Hong Kong hospital apologises over death of man who suffered undiagnosed heart attack and failed to receive timely treatment
A Hong Kong hospital has apologised for a medical blunder that led to the death of a middle-aged man who had suffered an undiagnosed heart attack and failed to receive timely treatment.
In a statement on Sunday evening revealing the botched diagnosis, Tuen Mun Hospital admitted to failures in clinical judgments and communication with the 57-year-old patient's family in relation to resuscitation.
The patient died last Wednesday after his doctor failed to diagnose an abnormal electrocardiogram (ECG) reading as a myocardial infarction, which was left untreated for hours and eventually killed the man.
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"TMH expressed its sincere apology for the wrong clinical judgment of myocardial infarction and failing to take into account the family's feelings when discussing the patient's condition," the statement said.
"TMH promised to follow up the incident proactively and work on improvement measures to prevent reoccurrence of a similar incident."
It said the case had been referred to the coroner for follow-up action.
According to the hospital, the patient, who had hypertension, cardiac disease and a history of stroke, was taken to its accident and emergency department by ambulance at about 7.30pm last Tuesday for chest pain and twitching. The patient also had received a Covid-19 vaccine in the previous 14 days.
Upon arrival at A&E, the patient started twitching again and was classified as in critical condition. His condition improved after initial treatment there and he was transferred to a medical ward at around 8.15pm and tests were arranged.
Initial results of a computed tomography (CT) scan of the patient's brain, ECG, troponin level, blood pressure and blood oxygen saturation revealed no abnormalities, the statement said. At around 4.30am the next day, ward staff performed another ECG for the patient and this time the result showed an abnormality.
The on-call doctor had also reviewed the patient's clinical condition and blood results.
"However, the on-call doctor had not timely made the diagnosis of myocardial infarction as indicated by the abnormal ECG results," the statement said.
"The doctor only prescribed an anti-emetic drug to treat the patient's vomiting and continued to monitor the patient."
At around 11am, the patient told his case doctor about his chest discomfort. The doctor immediately reviewed the man's clinical record and arranged blood tests and an urgent ECG, and prescribed angina drugs.
During a joint consultation with the cardiac team, the cardiologist decided to transfer the patient to the cardiac care unit for an urgent procedure known as percutaneous coronary intervention.
However, the statement said the patient deteriorated rapidly. He developed cardiac arrest and lost consciousness at 1pm. Resuscitation and intubation were performed.
The case doctor contacted the patient's relatives to tell them about his deteriorating condition and suggested the option of stopping cardiopulmonary resuscitation, which had "made the family feel disappointed and disturbed".
The patient suffered cardiac arrest again at 2pm, and cardiopulmonary resuscitation was performed and adrenaline injected. The patient died at 2.32pm.
After the incident, the hospital said, its medical department took immediate action to reinforce doctors' attention to ECG changes and the need to consult their seniors if in doubt.
The clinical team was also reminded to enhance communication when handling severely ill patients and to "take into consideration families' concern" towards the resuscitation arrangements, the statement said.
This article originally appeared on the South China Morning Post (SCMP).
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