Man dies after dissecting aorta goes undiagnosed

A 44-year-old computer network administrator died of a dissection of the ascending aorta that went undiagnosed by the attending physician responsible for inpatient hospitalization and his primary care physician.

In 2002, the man went to the emergency room after he was found by his girlfriend on the floor “writhing in pain.” His chief complaint was the acute onset of chest pain radiating to his back with a blood pressure of 81/35.

After a workup, the man was admitted to the hospital by a physician who wrote an order for a chest CT scan to rule out a “pulmonary embolism,” but the chest scan was never carried out by the attending physician.

The attending physician was told by the man’s girlfriend that there was a family history of abdominal aortic aneurysm.

Despite the persistence of chest pain, the attending physician failed to do a chest CT scan, concluding that a VQ scan, read as negative, had ruled out the possibility of a pulmonary embolism.

Although the findings were consistent with a leaking aortic dissection, persistent pain and blood-pressure history, the attending physician did not modify her differential diagnosis to include thoracic aortic dissection.

She discharged the man with a diagnosis of possible musculoskeletal strain and pleuritic pain with instructions to see his primary care physician.

The man was seen several times by his primary care doctor who, despite the patient’s history, also failed to order a chest CT scan and failed to diagnose the condition.

Two weeks later, the man collapsed at home and died. An autopsy concluded that he died of a ruptured thoracic aortic dissection.

The plaintiffs contended that, with timely diagnosis of the dissecting aorta, the man would have undergone life-saving surgery.

The case settled prior to trial for $2 million.

Type of action: Medical malpractice

Injuries alleged: Undiagnosed dissection of the ascending aorta

Date of settlement: June 2007

Submitted by: Annette Gonthier-Kiely, Annette Gonthier-Kiely & Associates, Salem (for the plaintiff)