0:00 0:00

Duration: 9:05

This podcast is an episode of Case Studies. You can find other episodes and subscribe using the links to the left.

A missed MI diagnosis after office visit

A 53-year-old male called his PCP’s office complaining of worsening heartburn, and requested a visit to see if there might be a different medication he might try. His past medical history included a 10-year history of gastroesophageal reflux disease, as well as COPD, elevated cholesterol, borderline hypertension, smoking, and chronic back pain.

During the exam, he explained that he had been taking Prilosec 20 mg daily as prescribed, but his acid reflux was coming more frequently in the past week. He tried taking extra TUMS®, but this had not helped. On exam, his BP = 150/90, wt = 205 lbs., ht = 5’10”. His physician talked to him about some strategies, including avoiding heavy meals, no meals within two hours of going to bed, and elevating the head of his bed at night. In addition, he told him to increase his Prilosec. A follow-up appointment was scheduled for a month later to check his symptoms. His doctor also asked him to call the office if his symptoms get any worse in the meantime.

The next day the patient was found dead at home; cause of death — cardiac arrest. The family sued the primary care physician, alleging negligent failure to diagnose acute MI, resulting in death. The case was settled in the high range.

Subscribe to MedMal Insider
Sign up and keep up.

MedMal Insider

Real Malpractice Cases from the Harvard Medical Community.
See all episodes

About the series

Even in the safest healthcare setting, things can go wrong. For more than 40 years, CRICO has analyzed MPL cases from the Harvard medical community. Join our experts as they unpack what occurred and the lessons learned for safer patient care from the causes of these errors.


Recent Episodes from the MedMal Insider Series
    older man smoking a cigarette

    Incidental Lung Nodule Overlooked, No Follow-up, Fatal Cancer Advances

    A patient was imaged for abdominal pain, but the radiologist saw and reported an incidental finding of a nodule on the lower lung that was not pursued or revealed to the patient for 2 years. The cancer had metastasized, and the patient died from lung cancer 18 months later.
    Man seated on a sofa

    Overdose or Poor Documentation?

    The patient’s family alleged that improper management of the patient under anesthesia resulted in cardiorespiratory arrest, permanent brain damage, and a persistent vegetative state. While the cause of the patient’s cardiac arrest is uncertain, the CRNA failed to note which medications and doses were administered during the procedure, and the case was settled for more than $1 million.
    older man using computer

    Response to Charges of Discrimination can Help or Hurt a Hospital, Any Employer

    When hospitals and medical practices face charges of discrimination from employees, the consequences can include litigation, large payments, morale problems, and less quality care for the patients they serve. How an employer responds can make all the difference in outcomes. Based on closed claims in the Harvard medical system, two cases illustrate that point. We interview Megan Kures, of Hamel, Marcin, Dunn, Reardon and Shea, who offers some principles to follow.
Subscribe to MedMal Insider
Sign up and keep up.
Cookies help us improve your website experience.
By using our website, you agree to our use of cookies.