Failure to Diagnose Pulmonary Embolism: $7.55 Million Verdict

Medical malpractice verdict against a Boston Medical Center cardiologist who failed to rule out pulmonary embolism before discharging patient who collapsed 45 minutes later

2023 Medical Malpractice Settlement Report
By Adam R. Satin, Attorney for plaintiff
Suffolk County, Massachusetts

Case summary

The decedent was climbing the stairs to her 3d floor apartment when she began experiencing chest pain and shortness of breath. She tried to relax and eventually the symptoms subsided. However, the next morning, with even less exertion, the symptoms returned and an ambulance was called. She was brought to the Emergency Department where she was found to have had a minor heart attack. She was begun on IV Heparin and admitted to the care of the defendant cardiologist.

The defendant cardiologist evaluated the decedent and found her to be asymptomatic, but ordered a cardiac catheterization to determine whether any coronary blockages were responsible for the heart attack and required intervention with stenting. The cardiac catheterization revealed no coronary artery disease at all to explain the cause of the patient’s minor heart attack that brought her to the hospital. The plaintiff alleged that the next most common, and the next most life threatening, cause of her symptoms that can also result in troponin elevation that needed to be excluded was a pulmonary embolism (PE), which can be diagnosed or excluded with excellent accuracy with an imaging test called a CT Pulmonary Angiogram. The defendant did not order any testing to rule out a pulmonary embolism and discharged the patient home.

When the patient arrived home and began climbing the very same stairs she had been climbing when she first experienced her symptoms days earlier, the symptoms returned, 911 was called and, shortly thereafter, she became unresponsive and died. The cause of death was a pulmonary embolism. The defendant maintained that the patient was completely asymptomatic during the hospitalization and that the minor heart attack was most likely caused by microvascular disease (due to her diabetes) in the vessels feeding her heart that are too small to be seen on cardiac catheterization, which would be treated with medication as an outpatient. However, the plaintiff countered that she was likely asymptomatic because her treatment in the hospital for the heart attack with blood thinners happens to also be the correct treatment for a PE, but that this medicine was stopped after the catheterization showed no significant coronary artery disease. Thus, the treatment she was getting (albeit coincidentally) for a PE was stopped, which is why the decedent collapsed just 45 minutes after discharge.

The jury returned a verdict of $7.55 million with interest.

Lubin & Meyer medical malpractice attorneys Andrew C. Meyer, Jr., and Adam R. Satin  and Lynn I. Hu represented the plaintiff in this case.

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