If “Sudden” Cardiac Arrests Aren’t So Sudden, Is the Cardiologist to Blame?

While sometimes cardiac arrest symptoms appear all of a “sudden” (as in the case of spontaneous coronary artery dissection, a rare condition), often there are warning signs.

Numerous studies, including recently reported Danish research, show that most people experience symptoms of cardiac arrest hours or days before the actual event. These symptoms could indicate to an experienced health care provider that a patient may soon experience a cardiac arrest. Early diagnosis and appropriate medical intervention can save lives. But when signs are overlooked or mistakes are made, there may be grounds for a cardiology malpractice case.

What Is Cardiac Arrest?

Cardiac arrest refers to a condition where the heart’s electrical system malfunctions, causing the heart to stop beating properly. (A heart attack, or myocardial infarction, is a different condition, in which heart muscle tissue dies due to loss of blood, usually as the result of a blockage.) There are more than 356,000 out-of-hospital cardiac arrests annually in the U.S., nearly 90 percent of them fatal, according to a 2019 report from the American Heart Association. Performing cardiopulmonary resuscitation (CPR) immediately, then using a defibrillator to shock the heart and restore a normal heart rhythm, must be done within a few minutes to prevent death.

Signs and Symptoms Can Warn of Upcoming Danger

A 2006 study of Berlin cardiac arrest patients found that many patients experienced symptoms in the hours or minutes before a cardiac arrest, including chest pain, shortness of breath, nausea or vomiting, or dizziness. In 90 percent of the witnessed cases, symptoms lasted for at least five minutes. Only 25 percent of the victims had truly “sudden” cardiac arrests with no reported warning signs. This finding is correlated by the 2019 AMA report, which compiled data from a wide range of U.S. agencies and nationwide organizations. The Berlin study also found that two-thirds of the studied patients had previously diagnosed cardiovascular problems, including heart disease, previous cardiac arrest, or angina. 

The new Danish research reveals that over half of the studied cardiac arrest patients contacted the healthcare system (their general practitioner or a hospital) in the two weeks before the event. The group of nearly 29,000 cardiac arrest patients also had significantly more contact with their medical professionals in the year before the occurrence than the general public. A 2015 review of over 800 sudden cardiac arrest patients in Portland, Oregon, also revealed that more than half experienced warning symptoms in the four weeks before their cardiac event, although only 19 percent called 911 to report those signs.  

Medical Malpractice: Failure to Meet the Standard of Care

Michigan healthcare workers, including doctors, nurses, and other medical providers, must treat patients consistent with the generally accepted standard of care, which is defined as the type and level of care that an ordinary, prudent, health care professional with the same training and experience would provide under similar circumstances in the same community.

This means that the actions of a cardiologist with 25 years of experience, practicing in a well-equipped hospital or medical facility, would be measured against what is generally considered “reasonable” performance from an experienced cardiac professional in the same situation. There is no “one size fits all” definition of medical malpractice; whether a provider’s treatment meets the legal standard of care must be determined on a case-by-case basis.

If a provider’s actions – or omissions – fail to meet the standard, they may be liable for medical malpractice. Failing to take generally accepted steps to diagnose a potential cardiac arrest may, in certain circumstances, constitute professional negligence. Knowing that many “sudden” cardiac arrest patients have pre-existing cardiac risk factors and demonstrate warning symptoms may affect the appropriate standard of care for cardiologists treating these patients. 

Preventing Cardiac Arrest and COVID-19 

The COVID-19 coronavirus pandemic is also a factor in determining the reasonable and appropriate standard of preventative patient care or treatment. For example, it might be reasonable to avoid admitting a high-risk patient with mild cardiac symptoms into a hospital rather than cautiously keeping them for observation, as might be the usual practice. 

Healthcare professionals must balance the potential for cardiac arrest and the value of an immediate medical response against the danger of exposure to coronavirus and its potentially detrimental outcomes for each patient. Negligently failing to provide a patient with a reasonable treatment protocol may constitute medical malpractice, but so could negligently failing to take reasonable precautions to protect an especially vulnerable patient from infection. 

Determining whether a patient has received care that is reasonable and meets the legally-required standard of care requires skill, expert analysis, and investigation. An experienced medical malpractice attorney – like the attorneys at Sommers Schwartz – can help evaluate your unique situation and your options to pursue justice and compensation for your injuries.