Delay in Treatment of Aortic Dissection Leads to Death and $4.5 Million Verdict Against Hospital and Doctor; Estate of Elder v. Provena Hospitals



Jeffrey Elder, 43, was brought to the emergency department at Provena St. Joseph Hospital in Joliet, Ill., with severe chest pains. The emergency department physician, Dr. Andrew Zwolski, determined that Elder was not having a heart attack. However, he did order a CT scan, which showed a dilated aorta. This often leads to a diagnosis of an aortic dissection.  If confirmed, an aortic dissection would require immediate surgical repair to save the life of the patient. Aortic dissection symptoms are similar to those of other heart problems, such as a heart attack. Typical signs and symptoms include sudden severe chest or upper back pain, shortness of breath, sweating and a weak pulse.


To rule in or out the diagnosis of the aortic dissection, a CT scan with contrast was required. Because Dr. Zwolski’s shift was ending, he instead chose to delay the contrast CT testing until Elder was admitted into a room.


Before leaving the hospital, Dr. Zwolski called another internist, Dr. Hussain, who was named as a defendant as well, to admit Elder and take over as the attending physician.  He also called the defendant cardiologist, Dr. Yi, to provide a cardiac consultation.


Dr. Yi never saw Elder and did not call any cardiology consultant to see Elder. At 7:45 a.m., Elder was transferred from the ER to a regular room where he was evaluated by two nurses. Neither nurse saw, entered, or completed the emergency department physician’s order for the CT scan with contrast.


Dr. Hussain called the hospital twice about Elder, but did not check on the status of the contrast CT or diagnosis.  At 10:30 a.m., the defendant cardiologist saw Elder. He knew nothing about the order of the CT with contrast. After examining Elder and reviewing his chart, the cardiologist suspected an aortic dissection and ordered another CT with contrast but did not put in a rush to have it done. He also ordered an echocardiogram.


The nurses never saw, entered, or completed the cardiologist’s order for the CT with contrast.  The echo, however, was done at 12:30 p.m. showing the aortic dissection. The tech notified the cardiologist. A medical team tried to find a surgeon to repair the dissection on an emergency basis, but no one could be found in the hospital.


At 3:55 p.m., Elder suffered a cardiac arrest and died before the surgery could be done. He was survived by four children and 20 years of lost time from his job as a Caterpillar engineer.


The defense for the emergency room physician argued that the fault for not getting the contrast CT in a timely manner should lie with the hospital and the two doctors to whom he turned over the patient’s care.


The defense for the cardiologist argued that the fault for not getting the test done in time was with the hospital and the ER doctor. The internist blamed the cardiologist and the hospital for not getting the CT test done in a timely manner, and the hospital admitted negligence at trial. However, the hospital denied that the late CT test was a cause of Elder’s death.


This seems to be the case of defendants pointing the fingers at each other. There were several high/low agreements. The hospital entered into a high/low agreement prior to trial, which capped responsibility at $2 million. Dr. Zwolski and his group entered into a high/low agreement before trial and will pay the low of $500,000 since they were found to be not guilty. Dr. Hussain, an internist and his group, also entered into a high/low agreement during the jury deliberation capping their responsibility at $850,000. The jury’s verdict of $4.5 million found Provena St. Joseph Medical Center, Dr. Hussain and his group, responsible for the death of Jeffrey Elder. The cardiologist and the ER doctor, Dr. Zwolski, were found not responsible.


The jury’s verdict of $4,500,000 was made up of the following damages:


  • $4,000,000 loss of society;
  • $500,000 for conscious pain and suffering on Survival Act Count.


Estate of Jeffrey T. Elder, deceased v. Provena Hospitals, et al., 08 L 827 (Will County).


The attorneys for the Elder family were William Cirignani and James C. Harman. The plaintiff’s demand to settle before trial was $10 million. There was no offer noted in the Jury Verdict Report of this case.


Kreisman Law Offices has been handling medical negligence cases for individuals and families for more than 37 years, in and around Chicago, Cook County and its surrounding areas, including Joliet, Markham, Winfield, Vernon Hills, Burbank, Chicago (Archer Heights), Chicago (Marquette Park), Chicago (Burnside), Western Springs, Darien, Harvey, Arlington Heights, Berwyn, Brookfield and Chicago (Bronzeville), Ill.

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