Failure to Treat Mitral Value Regurgitation Lawsuit Against Union Memorial

Moyer v. Union Memorial Hospital

This is a hospital malpractice case filed on behalf of a woman in Baltimore City against Union Memorial Hospital and three doctors. It is the 376th medical malpractice case filed in 2016 in Maryland. It was filed in Health Claims Arbitration on August 1, 2016.

Summary of Plaintiff's Allegations

The decedent goes to the emergency room at MedStar Union Memorial Hospital complaining of leg pain that is worsening and radiating below her knee, in addition to swelling for over eight days. She also has headaches, constipation, and chills. Her medical history is significant for aortic insufficiency, hypothyroidism, diabetes, and chronic obstructive pulmonary disease. The ER admits her to the hospital for leg edema, with a concern for deep vein thrombosis and pulmonary embolism.

Defendant doctors are her attending physicians. They perform a duplex scan, which is negative for deep vein thrombosis, and a CT of the patient's chest is negative for pulmonary embolism. They do an echocardiogram, which shows severe mitral valve regurgitation, but a TEE is not ordered to investigate to determine if surgery is appropriate. Common causes of mitral value regurgitation are coronary artery disease, heart failure or rheumatic disease. A majority of the population has some degree of regurgitation of the mitral valve. More specifically, a vast majority of women over 50 have some degree of mitral valve regurgitation.

The following day, the woman has a cardiology consult, performed by one of the defendant doctors, which reveals a pulmonary effusion, is a side effect of mitral valve regurgitation.

She begins to complain of pain in her upper right quadrant and starts to become lethargic. She is transferred to the ICU with a significant amount of pain, an altered mental status, and C. difficile colitis. Over the next day, her condition continues to decline, and a doctor notes that there may be an additional source causing the changes in mental status other than just the C. diff.

Over the next three days, her condition continues to decline. An EEG done is abnormal, and she is diagnosed with a bilateral cerebral stroke, which is a severe complication of mitral valve regurgitation. In half a month, she is discharged to hospice care where she unfortunately dies three days later of cerebrovascular accident.

Her family brings a survival action and wrongful death medical malpractice lawsuit alleging that due to the negligent care the decedent received, she suffered conscious physical pain and suffering, emotional distress and suffering, and medical expenses.

Additional Comments
  • It is amazing how many medical malpractice cases in Maryland are filed on the eve of the statute of limitations without an expert report. This case was filed six days before the statute of limitations.
  • The complaint does not tell us enough to access this case. We assume that a transthoracic echocardiogram (TTE) was done that showed severe mitral value regurgitation. If that test did not give enough information or the images were not sufficient, a transesophageal echocardiogram (TEE) can be used. A TEE provides a higher-resolution image, particularly of the mitral valve, and is indicated for clinical decision making when the TTE is inadequate.
  • The focus of this wrongful death case appears to be on whether ordering a TEE would have led to a different diagnosis and outcome. A TEE is a special type of echocardiogram whereby a cardiologist will take a probe and slip it down the esophagus right behind the patient's heart. So it is more invasive. The TEE allows the doctor to see the left atrium in more extensive detail and, importantly for this case, the cardiologist can get a good look at the mitral valve
  • The mitral valve is just one of the valves that separates two chambers of the heart. It separates the left atrium from the left ventricle. It sits in a fibrous circular tissue called an annulus.
  • Mitral valve prolapse means the patient has redundant mitral valve leaflet tissue. If surgery is indicated, the surgeon snips the tissue and sews it together and make it a better fit.
  • You can expect Union Memorial to argue that the woman was not fit for surgery even if surgery was indicated for her mitral value regurgitation.
Jurisdiction
  • Baltimore City
Defendants
  • Union Memorial Hospital
  • Two internal medicine doctors
  • A cardiologist
Negligence
  • Failure to administer proper diagnostic testing
  • Failure to recognize and investigate the severe mitral valve regurgitation
  • Failure to treat the mitral valve regurgitation
  • Failure to diagnose and treat the decedent for stroke in a timely manner
Specific Counts Pled
  • Medical Negligence - Survival Action
  • Medical Negligence - Wrongful Death
Plaintiff's Experts and Areas of Specialty
  • None at this time
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