Heart Attack Misdiagnosis | Rockville Maryland Lawsuit

Urbina v. Kaiser Foundation Health Plan

This is a classic failure to diagnose a potential heart attack case against Kaiser Permanente and its health care providers. It was filed on February 3, 2016. It was the 52nd medical malpractice filed in Maryland in 2016.

Summary of Plaintiff's Allegations

A 63-year-old man presents to the Defendant Kaiser Permanente's Gaithersburg Medical Center with complaints of chest pain. Rather than evaluate the man's chest pain, the Defendant Kaiser Permanente instructs him to return to the office in two days. When he returns, still complaining of chest pain, his primary care physician orders an electrocardiogram (ECG) study. The primary care physician determines that the study is normal and sends him home without further instructions or interventions regarding his chest pain.

The man returns to the Defendants' office two months later. He is still complaining of chest pain, which he says now radiates up to his neck. An ECG is ordered and performed the same day. The doctor thought it was normal. Hs is sent home after scheduling a nuclear stress test (NST), a diagnostic test used to evaluate blood flow to the heart, for two days later.

The man returns to the office for his nuclear stress test two days later. He is discharged that morning after the test. That afternoon, the doctors interpret his test results to be abnormal. Later in the day, the man receives a telephone call informing him that his results are abnormal and that he should follow-up with a cardiologist. He schedules and appointment for six days later.

That same evening, the man is transported emergently from his home in Germantown, Maryland, to Shady Grove Adventist Hospital Emergency Room. Upon his arrival, he is diagnosed with acute coronary syndrome, shock, respiratory failure, and unstable cardiac rhythm. Efforts made to stabilize him in the emergency room prove unsuccessful; he is pronounced dead later that night.

The man's family files a survival action and a wrongful death claim in Montgomery County, alleging that the Defendants violated the standard of care by failing to recognize the seriousness of the man's condition and properly treat it. The family alleges that had the Defendants complied with the standard of care, this man would have avoided all of his injuries, including his tragic and untimely death.

Additional Comments
  • The most critical issue in the case is likely to be whether the abnormal stress test warranted a trip to the emergency room. The most effective medical approach to preventing the patient's death in a case like this is early detection and treatment. The primary tool used to detect acute coronary disease is a stress test followed by confirmation with coronary arteriography which is what the family's lawyers are going to argue at trial.
  • Heart attack is leading killer of Americans. Approximately 1.5 million of us have heart attacks. One-third of those heart attacks end in death and most cannot be avoided. Still, too many people with had chest pain and other warning symptoms and could have been saved with prompt attention, diagnosis, and treatment.
  • The failure to diagnose a heart attack accounts for one-fifth of all malpractice payouts against emergency rooms. While this is not at ER case, the target defendants are internists and cardiologists which is very typical.
  • Montgomery County
  • Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
  • Kaiser Foundation Health Plan, Inc.
  • Mid-Atlantic Permanente Medical Group, P.C.
  • Two internists
  • A cardiologist
  • Carol Cardinale, M.D. - Cardiology
  • A nurse practitioner
  • Two CNMTs
Hospital Where Patient Was Treated
  • Shady Grove Adventist Hospital
  • Heart Arrhytmia Death Case Failure to timely and adequately realize, diagnose, and appropriately treat the man's true and serious medical condition
Specific Counts Pled
  1. Medical Negligence- Survival Action
  2. Medical Negligence- Wrongful Death
Plaintiff's Experts and Areas of Specialty
  • Gary W. Crooks, M.D. - board certified in internal medicine; licensed to practice in Pennsylvania,
  • Joel K. Kahn, M.D. - board certified in internal medicine, cardiovascular medicine, and interventional cardiology; licensed to practice in Michigan; head of a cardiology center
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