Two recent medical malpractice cases regarding emergency room physicians raise the question of who should a patient trust for their ultimate diagnosis after an emergency room visit.
The first case involves a woman who was awarded $10 million for the death of her 73 year old husband whose premature death she claimed was a result of the negligent treatment of an emergency room physician for failing to administer anti-clotting medication for more than 2 hours after he presented to the ER suffering a heart attack in 2003. However, her husband lived 3 more years after this ER visit and had a heart transplant in 2006. His immediate cause of death was an infection he got a month after the transplant (a known and common risk with all transplants).
The second case involves a jury verdict of $5 million dollars to the family of a man who died from an aortic rupture which was undetected by an emergency room physician. The decedent in this case, age 30, presented to the Swedish Medical Center in Washington and was prescribed heartburn medication and sent home. Two days later, he went to the University of Washington emergency room and an aortic tear was diagnosis and he died shortly thereafter of a heart infection. Evidence was presented that the tear should have been detected.
I have a few thoughts on these cases. First, compare the amounts of the verdicts. The death of a 73 year old who died more than 3 years after the alleged malpractice occurs commands a $10 million dollar verdict, whereas the death of a 30 year old, who suffers an almost immediate death from the alleged malpractice, gets half that. I would also like to know more about facts about the 73 year old case because I have trouble understanding how the late administration of the clotting medicine caused his death. I assume facts were presented which showed that this failure somehow damaged his heart and thus led to the eventual need for a transplant.
Perhaps the nature of emergency medicine–quick and dirty as it often may seem—makes it necessary, in an abundance of caution, for all patients to go for followup care just in case something was missed. However, with rising health care costs, duplicative care is probably not the answer that insurance companies would prescribe, or cover. And, it may often be hard to justify, especially in cases like the second one where the diagnosis was heartburn. Who would get a second opinion for a hurtburn diagnosis.