This month’s case looks at a situation involving two physicians and multiple errors. One physician ultimately settled the case out of court, while the other – the patient’s primary care physician – took her chances at trial.

The patient was a 45-year old disabled man named Mr. B, who lived with his parents. Mr. B had suffered a brain tumor some years earlier which had resulted in his disability and his need to live with caretakers. One evening, Mr. B began complaining of symptoms consistent with a stroke. His parents immediately took him to the emergency department of the local hospital.

In the emergency room, an EKG was ordered as part of the patient assessment. The EKG revealed that Mr. B had suffered from two heart attacks in the past. Eventually, the patient was seen by the emergency room physician, Dr. E. The physician noted the patient’s symptoms as being consistent with a possible stroke and ordered a neurological consult, however, the physician did nothing regarding the EKG, and did not further assess the patient’s cardiac issues.

Mr. B was admitted to the hospital for evaluation. The next day his primary care physician, Dr. P came to see him. During her visit, she performed a brief physician examination of Mr. B, but she did not look at the EKG that had been taken the night before in the emergency room. Nor did she discuss it with any of the hospital staff.

Mr. B was stabilized, and after three days his primary care physician, Dr. P, signed his hospital discharge papers and the patient was released home. Three days later, Mr. B suffered a cardiac arrest. He was resuscitated, but remained in a coma until his death, three weeks later. After the cardiac arrest, it was discovered that one of Mr. B’s coronary arteries was completely occluded.

Mr. B’s devastated parents sought the counsel of a plaintiff’s attorney and showed him the medical records. The attorney was shocked that the EKG results had not been acted on, and asked a medical expert what should have been done. The expert told him that the blocked artery should have been discovered and treated with a stent while Mr. B was hospitalized, and that both physicians had failed by not acting on the EKG results. The attorney told Mr. B’s parents that he believed they had a viable medical malpractice case, and he proceeded to serve the two physicians with notice that they were being sued.

Dr. E, the emergency room physician, had read the EKG at the hospital, but had failed to take appropriate action. When he spoke to his defense attorney, the physician explained that his main concern had been the stroke symptoms. After some discussion, the attorney advised the physician to settle the case out of court – which he did.

However, Dr. P, the primary care physician, decided to chance a jury trial. At trial, the plaintiff presented evidence of the EKG, the patient’s blocked artery and the danger that causes, and the fact that the standard of care required both physicians to take action upon discovering the cardiac issues. For her part, Dr. P testified that she’d been informed that her patient had a neurological issue at the hospital, not a cardiac issue, and that it was the emergency room doctor’s responsibility to follow-up on the abnormal EKG.