Doctor Cleared on Death of Teen With Heart Issue

     (CN) - A 17-year-old Florida boy's fatal heart attack during baseball practice was not the fault of his doctor, a state appeals court ruled.
     Matthew Miulli, who was born with a condition called aortic valve stenosis, collapsed during a workout on Jan. 19, 2005, and could not be resuscitated.
     Aortic valve stenosis causes the aortic valves to narrow progressively over time, making it harder for the heart to pump blood throughout the body. People with aortic stenosis are at risk for premature, sudden cardiac arrest.
     Though Miulli's childhood doctor forbade contact sports, he allowed the boy to play baseball. Miulli last visited his cardiologist in August 2002, even though his pediatrician advised Matthew's father to schedule a follow-up appointment with one after a July 2003 visit.
     Shartz gave Miulli a physical exam and sports in August 2004, signing the release form even though he noted he would need to call the boy's cardiologist.
     When Shartz called the cardiologist, he learned that Miulli had not seen a heart doctor for nearly two years. He testified that he left six messages on the family's answering machine over a four-day span.
     Later that month, Dr. Shartz sent letters through regular and certified mail.
     After Miulli's death, his mother sued Shartz for medical malpractice. She also sued HealthPoint Medical Group for failing to inform Shartz that the certified letter had been returned.
     A trial judge for the Hillsborough County Circuit Court refused to give the defendants a directed verdict at the end of the trial, and the jury entered a $2 million verdict for Miulli's estate.
     Since the jury assigned blame at 60 percent for Miulli's parents, 20 percent for Schartz and 15 percent for his practice, the court entered a combined $717,728 verdict against the Schartz and HealthPoint. Jurors found the Hillsborough County School Board responsible for the other 5 percent, but the claims were dismissed after the verdict.
     On Friday, the Lakeland-based Second District Court of Appeals concluded that Schartz and HealthPoint were entitled to a directed verdict.
     Though the family's expert, Dr. Randy Wertheimer, faulted Schartz for failing to "close the loop" by confirming that the family understood Miulli should not play sports before seeing his cardiologist, that testimony did not prove causation, according to the ruling.
     "No one testified that Matthew would not have participated in baseball conditioning had Dr. Shartz 'closed the loop,'" Judge Anthony Black wrote for a three-person panel. "And no one testified that had HealthPoint advised Dr. Shartz of the returned letter, Matthew would not have participated in baseball conditioning. Without that testimony, Dr. Wertheimer's opinions that Dr. Shartz's and HealthPoint's actions and inactions contributed to Matthew's death are conclusory, speculative, and not based on facts presented at trial, requiring an impermissible stacking of inferences."