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Germanoff v. Aultman9/23/2002
JUDGMENT: Affirmed
Plaintiff-Appellant Stephen Germanoff, the administrator of the estate of Connie Sue Germanoff, appeals the decision of the Court of Common Pleas, Stark County, which entered judgment in favor of various defendants in a medical malpractice action. The relevant facts leading to this appeal are as follows.
On December 26, 1999, Connie Sue Germanoff, age 49, died from heart failure after reporting to the emergency room at Appellee Aultman Hospital ("Aultman") in Canton, Ohio. Between December 16, 1999 and the date of her death, Connie went to Aultman on four occasions and was seen by several different physicians. On December 16, 1999, Connie presented to Aultman with chest pain radiating into her left arm. Serial enzyme blood tests were ordered, including readings for "cardiac markers" myoglobin, troponin, and creatine phosphokinase (CPK). Peter Y. Lee, M.D., a cardiologist, was consulted on the morning of December 17, 1999 to assess the nature of Connie's chest pain. Dr. Lee reviewed Connie's records, including results from a stress test conducted in September 1999, and performed a physical examination. He further ordered an adenosine cardiolyte stress test, which mimics the effect of physical activity without the patient having to undergo a treadmill exercise test. Dr. Lee left the hospital upon completion of his rounds on December 17, 1999, and commenced a vacation. He did not review Connie's aforementioned myoglobin and troponin results prior to departing. At the time, Aultman's "reference ranges" for troponin, an indicator of heart muscle damage, were as follows: .03 or less was normal, .04 to .15 was a "gray" or indeterminate zone, and .15 or higher was diagnostic of a heart attack. Connie's first troponin level was .03. On the morning of December 17th, it was .05. At 5:00 pm that afternoon, it was .08. Connie's myoglobin readings, which are recognized as less specific cardiac markers, also went up during this period from 130 to 145, both of which were in an elevated range. Dr. Lee, however, admittedly did not see said results and did not order a cardiac catheterization for Connie.On December 17, 1999, Connie was seen by Allen Kamen, M.D., a cardiologist and partner of Dr. Lee. Dr. Kamen found Connie's laboratory results to be nondiagnostic. Dr. Kamen also supervised the adenosine cardiolyte stress test previously ordered. The results of that test were normal. Dr. Kamen thereupon determined that Connie could be discharged from a cardiology standpoint. On December 18, 1999, Dr. Humble, one of Connie's family physicians, discharged Connie from Aultman with instructions to follow up with him in two to three weeks and to consult with a gastroenterologist.
Connie returned to Aultman on the evening of December 20, 1999, again experiencing chest pain radiating into her left arm. She was seen at that time by M.W. Hatcher, M.D., an emergency room physician and an employee of Appellee Canton Aultman Emergency Physicians, Inc. Dr. Hatcher ordered an EKG and one set of cardiac marker enzymes. The EKG was normal. Connie's troponin level registered in Aultman's indeterminate range (.04) and her CPK level was normal, while her myoglobin level was abnormal. Nonetheless, Dr. Hatcher marked the overall cardiac marker panel as normal. Dr. Hatcher also reviewed Connie's medical history and performed a physical exam. Connie's blood pressure was initially elevated, but subsequently returned to normal. Dr. Hatcher also ordered a chest x-ray, which was normal. Because Connie's chest pain had lasted for several hours during that evening, Dr. Hatcher felt that this symptom was more consistent with gastroesophageal reflux. He concluded that Connie should be discharged that
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