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Internal Medicine, Cardiology
Ref. # 82118

An Illinois man was taken by his wife to the ER with chest pain. EKGs were negative. The work-up was concurrent with unstable angina without infarcting. The ER physician planned to admit the patient, but then called an internist for consultation. The internist instructed the ER physician to discharge the patient, which was done, and have the patient present directly to the internist's office at the hospital. According to the patient's wife, when the internist learned the patient was uninsured, he simply referred the patient to a clinic without examining him. The wife phoned the clinic for two days to schedule an appointment but was unsuccessful. The man suffered a massive MI at home and died. A medQuest internist/cardiologist opined the internist and ER physician were negligent to discharge the patient, who required a cardiac work-up and catheterization. With timely CABG, the patient more likely than not would have survived.