When the decedent presented to the emergency room, he had significant anemia due to a gastrointestinal bleed, and at the same time, he was having a myocardial infarction caused by a 100% occlusion of his left circumflex artery (LCX), which had substantial chronic stenosis for several years and had developed collateral circulation. The heart attack was completed, and the impacted heart muscle was dead within 24 hours of the heart attack.
The two treating cardiologists failed to realize that the heart attack was completed and that the patient’s ongoing complaints were due to the impacts of the heart attack, his anemia, and fluid overload from treating the anemia. They mistakenly decided to try and open up the LCX even though the heart muscle served by the LCX was already dead. During the attempt to open the LCX (which did not need opening), the left anterior descending (LAD) artery became full of clot caused by the instruments the doctor placed in the LAD and because the decedent was not adequately anticoagulated. The LAD was the major artery that was supplying blood to the heart muscle that was still alive. As a result of clotting off the LAD, the decedent then went into cardiogenic shock. Despite three attempts at cardioversion and CPR with shocking and intubation, he never regained consciousness and died two days later.
The lawsuit claimed that by failing to perform a left ventriculogram, the treating cardiologist did not determine that the patient had a completed posterior wall myocardial infarction, and that opening up the LCX would not help. Similarly, the suit alleged the cardiologist was negligent in unnecessarily opening the patient’s LCX when it was completely occluded and not the cause of the patient’s problems, which led to the blockage of the LAD that was feeding the heart. Because all of the impacted heart muscle had already died from the infarction, had they treated the patient medically and not attempted to open the LCX, he would still be alive today.