The Superior Court of Pennsylvania (“Pennsylvania Appellate Court”), in its Memorandum Opinion filed on July 19, 2019, affirmed a Pennsylvania medical malpractice jury’s verdict in favor of the plaintiff in the amount of $3,364,017.40, stating, “It is undisputed that in 2014, [the plaintiff’s] first EKG results already showed a low ejection fraction, indicating heart failure. [The plaintiff’s] claims of negligence went to the defendants’ misinterpreting or misreporting this condition. The question of why or how [the plaintiff] came to have heart issues was not relevant to whether Appellant had a duty of care to properly report the EKG results, breached this duty, or had actual or constructive knowledge of the defect or procedures which created [the plaintiff’s] harm.”
The Underlying Facts
The plaintiff alleged in his Pennsylvania medical malpractice lawsuit that when he was 47-years-old, he underwent a stress echocardiogram (EKG) for screening on January 9, 2014, due to a family history of coronary artery disease. The EKG result was “abnormal” and showed a low ventricular ejection fraction of 45.6%. Nevertheless, the defendants reported to the plaintiff’s primary care physician that the overall impression of the EKG was normal except for poor patient physical conditioning.
In December 2015, the plaintiff presented to the defendant hospital’s emergency room with shortness of breath and other symptoms. An EKG taken on December 29, 2015 showed “profound abnormalities including [worsened] left ventricular dysfunction with ejection fraction of 10-15%.” The plaintiff was diagnosed with non-ischemic cardiomyopathy, underwent cardiac catherization, and was placed on a wearable defibrillator ‘Life Vest.’ The plaintiff alleged in his Pennsylvania medical malpractice lawsuit that the defendants’ negligence caused an increased risk of harm of progression and worsening of his cardiac condition.
One of the plaintiff’s medical experts testified during trial that a physician’s failure to evaluate ejection fraction, a cardiologist’s failure to communicate an EKG report to a patient or the ordering physician, and a cardiologist’s failure to sign an EKG report all fall below the standard of care.
On March 6, 2018, the Pennsylvania medical malpractice jury found that the defendants’ conduct fell below the applicable standard of medical care, and that their negligence was a factual cause of harm to the plaintiff, apportioning 80% of the causal negligence to one defendant and 20% to another defendant, and awarded a total judgment of $3,364,017.40 ($2,432,052 for future medical and related expenses for the year 2018; $85,776 future medical and related expenses for the year 2026 (the jury awarded $0 for the years 2019 through 2025, and 2027 through 2046); $80,000 for past loss of earnings; $41,111 for past physical pain, mental anguish, discomfort and distress; $88,806.40 for past medical expenses; $429,000 for future loss of earnings; and $207,272 for future physical pain, mental anguish, discomfort and distress. The jury awarded zero to the plaintiff’s spouse for her loss of consortium claim. The defendants appealed.
The Pennsylvania Appellate Court stated, “We are not persuaded by Appellant’s insistence that this case presents the complex issue of “[t]he interplay” between a physician’s discretion “in deciding what information to include in” a report and a hospital’s duty to regulate what information is included in a report … Appellant overlooks the trial testimony, given by its own employee, that Appellant had procedures for ensuring that the appropriate physician timely completed an EKG report; Appellant, and not a cardiologist, was responsible for sending an EKG report to the appropriate physician; and if these procedures were not followed, it was Appellant’s responsibility to enforce them … It is well settled that a hospital staff member or employee has a duty to recognize and report abnormalities in the treatment and condition of its patients … we conclude the trial court did not abuse its discretion in instructing the jury that under Pennsylvania law, a hospital has a duty to report abnormalities in a patient’s condition … under the relaxed standard, because there was testimony about Appellant’s failure to timely detect [the plaintiff’s] lower ejection fraction, and such failure increased the risk that [the plaintiff] would suffer harm, it was a question for the jury whether, by a preponderance of the evidence, Appellant’s acts or omissions were a substantial factor in bringing about the harm.”
Source Macosky v. Udoshi, M.D., J-A16017-19.
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