Legal Background

At trial, the plaintiff introduced testimony of experts who testified on her behalf in the fields of oncology and cardiology. She herself testified about her symptoms, her reduced quality of life, the effect that her declining health had on her marriage, and the fact that she had no recollection of Dr T ordering an echocardiogram prior to prescribing the chemotherapy medication.

Dr T testified that he recalled ordering the echocardiogram at the time he was prescribing the doxorubicin, but decided it was advisable for the patient to start on the drug immediately. He had no explanation for why there was no note of it in the patient’s chart. Dr T argued that the performance of an echocardiogram prior to the delivery of doxorubicin is not required by the standard of care.

The defense team introduced its own cardiology and oncology experts who agreed that the standard of care does not require an echocardiogram. The experts also contended that the symptoms that Mrs B exhibited were non-specific and consistent with any patient who was on chemotherapy. It was not until the following year that the patient exhibited objective symptoms of cardiomyopathy, at which time Dr T ordered the echocardiogram and a diagnosis was then made.

When the jury was sent to deliberate, one of the questions that the jury was asked to decide was the following: “Do you find that the conduct of the oncologist was negligent and that such negligence was a proximate cause of Mrs B’s injuries?” The jury ultimately answered “no” to this question, believing that Dr T had not breached the standard of care, and held that Dr T was not liable for Mrs B’s injuries.

The elements of medical malpractice are the following: a duty owed (which always exists between a doctor and a patient), a breach of that duty, injury caused by the breach of duty, and resulting damages. The jury did not believe that the physician had acted negligently in this case and could not then find that his conduct was the cause of the injuries to the patient. If any of the 4 elements of a medical malpractice case (duty, breach, injury, and damages) are missing, the case will fail.

Related Articles

Protecting Yourself

Although obtaining an echocardiogram was not the standard of care required in this case, Dr T had thought it important enough that he recalled ordering one at the same time as he prescribed the medication. However, he did not write it in the patient’s chart, and since it was not written down or noted, he never followed up. It is imperative to always note in the chart when tests are ordered for patients, and to then follow up on test results. Otherwise, a trial will always result in a “he said, she said” situation.

This case could probably have gone either way, depending on the jury. In past columns, we have seen similar cases where juries have decided in favor of the plaintiff. It’s important to remember that a jury is just a group of people, who might be swayed by the fact that a physician neglected to note an ordered cardiac test in the patient’s chart. Always write things down, for your own protection.