Peter H. Pogue, a Principal Partner of Schultz & Pogue, LLP, recently obtained a defense verdict on behalf of a cardiologist in a heart attack resulting in death case tried to a jury in Danville, Hendricks County, Indiana. The decedent, a 47 year old male, presented to the Emergency Room complaining of chest pain, shortness of breath on exertion, sweating, dizziness, nausea, and vomiting, which had been occurring on and off for 2 days prior to presentation. The decedent had also presented on two prior occasions to the ER in the previous 6 weeks with similar complaints.
An EKG and cardiac markers were normal in the ER. However, due to the decedent’s complaints of chest pain, the decedent was hospitalized for further cardiology evaluation for chest pain. The defendant cardiologist performed a cardiology workup for the chest pain, inclusive of an exercise treadmill test with echocardiography. The decedent exercised greater than 10 METS on the treadmill, and the cardiologist believed the treadmill EKG and echocardiogram were normal. Two sets of additional cardiac markers were run showing elevated Troponin of .3 and .4, after the initial Troponin was normal at .2. Based on the normal exercise treadmill EKG and echocardiogram, the defendant cardiologist released the decedent and instructed him to follow-up in one week in the cardiologist’s office.
The decedent followed up with the cardiologist’s practice in one week. The decedent was seen by one of the cardiologist’s partners who believed the decedent had GERD and released the decedent to be followed by the decedent’s primary care physician. Eight days later the decedent had an acute myocardial infarction at home. He could not be resuscitated. The autopsy showed a 90% occlusion of the LAD Artery totally occluded by thrombus.
An Indiana Medical Review Panel consisting of 3 cardiologists found that the defendant cardiologist had breached the standard of care and caused the decedent’s death. The Panel relied on the abnormal Troponin level at discharge, and believed the EKG showed ST depression with the echocardiogram showing abnormal wall motion necessitating a heart catheterization. At trial, Peter called an expert witness cardiologist who testified that the defendant cardiologist had appropriately risk stratified the decedent as a low to moderate risk patient based on the decedent’s exercise tolerance, and that the EKG and echocardiogram were normal. The defense expert testified that the decedent could be released and followed with medications.
After 30 minutes of deliberations, the jury returned a defense verdict in favor of the cardiologist.