An autopsy revealed evidence of MI on the posterior portion of the heart, which corresponded with the complaints of chest pain about a week earlier. The decedent had 75% narrowing of the left anterior descending coronary artery, 75% narrowing of the right circumflex artery, and 30% narrowing of the right coronary artery. No thrombus or plaque rupture was identified. The cause of death was determined to be MI secondary to fatal arrhythmia, associated with coronary artery disease.
The plaintiffs claimed that Dr. C. should have included unstable angina in the differential diagnosis and should have assumed that the decedent had had a heart attack until proven otherwise. The plaintiffs claimed that the ECG taken in Dr. C.’s office was subtly abnormal and that the decedent should have been sent to a hospital immediately; there, they argued, blood would have been drawn and abnormal troponin levels detected. The plaintiffs claimed that the decedent would have then been sent to the catheterization lab for treatment—most likely, stenting.
The plaintiffs further claimed that Dr. W. took an inadequate history and that a treadmill test should not have been performed. The plaintiffs claimed that a myocardial perfusion test or nuclear imaging should have been performed. Further, the plaintiffs maintained that the ECG portion of the treadmill test had subtle abnormalities that Dr. W. overlooked, and that Dr. W. failed to appreciate the abnormality in the decedent’s blood pressure remaining flat during the test.
Dr. C. claimed that the decedent’s claims of chest pain at night suggested that the pain was not cardiac in origin. Dr. C. also claimed that he had acted reasonably in performing and interpreting the ECG. Dr. W. claimed that a treadmill stress test was appropriate for the decedent and that test results were normal.
The defendants both argued that the cause of death was not coronary artery disease, but coronary spasm. They maintained that there was only 50% narrowing in the coronary arteries and that the absence of thrombus or plaque rupture was inconsistent with a classic cardiac death resulting from coronary artery occlusion.
According to a published account, a defense verdict was returned for Dr. W. The jury was undecided in the case against Dr. C.
Obstetrician “Forgets” to Perform Tubal Ligation
A young woman in California became pregnant with her fourth child, although she was using birth control. During her prenatal care, she and her husband told the defendant obstetrician that they did not want, nor could they afford, any more children. They requested a bilateral tubal ligation at the time of a cesarean delivery, which was scheduled for a week before the projected due date.
The woman went into labor two days before the scheduled surgery. The prenatal records could not be found and the obstetrician’s office was closed. He delivered the baby by cesarean section but did not perform the tubal ligation. The mother was in the hospital for three days and was seen by the defendant for a six-week postpartum visit, but she claimed he never told her that he had not performed the tubal ligation. The mother did not take precautions to prevent pregnancy and subsequently conceived her fifth child. The plaintiffs did not opt to abort.
The plaintiffs alleged negligence and wrongful birth, contending that they were never told the tubal ligation had not been performed until after the fifth child was conceived.
The defendant claimed he told the mother at her six-week visit that the tubal ligation had not been performed and advised her to use birth control until she recovered from the cesarean delivery, when she could then undergo a tubal ligation. The obstetrician acknowledged that he had forgotten to perform the tubal ligation but insisted that there was no negligence involved.
According to a published account, a defense verdict was returned.