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Missed Diagnosis of Deep Vein Thrombosis and Pulmonary Embolism Lawsuits

In May 2016, a Philadelphia jury awarded $7.7 million in damages to a family of a woman who had died of a pulmonary embolism (PE). The jury determined that her doctors had failed to properly diagnose the problem, and because of their negligence, the woman died.

In another similar case, a 41-year-old New Jersey man died of a PE. His family sued the hospital where he was treated prior to his death and reached a $975,000 settlement with the facility. The man had gone to the emergency room with symptoms including hypoxia (low oxygen) and rapid breathing. He had also fainted, twice. An attending physician examined him, but neither administered the right treatment and he died 12 hours later.

Unfortunately, missed diagnoses of PE are not rare. According to a recent study published in the British Medical Journal (BMJ), 26 percent of patients who go to their general practitioner with symptoms of a PE receive a delayed diagnosis of 7 days or more. This is dangerous because PEs are serious medical conditions that can be deadly if necessary treatment is not received.

Pittsburgh residents who experienced PE injuries because of delayed or missed PE are advised to speak to the medical malpractice attorneys at Chaffin Luhana immediately. In many cases, a medical error may have caused these diagnoses to be missed, and families may be able to recover damages in court.

What is a Pulmonary Embolism?

A pulmonary embolism (PE) is a blood clot in the lungs. These blood clots usually develop in the veins deep in the legs and are the result of deep vein thrombosis (DVT).

DVT occurs when a blood clot forms in one or more of the deep veins in the body, usually the legs. It can cause symptoms like pain, aching, warmth, and swelling, or may occur with no symptoms at all. Sometimes, these clots can break off and travel in the bloodstream up into the heart and the lungs, where they may lodge in the lung arteries. Once there, they can cause a deadly PE.

A blood clot in a pulmonary artery prevents the blood from circulating normally. This can cause distress on the heart, causing it to struggle to do its job. How much it struggles depends on where the clot is—whether it’s in the smaller lung arteries that are farther away from the heart, or in the larger ones that are closer to the heart. In many cases, blood pressure increases in the lungs as the heart works harder than normal to pump blood.

Meanwhile, PEs can also prevent blood from reaching parts of the lung, which causes symptoms like shortness of breath, chest pain, painful breathing, dizziness, passing out, coughing up blood, irregular heartbeat, and in severe cases, shock, loss of consciousness, heart attack, and death.

Risk of PE increases with age. Other risk factors include long periods of inactivity (such as that which occurs during long car or airplane trips), smoking, cancer, obesity, cardiovascular disease, pregnancy, hormone supplements (birth control and hormone replacement therapy), and a family history of blood clotting disorders.

The Mayo Clinic states that about one-third of people with undiagnosed and untreated PE don’t survive. “When the condition is diagnosed and treated promptly, however,” they add, “that number drops dramatically.”

How is Pulmonary Embolism Diagnosed?

When a patient shows up in an emergency room or a doctor’s office with symptoms, the doctor should perform a thorough exam. If the patient has any symptoms that may indicate a PE, the doctor is supposed to conduct additional tests. These symptoms include those listed above—chest pain, difficulty breathing, and an abnormal heart rate.

Even if the patient is having symptoms that may not be commonly associated with PE, it’s up to the doctor to watch for signals that may indicate the lungs are in distress. Any signals at all should prompt the doctor to conduct additional tests to evaluate the patient’s risk of PE, such as the following:

  • Blood tests: Doctors look for high levels of a clot-dissolving substance called “D dimer.” High levels could suggest the presence of a blood clot. Blood tests can also show low levels of oxygen and the presence of an inherited clotting disorder;
  • X-rays: These can show the heart and lungs, but they may appear normal even if a PE exists;
  • Ultrasound: This test uses sound waves to look for blood clots in the leg veins;
  • Spiral CT scan: This is a type of CT scan that can find abnormalities in the lung arteries.
  • Pulmonary angiogram: This test has potentially serious risks, but may be used if other tests don’t produce a definitive diagnosis. The doctor threads a small, flexible tube into a large vein and up into the heart and lung arteries, injects a catheter, and then performs x-rays to follow the progress of the dye in the lung arteries;
  • MRI: This is an imaging test that can give doctors a better view into the lungs; and
  • EKG: This test shows the electrical activity of the heart.

How do Doctors Miss a PE Diagnosis?

Studies show that doctors fail to diagnose PE too often. In a 2017 study, researchers stated, “[d]iagnostic delay of more than 7 days in the diagnosis of PE is common in primary care.” This is even more likely in elderly patients, and in those who don’t have chest pain.

In a 2009 study, researchers found that PE is the “most frequently missed” or delayed diagnosis in clinical practice: “[e]rrors related to delayed or missed diagnoses are a frequent and underappreciated cause of patient injury,” the researchers wrote. They found that in most cases, doctors failed or were slow to consider that PE may be the cause of the problem.

According to the 2017 study, even when symptoms are typical, doctors can still dismiss them. In one case, for example, a 26-year-old woman went to the emergency room in Detroit, Indiana, feeling short of breath. The physicians diagnosed her with a virus and sent her home, and she died the next day.

While most physicians will often consider PE in patients who are coughing up blood, or who have painful breathing or shortness of breath, these types of symptoms are not always present.  But according to some studies, these symptoms are only present in a small number of cases. Other symptoms may include a simple cough, muscle pain in the chest, heart attack, or even kidney stones. PE can also occur with other medical conditions like respiratory infections, so doctors may believe that all the symptoms are caused by that other condition, and fail to check for PE.

Researchers say that doctors need to be more aware of when PE may be present, particularly when patient symptoms don’t improve, or when other risk factors are present. Doctors must look at all the data, including what the patient was doing prior to arriving at the office or emergency department. Did she just return from a long car or plane ride? Does she frequently stand or sit for long periods of time? Does she have a family history of blood clots? Is she over the age of 65? All these factors and more should be considered when doctors are making a diagnosis.

When physicians follow specific predictive models for the diagnosis of PE, diagnostic failure rates should be reduced. For example, in a 2015 study, researchers concluded that five diagnostic PE prediction models are “easily applicable in primary care.”

Why Do Misdiagnoses Occur?

A misdiagnosis may occur for the following reasons:

  • Doctor fails to order the appropriate medical tests
  • Doctors assume patients are stressed or anxious and dismiss them without a thorough medical workup
  • Doctors assume symptoms are caused by something else
  • Patient symptoms are atypical
  • Technicians misinterpret test results
  • Medical facilities are understaffed
  • Healthcare providers are overworked
  • Medical staff received inadequate training

Types of DVT/PE Misdiagnosis Injuries

Injuries that may occur when doctors delay or miss a diagnosis of DVT and/or PE include:

  • Heart attack
  • Shock
  • Abnormal heart rhythms
  • Death to part of the lung (pulmonary infarction)
  • Pulmonary hypertension (high blood pressure in the lung)
  • Stroke
  • Pleural effusion (buildup of fluid in the lungs
  • Continued abnormal heart or lung function
  • Death

Fortunately, if treatment occurs in time, it is usually successful in treating the clot. Treatments include blood-thinning and clot-dissolving medications, and surgical procedures.

Missed DVT and PE Diagnoses Lawsuits

Plaintiffs who can show that the hospital or doctor missed the diagnosis of a pulmonary embolism due to medical negligence, they may be able to recover damages in court.  Many plaintiffs have been awarded verdicts in the millions of dollars because they suffered unnecessarily at the hands of a negligent medical professional.

The family of a 29-year-old man brought suit against a medical facility that treated a man who later died of a PE. He had gone to the emergency room feeling lightheaded and dizzy, and had collapsed before arrival. Doctors ordered a CT scan, X-ray, and an EKG. The initial physician’s shift ended and he transferred the case to the oncoming physician, who reviewed the test results and sent the man home. Later that day, the man collapsed and died. The autopsy revealed the cause of death to be a PE. The family sued and won $2.7 million in damages.

There have been many other similar cases. The attorneys at Chaffin Luhana are actively investigating potential medical malpractice lawsuits because of missed DVT and PE diagnoses. Individuals in the Pittsburgh and Ohio Valley areas who suffered serious injuries because of these missed diagnoses may be able to recover damages in a personal injury lawsuit. Call today for a free case evaluation at 1-888-316-2311.

how not to be a lawyer

according to eric t. chaffin

“My father was a union witness at an arbitration in a steel mill. After the hearing, my father, dressed in blue jeans and a sweatshirt, stuck out his hand to shake hands with the company’s lawyer. The lawyer refused. The lawyer was not upset because my dad got the best of him but because he frowned upon working class people. I was the first person in my family to graduate from college. My dad used this story to remind me to respect others, to remember where I came from and as an example of how not to conduct myself as a lawyer.”

eric t. chaffin

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