However, when the clinic officially opened, the man did not return. Shortly after the clinic opened, Ms. M and the other clinic staff heard a commotion in the lobby of the building and saw an emergency medical team running into the building and heading up in the elevator.
A short time later, they wheeled someone out. Later that afternoon, one of the other clinic staff asked Ms. M whether she had heard about the guy on the fifth floor who had died of a heart attack that morning.
Ms. M realized that it was likely the man who had come into the waiting room earlier that day. She felt terrible that she had not called an ambulance for him.
After he had tried to get medical help from Ms. M that morning, the man—Mr. D—went to the pharmacy as Ms. M had suggested and bought an antacid.
He returned to his office and told his co-worker that he had not been able to get into the clinic yet, but he had spoken to a nurse and he was going to try an antacid in the meantime.
The co-worker found Mr. D slumped over in his chair a short time later and called 911. But Mr. D had had a massive cardiopulmonary event and was declared dead on arrival at the hospital.
The co-worker told Mr. D’s family about his encounter with the nurse at the clinic that morning. His family hired a plaintiff’s attorney and sued the walk-in clinic.
Ms. M and the supervising physician met with their defense attorney.
“We never treated that man,” the physician said. “Ms. M merely talked to him and told him we weren’t open yet. He wasn’t actually a patient.”
The attorney asked Ms. M some questions: Was the man exhibiting signs that indicated a heart attack? Did Ms. M suggest calling for emergency medical help?
Ms. M described her interaction with the man, including the symptoms he described, his appearance, and her suggestion that he go to the pharmacy and come back in an hour. The attorney consulted with a medical expert who confirmed that the symptoms described were consistent with signs of a heart attack.
After some months of negotiations, the case was settled out of court for $900,000.
Cases may settle out of court for any number of reasons. Taking a case to trial is expensive and time-consuming, and the result is unpredictable, particularly when a jury is involved. In this case, the defense attorney made a tactical decision to settle. Taking the case to trial would have resulted in bad publicity for the clinic and its staff. Although the clinic did not officially treat Mr. D and he was not a patient as such, once Ms. M spoke to him and noted that he was exhibiting cardiac symptoms, she should have called an ambulance.
Clinicians are well acquainted with the signs and symptoms of a heart attack. Abdominal pain that radiates and pale sweaty skin are signs exhibited by Mr. D that should have been enough to alert Ms. M that the situation should be treated as an emergency.
Although Ms. M thought she was doing the right thing by referring Mr. D to the nearby pharmacy for an antacid and expressing concern about whether an ambulance would be covered by Mr. D’s insurance, she was doing him a great disservice. Once she heard the symptoms he was describing and recognized that it could be an indicator of a heart attack, she should have either called an ambulance immediately or instructed the patient to take himself to the nearest hospital right away. Either option might have both saved the patient’s life and prevented a costly lawsuit.
Ann W. Latner, JD, a former criminal defense attorney, is a freelance medical writer in Port Washington, N.Y.