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Failure to Diagnose Aortic Dissection Leads to Death and Settlement

Recently, a Massachusetts family settled a medical malpractice case involving a radiologist's failure to diagnose an aortic dissection for $1.75 million dollars.  According to the family, the decedent, a 24 year old man, went to the hospital emergency room with a primary complaint of severe back pain.  An emergency room physician suspected an epidural abscess (infection near the spinal cord) and ordered an MRI.  While the results were pending, the decedent developed significant hypertension (elevated blood pressure) and severe 10/10 pain.  A radiologist subsequently interpreted the MRI as negative.  Several hours later, while still in the ER, the decedent collapsed on the floor and become non-responsive.  During resuscitation efforts the MRI was reviewed a second time.  This review revealed a significantly widened aorta, indicating a ruptured dissection.  The decedent subsequently died during emergency surgery.  In the Complaint, the family argued that the original radiologist only read 1/2 of the MRI and failed to inform the ER doctor that he had not read the entire test. 

An aortic dissection is a very serious condition in which a perforation / tear develops in the inner layer of the aorta.  The aorta is comprised of three layers:  intima (inner most layer), the media (middle layer) and adventitia (outer layer).  An aortic dissection begins with the formation of a tear in the aortic  intima that directly exposes the medial layer to the pulse force of the blood.  The blood then penetrates the medial layer and dissects the aortic wall.  The blood-filled space between the dissected layers of the aortic wall become the false lumen (channel).  Eventually, the false lumen expands to such a point that it ruptures, much like  an aneurysm, causing the person to exsanguinate (bleed to death).  Not surprisingly, high blood pressure is a risk factor for aortic dissection.  Aortic dissections are classified based on the location and extent of aortic involvement.  There are generally speaking two types of dissections.  Type A (ascending) and Type B (descending).  Type A dissections occur when the tear originates in the ascending aorta (coming out of the heart) and propagates either backwards toward or away from the heart into the aortic arch.  Type B dissections occur when the tear originates in the aortic arch and/or the descending aorta and propagates exclusively away from the heart, downward toward the blood vessels branching off the aorta.  An acute aortic dissection is an emergency.  Aortic dissections are generally regarded as the most common acute aortic condition requiring emergent intervention.  In patients who present with a sudden onset of severe chest or back pain, the 3 potential coronary diagnoses that are imminently life threatening, and must be ruled out, are myocardial infarction (heart attack), pulmonary embolism (blood clot) and aortic dissection.  The survival rate increases dramatically the sooner a person is treated for aortic dissection. 

At STSW, our lawyers recently successfully handled a medical negligence case involving the failure to timely diagnose an aortic dissection at a local hospital.  If you or a loved one has suffered a significant injury or death due to a physician's failure to diagnose an aortic dissection, call our team for a free consultation at (410) 385-2225. 

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