. The nurse brought the patient immediately into the emergency room and began hooking him up to an EKG monitor and getting his vital signs.
Within minutes, a physician was attending to him and began to evaluate his condition. The patient was told he was going to have a series of tests including blood work and he would also have an EKG to see what was going on with his heart.
The blood work came back as normal except it did show that he had elevated cholesterol levels. He had no history of heart disease although he was overweight. He did have a very high stress job and was a superstar in the company he worked for. He was constantly being showered with awards, gifts, certificates and prizes for being the number one salesperson in his company, year after year.
PATIENT IS SENT HOME
After two days of observation and a battery of tests, the patient was told he was fine and should merely follow up with a cardiologist he chooses after being discharged. He was told his chest pain was related to anxiety and stress and to simply follow up with a cardiologist for routine checkups.
The patient did exactly as he was told. He was an otherwise healthy young man, early in his career and had no reason to dispute or disagree with the doctors at this local community hospital.
PATIENT FOLLOWS UP WITH A LOCAL HEART DOCTOR
He made an appointment with a local cardiologist. He told the heart doctor everything that happened a few weeks earlier and the doctor examined him and pronounced that he was fine. The doctor never obtained the original EKG record from the emergency room for his own review. The patient continued to follow up with the doctor each month over the next three months.
Interestingly, on each visit to the private cardiologist, the patient had complaints of ongoing continued chest pain that did not go away. His heart doctor reiterated what the emergency room doctor had told the patient; that this pain is nothing more than anxiety and stress.
Neither the doctors at the hospital or the private cardiologist ever recommended performing additional tests to get to the bottom of why this patient continued to complain of ongoing chest pain. No stress test was ever ordered or performed. No cardiac angiogram was ever ordered or performed.
On the third month after being discharged from the community hospital, and seeing the private cardiologist for the third time, within days, the patient experienced massive and excruciating chest pain to the point where he could barely breathe. The symptoms were the same as three months earlier. The pain was radiating to his left shoulder and down his left arm. He was sweating heavily yet his skin was cold and clammy. He knew something was wrong.
In the middle of the night he was taken by ambulance to the same local emergency room. He was immediately diagnosed as having a massive heart attack. This small community hospital was incapable of treating his emergency and was transported by ambulance to a major university medical center in New York City.
As a result of this massive heart attack, also known as a myocardial infarction, the patient suffered damage to 70% of his heart. That meant that the majority of his heart had died as a result of this massive heart attack.
Since most of his patient's heart had been destroyed he was physically incapable of going to rehab and doing any exercise whatsoever. He was physically incapable of walking 10 feet without stopping repeatedly to catch his breath. His heart was unable to pump blood throughout his body sufficiently to allow him to accomplish small tasks such as walking across the room without assistance.
SHE PICKED UP THE PHONE TO ASK QUESTIONS
His wife reached out to me because she had overheard two of the doctors talking about the original EKG that was done in the local community hospital three months earlier. There was some suggestion that there was something suspicious on that EKG that might have warranted further evaluation at that time.
After doing a thorough investigation, and sending the records out to three different cardiac specialists, each one told me that we had a solid basis for a medical malpractice case.
EVERY EXPERT CONFIRMED THERE WAS A VALID CASE
What was it about the patient's treatment that caused every cardiac doctor to confirm that there was (1) wrongdoing, (2) that the wrongdoing caused injury and (3) that the patient's injuries were significant and permanent?
If you remember, when the patient first went to his local community hospital three months earlier, the cardiac doctor did an EKG and concluded that “everything was fine and normal.” It turns out that a computer read and interpreted the EKG findings and generated its own conclusion. In this patient's case, the computer indicated that the findings were abnormal and required further evaluation.
FIND OUT WHAT THE EMERGENCY ROOM DOCTOR SAID
Once a lawsuit was started, I had an opportunity to question the heart doctor who performed the EKG in the emergency room at this local hospital. It was his belief and conclusion that the EKG was totally normal. He also indicated that he gave the computer-generated opinion absolutely no weight and said this was merely something that was automatically generated for every EKG. He never relied on it.
ALL 3 EXPERTS DISPUTE THE EMERGENCY ROOM DOCTOR'S FINDINGS
Each of the three cardiac experts confirmed that their own reading and interpretation of the patient's original EKG was significantly abnormal and showed that the patient had ischemia, which is a decreased blood flow to one or more parts of the heart. Had the cardiac doctor recognized this, the patient would then have been sent for a coronary angiogram.
An angiogram is a test where dye is injected into the veins and arteries of the heart and then imaging studies are done to see where the dye goes to and if there are any blockages preventing the passage of that dye.
Had this been done, the doctors would have immediately recognized that three of the patient's cardiac arteries were clogged and the patient would have had elective triple bypass surgery. This is known as coronary artery bypass grafting or CABG. If the patient had a timely triple bypass surgery, he would never have had a massive heart attack causing him to become permanently disabled at the young age of 34.
As a result of his severe heart damage, he needed a heart transplant since his heart was not functioning well enough. Unfortunately, all the medications the patient was taking were causing massive side effects to his organs including his kidneys that prevented him from getting onto the heart transplant list.
Shortly after I questioned the cardiac doctor from the local community hospital, we entered into settlement negotiations with the hospital and the private cardiologist. After hard-fought settlement discussions with the defense attorneys and their insurance carriers, I was able to successfully settle this case for $6 million.
As I look back on this tragic case I am continually reminded of the emergency room doctor's cavalier attitude in believing that his interpretation of the EKG was correct and accurate, when in fact it was just the opposite.