Comments on: Liable for not doing a heart cath on a 49 year-old

By: hlebushek

hlebushek — Sat, 28 Apr 2007 14:18:00 +0000

I am not medic, but have few friend who are. I am coming from the position that patient is entirely responsible for their own health. Doctors' responsibility is to think hard and offer known tests and treatments, and explain known consequences of each.
From that position, the doctors in the case should have offered to patient the option of doing cath test, with explanations of all risks. Explain to the point where patient could make informed choice whether to take this test or not, give known percentages of risk. And so on to more elaborate tests if cath test results were not definitive. Would this work in current system?

E.g. "You have risk of heart failure, [such-and-such] big based on [such-and-such] factors and symptoms. Previous tests are negative, but are only 75% reliable. This cath test could make it 99% reliable, but it can ccost you a leg or arm in 0.1% of cases. This is best we can do. Shall we do it?" (I made up all percentages above. Real doctors would do better.)

By: Anonymous

Anonymous — Tue, 18 Jul 2006 05:55:00 +0000

The first stress test was a thallium stress test; the second was a stress echo. He also had a holter moniter.

He felt somewhat better on proton pump inhibitors. He had guaic positive stool.
He died the day after his EGD.

Jury awarded 850K to the widow. They deliberated less than 2 hours.

By: Anonymous

Anonymous — Mon, 05 Jun 2006 19:41:00 +0000

Does anyone else get concerned over the Drs, here who make comments over and over relating that “Death will happen sooner or later” Of course it will, I think we all realize that, but some of these guys seem way to accepting of it and seem not to be bothered if it happens sooner than it should. Is that now the accepted excuse for when mistakes happen…”Oh well the poor guy was going to die at some point anyway?”

By: jb

jb — Mon, 05 Jun 2006 06:34:00 +0000

anon 742,

IMO care was very reasonable. Patient could seek a second opinion. There is never 100% certainty, only that death will at sometime happen. I have seen a bonofide MI a couple weeks after a bonofide normal cath.

By: Anonymous

Anonymous — Sun, 04 Jun 2006 23:42:00 +0000

So would you or would you not consider it reasonable, absent all your claimed lawsuit fears, to act as this physician did? Would you have ordered, or at least informed him of, the procedure?

By: Anonymous

Anonymous — Sun, 04 Jun 2006 23:39:00 +0000

The catheterization should have been performed…why would the cardiologist NOT do it? When the patient went to the GI, he was scoped, right? Did the GI say he has gerd without doing the scope? No…he gets corroborration of the diagnosis, excludes gi cancer, etc, and gets paid $$$ for the test…so what if there is a small risk of harm to the patient, there is more risk to omitting tests as showcased with this narrative…

the lesson is when you see a patientm, think about how you can get sued and then do everything possible to cover your ass, fuck the patient, think about yourself…

look at the above lay posters, they think you can diagnose everything and cath everyone with absolute 100% certitude, this is what is expected by a jury as well, test away and then retire…

By: Anonymous

Anonymous — Sun, 04 Jun 2006 21:28:00 +0000

Bottom line is…someone, anyone could show up at the er having chest pains and say, “you know I’ve had them before and this time I was a heart cath.” You refuse and the guy dies from a massive MI. The next day there will be 47,000 of you (medical doctors) saying that you did nothing wrong.

How can you ever hope for good reform when you refuse to police your own?

By: Anonymous

Anonymous — Sun, 04 Jun 2006 19:52:00 +0000

So you are saying that the reasonable standard is exactly what the defendant physician did?

By: Anonymous

Anonymous — Sun, 04 Jun 2006 19:05:00 +0000

So what if they did run a cardiac cath and it didnt show any blockages, yet he still had a blockage?

Is there some super duper test beyond cardiac cath thats supposed to be even BETTER at picking up coronary blockages?

Say for example, cardiac magnetic resonance angiography?

If cardiac cath came back normal, and the guy still died from a blockage, these same lawyers would still be sueing the docs, claming that a cardiac MRA should have been done.

In other words, keep testing until you find something wrong.

By: Anonymous

Anonymous — Sun, 04 Jun 2006 17:54:00 +0000

So was this gentleman given the option of the heart cath? Since there had been repeated episodes of the same symptoms, and nothing had shown up, would taking the next step to the more accurate procedure not be the reasonable course?