Amount of Settlement: $1,250,000
Case Summary:
37 year old man, was taken to a local Emergency Department by ambulance from a rehabilitation facility where he had been recovering from spinal surgery performed two weeks earlier. He had been scheduled to be discharged from the rehabilitation facility that day. Plaintiff's decedent had been complaining of "a syncopal episode" followed by a second episode with similar symptoms of weakness, lightheadedness, dizziness, and sweatiness. Physical examination at the Emergency Department showed no wheezes or rales and a regular heart rhythm with no murmur or gallop. While in the emergency department, plaintiff's decedent's pulse elevated from 94 BPM to 116 BPM and his blood pressure climbed from 106/82 to 145/102. EKG performed in the emergency department was noted to be "abnormal." Defendant emergency medicine physician noted in his report that "suspicion for this being related to pulmonary embolism is extremely low." No testing was ordered to rule in/out the diagnosis of pulmonary embolism. Defendant's Clinical Impression was "likely vagal syncope." He was discharged from the emergency department to return to the rehabilitation facility "for D/C."
After his return to the rehabilitation facility that day, plaintiff's decedent was convinced to stay overnight for observation rather than be discharged that same afternoon. The following day, Saturday, plaintiff's decedent again requested that he be discharged and the rehabilitation facility agreed to allow him to leave, somewhat reluctantly, as long as he agreed to return to the emergency department if he developed similar symptoms and promised to see his primary care physician that coming Monday.
That Monday morning, before plaintiff's decedent could see his primary care physician, he became short of breath and passed out at home. An ambulance was summoned and he was taken to a hospital proximate to his residence. Resuscitative efforts were not successful, and he was pronounced dead. Autopsy revealed the cause of death as "pulmonary thromboemboli due to deep vein thrombosis."
Experts in emergency medicine and in pulmonary medicine were retained. The emergency medicine physician opined that the defendant failed to take appropriate steps to rule in or rule out the diagnosis of pulmonary embolism which were required, given the decedent's obesity, history of recent back surgery, immobilization, syncope, tachycardia, elevated blood pressures and EKG findings in the emergency department. The emergency medicine expert also opined that the testing that needed to be ordered to comport with applicable standards of care would have included a D-dimer and more appropriately a pulmonary angiography. Plaintiff's expert in pulmonary medicine likewise opined that the emergency room physician departed from applicable standards of care and that had a pulmonary angiogram been ordered to rule in or rule out the diagnosis of pulmonary embolism, it would have detected that condition, plaintiff's decedent would have been placed on appropriate anti-coagulation therapy, and more probably than not would have survived this event.
