Doctors Worry About the Rise in Med-Mal Payouts; More

Wayne J. Guglielmo, MA

December 02, 2019

Cardiologist Is Still in Hot Water

Six years out, the case against a consulting cardiologist continues, despite his co-defendants being dropped from a claim involving the death of a heart patient.

According to a report posted on Legal Newsline , a suit was brought by the widow of Edward Szekely, who was treated in a Michigan hospital for chest pain and shortness of breath. During his three-day stay, Szekely was seen by a consulting cardiologist.

Twelve days before his admission, Szekely had suffered a heart attack, which required that his doctors place an implantable cardioverter defibrillator (ICD) in his heart, with a lead going to his right ventricle. To date, there have been no allegations of negligence regarding the implantation procedure itself, although such procedures pose risks, including the chance that the wire lead will migrate and cause tissue and other damage to the heart.

About a week after his August 4 discharge from the hospital, Szekely visited his primary care doctor's office complaining of shortness of breath, chest pain, and pain while breathing. He was seen by a physician assistant, who a few days later followed up with the patient and noted in his chart that he was "doing well." Szekely continued to experience problems, however, although he didn't seek further treatment.

On August 18, 2013, he died. An autopsy showed that he had suffered a cardiac tamponade — the compression of the heart from an accumulation of fluid within the pericardial sac.

In her suit, Debra Szekely alleged that the defendants — her husband's PCPs, their PA, the consulting cardiologist, and Michigan CardioVascular Institute, the consultant's professional corporation — failed to take appropriate medical action, despite her husband's complaints of chest pains and shortness of breath and despite the results of a computed tomography angiography (CTA) scan allegedly showing a mild pericardial effusion, the result of his ICD's lead migration. His providers, claimed Debra Szekely, were negligent in not detecting and repositioning the lead before it caused her husband's death.

The trial court disagreed, noting that the evidence showed conclusively that the perforation and bleeding around Edward's heart had occurred shortly before his death and "not on or before the dates of the pertinent treatments by defendants." A summary judgment was issued in favor of each of the defendants.

At this point, Debra Szekely and her attorneys appealed the lower-court judgment to the Michigan Court of Appeals. Late last month, the appeals court handed down its decision. While permitting the summary judgment in favor of the other defendants to stand, it reversed "the grant of summary disposition for the consulting cardiologist and his associated professional corporation and remand[ed]…[the] case for further proceedings consistent with this opinion."

Among other things, the court agreed with the plaintiff's argument that "the trial court improperly made findings of fact, assessed the credibility of witnesses, and weighed the evidence concerning whether [the cardiologist] acted negligently and whether his negligence led to Edward's death."

The court was especially critical of the lower court's failure to hear the testimony of the plaintiff's expert witness, who explained that the consulting cardiologist had not acted according to the standard of care when he failed to call for further testing after the initial CTA scan proved inconclusive. Had he done so, the expert witness said, the consulting cardiologist would have established that the patient's symptoms were the result of a perforation caused by the ICD lead.

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