Medical Malpractice Case Report: $625,000 settlement after negligent failure to diagnose coronary artery disease in a timely manner

Firm partner John F. Eisberg of Robins, Kaplan, Miller & Ciresi L.L.P. secured a settlement of $625,000 in a failure to diagnose case involving the failure to diagnose coronary artery disease in a timely manner resulting in death of a 48-year-old woman. Read the following Minnesota Association for Justice (MAJ) Minnesota Case Report:

Selected Results*

(Excerpts taken with permission from Minnesota Trial Lawyer Association’s (MTLA) “Minnesota Case Reports”)  

Decedent was a long-standing, insulin-dependent diabetic with very high cholesterol and triglycerides.  She also smoked.  Plaintiff alleged that the Defendant, decedent’s long-time primary care physician, should have recognized that decedent was at high risk for coronary artery disease and should have taken appropriate steps to modify her risk factors and been vigilant and proactive in monitoring for and treating any signs of heart disease.  When Plaintiff ultimately  presented with both subjective and objective evidence of likely heart disease Defendant should have referred her for an immediate angiogram and treatment of her heart disease. Instead, her coronary artery disease went undiagnosed and untreated for an extended period of time. 

On February 22, 2000, decedent presented to the ER with complaints of cough and shortness of breath.  An EKG was performed which showed evidence of a prior heart attack.  A chest x-ray was also done and demonstrated pulmonary edema.  The radiologist reading this film suggested that “myocardial infarction [heart attack] should be a consideration” as the cause of this finding.  On March 6, 2000 decedent presented to defendant doctor at his clinic for follow up of the ER visit.  Neither a chest x-ray nor EKG were repeated.  There was no discussion of heart disease being the cause of her complaints.  Her elevated cholesterol levels, not checked for years, likewise were not evaluated.

On March 28, 2000, decedent called the clinic with complaints of “crackles in her lungs.”  She went in for a chest x-ray, which again showed pulmonary edema. On this visit, the defendant noted the prior EKG as showing “possible inferior and anterior scars.”  An echocardiogram the next day revealed abnormal heart function with a decreased ejection fraction and diminished motion of the left ventricle.  In response, defendant doctor prescribed only an ACE inhibitor and Lasix. There was no discussion of heart disease and no referral for further testing or to see a cardiologist.  Decedent continued to treat with defendant and his clinic.

On January 17, 2002, decedent called the clinic with complaints of chest pains.  She was instructed to take a heartburn medication and was not seen.  On January 31, 2002, she presented to the ER with burning chest pain radiating across her shoulder blades.  She was admitted and remained hospitalized for two weeks.  Admission diagnosis was a heart attack.  The angiogram showed “severely reduced left ventricular function” from damage done by the undiagnosed and untreated heart disease.  She underwent coronary bypass surgery.  At  discharge she was still battling congestive heart failure.  On April 17, 2002 she was again hospitalized and was being considered as a heart transplant candidate.  Repeat bypass was attempted as a bridge to more definitive treatments, but they could not stabilize her.  Eventually, she was removed from life support and died on May 25, 2002.

Plaintiff’s experts would have testified that had decedent’s coronary artery disease been diagnosed in a timely manner, she would have undergone definitive treatment and aggressive risk reduction and could have lived another 20 years.  Defendants argued that decedent’s history of diabetes and smoking would have reduced her life expectancy to only 5 or 6 years.  Defendants also argued that decedent was non-compliant in her medical care, which plaintiff disputed.   Decedent is survived by her husband of 30 years, two adult sons (one of whom has cerebral palsy and lived at home with his parents), two grandchildren, her mother and several siblings. Funeral expenses were $6,631, and family expenditures for travel, etc. during her extended hospitalization were $8,600.

Settlement:                  $625,000 (at mediation)
Case Name:                 Next-of-kin of 48-year-old woman
                                   v. Dr. and Clinic
Date of Disposition:       November, 2004         
Attorney:                      John F. Eisberg