Seven-figure recovery for emergency room failure to diagnose evolving heart attack
One of the most common, yet serious, conditions that emergency room doctors face on a regular
basis is when patients present with sudden onset of chest pain. Sometimes, chest pain can be
caused by innocent, non-threatening conditions such as muscle pain or indigestion, but other
times they can represent a clear warning sign of a threatened or evolving myocardial infarction
(heart attack). Therefore, it is critical for the emergency room physician to be vigilant in
investigating the onset and character of chest pain. For example, chest pain that radiates down
the left arm or into the jaw and which comes on with exertion is typically an indication of a
possible acute heart problem. Also, doctors look for important signs in the patient’s background
including whether they have health factors that place them at higher risk for heart disease such as
elevated blood pressure, smoking, high cholesterol, etc. and also whether the patient has a family
history of any heart disease. The most important test to be done to evaluate chest pain is the
In this particular case, our client, a man in his mid-50s, presented to a Pittsburgh area hospital
with sudden onset of chest pain, radiating down his left arm, and shortness of breath. The patient
also had definite risk factors for heart disease including high blood pressure, a history of
smoking, elevated cholesterol, and a family history of heart disease. An EKG was done and said
to be normal, and therefore, the emergency room physician sent the patient home believing that
the chest pain was not indicative of a heart problem. Approximately 12 hours later, the patient
suffered a heart attack which caused significant, permanent damage to the heart.
We had the medical records reviewed by an emergency room specialist, and he indicated that
while an EKG is an important test in any patient with chest pain, it is not the “be all and end all”
when it comes to deciding whether the chest pain is indicative of an evolving cardiac problem.
In this case, our expert said that given the specific character of the chest pain and the fact that the
patient had significant risk factors for heart disease such as a smoking history, elevated blood
pressure, cholesterol, and a family history of heart disease, he should have been kept in the
hospital at least overnight for observation. Had that been done, he would have been connected to
a cardiac monitor and as soon as his myocardial infarction started to occur, he could have been
given medication or other treatment that would have stopped the infarction from extending and
causing further heart damage. Here, however, because the infarction occurred and extended due
to the absence of any treatment, the patient was left with permanent damage to his heart muscle.
The biggest fear whenever a patient has a heart attack is that they will not survive. However,
even when a patient survives, there is another concern, and that is how much heart damage did
the myocardial infarction cause. That is something that can be measured by tests which assess
the strength or pumping power of the heart following a heart attack. If the power of the heart has
been significantly reduced, that can permanently limit a person’s strength and vitality, and
particularly their ability to withstand strenuous work or activity.
In our case, the patient suffered widespread damage to the heart muscle such that his doctor said
it would not be medically advisable for him to return to his former job as a truck driver since it
involved significant lifting and carrying. Therefore, a large part of our claim was based on the
lifetime earnings loss that our client would experience as a result of his myocardial infarction.
Additionally, our damage claim included compensation for certain day-to-day activities which he
previously enjoyed but would no longer be able to do as regularly or as vigorously as before.