cardiac symptoms, but refused their recommendation to go to the emergency room for further testing. The patient instead went home and died of a cardiac event later that night. Her husband claimed that the doctors should have done more to convince the patient to go to the emergency room.
The patient was a 52-year-old, overweight, non-smoking woman with a family history of heart disease, who had felt chest pain the previous afternoon, took a decongestant, then felt tightness in her chest. Attributing the tightness to the decongestant and hunger, she ate and went to bed.
The next morning the chest pain started again, although it came and went. The patient took Tums and Pepto-Bismol, which were usually effective, but they did not provide relief. In the afternoon she took some Zantac and went to an urgent care where she was seen by a family medicine physician. The patient believed she was suffering from heartburn, but the physician thought the symptoms could be cardiac in origin and immediately arranged for her to see a cardiologist in the same office. Despite this, the patient asked to see a gastroenterologist instead, but ultimately agreed to see the cardiologist.
The patient told the cardiologist that her chest pain felt like “pressure” radiating to both arms and into her neck. The cardiologist felt that the family history of heart disease was significant; his differential diagnosis was that the chest pain was cardiac-related, and he wanted the patient to go to the emergency room by ambulance for troponin testing, which would confirm heart damage. He told her that she might die if she did not go to the emergency room.
When the patient continued to refuse, the cardiologist asked his nurse to give her a dose of nitroglycerin (which had no effect) and try to convince her to go to the emergency room. After 20 minutes of discussion, the patient still refused to go to the emergency room and insisted on going home. She was given an appointment for an echocardiogram the next morning.
The patient went home, went to bed, and died in the middle of the night. The patient’s husband alleged that FKC&S’s clients were negligent in not convincing or forcing the patient to go to the emergency room.
FKC&S filed a motion for summary judgment, arguing that their clients did as much as they could properly do to convince the patient to go to the emergency room, and that a competent patient ultimately has the right to refuse even possibly life-saving treatment. The plaintiff argued that FKC&S’s clients could have done more to convince the patient to go to the emergency room, including having her call her husband (which she had refused), calling her husband themselves and even calling an ambulance to take her to the emergency room despite her refusal.
The court agreed with the arguments in FKC&S’s summary judgment motion and, finding the plaintiff’s opposition to be speculative hindsight and contrary to the evidence, granted the motion and dismissed all the claims against FKC&S’s clients.