One Hour Delay Nets $900,000 Settlement

In hospitals, certain presentations trigger certain actions. At this point, such protocols should be observed by all hospitals. Failure to do so is a breach of the standard of care. It’s negligence.

When a patient comes into an emergency room with complaints indicative of a heart attack, rapid action is necessary. The most important thing to do initially is to get an EKG, a tracing of the heart’s electrical activity. This test can give the healthcare providers important information as to whether the patient is having a cardiac event and, if so, the nature of it.

The well-accepted national standard for getting an EKG is 10 minutes. That’s also the standard in Virginia. No surprise.

In our case, the patient came to the Emergency Room and reported a history which was classic for a heart attack. The triage nurse appropriately ordered an EKG.

But it took over an hour for an EKG to be done.

There was no question that this was a breach of the standard of care. Proving the hospital was negligent would be easy.

Negligence, however, is only half of the equation. We also needed to show that the delay proximately caused the patient’s death a few days later. This is where the case got sticky. The patient presented to the hospital over six hours after the onset of his symptoms. After correct treatment was initiated, it was found that he was already in heart failure.

Heart failure is a bad prognostic indicator. Even with entirely appropriate care, the survival odds are problematic – and that might be putting it optimistically.

We found great experts, including one who is an academic expert in such situations. That doctor carefully connected the dots, giving us strong evidence that the seemingly short delay made a huge difference. As an interesting aside, our case was the first time this relatively young doctor had ever testified in a deposition. He was among the best witnesses I have ever seen – and I have seen more than a few at this point.

Still, the defense had a potentially effective defense. “This guy was very sick when he walked in the door. Do you really think an hour mattered that much?” I have seen juries buy worse arguments – including ones that I advanced as a defense lawyer.

In other words, even with a clear breach, this case was not a slam dunk for us.

On the other hand, the defense knew we would try this case, and they knew we would do it right.

About a month before the scheduled trial, my law partner, Peter Anderson, negotiated this excellent settlement.