Fatal Pulmonary Embolism Leads to 36-year-old's Death - - $1.2 Million

While fishing with his friends late one Friday night, 36-year-old Jim Winfrey suddenly developed sharp chest pain, so he went home. On Saturday morning, still in distress, Jim went to the local emergency room, where he was seen by the defendant, Catherine White, D.O.

Jim had sharp pain in the front of his chest that radiated around the lungs and made it hard for him to inhale or exhale without pain (pleuritic chest pain). His respiratory rate was abnormally rapid. With her stethoscope Dr.White heard rales (crackling), no breath sounds on the left, and splinting. The blood gas analysis revealed a borderline low oxygen level. A chest x-ray showed left pleural fluid (effusion) and suspected left lower lobe infiltrates. An EKG was normal. There was no fever, no elevation in the white blood cell count, and no cough. Jim indicated that he had had elbow surgery a week earlier. He also said he had the same pain six years earlier, and it was thought to be pneumonia. Jim's pain improved about an hour after he was given pain medication. The symptoms, test results, and history were nonspecific and did not conclusively support any particular diagnosis.

Dr. White considered pulmonary embolism and pneumonia in her differential diagnosis. She decided not to do the tests that had the best chance to determine if Jim had a pulmonary embolism - a ventilation-perfusion (V/Q) scan or a pulmonary angiogram - because of Jim's previous episode which was thought to be pneumonia and because of the pain relief. Dr. White discharged Jim home with the diagnosis of

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