An Alabama widow was awarded a $4 million malpractice payout. Her husband, Terry Hallmark, died after an emergency department physician mistook the patient’s heart attack for a gastrointestinal illness. The seven-day trial resulted in the largest medical malpractice award in Walker County history.

The plaintiff, Donna Hallmark, claimed that the patient, aged 40 years, died as a result of a misdiagnosis by Charles Shipman, MD. According to the lawsuit, Terry Hallmark began feeling ill after eating breakfast on the morning of Jan. 11, 2008. He continued feeling ill for the next two days, and finally presented to the emergency department of the Walker Baptist Medical Center on Jan. 13.

At the hospital, Hallmark complained of nausea, chest pains, and shortness of breath. Nurses in the emergency department documented Hallmark’s complaints, including chest pains, and he was examined by Shipman.

Shipman, however, only noted the abdominal complaints and diagnosed Hallmark with a gastrointestinal issue before sending him home. Hallmark spent between four to five hours in the emergency department before being discharged.

According to the lawsuit, two days later, Hallmark fell back, clutching at his chest and asked his wife to call 911. He was rushed to the hospital by ambulance, but he could not be revived and was pronounced dead.

A subsequent autopsy by a cardiac pathologist revealed that Hallmark’s cause of death was a coronary event caused by triple vessel coronary artery disease. The three main arteries of his heart were blocked 75%, 60% and 100%, respectively.

The case centered on whether the physician had met the standard of care, which would have required him to consider a heart problem, and then rule it out before discharging Hallmark. Defense experts argued that Hallmark was suffering from a stomach bug when he presented on Jan. 13. Experts for the plaintiff testified that Shipman should have ordered blood tests to look for cardiac damage, but no blood tests were ordered.

The jury concluded that Shipman had not met the standard of care in treating his patient, and thus was liable for his untimely death. The plaintiff’s attorney stated that he hoped the verdict would improve treatment for patients in emergency departments. Shipman’s attorney has not yet said whether his client plans to appeal.

Ann W. Latner, JD, a former criminal defense attorney, is a freelance medical writer in Port Washington, N.Y.