In Mancini v. United States, the Tenth Circuit Court of Appeals upheld a $5.8 million judgment against the federal government under the Federal Tort Claims Act (FTCA). The case arose from inadequate medical treatment provided to a veteran by the Department of Veterans Affairs (VA) in Colorado, which led to a delayed diagnosis of critical heart disease and resulted in permanent cardiac damage.
Christopher Mancini, a 47-year-old Army veteran, began seeking treatment for chest discomfort in 2014 at a VA clinic in Colorado Springs. During his initial appointment in November 2014, he described symptoms including chest tightness, fatigue, and shortness of breath. Despite these being potential indicators of cardiovascular disease, no diagnostic testing specific to cardiac evaluation—such as an electrocardiogram (EKG)—was ordered. Instead, VA providers attributed the symptoms to gastrointestinal issues and prescribed antacids.
Mancini returned to the clinic multiple times over the following months, including in March and July 2015. Each time, he continued to report concerning symptoms. Providers again failed to perform any cardiac tests or refer him to a cardiologist. According to the record, these visits were documented with language downplaying the possibility of cardiac disease, despite a growing list of risk factors, including elevated cholesterol, obesity, and a family history of heart disease.
In August 2015, Mancini collapsed while hiking with his family. He was transported to a civilian hospital, where emergency medical personnel performed an EKG and determined that he was suffering from significant coronary artery disease. He was diagnosed with critical stenosis in his left main coronary artery, commonly referred to as a "widow-maker" blockage. This condition required immediate intervention, and he underwent multiple cardiac procedures, including angioplasty and stent placement.
Despite the emergency treatment, Mancini suffered irreversible damage to his heart. He experienced a substantial decline in physical capacity, chronic fatigue, and emotional distress. He could no longer maintain full-time employment or engage in many of his pre-event daily activities.
Mancini filed a medical malpractice lawsuit under the FTCA, which permits private parties to sue the United States for the negligent acts of federal employees acting within the scope of their employment. The case proceeded to a bench trial in the U.S. District Court for the District of Colorado.
At trial, expert witnesses testified on both sides. Mancini's cardiology expert stated that the standard of care required a basic cardiac workup, including an EKG, as early as his initial VA visit. The expert concluded that timely testing and referral would likely have detected the blockage before it reached a critical stage. The government’s expert disputed these conclusions but acknowledged that Mancini presented with some cardiac risk factors.
The district court ruled in Mancini’s favor, finding that VA providers breached the standard of care by failing to perform routine cardiac evaluations over multiple visits. The court determined that this breach was the direct cause of the delayed diagnosis and resulting heart damage. The court awarded $5.8 million in damages, accounting for lost earning capacity, ongoing medical needs, and pain and suffering.
The United States appealed the judgment, challenging the district court’s findings on breach, causation, and damages. On appeal, the Tenth Circuit reviewed the lower court's conclusions under the clear error standard and upheld the judgment in full.
The appellate court found that the evidence supported the district court’s determination that VA clinicians failed to act on clear warning signs. The court also agreed that earlier detection would have altered Mancini’s medical outcome. The damages award was affirmed, with the appellate panel emphasizing the credibility of the district court’s fact-finding and its application of medical expert testimony.
The ruling in Mancini v. United States reinforces that federal healthcare providers, including VA personnel, are subject to the same standards of care as their private counterparts. It also highlights the role of the FTCA in allowing individuals to pursue compensation when government-employed clinicians fail to follow accepted medical protocols.
If you or a loved one has experienced harm due to delayed diagnosis or inadequate care from a federal medical facility, our team at Whitcomb, Selinsky, PC can evaluate whether an FTCA claim may be appropriate. We assist in reviewing medical records, coordinating expert testimony, and navigating the procedural steps required for pursuing a federal malpractice case.