IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF OHIO

EASTERN DIVISION

JOHN E. VEST

1391 Bennett School House Rd

Wheelersburg, OH 45691

AND

PAMELA K. VEST

1391 Bennett School House Rd

Wheelersburg, OH 45691

Plaintiffs,

vs.

THE UNITED STATES OF AMERICA

950 Pennsylvania Avenue, NW

Washington, DC 20530-0001

Defendant.

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CIVIL ACTION NO.: 2:18-cv-70

JUDGE: 

COMPLAINT FOR MEDICAL 

MALPRACTICE AND RELATED 

TORTS 

FACTS COMMON TO ALL CLAIMS

1. This action arises under the Federal Tort Claims Act (FTCA).

2. Jurisdiction is proper pursuant to 28 U.S.C.A. § 1346(b)(1) and 28 U.S.C.A. §§ 

2671 to 2680.

3. An administrative claim was filed with the Department of Veterans Affairs, VA 

Regional Office on June 21, 2017. (See Exhibit 1 attached hereto, Standard Form 95-Claim for 

Damage, Injury or Death.)

4. As of January 2, 2018, the Department of Veterans Affairs failed to make final 

disposition of Plaintiffs’ administrative claim, thereby denying such claim in accordance with 28 

U.S.C. § 2675(a). 

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5. This action properly lies in the Southern District of Ohio, Eastern Division, 

pursuant to 28 U.S.C. § 1391(b), because a substantial part of events or omissions giving rise to 

the claim occurred within this judicial district.

6. Plaintiffs John E. Vest and Pamela K. Vest were and are, at all relevant times, 

residents of Minford, Ohio, which lies within Scioto County, Ohio. 

7. Plaintiff John Vest received treatment at Chillicothe VA Medical Center, which lies 

within Ross County, Ohio.

8. Defendant, Chillicothe VA Medical Center (hereinafter “Defendant VA”), an entity 

of the United States government, provides medical care to veterans through its actual and 

ostensible agents, employees, and members.

9. Defendant VA engaged in behavior, more fully described below, which rose to a

level of negligence that would give rise to liability, under negligence and medical malpractice 

theories, if the United States government were a private person. 

10. Plaintiff John Vest has a past medical history consisting of known coronary artery 

disease which first presented in 2007.

11. In the period between May 21, 2010, and April, 2012, Plaintiff John Vest underwent 

additional cardiac evaluation for presentations with chest pain.

12. On February 10, 2016, Plaintiff John Vest presented to the Southern Ohio Medical 

Center (“SOMC”) emergency department with complaints of chest pain radiating to his jaw for 

one week. High-risk chest discomfort was noted in the documentation, but no acute EKG changes 

or troponin elevations were found. The chest pain was documented to have resolved, and the 

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recommendations given to the Plaintiff included a follow-up with cardiology for a stress test as 

well as pulmonology for evaluation of his shortness of breath.

13. On February 24, 2016, Plaintiff John Vest presented to Defendant VA as an 

outpatient and reported chest pain as one of his presenting complaints. No additional cardiac 

evaluation was ordered by the clinicians and Plaintiff John Vest was instead referred for mental 

health evaluation. 

14. Within the VA records on the same day, February 24, 2016, is a triage phone call 

in which Plaintiff states that he “needs to be seen by pulmonary and cardiology.” No 

documentation supports a referral to either specialty or a plan for additional cardiac evaluation.

15. On June 10, 2016, during evaluation for dyspnea by the VA pulmonology, coronary 

heart disease was mentioned as part of the differential diagnosis for his presenting complaints.

16. Plaintiff John Vest was eventually seen by the VA cardiology department on June 

30, 2016. His chest pain was noted to be more frequent and more intense and now beginning to 

occur at rest. Cardiology’s assessment at that time mentions unstable angina, and a STAT stress 

test was recommended to evaluate his condition. 

17. Despite this recommendation, there is no documented evidence that the 

recommended STAT stress testing was scheduled. The physical exam documented during this 

visit makes no mention of signs of heart failure. 

18. Defendant VA’s failure to schedule the cardiac testing in an expedited fashion, as 

recommended by the treating physician, at that time represented substandard care and a deviation 

from expected practices. [Affidavit of Merit, Exhibit A.]

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19. On July 12, 2016, Plaintiff John Vest presented to Defendant VA as an unscheduled 

clinic appointment for worsening shortness of breath. His physical exam at that time was consistent 

with new onset heart failure. 

20. Further consequences manifested themselves on July 16, 2016, when Plaintiff John 

Vest presented to Adena emergently with a NSTEMI and worsening heart failure. An 

echocardiogram conducted at that time demonstrated an EF of 35%, which represented new 

systolic dysfunction directly resulting from untreated coronary artery disease. Additionally, his 

ventricle had enlarged (LVIDd noted to be 6.2 cm), and a left heart catheterization confirmed 

severe progressive coronary artery disease in a pattern that is not consistent with sudden onset, but 

rather from subacute progression (collateralization). Subsequent attempts at surgical 

revascularization were complicated by postoperative cardiogenic shock.

21. A follow-up evaluation on August 16, 2016, documents ongoing heart failure.

22. Plaintiff John Vest’s substandard treatment of his coronary heart disease at the VA 

led to his heart failure and LV systolic dysfunction. The occurrence of heart failure for Mr. Vest 

has direct consequences on his life expectancy. 

23. Heart failure is known to have an extremely high mortality, estimated to be 50% at 

five years and 10% at 10 years. Furthermore, reduced systolic function is known to be associated 

with an increased risk of sudden cardiac death. In addition to mortality risk, the diagnosis of heart 

failure carries with it a high probability of hospitalizations as part of the disease process. 

24. Plaintiff John Vest is at risk for all these worsening outcomes given his resultant 

heart failure and, therefore, suffered a loss of chance. Severe progression of heart failure may well 

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also demand advanced surgical therapies such as cardiac transplantation or mechanical circulatory 

support.

25. Plaintiff John Vest’s undertreated coronary artery disease at the VA played a 

critical role in the timing and severity of his eventual heart failure presentation. Plaintiff John Vest

is now subjected to a lifetime of ongoing medical care, medical therapies, potential 

hospitalizations, and possible device therapies such as an Implatable Cardioverter Defibrillator 

(“ICD”) because of Defendant VA’s failure to adhere to acceptable clinical standards for “STAT” 

testing. 

26. Alternatively, Defendant caused a loss of opportunity to appropriately treat Mr. 

Vest that would more likely than not would have prevented his heart failure. Plaintiff John Vest 

now has a lifelong, incurable medical condition as a consequence.

27. Plaintiff has incurred out-of-pocket medical expenses due to the malpractice by 

Defendant VA, from whom he sought treatment in June 2016 because he did not have health 

insurance given his right to the VA benefits. 

28. Plaintiff has incurred and will continue to incur both medical expenses and other 

financial losses as a result of Defendant VA’s negligence. 

29. Due to Defendant VA’s negligence, Plaintiffs’ are claiming the following damages: 

A) current medical expenses of $339,859.23; B) future medical expenses of $1,000,000; C) pain, 

suffering and loss of enjoyment of life of $500,000; and D) Plaintiff Pamela Vest’s consortium 

claim of $100,000. 

30. The emotional suffering of Defendant VA’s negligence on Plaintiff John Vest has 

likewise been as significant.

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31. Plaintiffs’ total claim for damages is One Million Nine Hundred Thirty-Nine 

Thousand Eight Hundred Fifty-Nine Dollars and Twenty-three cents ($1,939,859.23).

COUNT ONE – NEGLIGENCE

32. Plaintiff realleges paragraphs 1 through 31 as if fully rewritten herein. 

33. On or about June 30, 2016, Defendant VA breached the standard of care owed to 

Plaintiff John Vest by negligently failing to adhere to acceptable clinical standards for “STAT” 

testing resulted in a loss of opportunity to appropriately treat Mr. Vest and would more likely than 

not have prevented his heart failure. 

34. As a direct and proximate result of Defendant VA’s failure to treat Plaintiff John 

Vest and observe him, Plaintiff John Vest sustained the injuries and losses set forth herein as he 

suffered heart failure and the lost opportunity to receive treatment preferred to prevent or to 

eliminate or nearly eliminate the physical and psychological deficits caused by the heart failure. 

35. Defendant VA’s negligence proximately caused Plaintiff John Vest to suffer a loss 

of a chance of having a substantially improved outcome in his physical condition following his 

heart failure compared to the outcome he did receive.

36. Defendant’s negligent acts or omissions increased the risk of harm to the Plaintiff

John Vest, and in fact did cause him harm, including a substantially reduced life expectancy.

37. As a further direct and proximate result of the negligence of Defendants, Plaintiff 

John Vest has been forced to endure, both to date and on a permanent basis, prolonged pain and 

suffering, and has caused Plaintiffs to incur medical expenses in excess of $339,859.23 from the 

date of Defendant’s negligence until now, and which will increase in the future. 

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38. Plaintiffs further state that all of the injuries, losses and damages, many of which 

are permanent, were, are and will be the proximate result of the negligence of Defendant, without 

any negligence on the part of the Plaintiffs contributing thereto. 

39. Liability is imposed upon the Defendant for breach of the standard of care pursuant 

to the FTCA.

COUNT TWO – PROFESSIONAL NEGLIGENCE

40. Plaintiff realleges paragraphs 1 through 39 as if fully rewritten herein. 

41. Defendant VA holds itself out as a professional provider of medical services in the 

Chillicothe, Ohio area.

42. As such, Defendant VA had a duty to provide such services in compliance with the 

standard of care prevalent in his community. 

43. On or about June 30, 2016, Defendant VA breached the professional standard of 

care due and owing to Plaintiff John Vest. 

44. By failing to admit Plaintiff for observation and evaluation when he presented 

symptoms indicating that a heart failure was occurring, or had a substantial likelihood of occurring 

within the next few days, Defendant VA proximately caused Plaintiff John Vest to sustain a loss 

of a chance of avoiding heart failure altogether or having a full or greater recovery from the heart 

failure.

45. As a proximate result of that breach, Plaintiffs have sustained injuries and losses as 

set forth herein. 

46. The Affidavit of Merit of Sitaramesh Emani, MD, together with its incorporated 

attachment, is attached as Exhibit 2 and incorporated herein as required by Ohio Rule of Civil 

Procedure 10.

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47. Liability is imposed upon the Defendant for breach of the standard of care pursuant 

to the FTCA.

COUNT THREE – LOSS OF CONSORTIUM

48. Plaintiff realleges paragraphs 1 through 47 as if fully rewritten herein.

49. As a direct and proximate result of Defendant VA’s actions as outlined herein, 

Plaintiff Pamela Vest, as the spouse of John Vest, at and since the time of the accident, has 

sustained and will continue to sustain a loss of consortium, due to her losses of the services, 

companionship, comfort, and solace of her husband, Plaintiff John Vest.

50. Liability is imposed upon the Defendant for breach of the standard of care pursuant 

to the FTCA.

WHEREFORE, Plaintiffs John and Pamela Vest pray for judgment against the Defendant 

named herein as to Count One, Two and Three in an amount of $1,939,859.23 plus the costs of 

this action herein, and for reasonable attorneys’ fees, and for whatever other relief this court deems 

appropriate in equity or at law.

Respectfully submitted,

/s/ Daniel J. Fruth

DANIEL J. FRUTH (0075309)

STEBELTON SNIDER, LPA

109 North Broad Street, Suite 200

P.O. Box 130

Lancaster, OH 43130

Tel: (740) 654-4141; Fax: (740) 654-2521

Email: djf@stebelton.com

Attorney for Plaintiffs John and Pamela Vest

(2018 01 26 Complaint)

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EXHIBIT 1

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EXHIBIT 2

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