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A Missed MI Diagnosis and Death After Office Visit


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A Missed MI Diagnosis and Death After Office Visit

By Thomas Sequist, MD, MPH

Related to: Ambulatory, Claims, Clinical Guidelines, Diagnosis, Primary Care, Other Specialties

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.

July 25, 2013
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