$725,000 Settlement After ER Missed a Complete Coronary Artery Blockage

A 66-year-old man with a known cardiac history arrived at the emergency room reporting chest pain. The treating team ordered one EKG and one troponin test, both of which returned nonspecific results. Around the same time, the patient began belching after eating broccoli and drinking soda. Staff administered a gastrointestinal cocktail, and when the patient said his pain had eased and he fell asleep, he was discharged home.

The next morning, the chest pain returned. He came back to the ER, and this time was airlifted to VCU Medical Center, where imaging confirmed what had been missed the night before: a 100% occlusion of the mid-right coronary artery, a complete blockage cutting off blood supply to a major section of the heart.

The delay had consequences that went far beyond the heart. By the time he reached VCU, the patient was in shock. He also suffered a stroke, transient paresthesias, respiratory failure, acute kidney injury, and acute liver injury. Each of those complications traced back to the hours that passed while the blockage went untreated.

William B. Kilduff and Christopher L. Spinelli of Emroch and Kilduff in Richmond took on the case. The defense argued that the severity of the hospitalization was largely a product of the patient's pre-existing conditions, not the missed diagnosis, and pointed to his eventual recovery as evidence that damages were limited. The plaintiff's team pushed back, contending that the initial ER workup fell below the standard of care for a patient presenting with chest pain and a cardiac history, and that a timely diagnosis would have prevented the cascade of complications.

The case settled for $725,000 in 2021. The patient was referenced in coverage as a 66-year-old male; no name was publicly reported.