Aortic Dissection Misdiagnosis Wrongful Death Lawsuit

Mullikin v. Groover, Christie, and Merritt, P.C.,et al.

(Filed on January 19, 2016)

Jurisdiction
  • Montgomery County
Defendants
  • A radiologist
  • Doctors Groover, Christie, and Merritt, P.C.
  • A cardiologist
  • Maryland Heart P.C. d/b/a/ Johns Hopkins Community Physicians
  • Suburban Hospital, Inc.
  • Suburban Hospital Healthcare System, Inc.
Summary of Plaintiff's Allegations

A 71-year-old woman presents to the Suburban Hospital's emergency room in Montgomery County complaining of chest pain radiating up to her shoulder. An EKG shows that the woman's heart rate is lower than normal, and a chest x-ray shows that her heart is slightly enlarged. Coronary ischemia is suspected (not having enough blood through the coronary arteries) and the woman is admitted for cardiac catheterization. She is discharged later that day.

The woman returns to Suburban Hospital Emergency Room the next day complaining of the same symptoms. No EKG changes are noted and a chest x-ray again shows that the woman's heart is enlarged. Laboratory results reveal that the woman is suffering from hypokalemia (a potassium deficiency) and that her red bloods cells/hemoglobin/hematocrit levels have dropped since the day before.

Early the following morning, a Computed Tomography Angiogram (CTA) of the woman's chest is performed. In the CTA report, a doctor states that there is no definite artery blockage or evidence of aortic dissection. The woman is admitted to the Clinical Decision Unit (CDU) for further evaluation. She experiences pain throughout the morning. Her red blood cells/hemoglobin/hematocrit continue to lower.

A radiologist at Groover, Christie, and Merritt, a Montgomery County radiology group with 17 locations, interprets the results of the CTA as showing no evidence of artery blockage. He simply interprets the CTA as showing an enlarged heart. The doctor fails to diagnose a penetrating ulcer in the ascending aorta with thickening of the wall, which likely represents an intramural hematoma.

Later that morning a transthoracic echocardiogram (TTE) is ordered. The defendant cardiologist interprets the TTE and attributes the woman's chest pain to inflammation of the lining around her heart. The doctor fails to diagnose an atypical linear element in the superior ascending aorta, which likely represented an intramural hematoma requiring further evaluation.

In the afternoon the woman is discharged and told to follow up in one week. The woman presents to her follow-up cardiology visit as instructed. Her blood pressure is elevated, she is prescribed some medication, and she is told to follow up in one month.

The following day the woman's family finds her unresponsive on the bathroom floor. Her family begins performing CPR while awaiting emergency medical personnel. CPR is unsuccessful. The woman is transported to Suburban Hospital where she is pronounced dead later that night. The autopsy report reveals that the cause of death is dissection and rupture of the proximal aorta. This dissection is likely what was responsible for the woman's chest pain a week earlier.

The woman's estate files a survival action against each of the doctors, claiming that the first doctor breached the standard of care by failing to properly interpret the CTA scan and that the second doctor breached the standard of care by failing to realize the significance of the woman's chest pain and properly interpret the TTE. The woman's family also files a wrongful death action against each of the doctors. The family claims that had they met the standard of care, their mother/wife would have been properly diagnosed and would have survived.

The woman's estate and her family also bring actions against Maryland Heart P.C., Suburban Hospital, Inc., Suburban Hospital Healthcare System, Inc. - the doctors' employers.

Negligence
  • Doctor Reviewing a Generic DiagnosticRadiologist: Failed to properly analyze the CTA scan
  • Cardiologist: Failed to realize the significance of the woman's chest pain and properly interpret the TTE
Specific Counts Pled
  1. Survival Action
  2. Wrongful Death Action
  3. Respondeat Superior
Plaintiff's Experts and Areas of Specialty
  • Richard Friedlander, M.D. - board certified in cardiology; licensed to practice medicine in New York
  • Keith Allen, M.D. - board certified in thoracic, vascular, and general surgery; licensed to practice medicine in Indiana, Kansas, and Missouri
  • Michael Chaliff, M.D. - board certified in radiology; licensed to practice medicine in Georgia, Florida, and South Carolina
Additional Comments
  • It is difficult to ascertain the strength of the Plaintiff's case based on the Complaint without seeing the CTA or TTE. But it would be surprising, given Maryland's cap on non-economic damages, that a medical malpractice lawyer would take a multiple expert case involving the death of a 71 year-old woman unless the liability case was very strong.
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