Medical Malpractice Lawyer, Seth Gladstein, Obtains $195,000 Settlement For Victim's Family

Hospital settles outside of court in wrongful death case of a 78 year-old woman.

A North Carolina family has been awarded $195,000 in a pre-litigation settlement for the wrongful death of a mother and grandmother.  The decedent, a 78 year-old woman, died as a result of gross negligence on the part of the hospital’s physicians who failed to properly diagnose and treat a life-threatening cardiac condition. 

The decedent originally presented to a rural North Carolina hospital with complaints of foot, ankle, and right-sided flank pain. While in the ER, she had an EKG taken, which was interpreted as demonstrating a cardiac conduction abnormality known as a left bundle branch block. It turned out, however, the machine’s reading was misinterpreted. It was later discovered the EKG tracings clearly indicated that the decedent was suffering from 2:1 second-degree atrioventricular (‘AV’) block, also known as heart block. Heart block is a serious medical emergency as it can rapidly lead to a complete heart block, and the heart stops beating altogether. Second-degree AV block can also lead to Stokes-Adams syndrome, cardiac arrest, or sudden cardiac death. Effective treatment for Mobitz type-II AV Block requires the implantation of a pacemaker. However, in a patient suffering from second-degree AV block, the pacemaker implant surgery cannot be performed without the standard procedure of continuous electrocardiographic monitoring and the placement of an external pacemaker. 

Even though the second-degree AV block should have been clear from the test results, neither the attending physician’s assistant nor the ED attending physician made the correct diagnosis or ordered the appropriate treatment interventions. Therefore, only one of two possible scenarios could have played out. First, the attending physician or P.A. failed to recognize the second-degree heart block through a negligent misinterpretation of the EKG data. The other possibility being that the attending physician or P.A. failed to personally review the EGK tracings, relying simply on the computer’s interpretation. An hour after the misdiagnosis, the decedent was discharged from the hospital with nothing more than a prescription for hydrochlorothiazide to treat her high blood pressure.

Approximately 18 hours later the decedent returned to the hospital’s ED, complaining of shakiness, mild disorientation, and hand and facial numbness. Upon examination, a different ED physician found that the decedent had an unsteady gait, she seemed confused and she needed help walking. This physician noted that the decedent kept her eyes closed when ambulating and that her left visual field was cut, a condition known as homonymous hemianopsia. Because of these findings, the physician ordered a head CT, which demonstrated chronic small vessel changes, but no acute abnormalities. When the attending physician ordered a new EKG, he discovered that the decedent was now in third-degree AV block, or complete heart block. Third degree AV block is also treated with the implantation of a pacemaker. When patients suffering from third-degree AV block are treated with permanent cardiac pacing, they have an excellent prognosis. It’s important to note that while explicitly writing on the EKG tracings that the decedent was in third-degree AV block, there were several other places on the chart where the ED physician erroneously recorded that the decedent was in second-degree AV block. However, despite knowing, and repeatedly charting, that the decedent was in either second or third-degree heart block, the ED physician negligently failed to place her on cardiac monitoring or telemetry, call for a stat cardiology consultation, or place an external pacemaker, all of which the applicable standard of care required. Instead, the attending physician simply admitted the decedent for observation. Furthermore, the attending physician failed to recognize the clinical signs of AV block, including, dizziness, malaise, and weakness; all of which the decedent complained of when she was presented to the ED for the second time on January 15, 2012.

At approximately 3:00 a.m. on January 16, 2012, nursing staff found the decedent groaning but nonresponsive in her hospital bed. As the hospital staff negligently failed to place the decedent on any form of cardiac monitoring, it is impossible to determine how long she had been nonresponsive before being found. The hospital staff immediately called for code; however, before the hospital staff initiated resuscitative measures, they inexplicably moved the decedent from her hospital room to the ED. Doing so wasted precious time and reduced the chances for recovery, as code measures were not started until 3:30 a.m.

Moreover, the code team encountered difficulties when attempting to oxygenate the decedent with a bag valve mask. In his discharge summary, the attending physician recorded that they had difficult with the Ambu-bag, which resulted in more lost time.

The code team’s misadventures when attempting to oxygenate the decedent unnecessarily prevented oxygen from reaching her brain, worsening her hypoxic brain injury. Similarly, the hospital code team wasted additional time when intubating the decedent; specifically, the code team placed the endotracheal tube’s tip 1.5cm within the decedent's right stem bronchus, which required the attending physician to reposition it. That error further prevented oxygen from timely reaching the decedent's brain. Because of these difficulties, it took approximately 15 minutes for the code team to resuscitate the decedent. However, after she was resuscitated, the decedent's pupils were nonreactive and she had no response to painful stimuli. The decedent was subsequently transferred to a larger hospital via helicopter where, upon arrival, she was found to be comatose. At the larger hospital, the decedent underwent a lumbar puncture to determine whether the herpes zoster could have caused her brain injury. That study, however, showed no growth. After the decedent was comatose for three days, she underwent a head CT that revealed secondary severe brain swelling and other serious complications.

Later that day, the decedent underwent an electroencephalogram, EEG, which demonstrated “a lack of clearly definable cerebral activity.” The interpreting neurologist concluded that the EEG results were “supportive of brain death.” Due to her dire and irreversible condition, on January 20, 2012, the decedent’s family agreed to transition her to comfort measures only. A few hours later, the decedent passed away. An autopsy performed on January 23, 2012, revealed “histologic evidence of global ischemic encephalopathy and gross evidence of tonsillar herniation.” Of note, “[n]o viral encephalitis [was] identified” during the autopsy, thus ruling out the decedent's shingles as the cause of her brain injury. The decedent was survived by her husband, three adult children, and many grandchildren.

 For more information, visit


Tags: malpractice, medical malpractice, Medical Malpractice Lawyer

About Gladstein Law Firm, PLLC

View Website

Gladstein Law Firm is a personal injury law firm serving the Lexington area of Kentucky. Practice areas include medical malpractice, birth injuries, nursing home abuse, wrongful death, and slip and fall.

Gladstein Law Firm, PLLC
312 South 4th Street #600
Louisville, KY 40202
United States