The Joplin Globe, Joplin, MO

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October 15, 2007

Jurors begin hearing lawsuit against cardiologist, Freeman

By Jeff Lehr

jlehr@joplinglobe.com

The trial of a wrongful-death lawsuit brought against a cardiologist and Freeman Health System by the father of a Barton County man who died of a heart attack more than two years ago began Monday in Jasper County Circuit Court in Joplin.

Lester Rush, 91, of Golden City, sued Dr. David Zuehlke and Freeman Health System, alleging medical malpractice in the death of his 65-year-old son, Larry Rush, in January 2005 at Freeman Hospital West.

Glenn Gulick, the attorney representing the plaintiff, told jurors that they would be hearing a case that boiled down to a failure on Zuehlke’s part to get an angiograph done in a timely manner despite repeated medical indications that it was needed immediately.

He said Larry Rush was sent to Freeman on Dec. 31, 2004, by a doctor at Barton County Memorial Hospital in Lamar, where he had gone with symptoms of a heart attack. Zuehlke was the cardiologist on call at Freeman that day, and Rush was directly admitted to the Joplin hospital at 4 p.m. on Dec. 31, Gulick said.

But the doctor did not schedule Rush for an angiograph in the cath lab, where a blockage of his coronary arteries could be addressed, before 10 a.m. the next day, Gulick told the jury. In the meantime, Rush suffered recurrent signs of ischemia, a deficiency of blood getting to the heart muscle because of a blockage, and angina, a resulting pain of ischemia that can be felt in the chest or radiate to the shoulders, back and arms, Gulick said.

While Zuehlke ordered tests and medications and had the patient sign authorizations for the cardiac catheterization the next morning, he did not actually take a look at the patient before leaving the hospital at 8 p.m. to attend a New Year’s Eve party, where he and his girlfriend were to serve as co-hosts, Gulick said.

By the time Rush was ordered into the cath lab the next morning, he already had undergone several hours of recurrent ischemia, and the angiograph showed an immediate need for surgery, Gulick said. A cardiac surgeon performed that surgery, but by then it was too late because too much of Rush’s heart muscle had been permanently damaged from lack of blood, Gulick said.

“The family agreed, and they withdrew life support and Larry died,” Gulick told the jurors.

Kent Hyde, who along with attorney David Overby is representing the defendants, told jurors that Rush suffered a heart attack before he ever got to the hospital in Lamar. He said it was the type of heart attack that made it necessary for the doctor to wait and let the heart heal and regain some equilibrium before subjecting it to potential traumas of the cath lab.

“All of that is very hard on a heart,” Hyde said. “So they want a patient in as good a shape as they can get him before they do all that.”

He said the doctor’s plan was to put Rush on medications to keep blood flowing to his heart and to give the heart some time to heal overnight. He said the pain the patient was feeling was not unusual after a heart attack, and that the doctor ordered medications to ease the pain.

Hyde said Zuehlke, 60, has been a doctor for 35 years and performs up to 500 cardiac caths annually. He said Zuehlke is as much an expert in the matter as anyone the jury will hear testify at the trial, and that he knew what he was doing.

Hyde told jurors that Gulick’s insinuations that the angiograph was delayed because the doctor had a party to attend were absurd.

“That is baloney,” he said.

He said the doctor who performed the surgery found a fresh clot on the other side of Rush’s heart from where he had suffered damage from the heart attack.

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