A court has issued a ruling in favor of the defendant in a medical malpractice case in which the plaintiff sought three million dollars in damages. The cardiology practice to which the doctor belonged and the hospital where the surgery took place were also named as defendants. The plaintiff alleged that the defendant caused him to need many future heart surgeries because of a defective cardiac defibrillator when, in fact, the standard of care would dictate that this patient not have a cardiac defibrillator implanted at all.
When the plaintiff first entered the care of the defendant, the plaintiff was 25 years old and suffering from a host of health problems. He suffered from high blood pressure, shortness of breath, and swelling of the hands and feet. In the summer of 2007, the plaintiff went to the emergency room, where he was diagnosed with dangerously high blood pressure and kidney disease. Records from the visit say that he was showing signs of heart failure.
The defendant cardiologist, who treated the plaintiff during the emergency room visit, diagnosed the patient with coronary artery disease and a persistent fast heartbeat and told him that he was at risk of sudden death. He advised him to have a cardiac defibrillator implanted. Attorneys for the plaintiff would later argue that the defendant’s readings of the plaintiff’s heart rate were incorrect, as was his assessment of the degree of heart failure.
After his release from the emergency room, the plaintiff consulted an electrophysiologist, who said that the plaintiff’s risk of dying suddenly was only 1%. In accordance with the guidelines of the American Heart Rhythm Society, the electrophysiologist advised the patient to take medication to lower his blood pressure and to return to the electrophysiologist for a follow-up visit in 90 days.
The patient’s condition improved after he took the medicine prescribed by the electrophysiologist. He was able to breathe more easily, and the swelling of his hands and feet decreased. Still plagued by fears about the poor prognosis indicated by the defendant cardiologist, though, the plaintiff returned to the defendant physician and agreed to have the defibrillator implanted. The defendant physician implanted the defibrillator during a surgery performed in late 2007. Because the battery life on a cardiac defibrillator is about seven years, patients with cardiac defibrillators must undergo surgery every seven years to have the batteries in the device replaced.
After the surgery, the plaintiff read that the defibrillator device with which he had been implanted had been recalled because it had been found to be defective. He filed a medical malpractice claim against the defendant physician. The medical review panel, which included three medical experts, declared that the defendant had exposed the plaintiff to unnecessary risks by implanting the device. To remove the defibrillator would be risky, but so would leaving it in place, and even in the best-case scenario, the plaintiff would still require future surgeries every seven years.
Attorneys for the defendant argued that the plaintiff’s condition was, in fact, dangerous when he came to the defendant physician. Any 25-year-old man who comes to the emergency room with blood pressure of 178 over 122 and who gets short of breath during normal activities is at high risk, they said. Additionally, the defendant physician recommended implanting the defibrillator because he feared that the plaintiff would not comply with his medication regimen well enough to manage his condition successfully without surgery; the plaintiff had been prescribed blood pressure medication before, but it was not enough to prevent the high blood pressure emergency that brought him to the hospital in June 2007. Perhaps most importantly, the plaintiff returned to the physician after seeking a second opinion and attempting to manage his condition with medication only. It is not as though the defendant physician refused to release the plaintiff from the hospital unless he underwent immediate surgery.
In 2013, the plaintiff had the device surgically removed, but he chose to have a similar defibrillator implanted in its place. Attorneys for the defendant used this fact as an example of how medicine, and cardiology in particular, is not as simple as following a recipe, as they put it. Some doctors might have recommended leaving the device out, but the issue is not clear-cut.
During the medical malpractice trial, which took place in 2018, after the defendant cardiologist had retired, the physician testified in his own defense. He stated that the patient’s history of congestive heart failure, severe obesity, and sleep apnea were evidence that a serious intervention like a cardiac defibrillator implant was in order.
The jury ruled in favor of the defendants. Meanwhile, hundreds of other patients have filed claims against the cardiologist, accusing him of counseling them to have medical devices implanted unnecessarily.
The plaintiff is now 36 years old and has a cardiac defibrillator implant other than the one the defendant originally implanted.
Cases like these come down to individual judgment, and the expertise of medical expert witnesses, including cardiologists and electrophysiologist, was instrumental to the outcome of this case.
