Family of Pennsylvania woman receives $7.25 million after daughter dies from delayed heart condition diagnosis
Key Takeaways
A Pennsylvania woman previously diagnosed with a heart valve abnormality waited over 5 hours in an emergency room before being diagnosed with an aortic dissection and suffering a fatal cardiac arrest the following day.
The patient's family settled with the emergency room and three of her previous physicians for over $7 million.
Repeated surveys and studies have found that misdiagnosis and delayed or missed diagnoses are the most common reasons for malpractice suits.
Last month, Moses Taylor Hospital, part of the Commonwealth Health System in Scranton, PA, agreed to a $7.25 million settlement with the family of a woman who died from an aortic dissection in December 2020. Kerie Mecca of Taylor, PA, was 32 when her mother, Mary Mecca, drove her to the Moses Taylor emergency room with chest and abdominal pain that she described as “sharp” and “burning.” Kerie had a history of cardiac health concerns; she’d been diagnosed with a heart valve abnormality in 2017.[]
Despite Kerie’s medical history and complaints of pain, her mother reported that the emergency room staff at Moses Taylor did not order needed tests with the appropriate urgency. It took 5 hours for Kerie to receive a diagnosis. She was then transferred to Regional Hospital of Scranton and underwent emergency heart surgery. Early the following morning, she suffered cardiac arrest and died.[]
Kerie’s parents, Mary and Joseph Mecca, filed suit against Moses Taylor and members of the emergency room staff who provided treatment, including John Stanton, MD. The family also filed suit against three doctors who treated Kerie in the years prior to her death, alleging that her heart valve abnormality was not monitored and treated appropriately.[]
The case was set to go to trial before a Lackawanna County judge on June 12, 2023. However, a settlement between the Meccas and all parties was reached before the trial began. Commonwealth Health System has not commented on the settlement.
Delayed diagnosis and malpractice
Although it might seem counterintuitive, missed, delayed, and misdiagnosis aren’t linked primarily to rare conditions. In fact, this type of medical error is often seen in patients like Kerie Mecca. About three-fourths of all death and disability claims resulting from missed diagnosis, delayed diagnosis, or misdiagnosis are related to vascular infections, events, or cancer.
The Coalition to Improve Diagnosis, a collaborative organization led by the Society to Improve Diagnosis in Medicine (SIDM) and made up of over 60 healthcare and patient advocacy organizations, has identified multiple factors that play key roles in the prevalence of missed diagnosis, delayed diagnosis, and misdiagnosis, including:[]
Short appointment times and rushed patient care windows
Incomplete communication between healthcare providers and facilities
Lack of standardized guidelines or feedback regarding diagnosis
Lack of tools and resources for accurately assessing symptoms that are present in hundreds of possible conditions
Patient confusion regarding which symptoms to report, what questions to ask, what doctor to bring what symptoms to, and when testing is complete
Carolyn McClain, MD, an emergency physician in Minnesota and Medical Board Base reviewer for Constellation, Inc, Malpractice and Liability Insurance, agrees, pointing out many of the same factors as major reasons for missed diagnoses and misdiagnoses.
“There is repeated reliance on negative data and tests and failure to respond to patients’ repeated concerns or symptoms. Communication between providers regarding the patient’s condition is a problem,” Dr. McClain says. “We see that there is commonly a failure to order a diagnostic test and to establish a differential diagnosis. There’s a tendency to assume that a chronic or previous condition is the cause for a patient’s complaints.”
Preventing delayed diagnosis
Like so much within practicing medicine, diagnosing is prone to human error. It’s not feasible to have a 100% accuracy rate. However, there are ways to reduce the risk of delayed and missed diagnoses. As is often the case with ensuring patient safety and preventing malpractice, communication, and documentation are key. Clear information exchange between patients and physicians, between physicians and other providers, and from one physician to another increases the chances that a diagnosis will be accurate. At the same time, detailed documentation helps ensure that communication is clear.
Avoiding biases and assumptions can also play a significant role. It can be easy to link symptoms to the most common condition or a patient’s chronic condition, but doing so without ordering appropriate testing to identify whether there’s another cause can lead to these delayed diagnosis, missed diagnoses, and misdiagnosis errors.
“We really encourage our clinicians to say, ‘What else could this be?’ and to look for those alternate diagnoses,” says Dr. McClain. “In 30% of our cases where a diagnosis was missed, there’s no evidence there was a list of symptoms or causes—a fully thought-out list of expanded differential diagnosis.”