Medical Malpractice

Nassau County, New York

 

Cardiac Malpractice

 

This case involved a failure to timely transfer a patient from a local community hospital to a tertiary care hospital once a diagnosis had been made of unstable angina. The patient's angina required urgent cardiac catheterization which was not carried out until approximately 31 hours later. In the interim the patient sustained two heart attacks or myocardial infarctions. The case was tried before a jury in Nassau County resulting in a substantial verdict.

 

At trial the defense called an interventional cardiologist to support its claim that cardiac malpractice did not occur and that heart damage if it occurred was minimal. The so-called “expert witness” was board-certified in three areas, internal medicine, cardiovascular disease and interventional cardiology. He had 23 years of experience and had published approximately 45 peer-reviewed medical journal articles. As initially presented this witness appeared to be a credible witness for the defense. Testimony was offered about the heart, stress tests, hypertension, high blood pressure, coronary artery disease, cholesterol, blood supply to the heart, ejection fraction, cardiac enzymes, bypass surgery, cardiac catheterization, angioplasty, cardiac stents and treatment with TPA.

 

On cross-examination this golden witness for the defense lost some of his luster. The purpose of cross-examination was to attack the witness’s credibility and to get as many medical concessions as possible to aid our case.

 

He testified on cross examination to the following key points:

1. We learned that he’d been involved in medical legal affairs for approximately 15 years and had been primarily testifying as a defense witness.
2. He was charging $375 an hour for reviewing records.
3. At trial he could not remember which physician’s records he looked at.
4. He did not read any of the pretrial deposition testimony of the parties and witnesses.
5. Although his custom and practice was to make notes regarding his review of the medical records he could not recall if he did so in the case on trial.
6. He conceded that it was a departure from the standard of care not to take serial cardiac enzymes.
7. He could not find any other evidence of departures from the standard of care.
8. In order to become an attending physician at a hospital a doctor had to agree to be bound by the hospital’s rules and regulations.
9. The witness agreed that whether or not a physician took the time to read a hospital’s rules and regulations he was bound legally to follow them.
In our case we contended that the defendant did not follow hospital rules and regulations.
10. The witness was compelled to stress the importance of early diagnosis and prompt treatment in heart attack malpractice cases.
11. It was the goal of cardiologist to strive to achieve the best possible chance for the best possible outcome for his patients.
12. When having a heart attack it was a truism that “time is equal to muscle”.
13. The faster one acts, the lesser cardiac muscle is damaged.
14. In the case of stable or unstable angina serial EKGs or electrocardiograms were the standard of care to be taken every six hours.
15. In spite of his assertion that he could not find any other evidence of departures from the standard of care he later conceded that in this case serial EKGs were needed and not performed.
Hence, another departure from standard of care was confessed.
16. He finally conceded that a diagnosis of diastolic dysfunction had been made by other physicians and that condition could be related to the two heart attacks or myocardial infarctions that the patient endured.
17. Finally, that had the patient and timely transferred to St. Francis Hospital (a tertiary care facility) at the least one of his heart attacks would have been avoided.

 

Click here to read the full trial testimony of the expert witness including the direct examination by the defendant’s attorney and cross-examination by our office.

 

If you or a loved one has had a heart attack and have questions about the quality of the medical care received, please contact the medical malpractice lawyers at Silberstein, Awad & Miklos for answers. Serving clients in New York, including the Bronx, Brooklyn, Queens and Long Island. Together we will continue our fight against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES.
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