Nogueras v. LaBarbera Medical Malpractice-Diagnosis of Myocardial Infraction Suffolk County CASE: Miriam Nogueras, indiv. and
result of heart failure. Plaintiff also argued that
Defendant was negligent for taking only one
blood pressure reading and for basing his
reading. Pltfs. Expert contended that the
prescription of Calan was contraindicated in
the face of left ventricular failure and that the
combination of Calan and Corgard lowered
decedent’s heart rate and blood pressure,
COURT: Suffolk Supreme VERDICT:
decedent, who took his own blood pressure,
told her on the morning of his visit with Deft
PLAINTIFF:
contended that a nurse at decedent’s job took
ATTORNEYS: James Duffy of Kramer,
his blood pressure on the morning of his
death, and that his pressure was again quite
DEFENSE: ATTORNEY: David W. Brand of Brand &
suffering from left ventricular failure or heart
failure at his office visit. He argued that
FACTS & ALLIGATIONS: Decedent, a 59-
decedent’s congestion was caused by a cold
or bronchitis. Defendant denied that decedent
exchange, presented to Deft: internists on
had orthopnea, which appears in advanced
11/14/87 with complaints of occasional chest
stages of congestive heart failure, because
coughing and wheezing at night. He also told
Defendant that he used two pillows to sleep at
shortness of breath. He contended that in a
case of classic orthopnea, the patient sleeps
cardiac infraction in 1977 and angina. His
in an almost upright position, requiring more
previous doctor had prescribed Corgard, a
than two pillows. Defendant also claimed that
diagnostic for uncontrolled hypertension. He
therapeutic for patients at risk of a mild
that if decedent had presented with heart
INJURIES & DAMAGES:
failure, that condition would have been the
diagnosed atherosclerotic heart disease and
cause of his death. Heart failure was not
uncontrolled hypertension and prescribed by
indicated as a cause of death on the hospital
record or in decedent’s death certificate.
told decedent to return in 2 weeks with his
medical records. Decedent died 2 days later
Plaintiff admitted that an acute anterior wall
of an acute anterior wall myocardial infarction.
myocardial infarction was a contributing factor
in decedent’s death, but argued that the
infarction was caused by stasis in a coronary
negligently failed to diagnose left ventricular
artery as a result of very low blood pressure,
failure at decedent’s office visit. She
contended that the fact that decedent was
contended that decedent suffered from heart
using two pillows at night was evidence of
block, a delayed conduction of electricity in
orthopnea, or congestion while reclining a
the heart, resulting from the combination of
decedent had heart block and noted that it was not mentioned in the hospital record or on decedent’s death certificate. Deft’s expert testified that in his 37 years of practice, he had never seen a patient suffer a heart attack as a result of low blood pressure. Decedent, at age 59 at his death, left a wife and three children, two of them adults. Demonstrative evidence: blackboard drawings; EKG tracings, Offer $100,000: demand $1,000,000 plus excess coverage; amount asked of Jury: $2,900,000 ($150,000 for household services: $500,000 for lost earnings; $750,000 for pain and suffering: $400,000 to each of two children for loss of parental guidance; $600,000 to the third Child). JURY DELIBERATION: 6 hours CARRIER:
PLAINTIFF EXPERT: Dr. Ernestos Jonas, DEFENSE EXPERT: Dr.Charles Bertrand, Chief
Best Evidence Summaries of Topics in Mental Healthcare BEST in MH clinical question-answering service www.bestinmh.org.uk Section for Evidence-Based Mental Health P.O. Box 32 Health Services and Population Research Department Institute of Psychiatry De Crespigny Park London SE5 8AF Tel: 020 7848 0498 Email: [email protected] Question : In adults with depression, what
Journal of Affective Disorders 97 (2007) 23 – 35A.F. Thachil ⁎, R. Mohan 1, D. Bhugra 2Kings College London, Section of Cultural Psychiatry, HSRD, PO: 25, Institute of Psychiatry, DeCrespigny Park, London SE5 8AF, UKReceived 31 January 2006; received in revised form 22 June 2006; accepted 23 June 2006Background: Depression is one of the leading indications for using Complementary and A