Hypoxic Ischemic Encephalopathy

[squishO90]

What is the name of your state? RI
Hi,
I wanted to get you all's opinion on whether you think I might have a case, so here goes.
Back in July of 2006 I had a spinal fusion performed. The required stay in the hospital is 4 days. Well everyhting was going well until the morning I was supposed to go home I was found unresponsive. My O2 sat's were in the 40,s although at the time my blood pressure was ok. I was being treated with 80 mg of Oxycontin throughout this whole process.. Anyway 10 minutes after finding me they called a code blue and my blood pressure went down as low as 40/p. I was given NARCAN to try to reverse the effects of the Oxycontin but to no effect. I was intubated at approximately 7:30 ( the code blue was called at 7:00 am.). I had apparently aspirated and it went into my lungs and I also had a large pulmonary embolism in the right something or other of my lung. I ended up with a case of Hypoxic Ischemic Encephalopathy, which has profoundly changed my life. After reading the records from the night before my event, my wife noticed that at midnight the nurse took my blood pressure which was kind of high, 178/88 I think. 15 minutes later, she took it agin and it was 138/72. Then she says in her notes that she checked on me frequently through the nigh, and saw me repositioning myself. She doesn't note what time she saw me repositioning myself or any of the times she "frequently" checked on me, but that's what the records say. I could have been puking for all she knew. There is no notation in the chart that she checked my blood pressure again all evening. Doesn't it seem strange that she was concerned enough about my blood pressure at midnight to take it again 15 minutes later and then didn't take it again until 6:50 in the morning? Thank goodness for me that at shift change they came in and checked and that's when they found me unresponsive in respiratory arrest. They called my wife immediately and told her to get down to the hospital right away because something
"bad" had happened to me. When she got there she was told I had severe brain damage and would probably never recover. Damage to the brain stem they said and I had negative "doll's eye" response. They really put her through hell. My MRI showed damage to the brain stem and in the globus pallidus bilaterally with a tiny infarct in the left frontal lobe above the vertex, and in the basal ganglia. Anyway as you can see by my writing this, that I am alive and well enough to write this note to you all. My question is, did the nurse screw up by not checking my vital signs at sometime during the evening? It says in the records that the night before that they checked it at 4:55 in the morning, so why didn't they check it again at that time of the morning? And as far as frequently checking on me, doesn't it sound a little suspicious that she would write that, considering she hadn't noticed that my condition was deteriorating? I'm sure I just didn't get into this state in a few minutes, I think it probably took a while. And according to the medical literature I read, primary attention should be taken to secure ventilation for a patient who is in respiratory arrest while waiting for NARCAN. They didn't intubate me until a half hour after the code was called. Also with respect to the Oxycontin, don't you think 80 mg's is a bit high to start an opioid naive patient like me on? All the literature I've read says that 80 and 160 mg of Oxycontin should not be used on opioid naive patients and Oxycontin should be titrated up to a dose that kills the patients pain. Also it was a standing order for the 80 mg's, no real attention paid by my doctor. I also (according to the records) refused percosets on the evening of my event, and I was also very nauseous all 3 days while in the hospital so i was given Zofran, an anti-emetic, which is a centrally acting drug, which means it can also cause respiratory depression. The literature that I,ve read syas that when another centrally depressing drug is used Oxycontin should be give at 1/2 to 1/3 of the dose normally given. So in summary, I think the nurse screwed up by not checking on me properly, and by giving me 80 mg's of Oxycontin when I had a pain rating of 2 out of 10 or 3 out of 10. I think the doctor screwed up by starting me on a dose of 80 mg's of Oxycontin and then especially ordering Zofran to help with my nausea, and I think the team on the code blue screwed up by not intubating me immediately instead of waiting a half hour. My deficits are basically getting me fired from my job as an Air Traffic Contoller, I have to go out on disability because I can't see lines on the radar scope the same way I used to, I have problems initiating things ( my wife is making me write this) I have debilitating fatigue, I feel like I have to take a nap every early afternoon, I have a flat affect,and I have had a couple of seizures, which I am on 150 mg of Lamictal for. I also take wellbutrin to help with my mood and Provigil to help me try to stay awake during the day. All of these medications disqualify me from being an air traffic contoller. In fact the regional flight surgeon told me last week he was going to permanantly medically disqualify me because of the notes I've gotten from my doctors and neuropsychologists and the drugs I will be taking indefinitely. I will be losing $2 million worth of pay because i won't be able to work til I'm 65. Anyway. what do you all think. Case or not?

RickWhat is the name of your state?