Dr. P also increased the patient’s omeprazole dose to 40mg per day, and scheduled an appointment in a month for a follow-up to check on the patient’s symptoms.

“Feel better,” the physician said pleasantly, escorting the patient out of the exam room. “If your symptoms get any worse before your next appointment, be sure to call the office.”

Unfortunately, the patient never had the opportunity to call the office, or to show up for his next appointment. Mr. H was found dead at home the morning following his appointment with Dr. P. The cause of death was cardiac arrest.


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Mr. H left behind a wife and three children still in school. After the family had recovered from the shock of Mr. H’s unexpected death, his widow sought the counsel of a plaintiff’s attorney. After reviewing the patient’s medical files, the attorney took on the case, and served Dr. P with notice that he was being sued for negligent failure to diagnose acute myocardial infarction resulting in death.

Dr. P had never been sued for malpractice before. He contacted his insurance company which provided a defense attorney. The attorney hired a medical expert to review the case, and then the physician and attorney met to discuss his options.

“Our expert physician was concerned about our chances of success with this case,” said the attorney. “She felt that under the circumstances – and considering the patient’s age, sex, cholesterol and blood pressure numbers, as well as the fact that he was overweight and smoked – that myocardial infarction should have been one of your possible diagnoses. Did you at least consider it?”

Dr. P looked crestfallen. He had not considered it. He had simply assumed that because the patient already had GERD and heartburn, and because the patient was self-reporting that his heartburn had worsened, that it was simply heartburn. Myocardial infarction was never considered, nor, really, was any other diagnosis.

“Did you consider an ECG?” asked the attorney.

“I did not,” admitted the physician.

After several months of discovery and paperwork, Dr. P’s attorney advised him to settle the case out of court within his insurance range. The case was settled prior to trial.