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Jury says doctor didn't do enough to help obese smoker

In the Courts. By Tanya Albert, amednews staff. May 12, 2003.

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As scientists better understand how excess weight, age, sex, smoking and stress increase the risk for heart disease, one Cleveland jury says physicians have a greater responsibility to make sure patients keep those factors in check and to refer patients with risk factors to specialists more quickly.

They backed up that opinion with a $3.5 million judgment against a Cleveland internist whose patient died of a heart attack. An autopsy performed on the 54-year-old, overweight man showed coronary artery disease.

Some experts argued that the doctor, Franklin Price, MD, did everything possible to try to help the patient, Lawrence Smith. They say people need to take more personal responsibility for what they do to their bodies.

Other experts, though, say the case is about whether Dr. Price did enough to help Smith avoid a heart attack given his risk factors.

In addition to being overweight and older than 50, Smith also smoked and had a stressful job.

Six jurors said Dr. Price could have done more, while two said he did enough. (Civil juries in Ohio do not have to be unanimous for the plaintiff to win.)

The case is sure to trouble physicians, who will be wondering what perfect combination of their care and patient responsibility is going to put them on the winning end of a lawsuit.

"If an internist is going to take it upon himself or herself to be the first level of diagnosing heart disease or to be the gatekeeper before a patient sees a cardiologist, they have to be aware of what impact risk factors have on their responsibility," said Peter H. Weinberger, who represented Smith's wife, the plaintiff. "They have to know when they have the obligation and the duty to have someone else look at a patient."