Queller, Fisher, Washor, Fuchs & Kool, L.L.P.

Myocardial Infarction Heart Attack

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.

At 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 you deserve.

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 in survivors.

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 first responders.

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 Medical Malpractice?

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 described below.

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.

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