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Case Settles – Healthcare Professionals Fails to Follow Medical Diagnosis Safety Rules

On a Wednesday in July, a 32-year-old school teacher was coaching a summer league basketball game when he suddenly experienced a sharp stabbing pain in his neck, with pain in his chest area that he thought to be “heartburn”. Although his neck pain went away, he still had general feelings of weakness and malaise, which prompted him to see his family doctor the next day. At that appointment, he was examined by a physician’s assistant. An EKG was performed which was interpreted as normal. The patient was told there was nothing to worry about.

Two days later, while playing video games with his neighbor, the patient collapsed. He was pronounced dead upon his arrival at the emergency room. He suffered from a dissected aorta, the major artery that attaches to the left ventricle of the heart.

A team of lawyers from Atlee Hall concluded the case successfully, arguing that the physician’s assistant should have sent the patient for an urgent CT scan to rule out cardiac issues, including a possible dissection of the aorta. It was plaintiff’s position that the combination of a sharp stabbing pain in his neck, a symptom the patient had never experienced before, coupled with a report of pain that the patient believed to be heartburn warranted investigation beyond the normal EKG. Because cardiac abnormalities can lead to sudden, immediate death, it was incumbent upon the physician’s assistant to order the additional tests immediately.

Another factor that should have led the defendants to immediately order appropriate tests was the fact that the patient was extremely tall, and exhibited some features that are typical of patients with Marfan’s syndrome. Marfan’s syndrome is a connective tissue disorder that places the patient at an increased risk for aortic dissection. Numerous athletes, typically basketball or volleyball players, have experienced sudden death due to aortic dissection from Marfan’s syndrome.

The case demonstrates that healthcare professionals must pay attention to all available information when forming a differential diagnosis of the patient’s complaint. The differential diagnosis is a cornerstone of modern medicine, requiring the healthcare professional to take all available information and form a list of possible causes of the patient’s new complaint. If that list includes any cause which could result in imminent harm to life or limb, the healthcare professional must assume the patient has that life or limb threatening condition until proven otherwise. This fundamental rule, if followed by healthcare professionals, would prevent countless deaths and disabilities, as was the case at hand.

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