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Confidential Settlement – Death Following Failed Treatment for Heart Attack

Our Ohio Medical Malpractice Case Facts

Ron T was 67 years old when he went to the emergency department at a local hospital with a chief complaint of chest pain. He was diagnosed with an acute myocardial infarction (a heart attack), given a powerful drug (Retavase) to dissolve any clots in his coronary arteries, and admitted to the Intensive Care Unit.

Overnight, Mr. T’s condition worsened. He developed pulmonary edema and congestive heart failure. This means that fluid was building up around his heart, causing it to pump blood inefficiently. Despite the efforts of a critical care specialist and a cardiologist, Mr. T’s condition deteriorated over the course of the next day, and he went into cardiogenic shock. This means that his heart could no longer pump enough blood to his organs to keep them functioning adequately. Mr. T was then transported by helicopter to a regional hospital for an emergency cardiac catheterization and angioplasty. Unfortunately, efforts to save him at this hospital failed, and Mr. T died. Mr. T was survived by his wife and three adult children.

Our Ohio Medical Negligence Case: Discovery and Litigation

Where will this Medical Malpractice case be tried and against whom?

The Eisen Law Firm filed suit in the Cuyahoga County Common Pleas Court against the local hospital, four internists who cared for Mr. T while he was at the local hospital, a pulmonologist, and four cardiologists who all practice at the local hospital. We also filed suit against the regional hospital where Mr. T died.

Early legal maneuvering focused on the efforts of the defendants to have the case transferred from Cuyahoga County, where one individual defendant moved shortly before the Complaint was filed, to Huron County, where all the events giving rise to Mr. T’s death occurred. All parties anticipated that the ruling on that motion would bear significantly on the value of the case. The Eisen Law Firm prevailed on that motion, despite the very clear trend in Cuyahoga County of transferring such cases out of Cuyahoga County to other venues.

After the exchange of extensive written discovery (which required, among other things, the filing of a motion to compel against the local hospital for its failure to cooperate in discovery), depositions began in earnest. Depositions of all nine defendant physicians were completed, as were the depositions of several nurses who were responsible for Mr. T’s nursing care in the Intensive Care Unit at the local hospital.

The Eisen Law Firm did not want to leave any stone unturned in holding responsible those people and entities who caused Mr. T’s death. It also, however, did not want to “muddy the waters” by keeping in the case people and entities whose conduct either met the standard of care or did not contribute significantly in causing Mr. T’s death.

The pulmonologist (lung doctor) was dismissed following his deposition, as his role in the care and treatment of Mr. T turned out to be relatively limited and did not involve direct management of Mr. T’s heart attack. Similarly, two other doctors were dismissed after it was determined their conduct did not contribute significantly to Mr. T’s death. Finally, after the regional hospital was forced to produce critical records about the staffing of its cardiac catheterization laboratory, it too was dismissed from the case.

Based upon the documented medical records and the extensive deposition testimony, several criticisms were leveled at the nursing staff of the local hospital and at a group of doctors. Those criticisms were incorporated into the reports of The Eisen Law Firm’s expert witnesses.

Our Medical Malpractice Case - Expert Witnesses and What Really Happened to Mr. T

The Eisen Law Firm retained the services of four expert witnesses: (1) a board-certified interventional cardiologist; (2) a board-certified internal medicine physician; (3) a nurse specializing in the care of cardiac intensive care patients; and (4) an economist.

The Eisen Law Firm’s expert internist was of the opinion that the attending family practice physicians failed to recognize, diagnose, and treat properly signs and symptoms that the clot-busting drug administered in the emergency department failed to work, and that Mr. T was developing congestive heart failure. Furthermore, these physicians failed to contact the on-call consulting cardiologists to evaluate Mr. T on a timely basis.

The Eisen Law Firm’s nursing expert believed the nurses caring for Mr. T failed to meet the standard of care. Specifically, the nurses failed to communicate critical signs and symptoms that Mr. T’s condition steadily was deteriorating. Among other things, the nurses documented the reoccurrence of chest pain and administered morphine for that pain without contacting a physician. Moreover, when a nurse finally contacted a physician, she contacted the wrong physician – the family practice physician, rather than the cardiologist. And then, when the family practice physician gave orders that did not address the most likely source of Mr. T’s chest pain (not enough oxygen to the heart muscle), the nurses failed to contact Mr. T’s cardiologist.

The Eisen Law Firm anticipated that the defense would (weakly) defend the case on the standard of care but would focus its efforts on proximate causation. Accordingly, we retained a board-certified interventional cardiologist, who believed (and was prepared to testify) that earlier intervention – transfer to the regional hospital for an angioplasty – likely would have saved Mr. T’s life.

The defense retained experts in the following fields: (1) cardiothoracic surgery; (2) interventional cardiology; (3) internal medicine; and (4) intensive care nursing. The defense experts took the position that Mr. T’s heart attack caused such extensive heart damage that no intervention could have saved his life. They also claimed that none of the defendants deviated from the standard of care in any way.

The defense experts did not stop there. They also argued that Mr. T’s life expectancy was significantly reduced irrespective of his heart attack. This argument was based upon the fact that Mr. T had significant C.O.P.D. (chronic obstructive pulmonary disease) due to a very lengthy smoking history (several packs per day for 40 years) and a condition called Guillain-Barre syndrome. Guillain-Barre syndrome is an inflammatory disorder of the peripheral nerves that often results in paralysis of the legs, arms, breathing muscles, and face. In fact, this syndrome had forced Mr. T to retire on disability prior to his heart attack.

Our Ohio Medical Negligence Case: Mediation

The Eisen Law Firm was fully prepared to take this case to trial. However, a couple weeks before trial was to begin, negotiations were started. The parties recognized that this case had the potential for a resolution without trial but were unable to reach an agreement through negotiation. Accordingly, the parties agreed to a private mediation. An eleven-hour mediation resulted in an agreement in principle to resolve the case for a confidential sum. Given the very significant obstacles presented by the medical issues in this case and Mr. T’s reduced life expectancy, The Eisen Law Firm and our client, Mrs. T, felt that the settlement was a very good resolution of the matter and achieved the twin goals of securing compensation for Mr. T’s family and holding accountable those responsible for Mr. T’s death.