Aortic Dissection Diagnosis Delay: $4M Settlement
2017 Medical Malpractice Settlement Report
Delayed diagnosis and treatment of aortic dissection leads to paralysis in 51-year-old woman
At approximately 2 p.m., the plaintiff walked into the hospital after suffering sudden onset left-sided chest pain that radiated to her left arm and jaw. She reported no trauma or shortness of breath. She was seen by the nurse practitioner defendant who noted her acuity was urgent and to rule out myocardial infarction.
At 2:12 p.m., the physician defendant evaluated plaintiff and noted her abnormal EKG. The differential diagnosis, as noted by the defendants, included acute myocardial infarction, anxiety, coronary artery disease, chest wall pain, costochondritis, mitral valve prolapse, myocarditis, pneumonia, pneumothorax, pulmonary embolus, stable angina, unstable angina, and aortic dissection. Despite aortic dissection being on the DD, a chest CT/CTA was not ordered; only a chest x-ray was obtained.
Plaintiff’s blood pressure was elevated while in the emergency department. Troponin test was negative as was the chest x-ray. Plaintiff’s complaints of chest pain did not improve.
At 5:04 p.m., plaintiff cried out with complaints of severe chest, back and abdominal pain. She became diaphoretic and complained of “burning in her legs” and she was unable to feel her feet. The defendants ordered a CT angiogram to evaluate for dissection.
At 5:46 p.m., almost forty-five minutes later, she was taken for imaging which showed a complete dissection of the thoracic aorta. At 6:15 p.m., arrangements were made for transfer by life flight to a tertiary care facility. Plaintiff underwent emergency repair of her aortic dissection however she continued to exhibit signs of right lower extremity ischemia and compartment syndrome, and required 4 compartment fasciotomies. Following her extensive surgeries, she was found to have suffered paraplegia from spinal cord ischemia. Today, she is confined to a wheelchair with limited use of her arms. She is dependent upon others for all aspects of daily living.
Defendants were prepared to defend the claim on causation given the narrow window of time to transfer the patient between her arrival to the ER and the onset of lower extremity involvement. Plaintiff’s expert testified that once aortic dissection is on the DD you must order the imaging or immediately transfer to a facility that can handle this condition. Discovery was underway when the parties settled the claim for Four Million Dollars ($4,000,000).
Worcester Superior Court
See also: Related settlements for aortic dissection/aneurism lawsuits:
Abdominal Aortic Aneurysm Lawsuit: $1.25M Settlement
Death of 76 year-old-man from delay in diagnosis and treatment of ruptured abdominal aortic aneurysm.
Undiagnosed Abdominal Aortic Aneurysm Settles for $3 Million
Plaintiff claims his AAA was mistaken for kidney stones by urgent care physician leading to paraplegia.
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