Missed Aortic Dissection or Aneurysm in Michigan

A missed aortic dissection or aneurysm may support a Michigan medical malpractice claim when the medical team failed to provide the care the circumstances required and that failure caused additional injury or death. The diagnosis alone does not establish negligence. The important questions are what warning signs were available, how the team responded, and whether timely care probably would have changed the outcome.

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At Hoffer & Sheremet, we help seriously injured patients and families understand those questions. Our Grand Rapids-based medical malpractice attorneys accept cases throughout Michigan.

If symptoms are happening now: Call 911 for sudden severe chest, back, or abdominal pain, collapse, or new stroke-like symptoms such as trouble speaking or weakness on one side. These can signal a medical emergency. Do not wait for a legal consultation. This page cannot diagnose the cause of symptoms. NHLBI explains aortic emergency warning signs.

What is the difference between an aneurysm, a dissection, and a rupture?

These terms describe different problems involving the aorta, the large artery carrying blood from the heart to the body.

Aortic aneurysm: An abnormal enlargement or bulge in part of the aorta. A thoracic aortic aneurysm is in the chest; an abdominal aortic aneurysm, sometimes called an AAA, is in the abdomen. Some aneurysms grow without symptoms.
Aortic dissection: A tear in the inner lining that allows blood to separate layers of the aortic wall. It can interfere with blood flow to vital organs. A dissection is not simply another name for an aneurysm.
Aortic rupture: A break through the aortic wall that allows blood to escape. An aneurysm or a dissection can lead to rupture, but the terms are not interchangeable.

Aortic dissection belongs to a group of emergencies called acute aortic syndromes, which also includes bleeding within the aortic wall (intramural hematoma) and an ulcer that penetrates the wall. These related conditions also require prompt clinical assessment.

The distinction matters in a legal review. A case involving an overlooked finding on an older scan raises different questions from a case involving sudden pain and a missed emergency diagnosis. NHLBI's aortic aneurysm overview provides additional background.

When can a missed aortic condition be medical malpractice?

A serious outcome deserves a careful explanation, but it does not tell us whether the care was negligent. Aortic disease can be difficult to recognize and can cause catastrophic injury even when clinicians respond appropriately.

A review may examine whether a healthcare provider:

Failed to consider an aortic emergency despite a concerning combination of symptoms, history, and examination findings
Dismissed persistent or changing symptoms without appropriate reassessment
Failed to obtain appropriate imaging when the clinical picture warranted it
Misinterpreted an imaging study or failed to communicate an urgent finding
Recognized the emergency but unreasonably delayed specialist involvement, treatment, or transfer
Failed to communicate or arrange appropriate follow-up for a previously identified aneurysm

These are issues to investigate, not a checklist that proves liability. The analysis must use the information reasonably available during treatment, rather than assume the eventual diagnosis should have been obvious from the beginning.

For emergency department care, our page on emergency room errors in Michigan explains related concerns involving triage, reassessment, and discharge.

What warning signs should an aortic evaluation consider?

An aortic dissection may cause abrupt chest or back pain that is severe from the moment it begins, but patients do not always describe a classic “tearing” sensation. Symptoms can also resemble a heart attack, stroke, or an abdominal problem. Fainting, neurological changes, and changes in blood flow to an arm or leg may affect the assessment.

Medical history matters too. A known aneurysm, uncontrolled high blood pressure, certain inherited conditions, a bicuspid aortic valve, and a family history of aortic disease can change the level of concern. The absence of a known risk factor does not settle the diagnosis. Normal initial vital signs, similar pulses in both arms, or pain that temporarily improves also do not necessarily exclude a dissection. NHLBI discusses dissection symptoms and risk factors.

In a malpractice investigation, the question is not whether one symptom appeared on a list. It is whether the overall presentation called for a different response. That includes the symptoms the patient reported, the examination, changes over time, previous records available to the team, and the reasons given for ruling possible causes in or out.

Does every patient with chest or back pain need a CT scan?

No. Testing depends on the clinical assessment, the likelihood of an aortic emergency, the patient's stability, and the benefits and risks of the available tests.

The ACC/AHA aortic disease guideline recommends CT as initial imaging for suspected acute aortic syndrome; transesophageal echocardiography and MRI are reasonable alternatives in appropriate circumstances. A chest X-ray alone is not sufficiently reliable to diagnose or exclude acute aortic syndrome. The relevant question is whether the tests chosen addressed the condition reasonably suspected at that time. Read the ACC/AHA diagnostic guidance.

The name “CT scan” is not enough to evaluate a case. Reviewers may need the actual images, the body areas examined, the imaging protocol, and the radiology interpretation. A study ordered to answer a different medical question may not answer every question about the aorta. The American College of Radiology appropriateness criteria describe several imaging options for suspected acute aortic syndrome.

Screening and surveillance are different from emergency diagnosis

Screening looks for disease in a person who may have no symptoms. Surveillance follows a known condition over time. Neither is the same as evaluating a patient with new symptoms that could represent an emergency.

Ultrasound is commonly used to screen for an abdominal aortic aneurysm and to follow its size. Other aortic locations and clinical questions may require different imaging. Recommendations depend on the patient's age, history, risk factors, and the part of the aorta involved. NHLBI explains screening and diagnostic tests.

A delayed-diagnosis case may involve an aneurysm found incidentally during imaging for something else. Useful questions include:

Was the finding included clearly in the report?
Who received the report, and what follow-up was recommended?
Was the patient told about the finding and its significance?
Were later studies compared with earlier measurements?
Did new symptoms require a change from routine follow-up to urgent evaluation?

A small or stable aneurysm does not automatically require surgery. Monitoring and medical treatment may be appropriate. Decisions about repair depend on factors including location, size, growth, symptoms, and the individual's risks. NHLBI describes treatment considerations.

Why do the timing and location of a dissection matter?

A dissection involving the ascending aorta, often called type A, generally requires emergency surgical evaluation. Dissections that do not involve the ascending aorta, called type B, may be treated differently. Some uncomplicated cases are initially managed medically; complications can require intervention. The treatment plan must fit the actual anatomy and condition of the patient.

For that reason, a delay claim needs more than the statement that treatment should have happened sooner. The medical evidence must address what treatment was available during the disputed interval, whether the patient could have received it, and what difference it probably would have made. The ACC/AHA guideline summary distinguishes these treatment pathways.

What harm can delayed diagnosis cause?

A dissection can reduce blood flow to the brain, spinal cord, kidneys, bowel, or limbs. This is sometimes called malperfusion. Consequences can include stroke, paralysis, kidney failure, intestinal injury, or limb damage. Bleeding around the heart can prevent it from pumping effectively, a complication called cardiac tamponade. Rupture can cause massive internal bleeding and death. These complications are discussed in the ACC/AHA aortic disease guideline.

The diagnosis can also change which emergency treatments are safe. For example, the 2026 AHA/ASA stroke guideline cautions against intravenous clot-dissolving treatment in a patient with acute ischemic stroke and known or suspected aortic arch dissection. A legal review may therefore examine both delayed aortic treatment and treatment given for a different presumed diagnosis. This is a clinical-review issue, not advice to stop prescribed medication.

How is a Michigan missed-diagnosis claim proved?

Under MCL 600.2912a, a malpractice claim requires proof of a breach of the applicable standard of care and an injury more probably than not caused by the negligence.

For an aortic case, the investigation separates three questions:

What should the medical team have done?

Qualified medical review evaluates the provider's role and specialty, the clinical information available, and the circumstances of care. A guideline can inform that review; it does not replace a patient-specific analysis of the legal standard.

What harm did the delay cause?

The review must distinguish damage from the underlying disease from additional harm caused by negligent delay. A later rupture, stroke, organ injury, or death is not, by itself, proof that an earlier mistake caused it. The timeline and medical evidence must connect the alleged failure to the injury.

How has the injury changed the patient's life?

The consequences may include further treatment, rehabilitation, lost income, permanent limitations, and assistance with daily activities. We need to understand both the medical course and the practical effect on the patient and family. Our guide to recoverable damages explains the categories considered in a Michigan malpractice case.

What evidence can help explain what happened?

A portal summary rarely contains the complete story. Depending on the case, useful records may include:

EMS records and the emergency department's triage, nursing, and physician notes
Vital-sign trends and documented changes in pain, consciousness, or neurological function
Original imaging files, radiology reports, and earlier comparison studies
Laboratory results, consultation notes, and medication records
Transfer requests, acceptance records, and transport times
Electronic orders, alerts, and available audit-trail information that clarify the timeline
Operative reports and records of subsequent treatment
Earlier communications about an aneurysm or follow-up plan
Available autopsy and death-certificate records in fatal cases

Families can also preserve discharge papers, portal messages, and a short timeline of what they remember. Note who was present, what symptoms were reported, and what explanations were given. Keep the original documents and messages rather than editing them. You do not need to obtain every record before speaking with an attorney.

How long do I have to pursue a claim in Michigan?

Michigan generally uses a two-year medical malpractice limitations period. A discovery provision, a statute of repose, notice requirements, and exceptions may affect the deadline. Death and other circumstances can make the calculation more complicated. The Michigan Courts medical malpractice benchbook describes these rules.

Do not assume the deadline begins on the date a different doctor finally explains what happened. A lawyer should review the dates promptly. Our Michigan statutes of limitation and repose guide provides a starting point, not a calculation for your individual case.

Frequently asked questions

Can an aortic dissection be mistaken for a heart attack or stroke?

Yes. Symptoms can overlap. Whether a mistaken initial impression was negligent depends on the presentation, the differential diagnosis, subsequent findings, and the team's response. Considering one possible diagnosis does not answer whether another dangerous cause needed evaluation.

Does a normal chest X-ray rule out aortic dissection?

No. It may provide useful clues, but it cannot reliably exclude acute aortic syndrome. Whether further imaging was warranted depends on the full clinical assessment.

Can a routine CT miss a dissection?

It can. The contrast timing, body areas covered, and image quality may affect what the study can show. Reviewers need to evaluate the actual study and its clinical purpose, not simply whether the chart says “CT performed.”

Can there be a case if surgery was eventually performed?

Possibly. The issue is whether negligent diagnostic, treatment, or transfer delay caused additional injury before surgery. An eventual operation does not establish that earlier care was adequate, and it does not itself prove that a delay caused harm.

Does an aneurysm that later ruptures prove it should have been repaired earlier?

No. A later rupture does not, by itself, establish that an earlier treatment decision was unreasonable. Reviewers must examine the prior measurements, symptoms, growth, relevant risk factors, and the options available at the time.

What if the scan showed an aneurysm but nobody told us?

The report and communication history deserve review. An attorney will examine who received the finding, what follow-up was warranted, and whether the failure to communicate or act caused additional harm. An unexplained finding and a provable injury are separate parts of the investigation.

Can a family seek review after a loved one dies?

Yes. A family can ask an attorney to evaluate whether negligent diagnosis or treatment contributed to the death and whether a claim is available. Our medical malpractice wrongful death page explains the firm's work with grieving families.

Do I need all of the medical records before calling?

No. Start with the approximate treatment dates, the hospital or providers involved, what you were told, and the injury or loss. We can discuss what additional information a case review would require.

Start Your Free Case Review

If a missed aortic dissection or aneurysm left you seriously injured or caused a loved one's death, Hoffer & Sheremet can help you explore what happened. We represent patients and families in Grand Rapids, West Michigan, and throughout Michigan.

Call 616-278-0888 or request a free, confidential case review. You do not have to know the medical terminology or have the complete record to start the conversation.

This page provides general information, not medical advice or legal advice for a particular matter. Contacting the firm does not establish an attorney-client relationship; representation begins with a signed engagement agreement.