Louisiana Appellate Court Reverses Medical Malpractice Defense Verdict In "Loss Of Chance Of Better Outcome" Case

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The November 25, 2014 Louisiana Appellate Court Decision Reversing The Medical Malpractice Defense Verdict In A "Loss Of Chance Of Better Outcome" Case Is Discussed In Today's MedicalMalpracticeLawyers.com Blog

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The focus is whether the defendant's action or inaction deprived plaintiff of a chance to have a better medical outcome, not whether a better outcome would have, in fact, occurred

The Louisiana Court of Appeal Fifth Circuit ("Appellate Court") issued its opinion on November 25, 2014 in a medical malpractice case that reversed a defense verdict, finding that the plaintiff had proved by a preponderance of the evidence that he had a chance of a better medical outcome at the time of the medical negligence, and that the defendant physician's negligence deprived him of that chance.

Louisiana recognizes a cause of action in medical malpractice cases for a loss of a chance of a better medical outcome in which the issues are whether the plaintiff lost any chance of a better outcome because of the defendant's negligence, and the value of that loss.

According to the Appellate Court's opinion, the plaintiff had gone to a local hospital emergency room complaining of chest pain after eating. An endoscopy located food but showed that there was no longer any obstruction. An electrocardiogram was performed and a cardiac enzyme workup showed elevation in two of the four cardiac enzymes. The plaintiff continued to complain of chest pain throughout that evening and night. Repeat cardiac enzyme labs were drawn at 1:36 a.m. and the results that were available at around 2:50 a.m. showed that all four cardiac enzymes were elevated beyond normal limits. However, the defendant physician issued no new orders at that time.

Although the plaintiff's chest pain had resolved by morning, a cardiologist who evaluated the plaintiff around 8:30 a.m. performed an angiogram that afternoon that showed an arterial blockage. The cardiologist did not perform angioplasty because he felt that the plaintiff's heart muscle had already sustained permanent damage by then, according to the Appellate Court's opinion.

The Appellate Court noted that the plaintiff alleged that the defendant physician breached the standard of care by failing to arrange an immediate emergency cardiac consultation upon receiving the cardiac enzyme lab results at 2:50 a.m., which deprived the plaintiff of a chance to have a better medical outcome, and that the trial judge determined that the defendant physician breached the standard of care by failing to order an immediate cardiology consultation after being informed of the increase in cardiac enzymes at 2:50 a.m. but that the defendant physician's breach of the standard of care was not a proximate cause of the damages alleged to have been sustained by the plaintiff. The Appellate Court stated that the defendant had not appealed the trial judge's finding that he had been negligent and therefore it only had to decide whether the trial court erred in finding that plaintiff failed to prove a causal connection between the defendant physician's negligence and the plaintiff's resulting damages, and whether such negligence deprived the plaintiff of a chance of a better medical outcome.

The Appellate Court stated that the trial court failed to understand that the focus is whether the defendant's action or inaction deprived plaintiff of a chance to have a better medical outcome, not whether a better outcome would have, in fact, occurred. The testifying medical experts were all in agreement that the elevated enzymes at 2:50 a.m. were the earliest laboratory confirmation that plaintiff had, in fact, experienced a heart attack, or was, in fact, experiencing a heart attack.

The Appellate Court held that because it was clearly shown that time is of the essence in treating cardiac arterial blockages, the plaintiff proved by a preponderance of the evidence that the defendant physician's failure to call for a cardiac consultation at 2:50 a.m. deprived the plaintiff of the opportunity to have a specialist (a cardiologist) with specific expertise evaluate his case at 2:50 a.m., or very soon thereafter, and exercise his expert judgment regarding whether angioplasty (or other intervention) was an option at that time.

Harold Pesses versus Nicholas J. Angelica, M.D., et al., No. 14-CA-336.

MedicalMalpracticeLawyers.com's blog posting discussing this case can be read in its entirety by clicking this link.

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