Misdiagnosis of Heart Attack in NYC
Statistics suggest that more than 8,000 people will die this year as a
result of a misdiagnosed heart condition that leads to a fatal heart attack.
Twice that many may survive heart attacks that might have been prevented
with proper diagnosis.
Queller, Fisher, Washor, Fuchs & Kool, L.L.P.,, our New York heart attack lawyers have the knowledge and experience to
help you protect your rights in the wake of serious injury or death following
a misdiagnosed heart attack. Our
attorneys will build a team of legal and medical experts to fight for the compensation
Call Us to Learn How We Can Help
Our cases are taken on a contingency fee basis. If we accept your case,
there is no fee unless we recover damages for you. For a
free consultation with our New York personal injury attorneys, please call 212-406-1700 or
contact us online.
Information About Heart Attacks
Heart attacks have been, and remain, a leading cause of death for Americans.
According to CDC data (preliminary data from 2011, the most recent available),
"diseases of heart" remain the leading cause of death for Americans.
A heart attack - in medical terms a myocardial infarction - is damage to
the heart muscle resulting from a lack of oxygen to the tissue. Like all
tissue in the body, the heart requires oxygen. Thus, as oxygen rich blood
is received from the lungs and pumped by the heart to the rest of the
body, the heart too must pump oxygenated blood to its own tissues.
When coronary arteries - the blood vessels supplying blood to the heart
muscle itself - are blocked, this oxygen delivery system is disrupted.
Transient, or blockage that comes and goes, is referred to as angina.
These are called ischemic episodes, meaning there is a lack of oxygen
to the tissue. It is when the lack of oxygen progresses to infarction,
the death of tissue due to the lack of oxygen, that there is a heart attack
or myocardial infarction: "myocardial" referring to the heart
muscle (myocardium) and "infarction" meaning tissue death from
lack of oxygen.
Typically the coronary arteries become blocked when a "clot"
lodges in the artery blocking the flow of blood. The clot itself can be
a piece of plaque that has dislodged from the arterial wall. When the
arteries have become narrowed due to the buildup of plaques, the risk
of blockage increases.
Much research and effort has gone into the early detection and treatment
of heart conditions, before they become fatal, as well as into the prompt
treatment of heart attacks to increase survival and reduce disability
Beginning in 1948, for example, the Framingham Heart Study set out to identify
the leading risk factors for heart attacks. Since then, the study has
continued to enroll new participants and expand its research. Importantly,
it has provided physicians with commonly accepted risk factors for heart
disease; the major ones being high blood pressure, high blood cholesterol,
smoking, obesity, diabetes, and physical inactivity. The study has also
allowed physicians to calculate a person's risk score. With this knowledge,
physicians have the tools to better identify and modify major contributing
factors for heart disease. Physicians, moreover, have the ability to identify
those patients who are at a greater risk for heart attack. This allows
doctors to better interpret the significance of, and respond to, a particular
patient's complaints or symptoms. For example, a patient with high
blood pressure, who smokes, who complains of chest pain to a doctor -
even if the pain is "atypical" for heart disease - requires
a more careful and aggressive response than a patient with the same complaints
who is physically active and fit, a non-smoker, and without any of the
major heart disease risk factors.
A tremendous amount of work has also gone into responding to and treating
heart attack when it does occur. In 1960, three physicians documented
the survival of 14 heart attack patients with the use of what is now called
chest compressions. That same year, presenters at the Maryland Medical
Society meeting demonstrated the efficacy of chest compressions and rescue
breathes; what has since become known as CPR or cardiopulmonary resuscitation.
Two years later, in 1962, monophasic waveform external electronic defibrillation
was introduced - "shocking" the heart attack patient.
In 1966, the American Heart Association published its first cardiac life
support guidelines. Composed by a panel of internationally recognized
experts, based on the most current research, these guidelines are updated
about every five years. They represent the generally accepted "rules"
for identifying and treating a heart attack. These protocols affect treatment
by doctors, nurses, paramedics, emergency medical technicians, and other
In New York, a system of Regional Emergency Medical Councils has been established
to credential emergency responders and ambulance companies, and to coordinate
emergency responses to life-threatening conditions, such as heart attack.
The regional councils, in addition, prescribe protocols for the identification
and treatment of, among other things, heart attack.
Despite the tremendous advances in the area, tragically, heart attacks
are still too often causes of death or disability. Of considerable concern,
is when this on-going tragedy is a result of negligence by a medical provider;
that is, medical malpractice.
When is the Misdiagnosis of a Heart Attack or Failure to Respond Considered
In this area, malpractice falls, broadly speaking, into one of three categories:
(1) failure to modify a major risk factor; (2) failure to recognize the
early signs of heart attack; and (3) failure to timely or properly respond
to heart attack. Unfortunately, our attorneys have seen and litigated
malpractice cases involving each of these categories and the scenarios
No doctor can force a patient to change his or her life-style or to take
prescribed medications. Doctors can, however, readily determine whether
a patient has major risk factors, such as high blood pressure, high blood
cholesterol, or diabetes. A doctor's failure to recognize or address
the aforementioned conditions could be an example of negligence.
More commonly in malpractice cases, the patient presents the doctor with
complaints, some of which may be non-specific or "atypical."
When the doctor does not interpret those complaints in light of the patient's
risk factors, the early signs of a heart attack may be missed and the
chance to avoid a serious outcome - death or disability - could be lost.
In other circumstances, the patient goes to the doctor's office with
complaints that lead the doctor to perform an electrocardiogram (ECG),
a test to see the heart's electrical pattern which can show lack of
oxygen to the heart muscle - a heart attack or a condition that could
presage a heart attack. In some cases, however, the doctor misreads the
ECG and does not recognize the emergent nature of the condition. The patient
is then told to simply follow up with a specialist or to get further tests.
Tragically, a doctor's misreading of an ECG can lead to a patient
suffering a fatal heart attack before that work-up is obtained. In one
case, for example, the patient was told on a Friday to call the office
on Monday for a cardiology consult. The patient, however, suffered a heart
attack and died shortly after midnight on Monday.
A more extreme situation occurs when the doctor recognizes a problem on
the ECG or strongly suspects a heart attack from the patient's complaints
and history, but then tells the patient to take him or herself to the
emergency room rather than calling for an ambulance and initiating treatment
in the office. In one such case handled by our attorneys, the doctor told
the patient who was then having a heart attack to drive himself to a nearby
hospital. The patient then dropped dead on the sidewalk outside the office
while walking to his car. Had the doctor done something as simple as giving
the patient a baby aspirin and allowing him or her to lie in the office
with oxygen while the ambulance is en route can affect whether that person
lives or dies.
In the last category of cases, the patient is already having a heart attack.
He or she is already gravely ill and in need of good, effective, emergency
care. Despite the effectively universal availability of generally accepted
treatment protocols - guides that leave little judgment in how to intervene
and treat the patient - there are still instances when responders fail
to properly treat the patient. These cases typically involve improper
CPR technique, delayed or no administration of cardiac medications, or
improper electrical defibrillation. As to whether there was negligence
or malpractice, these situations are generally more straightforward than
other medical negligence cases, owing to the availability of the accepted
protocols. Few areas of medicine have such well-developed and generally
accepted protocols that practitioners are expected to follow.
Understanding Causation in Heart Attack Cases
Given the serious, life-threatening nature of the condition, these types
of cases present thorny questions of causation. In other words, can negligence
be said to have caused a person's death, for example, when, statistically
speaking, that person was likely to die anyway?
Proximate causation is a necessary component of any medical malpractice
case. Juries across New York are instructed that this means the negligence
or malpractice had to be "a substantial factor" in bringing
about the plaintiff's injury. How then does the failure to properly
treat a critical condition constitute "a substantial factor"
in a heart attack patient's death?
New York law does not require that a person first have a 51% chance of
survival - that it was more likely than not - before there can be a successful
malpractice case. Rather, what is required is that the person was deprived
of a "substantial opportunity" for a better outcome. This is
a qualitative test; meaning, there is no set percentage or chance of survival
in order for the patient to have a meritorious action for malpractice.
Nor does the term "substantial opportunity" imply or denote
a more-likely-than-not standard.
Our lawyers know this too well. In a major development, we successfully
obtained the reversal of summary judgment dismissing a family's action
for wrongful death stemming from the heart attack death of a man. The
patient suffered a heart attack at work. First responders were there quickly,
but then violated the applicable protocols for treating the heart attack.
The motion court dismissed the case finding that the patient was asystolic
- "flatline" - when the first responders arrived, and therefore
had only a speculative chance for survival even with the best of care.
The appellate court, however, reversed the dismissal, finding that it
cannot be determined that the patient was somehow destined to die. The
fact that there were guidelines in place for the treatment of this situation
indicated that there was a chance of survival, however statistically small
it may have been. It would, therefore, be up to a jury to determine whether
this gentleman was deprived of a "substantial opportunity" for survival.
How Can Our Attorneys Help You?
At Queller, Fisher, Washor, Fuchs & Kool, our attorneys have recouped
millions of dollars for the families of individuals who have lost a loved
one due to the misdiagnosis of or failure to properly respond to a heart
attack. We understand the emotional and financial burden that a family
can go through following the unexpected and unnecessary loss of a loved
one. As a result, our lawyers always pursue the maximum compensation available
for our clients.
If you have lost a loved one due to a misdiagnosed heart attack, you may
have grounds to file a lawsuit. For a free, no-obligation, case review,
call 212-406-1700 or
contact us online.