The family of a thirty-five year old man sued his physician, claiming that she had ignored the results of the man’s lipid panel and was complicit in his consequent fatal heart attack. Already carrying a history of smoking and hypertension, the man had been previously prescribed Metoprolol to reduce his risk of heart failure. A lipid panel drawn up by his primary care physician showed significantly low high-density lipid protein (HDL) levels, high cholesterol, and high triglycerides, but she chose to recommend diet and exercise rather than start him on statins to reduce his cholesterol. After another lipid panel one month later showed no change, the physician still chose not to begin prescribing him statins, and told the patient to make an appointment for January. He neglected to make the appointment, and died of a heart attack in late January due to a nearly complete constriction of blood flow to his right coronary artery. With the case caught between claims that statin drugs should have been prescribed and assertions that the patient had willingly not followed up with his doctor, an expert in treating patients with high risks of heart attack was asked to testify.
Question(s) For Expert Witness
- 1. Do you treat patients like the one described in this case?
- 2. Have you ever lectured or published on statins or treatment of hypercholesterolemia?
Expert Witness Response E-065446
I have treated high risk patients previously. This man is high risk due to gender, low HDL, and tobacco abuse. His high triglycerides suggest that he may have had metabolic syndrome, which is another risk for heart disease.
Expert Witness Response E-083466
Given the patient’s smoking history and how he was already was given a trial of diet and exercise and his lipid panel remained unchanged, I would have started a statin. It is hard to know if this would have changed the outcome, but it certainly could have given him a better chance of avoiding a heart attack.