Rochester Medical Malpractice and Personal Injury Lawyer Blog
A missed pulmonary embolism can transform a treatable condition into a life-threatening medical emergency. When a patient arrives at an emergency department with symptoms that may point to a dangerous blood clot, providers must decide whether the available evidence warrants advanced diagnostic testing. If providers do not order such testing, it may give rise to a medical malpractice claim. As a recent New York opinion demonstrates, the strength and specificity of expert testimony can determine whether the claim proceeds. If you suffered harm because health care providers failed to diagnose a serious condition promptly, you should speak to a Rochester medical malpractice attorney who can help you evaluate your rights.
Case Setting
Allegedly, the plaintiff went to the hospital’s emergency department with pain and breathing-related concerns. Providers documented severe right rib or flank pain, normal cardiovascular and respiratory examinations, a negative chest X-ray, and no chest pain complaint. A resident considered kidney stones, while the defendant physician also considered infection, pulmonary embolism, and acute coronary syndrome. The physician concluded that the presentation did not suggest the latter two conditions and ordered further evaluation.
Reportedly, the defendant physician treated the plaintiff from approximately 6:20 a.m. until 8:00 a.m., then transferred care to the day shift. After reviewing abdominal CT results, later providers reassessed the possibility of pulmonary embolism. They ordered an EKG and a D-dimer test but declined to order a CT pulmonary angiogram, which uses contrast dye. The plaintiff returned to the hospital five weeks later, and providers diagnosed a pulmonary embolism.
It is alleged that failing to perform the angiogram during the first visit delayed diagnosis and caused avoidable injuries. The defendants moved for summary judgment with records and expert opinions supporting their care and disputing causation. The plaintiff’s expert countered that his symptoms, imaging, and Wells score required further testing. The trial court denied dismissal as to both defendants, and they appealed.
Demonstrating Emergency Room Malpractice
On appeal, the court clarified New York’s medical malpractice summary judgment framework. A defendant must first show no departure from accepted practice or that any departure caused no injury. The plaintiff must then offer competent evidence creating a triable issue.
In the subject case, the hospital made the required initial showing, but the plaintiff’s expert raised factual disputes concerning its evaluation. The expert described extensive experience diagnosing pulmonary embolisms and explained that the presentation, a Wells score of 4.5, and elimination of kidney stones warranted an angiogram. He challenged the negative D-dimer test because providers administered it too soon. His view that earlier imaging could have reduced the injuries supported causation. The hospital’s radiology expert did not establish that first-visit imaging would have missed the condition.
The court reached a different conclusion for the defendant physician. The plaintiff’s expert relied heavily on chest pain that did not appear in the EMS report, triage notes, emergency records, or deposition testimony. He also failed to address evidence that the examination showed no movement or breathing limitations and did not answer the defense experts’ concern that contrast dye posed renal risks. The court therefore deemed his opinion speculative and hindsight-based.
The court also found that the plaintiff failed to demonstrate causation as to the defendant physician, because later providers completed the workup and independently chose not to order the angiogram after the physician’s shift ended. As such, the court modified the order by dismissing the complaint against the physician and otherwise affirmed, leaving the claims against the hospital for further proceedings.
Seek Help from a Rochester Syracuse Medical Malpractice Attorney
If negligent emergency care or a delayed diagnosis caused your injuries, you may have grounds to pursue a medical malpractice claim, and you should speak with an attorney promptly. At DeFrancisco & Falgiatano Personal Injury Lawyers, our dedicated Rochester medical malpractice attorneys understand the devastating consequences of diagnostic errors. If we represent you, we will carefully investigate your treatment, consult qualified medical professionals, and fight for the compensation you deserve. Contact our office through our online form or call 833-200-2000 today to schedule a free and confidential consultation.
