Sommers Schwartz attorneys Dina Zalewski filed a medical malpractice and wrongful death lawsuit on behalf of the estate of a 66-year-old Detroit woman who died hours after being discharged from a local hospital’s emergency department.
In the early morning hours of March 28, 2020, the decedent presented to the ER complaining of upper and mid-back pain that had begun several hours earlier. She reported that her pain was worse with movement and when she took a deep breath. She denied any falls, trauma, or other precipitating event. She had a known history of hypertension. A resident physician evaluated her, followed by an attending emergency physician.
The ER staff ordered a chest X-ray and concluded, without further testing, that her pain was “most likely musculoskeletal.” Cardiac causes were never considered. No CT angiogram of the aorta (a standard follow-up imaging study when aortic pathology is suspected) was ordered or performed. The hospital’s radiology team interpreted the chest X-ray as showing a “normal cardiac silhouette” with “no acute process.”
Imaging showed increased opacity in the ascending aorta, a finding consistent with aortic dissection (a tear in the inner wall of the aorta, the body’s main artery) that requires emergency surgical intervention. That finding was not recognized, not reported to the treating physicians, and not flagged for further evaluation.
The patient was discharged at 2:12 a.m. with pain medication and instructions to follow up with her primary care doctor in one to two days. She called her daughter shortly after arriving home to say she was still in pain. Approximately nine hours later, her daughter found her unresponsive in bed. CPR was unsuccessful. An autopsy confirmed the cause of death was a ruptured aortic dissection, the same condition that had been developing, undiagnosed, throughout her emergency department visit. Before her death, she suffered hemiplegia, paraplegia, severe brain damage, and multi-organ failure as the dissection progressed untreated through the night.
The standard of care required the emergency providers to perform a thorough examination, including measuring bilateral arm blood pressures, a key indicator of aortic involvement, and to include aortic dissection in the working list of possible diagnoses. The radiologists should have recognized the imaging abnormality and promptly communicated it to the treating team. There should have been prompt consultation with a cardiothoracic surgeon and follow-up imaging, including a CT angiogram of the aorta. Had those steps been taken, the decedent would have been diagnosed, taken to the operating room for life-saving surgery, and would still be alive today.
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