In this case, a veteran had been experiencing repeated chest pain. He had ECGs which were apparently normal. He had two nuclear stress tests, neither of which apparently demonstrated stress-induced ischemic disease. However, the first stress test showed major coronary artery calcification, which is associated with major adverse cardiovascular events. The second stress test showed the same, and also showed an ejection fraction (a measure of the heart's capacity to pump blood) which was greatly reduced compared to the first.
His reduced ejection fraction, arterial calcification, along with his history of conditions which contribute to coronary diseases, and his chest pain, should have been a warning to his care providers. However, instead of addressing any potential coronary disease, his VA care providers treated him for potential muscle pain and digestive issues, prescribing him medicines for both. Even his VA mental health care provider dismissed his chest pain as possibly due to anxiety.
Perhaps unsurprisingly, his chest pain continued.
He complained of chest pain repeatedly to his VA care providers for more than a year and a half. But, even with a stress test showing greatly decreased heart capacity, his potential heart condition went undiagnosed and untreated.
Finally, he suffered a cardiac arrhythmia and died.
Though it seems from the narrative above that the malpractice was clear and would have been easy to prove, it was not necessarily so. Neither his ECGs nor his stress tests had ever demonstrated ischemic disease. This uncertainty can reduce settlements.
A significant portion of any recovery can often be lost income or medical bills caused by the malpractice. This veteran had no income, and, like many of the veterans we serve, received all of his medical care through VA, so had no relevant medical bills.
The remaining categories of money which can be recovered are often broadly called "non-economic" damages. These damages refer to things for which there can be no bill or receipt, such as grief or lost companionship. State law in this case also has historically limited, or "capped," these non-economic damages to a total of $250,000. That means, it was possible that the most we could possibly have been able to recover on our best day in court was $250,000. Given the uncertainty about the outcome, any settlement could have been even less.
However, after careful research, we found a recent case which had removed the cap for injuries other than those from medical malpractice. It is important to note that no court in that state has yet decided whether the cap still applies to medical malpractice or not. However, we argued that the cap would no longer apply in medical malpractice cases and we were able to settle for $500,000, or twice that potential cap.
This does not happen frequently, but it is a reminder not to make assumptions and to research carefully.