The plaintiffs claimed that the defendants were negligent in monitoring the decedent’s INR levels, which should have been done daily. The hemorrhage, the plaintiffs claimed, was caused by the heparin. The order was for heparin to be administered “per pharmacy protocol,” but the hospital pharmacy had no such protocol in place at the time. As a result, too much heparin was given.
The defendants contended that the decedent’s treatment was proper and that abdominal hemorrhaging is a known complication of anticoagulation therapy. Her hemorrhage, they claimed, was triggered by the restriction of her seatbelt when she drove over the railroad tracks on the way home from the anticoagulation therapy clinic. The defendants maintained that the decedent’s INR level was properly monitored and that the use of heparin was within the standard of care.
The matter was arbitrated, resulting in an award of $385,376.
Loss of Vision After Screening Colonoscopy
A 54-year-old man was referred to the defendant gastroenterologist for a screening colonoscopy. The patient had a family history of colon cancer and a long history of multiple medical problems, including four heart attacks, organic heart disease, diabetes, dyslipidemia, and hypertension.
The previous month, when testing revealed the presence of a kidney stone, the man’s blood pressure was 160/88 mm Hg. Before the colonoscopy, his blood pressure measured 93/50 mm Hg. He had no lightheadedness, dizziness, or chest pain.
An IV was started, and the patient was given meperidine and midazolam. After the scope was inserted, his blood pressure declined. The endoscopy nurse reported this to the gastroenterologist, who ordered an increase in IV fluids. The plaintiff’s blood pressure rose, and the procedure was completed.
In recovery, the patient was noted to be alert and oriented. He received a perfect score on discharge criteria and was released from the recovery area with a blood pressure reading of 90/60 mm Hg.
The man went straight to a donut shop, where he ate two donuts. He then experienced nausea that lasted throughout the afternoon, after attempts to eat and drink a number of items.
At about 4 PM, a call was made to the gastroenterologist’s office. The defendant returned the call, instructing the patient to report to the emergency department; the plaintiff later claimed that this was stated only as an option. Instead, the man elected to take an OTC antinausea medication and remain at home. The nausea subsided, and he went to bed and slept through the night.
When the man awoke at 5 AM, he was totally blind. He was taken to the hospital, where he was evaluated by a neuro-ophthalmologist and diagnosed with a posterior ischemic optic neuropathy.
The plaintiff charged that the rare form of blindness he experienced was the result of hypotension during the colonoscopy. He claimed that he was not given sufficient IV fluids to elevate his blood pressure and that he should not have been discharged home.
The defendant claimed that the plaintiff’s blindness was unrelated to the colonoscopy but resulted from hypotension that developed while he was sleeping.
An initial trial ended with a hung jury. At a second trial, a defense verdict was returned.