The plaintiff’s decedent, a 46 year-old male, had a history of asthma, hypertension and was a smoker. He saw the defendant family practitioner for management of his hypertension, asthma and eczema starting in 2004. The defendant prescribed medication to manage his blood pressure and also treated his asthma.
The blood pressure was never optimally controlled, in part because the patient did not always take the medication as prescribed.
In August 2005, the patient complained of shortness of breath and chest tightness on exertion and although the defendant felt these symptoms were due to an acute asthma attack and bronchitis, he recommended an echocardiogram on two occasions, which the patient did not obtain. As of the patient’s last visit with the defendant at the end of September 2005, he was feeling better following defendant’s treatment for asthma and respiratory infection and a chest x-ray ordered by the defendant was consistent with resolving pneumonia.
The patient presented to a local emergency department approximately one month later in October 2005 with acute shortness of breath but he declined admission to the hospital as recommended by the emergency room physician. The patient went home but his wife, after speaking by phone with the defendant doctor, brought him back to the emergency room two hours later with chest pain and respiratory distress that required intubation.
Unfortunately, due to constriction of the airway, the patient was not successfully intubated for approximately 30 minutes, during which time he suffered irreversible brain damage. Subsequent testing also revealed severely compromised cardiac function with congestive heart failure. The patient remained unresponsive on a ventilator until his death from complications of hypoxic ischemic encephalopathy ten months later
At trial, plaintiff claimed that the defendant failed to properly manage the patient’s hypertension and failed to refer him to a cardiologist or obtain an EKG or echocardiogram. The plaintiff’s experts testified that uncontrolled hypertension led to congestive heart failure and that many of the symptoms treated by the defendant as asthma exacerbation or acute respiratory illness were in fact cardiac in nature.
The plaintiff claimed that had a cardiac work up been done, the patient’s heart condition would have been diagnosed and treated, and the events that occurred in the emergency department in October 2005 would have been avoided.
The defendant maintained that he properly managed the patient’s blood pressure and referred him for an echocardiogram on two occasions and that the decedent was not compliant with his recommendation. The defense also maintained that there was no evidence that the patient had congestive heart failure prior to the October 2005 emergency room visit or that any cardiac condition caused his respiratory arrest.
The defense experts opined that the patient’s cardiac compromise and congestive heart failure did not cause his ischemic event but rather, they were caused by the ischemic event that damaged the heart as well as the brain.
In closing argument, plaintiff’s counsel asked the jury to award the plaintiff widow and her two young sons approximately $5.0 million. The jury deliberated for two hours over lunch before returning a verdict for the defendant.