Reprinted with permission from Medical Malpractice Verdicts, Settlements and Experts, Lewis Laska, Editor, (800) 298-6288.
Oversedated, Unresponsive After Aneurysm Surgery
A 73-year-old man went to a hospital emergency department (ED) with complaints of chest pain, bloating, and blood in his stools. CT revealed an aortic aneurysm, and surgery was performed three days later. In the recovery room, the patient became confused and agitated. He managed to leave the building before several nurses were able to restrain him and return him to his room.
It was determined that the man was experiencing symptoms of alcohol withdrawal, making him uncooperative and potentially violent. He was started on a detoxification protocol, which included lorazepam and haloperidol.
Over the next several days, the patient appeared oversedated and unresponsive, and his lorazepam dosage was reduced. When he developed a rattle in his chest and began to have trouble breathing, no action was taken. He went into respiratory arrest and was intubated; during this procedure, he sustained a punctured lung. Although the man was resuscitated, he was left with anoxic brain injury. He remained in a deep coma until his ventilator was turned off.
Plaintiffs for the decedent claimed that he was oversedated. He developed a mucous plug that he was unable to clear because of physical restraints and a decreased level of consciousness.
According to a published account, a settlement of $107,500 was reached.
Discontinued Monitoring for Abdominal Cyst
The plaintiff child, an infant girl, was delivered in September by an Ob-Gyn from a women's health practice. Her mother had undergone serial fetal ultrasonography to monitor an abdominal cyst that was detected in the unborn child early in the woman's pregnancy.
During the eight weeks following hospital discharge, the child was seen numerous times by physicians at a pediatrics/adolescent medicine group for digestive issues, including nausea, vomiting, diarrhea, and pale-colored stools. In late October, the mother asked one of the pediatricians whether the infant's problems could be related to the cyst; she questioned whether the prenatal ultrasounds had been faxed to the pediatrician's office.
When no follow-up testing was ordered, the parents took the infant to another doctor, who had her admitted. She was diagnosed with a choledochal cyst (a congenital bile duct anomaly) and liver failure. During surgery, associated biliary atresia was also discovered.
In February, the infant underwent a liver transplant. She suffered one episode of liver rejection and will require a lifelong regimen of antirejection medications.
According to the plaintiff, an Ob-Gyn had assured the mother that an order for postpartum ultrasonography would be placed in the chart to ensure follow-up on the infant's cyst, but the test was never ordered. The plaintiffs also claimed that the Ob-Gyn never informed the pediatrics/adolescent medicine group about the cyst and that no information about the cyst was placed in the newborn's charts by hospital nurses. The plaintiff claimed that proper monitoring would have led to early intervention at a time when the infant's liver was salvageable.
The defendants contended that they had communicated properly and that the child would still have needed a liver transplant, even if testing had been conducted earlier.
During the trial, a confidential settlement was reached with the hospital and the pediatrics group. According to a published report, a $16.5 million verdict was returned against the women's health practice.
Abscess Develops Following a Fall
One day at work, a 54-year-old man fell off his chair and landed on his right hip. He did not seek immediate medical attention but was in considerable pain by the time he arrived home. During the night, his pain worsened, and his wife called an ambulance.
When the patient arrived at the ED, he was barely able to walk and reported a 9 on the 10-point pain scale. His skin moistness, color, and temperature were all normal. An IV was started, and the man was given morphine. When his pain persisted, he was given ketorolac tromethamine, meperidine, and hydroxyzine pamoate.
The ED physician made a diagnosis of acute lumbosacral strain and released the man with prescriptions and instructions for hydrocodone/acetaminophen and cyclobenzaprine. He was to be on bed rest for two days, remain home from work for two more days, and see his primary care provider in seven to 10 days if his condition had not resolved.
The man's pain became increasingly severe. He could not walk unaided, and after four days, he was pale or grayish in color, clammy, sweaty, and short of breath. On the fifth day, this US Army veteran kept an appointment at a US Air Force/university hospital–based clinic, where a second-year resident examined him, diagnosed muscle sprain, and prescribed a few more days of rest. The patient was not seen by the supervising physician.