Hinlicky v. Dreyfuss

Marie Hinlicky (plaintiff), 71, consulted her primary care physician Dr. Robert Frank (defendant) for high blood pressure, shortness of breath, exhaustion, and chest pain. Hinlicky informed Frank that her sister had recently undergone carotid artery surgery and her brother had a heart bypass operation. Frank became concerned that Hinlicky had plaque blockages in her arteries obstructing blood flow to her brain. Frank referred Hinlicky to Dr. David Dreyfuss (defendant) for a surgical evaluation. Dreyfuss, a vascular surgeon, recommended an endarterectomy operation to remove the plaque buildup in her neck arteries. Because of Hinlicky’s age and the invasiveness of the operation, physicians often are required to determine whether the patient’s heart and other organs can tolerate the procedure. However, because of Hinlicky’s lack of heart attacks or other heart-related issues, Dreyfuss did not order a pre-operative cardiac evaluation. Additionally, the anesthesiologist involved in Hinlicky’s case, Dr. Ilioff (defendant), reviewed Hinlicky’s medical history and interviewed her personally. He determined that based on her lack of heart-related issues there was no need to send Hinlicky for a pre-operative cardiac evaluation. In making his determination, Ilioff followed a set of clinical guidelines (algorithms) published by the American Heart Association (AHA) in association with the American College of Cardiology (ACC). These guidelines analyze the patient’s medical conditions and history to determine whether a pre-operative cardiac evaluation is needed. Hinlicky underwent the endarterectomy operation to remove plaque buildup on her carotid artery. Although the surgery was a technical success, Hinlicky died 25 days later. The administrator of Hinlicky’s estate (the Estate) brought a malpractice action against Frank, Dreyfuss, and Riverside Associates, the medical practice of Ilioff. At trial, Ilioff testified that he had incorporated the algorithm into his practice shortly after it was published because it helped physicians decide which patients required a cardiac evaluation and which patients could proceed with surgery. Over the objection of the Estate, the algorithm was admitted into evidence. The jury found for the defendants and the appellate court affirmed. The Estate appealed.