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Failure to diagnose a heart problem

One of the main obligations in an emergency room is to properly "triage" a patient and try to figure out generally what is causing their complaints. In this case, a 68-year-old woman, who had a known history of heart disease, came into the emergency room with complaints of pain in her left side, left arm and leg. She was admitted to the hospital and blood work was done to check several things including something called cardiac enzymes. If these enzymes are elevated in blood work, it is generally an indication that the heart is experiencing some damage. In her case, the enzymes were elevated, but it does not appear that her doctor took notice of the test results. Also, later that day an EKG was done which showed an abnormally low ejection fraction which measures the pumping ability of the heart, but again, it does not appear that the physician who ordered these tests ever saw, or paid attention to, the abnormal results. Obviously, it is the obligation of all physicians to be aware of blood work and other tests which they order. In this case, the doctor apparently overlooked the results. Had he seen them, he would have suspected a heart problem and ordered the patient to be examined by a heart specialist. (That type of physician is called a cardiologist.) Unfortunately, no heart specialist was ever involved in the patient's case, and she suffered a cardiac arrest a few days later and died.

We had the record independently reviewed by a cardiologist who said that the abnormal blood work and abnormal EKG should have prompted an examination by a cardiologist who would have started medication and done a cardiac catheterization on the patient. This likely would have led to the discovery of a blocked artery which could have been treated with a cardiac stent.

Although the patient was not employed, she took care of the household occupied by her and her disabled husband who was suffering with issues of dementia. After his wife's death, the husband had to move in with his daughter.

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