CASE SUMMARY:
The decedent, a 55 year-old morbidly obese male, presented to the defendant physician for a Roux-en-Y gastric bypass procedure. Prior to the surgery, the decedent underwent pre-operative testing and the defendant concluded that no contraindications existed despite the plaintiff’s preexisting hypertension, sleep apnea and chronic hypoxia.
The decedent underwent an open Roux-en-Y procedure. The surgery proceeded as expected with no complications reported.
During the plaintiff’s post-operative course, his wife repeatedly reported her husband’s deteriorating respiratory condition, yet his medical records did not document any such decline. While his medical records documented that his lungs were clear, he also reportedly received nebulizer treatments leading the plaintiff’s expert to conclude that his respiratory status had in fact worsened, warranting these treatments. The plaintiff also received two units of packed red blood cells yet there was no indication in the medical chart as to the reason for these transfusions.
The plaintiff argued that the decedent’s post-operative care was managed exclusively by medical students and nurses as not a single entry was made in the decedent’s chart following post operative day (POD) one. The defendant claimed that despite the absence of any corroboration that he has personally examined the plaintiff after POD one, he claimed that he did in fact visit every post operative day, and that the decedent was doing well.
The morning of the decedent’s death, the decedent was noted to be “wheezy” and short of breath. There is no indication in the medical chart that any testing was performed to determine the potential cause of his declining respiratory status. At approximately 8:00 p.m., the decedent requested to use the bathroom. While in the bathroom, the decedent suffered a sudden cardiac event. A code blue was called and despite more than forty-five minutes of resuscitation efforts, the decedent died. An autopsy was performed, which revealed some evidence of pulmonary congestion, which the plaintiff’s expert was prepared to testify was highly suggestive of congestive heart failure (CHF).
The plaintiff’s medical expert witnesses were prepared to testify that the defendant failed to properly manage the decedent’s post-operative care and allowed his condition to deteriorate for several days following his surgical procedure. The plaintiff’s cardiology expert witness was prepared to testify that the decedent exhibited classic signs and symptoms of CHF, which were not adequately evaluated and treated and which ultimately led to his patient’s death. The plaintiff’s cardiology expert was prepared to testify that had appropriate treatment been initiated even as late of the morning of his death the decedent’s CHF would likely have been reversed and he would not have suffered the cardiac event that led to his death.
The defendant’s expert witnesses were prepared to testify that the defendant met the applicable standard of care at all times during his treatment of the decedent. Also, the defendant’s expert witnesses were prepared to testify that the decedent did not die as a result of CHF, but rather of a sudden cardiac event of unknown origin and that the autopsy report supported their position.
The case was settled shortly before trial. The decedent was survived by his wife.
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