Jody Houston, a 54-year-old avid kayaker and stock trader, presented to the defendant cardiologist on March 25, 2013, with a history of chest pain for two months, gastric reflux, high cholesterol, a lifetime of cigarette smoking, and an abnormal EKG during a EGD a week prior. In fact, the EGD had to be aborted due to concerning ST changes after the administration of anesthesia. Given Houston’s risk factors for coronary artery disease (CAD), the defendant scheduled him for a nuclear stress test the next day, an echocardiogram in five days, and then a follow-up appointment in a week to review the diagnostic test results and discuss treatment options. Houston underwent the nuclear stress test on March 26. He performed well. He achieved his max heart rate, reached 12.5 METs, and had no complaints as he exercised strenuously for 10 minutes. During the recovery phase, however, he complained of 8/10 burning chest pain, which resolved in minutes on its own. The defendant determined that the EKG results from the stress test were borderline, that the nuclear images did not show ischemia, and so he kept to his plan for Houston to have an echo on April 1 and then return for follow-up. On March 31, 2013, however, Houston was found dead in his basement couch by his son. At autopsy, the medical examiner found severe multi-vessel CAD, including 90 percent occlusion in the mid-left anterior descending artery and mid-circumflex artery.
Houston’s widow sued the cardiologist alleging that he was negligent by not immediately sending Houston for a cardiac catheterization after the nuclear stress test. Plaintiff’s cardiology expert testified that Houston’s burning chest pain and sinister ST elevations on the EKG were “red-flags” for severe CAD which warranted immediate catheterization and intervention, namely stenting or bypass surgery.
Defendant’s theme was that Houston’s strong performance on treadmill did not suggest severe cardiac disease, there were no ST elevations on the EKG, and that the cardiologist met the standard of care by continuing his work-up.
After four days of evidence, the jury deliberated for 2.5 hours before returning a defense verdict.
Type of action: Medical Malpractice/Wrongful death
Injuries alleged: Wrongful death of a 54-year-husband and father of three
Name of case: Rein, personal represenative of the Estate of Houston v. Cardiologist
Court: Alexandria City Circuit Court
Case no.: CL 15-1492
Tried before: Jury
Name of judge: Hon. Lisa B. Kemler
Date resolved: Feb. 11, 2016
Special damages: Lost services, solatium
Verdict or settlement: Defense Verdict
Attorneys for defendant: Byron Mitchell and Kristina Lewis, Fredericksburg
Plaintiff’s experts: Marc Cohen, MD (cardiologist, New Jersey); F. Lee Tucker,MD (pathologist, Roanoke)
Defendant’s experts: Sam Ahuja, MD (cardiologist, Maryland); Mark Wick, MD (pathologist, Charlottesville)
Insurance carrier: Professionals Advocate