Missed DVT and PE Diagnosis Lawsuits

A 59-year-old grandmother went to see her doctor because she was suffering from shortness of breath and heart palpitations. He sent her to the hospital, but the staff told her she was fine and sent her home. Two days later, she collapsed and died from an undiagnosed pulmonary embolism (PE)—a blood clot in the lung.

According to a report in the Daily Mail, the coroner ruled that the hospital’s risk assessment for the patient was “inadequately completed.” There were subtle signs of the PE present in the woman’s medical tests, and she should have undergone additional procedures that would have led to a correct diagnosis. Unfortunately, the healthcare professionals missed the signs and sent the woman home, telling her that her tests were normal.

Recent studies have reported that PE, a dangerous and potentially deadly condition, is frequently missed by health care providers. In 2017, for example, a study was published that found that out of 130 patients who went to their doctors complaining of symptoms of a PE, 26 percent had a delayed diagnosis by 7 days or more, leaving them vulnerable to serious injury and death.

Is a missed or delayed diagnosis of PE medical negligence? In many cases, it is. If you or a loved one have been injured or killed by a pulmonary embolism misdiagnosis, you may be eligible to file a medical negligence lawsuit against the doctor and/or medical institution that failed to adequately review the medical data.

What is a Pulmonary Embolism?

A pulmonary embolism (PE) occurs when a blood clot lodges itself in one of the pulmonary arteries in the lungs. Once there, it can be life-threatening, as it reduces the blood supply to the lungs. This causes the lung distress, affects breathing, and can cause part of the lung to die. That, in turn, can affect how much oxygen reaches the rest of the body.

The blood clots that result in PEs typically don’t form in the lung themselves, but develop in the deep veins in the legs in a related condition called “deep vein thrombosis” (DVT), where a clot forms in the legs, and then travels with the blood to the lungs, where they can become lodged in the pulmonary artery. People who have DVT are at a higher risk for PE, but even those without DVTs can develop a PE. Surgery, injuries, and trauma may also cause it.

The symptoms of PE include shortness of breath, dizziness, chest pain that worsens with breathing, cough (potentially with blood), increased or irregular heartbeat, and in some cases, shock, loss of consciousness, heart attack, and death. PE can also cause pulmonary hypertension, or high blood pressure in the lungs, which makes the heart work harder to pump the blood through the affected arteries. Over time, this weakens the heart.

The Mayo Clinic states that about one-third of people with undiagnosed and untreated PE don’t survive. “When the condition is diagnosed and treated promptly, however,” they add, “that number drops dramatically.”

The following factors increase the risk of PE:

• Deep vein thrombosis (DVT) diagnosis
• Heart disease
• Cancer
• Smoking
• Surgery
• Bed rest
• Long trips sitting down
• Overweight and obesity
• Supplemental estrogen (in birth control and hormone replacement therapy)
• Pregnancy
• Family history of blood clots

How is Pulmonary Embolism Diagnosed?

When patients go to their doctors complaining of some of the symptoms above, doctors are supposed to conduct certain tests to look for PE. The first is usually a blood test. Lab technicians look for a clot-dissolving substance called “D dimer.” High levels could suggest the presence of blood clots. And can also result in lower levels of oxygen in the blood. Blood tests can also reveal the presence of an inherited clotting disorder.

Other common tests include the following:

• X-rays: These can show the heart and lungs, but they may appear normal even if a PE exists.
• Ultrasound: This test uses sound waves to look for blood clots in the leg veins.
• Spiral CT scan: This is a type of CT scan that can find abnormalities in the lung arteries.
• Pulmonary angiogram: This test has potentially serious risks, but may be used if other tests don’t produce a definitive diagnosis. The doctor threads a small, flexible tube into a large vein and up into the heart and lung arteries, injects a catheter, and then performs x-rays to follow the progress of the dye in the lung arteries.
• MRI: This is an imaging test that can give doctors a better view into the lungs.
• EKG: This test shows the electrical activity of the heart.

How do Doctors Miss a PE Diagnosis?

According to the 2017 study in the British Medical Journal, “Diagnostic delay of more than 7 days in the diagnosis of PE is common in primary care.” This is even more likely in elderly patients, and in those who don’t have chest pain.

In fact, according to a 2009 study, PE is the diagnosis “most frequently missed” or delayed in clinical practice. “Errors related to delayed or missed diagnoses are frequently and underappreciated cause of patient injury,” the researchers wrote. They found that in most cases, doctors failed or were slow to consider that PE may be the cause of the problem.

Why does this happen? Researchers in the 2017 study explained that often, patients experiencing a PE have atypical symptoms, and doctors fail to make the connection. While they usually consider PE in patients who are coughing up blood, or who have painful breathing or shortness of breath, these types of symptoms are present in only about 10 percent of patients with PE. Instead, patients may be more likely to have a simple cough, muscle pain in the chest, heart attack, or even kidney stones, so doctors may not suspect that PE is the cause.

PE can also be present when patients have other conditions, like respiratory infections, so doctors may assume the symptoms can be attributed to those other conditions. Researchers say that doctors need to be more watchful for PE, particularly when patient symptoms don’t improve, or when other risk factors are present.

A patient may sit or stand for long periods of time, for example, which can increase the risk of PE, or may be taking hormones. He or she may be over the age of 65 or have a family history of blood clots. When physicians don’t examine all the data or consider that PE may be present, they put the patient at a high risk of serious injury and/or death. Lab technicians, as well, if they overlook something in a blood test, or fail to understand what the tests may suggest, can cause a misdiagnosis.

Why Do Misdiagnoses Occur?

A misdiagnosis may occur for the following reasons:

• Doctor fails to conduct the appropriate medical tests;
• Doctors assume patients are stressed or anxious and dismiss them without thorough medical workups;
• Doctors assume symptoms are caused by something else;
• Patient symptoms are atypical;
• Technicians misinterpret test results;
• Medical facilities are understaffed;
• Healthcare providers are overworked; and
• Medical staff lacks appropriate training.

According to a 2015 study review, the “Wells” model for the diagnosis of PE is “easily applicable in primary care” and was validated in 96 percent of cases.

Types of DVT/PE Misdiagnosis Injuries

Injuries that may occur when doctors delay or miss a diagnosis of DVT and/or PE include:

• Heart attack
• Shock
• Abnormal heart rhythms
• Death to part of the lung (pulmonary infarction)
• Pulmonary hypertension (high blood pressure in the lung)
• Stroke
• Pleural effusion (buildup of fluid in the lungs)
• Continued abnormal heart or lung function
• Death

Fortunately, if treatment is applied in time, it is usually successful in treating the clot. Treatments include blood-thinning and clot-dissolving medications, and surgical procedures.

Missed DVT and PE Diagnoses Lawsuits

Many patients who were injured by a PE, as well as families of those who’ve died because of a missed diagnosis, have filed medical malpractice lawsuits in an attempt to recover damages.

In August 2017, for example, a jury found the Detroit Medical Center was liable for the death of a college student. The 26-year-old woman went to the emergency room complaining of shortness of breath, but healthcare providers said she had a virus and sent her home. She returned to the hospital the next day by ambulance, unconscious, and died. At trial, her family was awarded a $40 million verdict.

If you or a loved one suffered from a PE-related injury, you may be eligible to file a medical malpractice lawsuit. Chaffin Luhana is investigating these cases and invites you to call today at 1-888-316-2311.