Physician Fails To Diagnose Early Heart Attack In Symptomatic Patient

ByWendy Ketner, M.D.

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Updated onApril 11, 2019

Physician Fails To Diagnose Early Heart Attack In Symptomatic Patient

This case involves a 52-year-old female patient with a history of high cholesterol and anxiety who presented with complaints of severe back pain. Although the defendant physician was aware of the patient’s symptoms and medical history, he did not perform a thorough cardiac workup or transfer the patient to the hospital for further investigation. The patient underwent an EKG, which was inconclusive and non-diagnostic for early heart attack. The defendant physician diagnosed the patient with a muscle spasm, gave her a prescription for muscle relaxers, and sent her home. Over the following weeks, the patient suffered several additional episodes of back and arm pain. Since she was told by the defendant physician that the pain was muscular, she took her muscle relaxers as prescribed and did not suspect that her pain had a cardiogenic source. One day while she was home, she lost consciousness. Despite CPR and advanced cardiac life support protocols, she remained in a cardiac arrest. The patient was transported to the hospital and pronounced dead on arrival. The cause of death was acute myocardial infarct. It was alleged that the defendant failed to provide a thorough cardiac workup and preventative care to the patient.

Question(s) For Expert Witness

1. Please describe your experience treating patients suffering from severe back pain.

2. Are you familiar with the proper steps in protocols that are typically followed when a patient presents with similar symptoms?

Expert Witness Response

inline imageI established and was part owner of a family practice clinic for 10 years. I currently teach in a doctoral level nurse practitioner program and teach cardiac modules and work-ups as part of both our acute and chronic patient care courses. Additionally, I work in a very busy emergency room and encounter patients with back pain multiple times in every shift. There can be many sources of back pain, with cardiac related back pain being the most significant. Ruling out cardiac causes is primary before moving on to ruling out other potential causes. I am very familiar with the proper protocols related to these symptoms, as well as current standards of practice.

About the author

Wendy Ketner, M.D.

Wendy Ketner, M.D.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.

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