A 58-year-old man went for a routine physical with his primary care doctor and had an abnormal EKG and a low ejection fraction. Suspecting mild myocardial ischemia, he was scheduled for a diagnostic cardiac catheterization at the hospital’s cath lab. During the procedure, the doctor got the catheter stuck in the wall of the patient’s left ventricle and accidentally injected the entire amount of dye into the wall. This caused severe damage to the ventricle wall, which, under the pressure of the heart’s pumping, was at high risk of rupturing. Despite the nurse pointing out the damage, the doctor continued with another nine angiograms and concluded there were no complications, telling the patient his heart looked fine.

After the procedure, while the patient was eating in recovery, he experienced severe chest pain and difficulty breathing. The recovery nurse called another cardiologist, who ordered an urgent echocardiogram and EKG. Upon seeing the catheterization films, the second cardiologist suspected a perforation in the ventricle wall with fluid filling the sac around the heart (pericardial effusion), leading to a life-threatening condition called cardiac tamponade.

The hospital lacked the facilities for open-heart surgery, and all cardiothoracic surgeons were at another hospital. There was an emergency transfer agreement between the two hospitals, and there was disagreement over why the transfer did not get scheduled. Unable to get a cardiac surgeon, two general surgeons and a vascular surgeon attempted to save the patient. They managed to remove the fluid around the heart, but could not close the 1-2 cm perforation in the left ventricle. The patient ultimately bled out and died.

The claims against the cardiologist were that he was negligent when he initially caused the catheter to get stuck, injected the dye incorrectly, and then failed to recognize the severity of the problem, or deal with it.  It was alleged that the delays in treatment led to the patient’s death.

The patient had no children and had been divorced a few years prior.  However, the patient and his ex-wife had reconciled and were planning to remarry.

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