Delay in Treatment of Heart Attack (Case #305)

• Medical Probability: 9 / 10
• Medical Error Summary: Sounds like the patient had severe coromary disease needed revascularization, and then heated up decompensating and normally in that situation they would require either a temporizing measure, such as ...
• Causation Probability: 7 / 10
• Causation Summary: Potentially there is because the patient had a bad outcome, which was preceded by a delay in care which was somewhat confirmed by the providers
• Expert Summary: I am an interventional cardiologist and have taken care of such patients multiple times, and I have seen this situation occur before, and I understand the nuances of this tupe of case
• Similar Summary: Pretty frequently patients who come in requiring inpatient urgent revascularization, such as this one occurs on a weekly basis. Much more rare would be someone who deteriorated into cardiogenuc shock...

64yo M elective peripheral angiogram, had arterial injury that req repair. Had CVA and other multiple complications. (Case #392)

• Medical Probability: 5 / 10
• Medical Error Summary: Based on what's provided the indication of the actual procedure of stenting, the iliac for claudication seemed appropriate again without having seen the pictures and preoperative studies and the degre...
• Causation Probability: 5 / 10
• Causation Summary: Don't have enough information about some of the details regarding both the procedural access and the post access management situation. But there's certainly a possibility. There was an error in judgme...
• Expert Summary: I have 11 years of interventional cardiology experience. I performed vascular procedures for nine years and I perform a lot of large bore femoral axis structural procedures where we deal with femorwl ...
• Similar Summary: For a complication of this degree of severity bleeding maybe once every 5 years

Preoperative clearance prior to elective hysterectomy. (Case #429)

• Medical Probability: 7 / 10
• Medical Error Summary: In this patient with long standing HTn seemingly untreated to undergo an elective procedure this was not an appropriate patient to deem appropriate risk. This is a high risk patient who should only ha...
• Causation Probability: 6 / 10
• Causation Summary: Clearly patient had a hypertensive stroke and this could have been avoided by better stabilizing BP prior to this surgery.
• Expert Summary: I have been practicing cardiology for 13 years. I have participated in a few expert witness cases in past as well. I do everything from office based general cardiology and advanced invasive coronary a...
• Similar Summary: Uncontrolled htn is very common in my practice population

Unnecessary Venous Ablations leading to consistent pain, swelling, and more (Case #476)

• Medical Probability: 8 / 10
• Medical Error Summary: Venus ablation therapy is indicated for patients who have symptomatic venous insufficiency manifested by pain, swelling, skin changes or ulcerations. It does not appear Patient had any of these proble...
• Causation Probability: 6 / 10
• Causation Summary: If the patient is experiencing chronic swelling since the procedure and they never had any symptoms prior to the procedure, then it does appear side effects of occurred. It’s unclear if this potenti...
• Expert Summary: I treated patients, chronic venous insufficiency, and performed ablation procedures for 10 years of practice before I stopped doing it about 2 to 3 years ago. I’m also RPVI certified and was previou...
• Similar Summary: These days I do come across patients who have seen vein specialists and undergo procedure procedures when they are not necessary

Procedural complication resulting in cardiac arrest from a cardiac perforation (Case #490)

• Medical Probability: 5 / 10
• Medical Error Summary: How to know whether there’s a medical error or not just based on the brief course of events as a perforation is a well-known complication of RV biopsy. In fact when we do them, we always perform an ...
• Causation Probability: 5 / 10
• Causation Summary: Can cannot assess whether there was a medical error or not since this is unknown complication of this procedure. Would have to dive into the notes and the fluoroscopic imaging to determine if there wa...
• Expert Summary: I’ve been at practicing interventional cardiologist for 13 years. I have done a few expert witness reviews. And I have been involved with several RV biopsies.
• Similar Summary: I’ve never experienced this complication myself, but I have discussed with colleagues who have

F/T diagnose and treat myocarditis in a 17-year-old resulting in severe heart dysfunction with a subsequent heart transplant (Case #532)

• Medical Probability: 6 / 10
• Medical Error Summary: Not having all the details, the one thing that stands out is the patient clearly had significant tachycardia since the initial visit I want to forward it based on the timeline of when she presented wi...
• Causation Probability: 6 / 10
• Causation Summary: It’s possible if the diagnosis was established earlier, it may have led down a earlyier intervention of medical therapy and a heart failure evaluation and possibly hospitalization and treatment with...
• Expert Summary: Cardiologist and I’ve been practicing for over 13 years as an attending currently at an academic institutionand I take care of critical care patients in the coronary care unit and have had many myoc...
• Similar Summary: Probably once a year we will see a case of severe myocarditis like this either I’m directly involved or it’s at our institution and we have multidisciplinary meetings discussing it.

Right BKA for failure to treat sepsis with necrotizing RLE cellulitis and abscess. (Case #541)

• Medical Probability: 7 / 10
• Medical Error Summary: Patient’s presenting post procedure with concerns of infection skin changes on the intervened leg. Leukocytosis and AK I patient should’ve been hospitalized both for the infection concerns with AK...
• Causation Probability: 6 / 10
• Causation Summary: Inappropriate management and delayed treatment contributed to the limb loss. again would need to know more detail.
• Expert Summary: Board certified interventional, cardiology, cardiology, vascular medicine. In practice for 13 years. 10 years of that I did vascular procedures. Take care of Cardiology and critically ill impatient ...
• Similar Summary: I don’t Gucci Vascular patients in the past couple of years as I’m focusing more Cardiology interventional structural heart. But I do comanage many Vascular patients with my colleagues and very ra...

Potential negligence in the management of cardiogenic shock (Case #572)

• Medical Probability: 9 / 10
• Medical Error Summary: Although it’s not unreasonable to utilize dilt as first-line therapy for unstable atrial arrhythmias if the patient is normotensive and not in obvious heart failure or show, By the time they recogn...
• Causation Probability: 8 / 10
• Causation Summary: Although it's hard to definitively know With certainty, based on the sequence of events described, I think it's very likely that the diltiazem contributed to the decline and progression to cardiogeni...
• Expert Summary: I am an interventional cardiologist who has been in practice for 13 years. I take care of inpatients with cardiogenic shock both in the cath lab and the CCU. I routinely round as an attending physicia...
• Similar Summary: We see many of these cases a year and I'm personally involved in several per year