Failure to Diagnose a Pulmonary Embolism Resulted in Catastrophic Injuries

A middle-aged widow suffered spastic quadriplegia, partial blindness and brain injury as a result of the failure to diagnose a pulmonary embolism following a knee replacement procedure. The woman went into the hospital for her surgery, which was completed without incident. During her recovery the next day, however, the physicians in charge of her care made a number of tragic, avoidable mistakes that resulted in her injury and permanent disability.

There were multiple serious departures from accepted medical care in this patient that directly contributed to her tragic outcome. These departures are attributable to failures in diagnosis and treatment on the part of the cardiologist and the resident.

MDL was able to clearly demonstrate by using expert witness testimony and detailed medical information that based on all data available, the cardiologist should have developed the proper diagnosis of pulmonary embolism and commenced appropriate therapy. The treatment rendered, however, was consistent with a diagnosis of congestive heart failure, which, flat out, was the wrong diagnosis.

We were thus able to present a strong case that the patient was suffering from pulmonary embolization clearly diagnosable between 8:00PM and 9:00PM on October 28, 2000 and thereafter. The failure to make this diagnosis was a deviation from accepted standards of care on the part of the cardiologist. Further, accepted standards applicable to the cardiologist required that he immediately call an appropriate consult if he felt unable to deal with the situation himself. The patient’s condition was treatable and if accepted standards of care and treatment protocols were followed, the medical catastrophe she suffered would have been averted.

In summary, there were marked departures from standard care by the attending cardiologist in his treatment and diagnosis of the patient, failing to evaluate correctly the results of the tests performed, and in rendering a diagnosis of congestive heart failure rather than pulmonary embolism. Standard workup and data interpretation would have led to a diagnosis by the reasonable cardiologist of pulmonary embolism, with the immediate institution of appropriate therapy. Instead, the defendant physician directed care toward treatment of a disease entity-congestive heart failure- that simply was not present in this patient. This physician’s failures in this regard, led directly, within a reasonable degree of certainty, to recurrent emboli. This resulted in the severe hypotension (shock) and cardiac arrest, which with a reasonable degree of certainty was responsible for her hypoxic/anoxic encephalopathy.