Aortic Dissection Misdiagnosis Lawsuit in Baltimore

Rochfort v. University of Maryland St. Joseph Medical Center

Heart ArrhythmiaThis is an emergency roomfailure to diagnose an aortic dissection lawsuit filed on behalf of a man in Baltimore County. It was filed in Health Claims Arbitration on April 11, 2017, and it is the 170th malpractice case filed in Maryland in 2017.

Summary of Plaintiff's Allegations

A 65-year-old man has a history of a prior aortic valve replacement that required anticoagulant therapy two years ago. He also has had two prior cardioversions. He goes to defendant ER with severe chest pain.

An EKG is done and it is abnormal - showing a first-degree atrioventricular block and left axis deviation. Another EKG is done later that day and reveals a right axis deviation, pulmonary disease pattern, a right bundle branch block, and nonspecific T-wave. A chest X-ray reveals cardiomegaly. The man is given nitroglycerin, but it does not alleviate his pain. He is diagnosed with a muscle strain and discharged home.

The next day, he is transported back to the hospital by an ambulance due to chest pain and back pain. The ER confirms a Type An aortic dissection extending to the external iliac artery with cardiac tamponade. The man suffers cardiac arrest in the ER. Defendants take him to the operating room to repair the dissection, but he goes into cardiac arrest again. He died just six days later in the hospital.

The man's family and estate files this claim, alleging that the hospital should have performed appropriate studies when he first presented to rule out an aortic dissection, especially since the man was a high-risk factor for this due to his cardiac history. Plaintiff's malpractice lawyer alleges that the ER doctor failed to me the standard of care for a reasonable and prudent physician in the diagnosis and management of a high-risk cardiac patient with a typical clinical presentation of an aortic dissection.

Additional Comments
  • An aortic dissection occurs when blood flow, under high pressure, tracks in between the inner layers of the aortic wall, disrupting the integrity of the wall and impairing normal blood flow.
  • A quick diagnose is key. If an aortic dissection is quickly diagnosed and aggressively treated with blood pressure lowering medications and prompt surgical replacement of the affected portion of the aorta with an artificial graft, patients often have a very good outcome.
  • The defense to these cases is that the symptoms of an aortic dissection are also the symptoms of other conditions. This is true. But given how serious an aortic dissection can be, the key test to rule out the possibility. This was not done in this cases, according to the complaint.
  • Plaintiff's expert says that had a CT scan been ordered, it would have shown the dissection. This presumably would have led the doctor to immediately order surgical replacement of the affected portion of the aorta with an artificial graft.
Jurisdiction
  • Baltimore County
Defendants
  • An ER doctor
  • Osler Drive Emergency Physicians Associates, P.A.
  • University of Maryland St. Joseph Medical Center
Hospitals Where Patient was Treated
  • University of Maryland St. Joseph Medical Center
Negligence
  • Failure to order an echocardiogram and chest CT scan
  • Failure to obtain a cardiology consultation
Specific Counts Pled
  • Wrongful Death
  • Loss of Consortium
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