When a patient goes to the emergency room, there is an expectation that staff will provide effective treatment following an accurate diagnosis. In order to do these things, a doctor must acquire a detailed medical history from the patient in order to rule out potentially critical, life-threatening problems that might not be obvious upon initial observation.
If emergency room staff fail to complete these essential steps in patient care, the patient inevitably suffers – which could lead to further injury, illness, or even death.
In this case, The Townsley Law Firm proved that an emergency room physician in a Louisiana hospital failed to meet standard of care, ultimately causing the death of our client. Our skilled attorneys represented our client’s family and secured a settlement of over $300,000 to bring accountability to those responsible, and to help ensure that other families don’t face this kind of preventable loss.
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What Happened: A Cardiac Emergency Dismissed as a Viral Infection
Our client was a 67-year-old woman with a well-documented medical history that included diabetes, atherosclerosis, and a prior heart attack. She came to the emergency room with a single chief complaint: shortness of breath on exertion.
On arrival, the nursing staff recorded that she was hypertensive (high blood pressure) and tachycardic (elevated heart rate). These are two of the most significant vital sign abnormalities an ER team can observe, especially in a patient with her cardiac history. Despite this, she was not given supplemental oxygen to relieve her distress.
The attending emergency room physician reviewed her complaint and, without adequately considering her medical history, her current vital signs, or the medications she took daily, diagnosed her with a viral respiratory infection. She was given Tylenol, told she would feel better in two to three days, and discharged after less than one hour in the ER.
She collapsed at home two hours after discharge, her family called 911. She was brought back to the same emergency room, unresponsive, with CPR already in progress.
She was pronounced dead. The cause of death: a heart attack. The very cardiac event the physician failed to investigate when she first walked through the door.
Her death was not inevitable. It was preventable.
What the Doctor Missed and Should Have Caught
This was not a subtle or ambiguous presentation. When reviewed by medical experts, the failures in this case were clear and systematic.
Her medications alone should have triggered a cardiac workup. At the time of her ER visit, our client was taking:
- Plavix (clopidogrel): a blood thinner used to prevent heart attacks and strokes in high-risk cardiac patients
- Aspirin: prescribed in cardiac patients to prevent arterial clotting
- Metoprolol: a beta-blocker used specifically for heart failure, high blood pressure, and arrhythmia
- Metformin: a diabetes medication, relevant because diabetic patients frequently experience atypical heart attack symptoms, including shortness of breath without chest pain
- Pravastatin: a statin used to lower cholesterol and reduce cardiovascular event risk
A patient on this combination of medications is, by definition, a patient being managed for active cardiac disease. The presence of shortness of breath in a patient on Plavix, aspirin, metoprolol, and a statin, while hypertensive and tachycardic, required a cardiac differential diagnosis. At minimum, it required a chest x-ray.
The physician performed neither. He did not consider a cardiac cause for her symptoms. He sent her home.
How We Proved Medical Negligence
The Townsley Law Firm built this case around a straightforward legal and medical argument. The physician’s failure to consider a cardiac cause for our client’s symptoms, given everything that was documented in her chart, fell far below the standard of care expected of a Louisiana emergency medicine physician.
Working with qualified medical experts, we established that:
- A reasonably competent emergency physician faced with this patient’s presentation, history, and medication list was required to rule out a cardiac cause before discharging her
- The failure to order an EKG and troponin testing was a direct deviation from accepted emergency medicine protocols
- The failure to administer supplemental oxygen to a symptomatic, hypertensive, tachycardic patient compounded the breach
- The misdiagnosis of viral respiratory infection, and the premature discharge, were the direct and proximate cause of her death
The case was resolved in a settlement for our client’s surviving family members.
What Is Emergency Room Misdiagnosis Under Louisiana Law?
Emergency room misdiagnosis occurs when an ER physician fails to correctly identify a patient’s condition, and that failure causes harm. In Louisiana, emergency physicians are held to the standard of care of a reasonably competent emergency medicine physician practicing under similar circumstances.
This does not mean doctors are required to be perfect. It means they are required to conduct a reasonable and thorough evaluation, consider the patient’s full clinical picture, including history, medications, and vital signs, and investigate potential life-threatening diagnoses before ruling them out. When a physician skips that process and a patient is harmed as a result, Louisiana law allows the patient or their family to hold that physician and their employer accountable.
What Is a Wrongful Death Claim in Louisiana?
When a patient dies due to medical negligence, Louisiana law allows the surviving family members to pursue a wrongful death claim against the responsible parties. Louisiana Civil Code Article 2315.2 grants this right to the patient’s spouse, children, parents, and siblings, in that order of priority.
A wrongful death claim in a medical malpractice context requires proving that the healthcare provider’s negligence caused the patient’s death, and that surviving family members have suffered compensable losses as a result. Those losses can include funeral and burial expenses, loss of financial support, loss of love and companionship, and the emotional pain of losing a family member to a preventable medical error.
Louisiana’s medical malpractice statute of limitations is one year from the date of death or the date the family discovered, or should have discovered, that negligence was involved.
Why Heart Attacks Cause Shortness of Breath — Especially in Diabetic and Elderly Women
Most people think of a heart attack as sudden, crushing chest pain. That presentation is common, but it is far from universal. Research consistently shows that women, elderly patients, and diabetic patients frequently experience atypical heart attack symptoms, of which shortness of breath is one of the most common.
In diabetic patients, nerve damage (diabetic neuropathy) can blunt the chest pain signals that typically accompany a cardiac event. This means a diabetic patient having a heart attack may present with only fatigue, shortness of breath, nausea, or vague discomfort. Symptoms that can be mistaken for respiratory or gastrointestinal illness.
Emergency medicine physicians are trained to know this. The presence of diabetes in a patient’s history is itself a reason to elevate the suspicion of cardiac disease when evaluating shortness of breath. In our client’s case, that knowledge existed in her chart, but it was not applied.
