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Lawsuit related to long QT

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Socrates25

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http://www.myfoxdetroit.com/dpp/news/local/marlette-couple-plans-to-sue-after-son-dies-20110104-wpms

Marlette Couple Plans to Sue after Son, 10, Dies
Updated: Tuesday, 04 Jan 2011, 9:17 PM EST
Published : Tuesday, 04 Jan 2011, 9:17 PM EST

By ROOP RAJ
WJBK | myFOXDetroit.com

DETROIT (WJBK) - The mother and father of Connor Burton came to Detroit from the small town of Marlette, Michigan to file a lawsuit against a doctor that performed a tonsillectomy on their son, who was seven years old at the time. Close to three-and-a-half years later, the boy died in his sleep. The parents said the doctor should have known.

"They tried to revive him three times there, and from there we went to the hospital," said Jay Burton, the boy's father.

The morning of April 17, 2009 is hard to forget for Jay and Suzanne Burton. Their ten-year-old son, Connor, died that morning. The cause of death? Answers found in an EKG. Prolonged QT Syndrome is what doctors call it. It causes the heart to stop as it did for Connor that morning.

The problem? The EKG was taken in June of 2005. Close to three-and-a-half-years later, he died. Why didn't someone tell the parents that Connor had this medical condition?

"He could still be here. I mean, we would've done whatever was suggested by those physicians. He would've been on whatever medication. If he would've had to have a defibrillator, he would've had whatever it took," said Suzanne Burton.

After his death on Connor's behalf, his parents got their son's blood work tested. It proved he had the dangerous heart condition. They went back to the hospital and asked for all of the test results. That is when they discovered the EKG results nearly four years later.

They took his malpractice and wrongful death case to attorney Brian McKeen in Detroit. He said the EKG was taken on the 21st, but the doctor, Mohan Macha, did not initial it until eight days later.

"Obviously if someone's going to do a diagnostic test, they'd better look at the result, and if the result's abnormal, they should do something about it and not let the patient slip between the cracks," said McKeen.

The day before he died, the athletic fourth grader, an avid baseball and basketball player, exercised as usual, and then laid down and watched television before going to bed.

There were no symptoms. He did not slow down a bit.

The lawsuit claims this could have been prevented had Dr. Macha from Marlette Community Hospital said something. That is the most painful part.

"It's a simple test anymore. The unfortunate part is that it's a silent killer, and … our son never physically gave us any indication that anything was wrong," Jay Burton said.

Dr. Macha has been made aware of the lawsuit as of last week. FOX 2 has been told it could be another 180 days until a lawsuit is officially filed.

FOX 2 called Marlette Community Hospital for a comment. A spokesperson told us that their thoughts and prayers are with the Burton family, but they will not comment on any pending lawsuit.



My issues with this are:

1. General surgeons dont have a cardiologist overread EKGs? That seems risky to me. Even if it doesnt change OR management, there are all sorts of subtle things under the surface that they arent trained to pick up on. I always assumed these pre-op EKGs get overread by a cardiologist later.

2. We all know the computer readouts dont mean jack, they consistently overcall stuff.

3. I'm not sure why this patient even needed a pre-op EKG in the first place.
 

Socrates25

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http://sanilaccountynews.mihomepape...ront_Page/Parents_to_sue_over_sons_death.html

Parents to sue over son’s death

Allege hospital, doctor ignored warning sign
by Carol Seifferlein Features Editor

Connor Burton
A Marlette family intends to sue Marlette Regional Hospital and Dr. Mohan Macha for failing to notify anyone of the condition that caused their son’s death.

The Detroit law firm of McKeen & Associates has sent the doctor and hospital the notice of intent to sue as required by Michigan law. The law firm must now wait 182 days from Dec. 18 before filing the wrongful death/medical malpractice complaint in Sanilac County Circuit Court.

Connor Burton, 10, son of Jay and Susan Burton, died suddenly April 17, 2009, of what is known as prolonged QT sysdrome.

The legal notice claims the autopsy failed to determine a cause of death so the medical examiner ordered genetic testing of Connor’s blood. In Sept. 2009 Connor’s DNA showed him testing positive for the mutation that is strongly associated with an arrhythmia-causing syndrome. His death certificate was amended to state “sudden cardiac death due to or as a consequence of prolonged QT syndrome...”

The notice claims Dr. Mohan D. Macha reviewed an EKG on June 29, 2005 prior to conducting surgery for tonsellitis on Connor. The notice states the computer readout of the EKG stated “prolonged QT”.

Jay Burton said the specialist they saw after their son’s death told them “prolonged

QT can’t hide on an EKG, you either have it or you don’t”.

However, in most cases of QT, particularly the most fatal type that Connor had there are no symptoms.

“The day before he died he went to school, did gymnastics, went to baseball practice and shot hoops. He was constantly on the go and never complained of chest pain,” Jay said.

Ablood test showed Jay and his wife and daughter do not have the syndrome, and are not carriers. Connor’s disease was a mutation.

The notice to sue claims Macha owed a duty to “interpret and/or consult an appropreiate specialist to interpret a pre-operative EKG; recognize and appreciate the significance of an abnormal EKG, including...a prolonged QT; disclose to the patient all clinical and diagnostic findings...notify the patient’s family doctor ofthe abnormal EKG and its potential significance;.. order and interpret any and all laboratory studies and diagnostic tests to rule in or rule out prolonged QT syndrome;...treat and or refer the patient for treatment for a cardiac abnornality...refer the patient to an appropriate specialist.”

Further, the notice claims as a “direct and proximate result of the ...breaches of the applicable stand of practice or care, the staff and physicians of Marlette Regional Hospital...(and) Dr. Mohan Machas, failed to timely and properly interpret Connor Burton’s...EKG.”

“As a direct and foreseeable consequnce of the negligence of the...healthcare providers, Connor Burton’s prolonged QT syndrome went untreated and unmonitored. As a result, Connor Burton experienced abnormal electrical activity in and out of the channels in the membranes surrounding his heart cells, which resulted in irregularities in his heart muscle contraction. The irregularities caused a decreased flow of oxygenrich blood to Connor Burton’s brain, resulting in sudden cardiac death.”

“Timely and proper compliance with the standards of care...would have prevented Connor Burton’s death.”

“My wife and I don’t want any parent to go through what we did,” said Jay. “The hardest thing to live with his he didn’t have to die. It is treatable.”

Hospital Marketing Director Janet O’Connor said the hospital cannot comment about pending legal cases.

“However, our thoughts and prayers continue to be with the Burton family,” she added.

Macha’s office did not respond to a request for a comment.

According to the notice, Connor’s father woke him at 6:50 a.m. April 17, 2009 for school and when he went back about five minutes later his son was unresponsive. Jay began CPR and his wife called 9-1-1. When the boy arrived at the hospital about 7:16 he was in ventricular fibrillation and was pronounced dead before 8
 

shark2000

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That is the reason you should not order a test when it is not indicated.

If this guy was as healthy as described, pre-op work up for tonsillectomy was not indicated, other than probably a CBC.

It this case, I am pretty sure, even if the EKG had been over-read by a cardiologist, still It would have not changed anything. Nobody would have read the report.
 

eccentric jet

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It this case, I am pretty sure, even if the EKG had been over-read by a cardiologist, still It would have not changed anything. Nobody would have read the report.

If it was a significantly prolonged QT interval I'm pretty sure a pediatric cardiologist would not have missed it.

Granted, I only spent a month this year doing pedicards, but a large portion of the office visits to see the EP guys were referrals for abnormal ECGs due to long QT. In the cases where the interval was actually long (i.e. it measured long, not just the computerized interpretation said it was), genetic testing was often done and patients were at least put on beta-blockers
 

shark2000

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I have seen a lot of times that surgeons order a test without even looking at the results. Most of them have a PA or NP. If those people care, then the patient is referred. Otherwise, nobody will see the report.
If you see prolonged QT is referred, it does not mean that all cases are routinely referred. You never see the cases that was not referred. Many of these people are out there without knowing and like other medical conditions most will get through it without complication.
 

Simann

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There is so many variables that are not disclosed as of yet. We all know that QT intervals increase or decrease with heart rate. If the kid is fit, "athletic heart", and his ecg revealed sinus brady with a prolonged QT, it could be interpreted as normal based on low normal resting heart rate. However, ive personally seen LQT syndrome as purely rate dependant. This will be a case i will follow.
 
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Trifling Jester

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I don't do peds stuff... but ordering genetic testing on every patient that the ekg software spits out "long qt" seems excessive.
 

tibor75

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Very unusual that this kid had an ECG years ago. Why? Amusing if it was pre-op. 7 year old getting tonsils out? stupid if that was the reason.

Main teaching point - don’t order tests that you don’t need. It wastes money and if it comes back unexpectedly abnormal, you do further tests. Or you forget to look up the results because you didn’t need the test in the first place.
 

Socrates25

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I don't do peds stuff... but ordering genetic testing on every patient that the ekg software spits out "long qt" seems excessive.

To be fair, I think he was stating that genetic workup is indicated only if the cardiologist confirms that its legit long QT and not just what the computer spits out.
 

joeDO2

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Very unusual that this kid had an ECG years ago. Why? Amusing if it was pre-op. 7 year old getting tonsils out? stupid if that was the reason.

Main teaching point - don’t order tests that you don’t need. It wastes money and if it comes back unexpectedly abnormal, you do further tests. Or you forget to look up the results because you didn’t need the test in the first place.

This study may be of interest:

ECG SCREENING OF 32,000 YOUNG ADULTS FOR SUDDEN CARDIAC
DEATH (SCD) UTILIZING TRAINED COMMUNITY VOLUNTEERS:
REPORT OF OUR EXPERIENCE
J.C. Marek, J. Davis, V. Bufalino, K. Marek
Midwest Heart Foundation, Lombard, Illinois, USA

There is already a screening program in Italy that has reduced SCD by 89%. The US study used community volunteers and a cardiologist trained in adolescent ECG interpretation. Using this method they were able to screen a huge number of students while keeping costs to a bare minimum.
 

captaincrunch

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Hmm...I agree that something doesn't quite seem right. Why would someone order a pre-op EKG on a child undergoing tonsillectomy? If there was a history of sudden cardiac death in the family, then the doctor is probably screwed, but they don't mention that in the article. I suppose this case would depend on how long the QT interval actually was (e.g., borderline vs obvious). I'm not sure if genetic testing was in widespread use in 2005, but maybe someone else knows the answer to that question.
 
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