LEWISBURG -- A Union County jury will decide whether a former Evangelical Community Hospital emergency room physician was negligent in failing to diagnose heart disease in a 53-year-old man who died three weeks after being treated in 2005.

The family of the late Fahrije Toci filed a lawsuit against Dr. Debra Stoner, Evangelical Community Hospital and Evangelical Medical Service Organization alleging medical negligence led to his April 2, 2005 death.

The defense said that because Toci's autopsy was incomplete, the cause of death isn't certain and Dr. Stoner can't be held liable.

Toci was an overweight, 53-year-old hard-working restaurateur when he visited the emergency room on March 7, 2005, complaining of fatigue, neck and left shoulder pain and arm numbness, plaintiff attorney Steven Laynas, of Philadelphia, told the jury in opening statements Monday.

In addition to the symptoms, Toci was found to have an extremely high blood pressure, all markers of a possible heart condition, Laynas said.

"That should have rang a bell, set off an alarm, for sudden cardiac death," he said.

However, five hours after he arrived at the ER, Toci was examined by Dr. Stoner, who diagnosed his condition as possible arthritis of the neck.

She ordered an X-ray of his neck, gave him Vicodin for the pain and suggested he consult with an orthopedic surgeon about his neck and a family physician regarding his elevated blood pressure before releasing him from the hospital.

Toci continued to take the painkillers when the symptoms arose and three weeks later his family found him dead in his bed.

An autopsy revealed Toci had an enlarged heart and blocked arteries. His heart weighed 550 grams, much larger than the normal heart of 350 grams, Laynas said.

On the witness stand, Dr. Stoner stood firm by her decision not to order a chest X-ray or EKG tests, which may have alerted medical professionals to Toci's cardiac issues, because there was evidence that something other than heart problems were causing him pain.

"If I had thought his complaints were cardiac-related, I would have asked for the tests," she testified.

The defense said Toci complained of a "pinching" pain in the back of the neck and a neck X-ray showed he had a degenerative disc disorder.

Defense attorney Richard Schluter, of Williamsport, said Dr. Stoner gave Toci specific orders to see an orthopedic surgeon and his family physician, which he failed to do.

Even more critical to the case, Schluter told the jury, was that the autopsy was incomplete and the cause of death is not known.