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Delays and Failures to Diagnose Cardiac Conditions

Delays and Failures to Diagnose Vascular Conditions

Vascular conditions such as deep vein thrombosis (DVT) and aortic dissection can be deadly if not timely diagnosed and treated. When health care providers delay and/or fail to diagnose vascular conditions, and patients suffer catastrophic harm as a result, we may be able to assist in bringing a medical malpractice lawsuit.

Each of us has a vascular system made up of blood vessels that carry blood throughout the body. Arteries carry oxygenated blood from the heart to the body, while veins are the vessels that carry the blood back from the body to the heart. (https://www.hopkinsmedicine.org/health/conditions-and-diseases/overview-of-the-vascular-system)

Many different diseases can cause the vascular system to stop working as well as it otherwise would. These diseases can be caused by trauma, inflammation, blood clots, or genetics, among other things.

Sometimes, it is the malpractice itself that causes the vascular condition to occur. One example of this is giving a person a medication intravenously instead of orally, causing the blood to immediately clot and causing the patient to die. Other times, a medical provider is not responsible for causing the vascular disease but has a responsibility to timely diagnose and treat it.

This can include cases in which a patient has a blood clot, either in his venous system or arterial system. These clots, if left undiagnosed, can cause serious harm, including death, if not timely diagnosed and treated. Clots can grow and block off blood to a part of the body, such as when pulmonary emboli block off blood from the lungs. Or, when a clot occurs in a leg, cutting off oxygen to the lower limb and causing cell death. A clot can also break off and travel upstream, lodging in a vessel and cutting off blood flow to vital organs, including the brain.

Another vascular condition that may give rise to a medical malpractice claim is when a patient has an aneurysm, which is a bulge in the wall of the vessel. The bulge causes the vessel wall to be weakened in that area, so if an aneurysm is not diagnosed and managed, it can go on to create a tear in the wall (called a dissection). This is a serious and sometimes fatal condition requiring prompt diagnosis and treatment.

Fortunately, with timely diagnosis, doctors have many ways in which to safely diagnose and manage clots, dissections, and other potentially deadly vascular conditions. This can include screening blood tests, and imaging tools to diagnose the clot and assist in planning for treatment. Treatment can include medications as well as surgical interventions.

While it is possible that specialists such as vascular surgeons, cardiothoracic surgeons, or cardiologists may fail to diagnose or treat a vascular condition, giving rise to a claim, it is often front-line providers who see such patients first, and must carefully evaluate a patient to avoid missing a possibly life-threatening condition. This includes emergency department doctors, urgent care clinic doctors, and primary care doctors. These more “generalist” providers are responsible for, at minimum, ruling out those conditions that may be deadly if not promptly diagnosed and managed.

Vascular conditions can be deadly if not properly diagnosed and managed.

Steve presented to his primary care team in early November complaining of symptoms that could be heart-related, so he was referred to a cardiologist. He told the cardiologist he had episodes of exertional chest pain as well as pain that would wake him at night. The cardiologist thought his symptoms were caused by previously diagnosed heartburn and recommended he double his dose of heartburn medication.

Eleven days later, just before Thanksgiving, the cardiologist’s office called Steve, who told them he was continuing to have chest pain off and on. Four days later the cardiologist recommended Steve come in for a stress heart test in December. That same day Steve suffered a heart attack.

Mike visited his primary care physician complaining of chest pain upon exertion, and an EKG in the office was read as abnormal. The primary care doctor sent him to the local hospital’s emergency room, which admitted him to rule out a heart condition as the cause of his symptoms.

Unfortunately, the admitting doctor never asked him about the nature of his symptoms, specifically whether he had exertional pain, a classic symptom of Acute Coronary Syndrome. Had the doctor asked, he would have ordered a formal cardiology consult, leading to angiography, discovery of the arterial occlusion causing the symptoms, and either stenting or bypass surgery. Unfortunately none of this was done, a “normal” pharmacological stress test was misleadingly reassuring, and he was discharged. He died of a heart attack four days later.

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