Dr Jonathan Stern, GP misdiagnosed heart attack

The HCCC recently prosecuted a complaint involving an alleged failure by Dr Jonathan Stern, General Practitioner to make a diagnosis of a heart attack and administer Aspirin.

The patient in question attended the GP’s St Ives’ medical practice complaining of chest pains. He was briefly seen by Dr Stern and was advised by the doctor to go to the hospital. The doctor did not call an ambulance nor phone the hospital ahead, and his referral letter was deemed to be inadequate. There was no provision of aspirin however Dr Stern did afford the patient some treatment by administering a Nitrolingual spray.

The patient’s work colleague who turned up to the practice drove the patient to the hospital. Unfortunately the patient collapsed and died at the reception desk at the hospital. The cause of death was ischemic heart disease and coronary atherosclerosis.

Expert evidence suggested that in situations like this a GP should-

  • Give aspirin
  • Perhaps give nitrolingual spray.
  • Call an ambulance
  • Monitor the patient whilst waiting for the ambulance to arrive
  • Be ready to administer CPR

The Professional Standards Committee imposed restrictions on Dr Stern’s registration, the main one being that he be mentored for a minimum period of 12 months.

Whilst this case is a disciplinary case, and not a tort action for medical negligence, it is important that medical practitioners take appropriate and timely action when a patient presents with symptoms of a heart attack.

In civil law suits for medical negligence however, medical evidence will need to be adduced to show that taking appropriate action would have made a material difference to the patient’s outcome in order for damages to be awarded. This legal issue is known as “causation”, and is not often addressed in disciplinary cases.

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