News and Notable Verdicts

The defendant was CoxHealth, which employed all the providers who saw and treated the patient. The plaintiff was the surviving spouse whose husband began having chest pain the day before his presentment to the hospital complaining of intermittent chest pain with radiation down both arms, which was aggravated by activity and accompanying shortness of breath. An EKG showed moderate T-wave abnormality, a possible old anterior myocardial infarction, but no evidence of ongoing ST-elevated myocardial infarction (Ml). The EKG was read as abnormal. A chest film showed minimal vascular congestion in the lungs. His oxygen saturation rates indicated that he was hypoxic. His initial troponin enzyme level was elevated but not diagnostic of a recent Ml. A BNP test was markedly elevated and suggested congestive heart failure.

The patient was seen by an emergency medicine doctor, who did not believe the patient was having an active MI, but believed he had congestive heart failure, and was at risk for an MI due to his complaints and cardiac risk factors. The patient was not experiencing chest pain when the doctor performed his examination. While the doctor apparently spoke with a cardiologist in a clinical observation unit, the patient could not be accepted due to his weight, which was nearly 475 pounds. The doctor then called the hospitalist service and spoke with another doctor. The hospitalist agreed to admit the patient and sent his nurse practitioner to assess the patient. The NP also felt the patient was experiencing cardiac issues. The NP ordered a stress test and an echocardiogram for the next morning, ordered trending troponins, and mentioned that a cardiology consult may be necessary pending the results of the tests. She also ordered Lasix for lower extremity edema and Lisinopril for hypertension. The hospitalist also later assessed the patient and agreed with the NP’s plan of care.

The patient was admitted to a telemetry floor. He had no chest pain or other issues overnight and his vital signs essentially returned to normal. Before he could be rounded on by the hospitalist service the next morning, the patient collapsed and coded. The code team attempted resuscitation efforts but was unsuccessful and the patient was declared dead. An autopsy was not performed, but the death summary and death certificate indicated that the cause of death was atherosclerotic coronary artery disease.

Plaintiff claimed the doctors were negligent in that they failed to diagnose acute coronary syndrome, and that the medical treatment should have been to prescribe a variety of medications and to immediately consult a cardiologist. Plaintiff claims that, had decedent been treated emergently by cardiac catheterization, he could have had an angioplasty which would have prevented his untimely death. Defendant disputed all of these claims and presented evidence that the patient died a sudden cardiac death from an arrhythmia, which was neither predictable nor preventable. Defendant claimed the arrhythmia resulted from the congestive heart failure.

Defendant presented three experts, specifically an emergency medicine physician, a cardiologist, and a hospitalist. During trial, plaintiff’s counsel requested just under $2 million in total damages. After a five-day trial, the jury returned a verdict in favor of defendant.