Wrongful Death Aspiration Pneuomina?

[bunswife]

What is the name of your state? Michigan

My husband (age 50) recently died while inpatient in a local hospital. He was recovering in a step-down unit from surgery and we had received good news the day before that he was recovering nicely and a full recover was expected. On the day he died, I called in the AM to check on him and was advised that he was having a bad morning but seemed to be in a little pain. I asked if I should come in, they advised that no, he seemed to be resting comfortably now. I called one hour later and his nurse advised that she was not in his room and she would be going in there next. About 40 minutes later, I received a call that he was transferred to ICU and I needed to get to the hospital ASAP. Upon arrival, I could not go to his room, they were working on him. The hospital Chaplain advised that things were getting better and that a Dr. would be in soon to talk with me. The Dr. arrived and advised that he had aspirated bile from his stomach into his lungs and suffered cardiac arrest. He was down for 29 minutes, and they got him back. He then coded once again for a short time and brought him back again. The pulmonary Dr. advised that they found him in his bed with bile on his clothes and it was determined that he had aspirated.They intubated and cleaned out his lungs, but he aspirated a large amount of bile from his stomach into his lungs. He had not been eating prior to this except for an occasional Popsicle or sips of water. I learned that morning, he had been complaining of extreme nausea. I received several different stories about what happened prior to him throwing up, one nurse said that they did not get the NG tube in another said that he did have an NG tube in and another said that they were just getting ready to insert the NG tube when he aspirated. After his original surgery, he had not been able to get out of bed and was weak. He could not hold himself up or turn by himself. He was able to control the bed up and down, and did have a sign above his bed that his bed should not be below 30 degrees. I will tell you that this was not followed, I often found him lying pretty flat in the bed. All the Dr's stated that they did not know why his reflex to cough did not help him, they assumed another medical event occurred at the same time, causing him to aspirate. From the autopsy results, there was no other event noted such as a blood clot, heart attack etc. When he was transferred to the ICU, the pulmonary Dr. lowered his temp, packing him in ICE and a cold blanket machine to preserve brain flow fearing brain damage. It did lower his temp. The surgeon called after hearing of the cardiac arrest and I could hear him yelling that he did not want him cold and to warm him up as he worried about bleeding. They started to warm him up, but he would not respond. During the course of the day, he did begin to bleed internally and they could never warm him up. He died 5 hours later. We had an autopsy performed and cause of death was aspiration pneumonia which caused multiple organ failure and eventual cardiac arrest. He had 2-3 liters of blood in his abdomen as internal bleeding did occur. My husband drowned in his own bile. I feel strongly that the hospital had a responsibility to my husband to ensure that he was adequately supervised as he stated that he was extremely nauseated, and would have needed assistance if he began to vomit. Days before, when he had a bout of nausea and did vomit bile, I was there and needed to hold him up and move him forward so that he could clear his vomit and airway. If he was supervised properly, this may have been prevented. I would like your thoughts. I have lost my husband and my children (19 and 22) their Father. Both kids are in college and I have lost a life time of income and mostly companionship and the security of a 26.5 year marriage. Thank you in advance for your advice!

[lya]

Your information is quite jumbled and I have to wonder if your understanding of events is just as jumbled. It would be quite natural for your thoughts to be anything but orderly during this time of shock and grief.

Much of what you describe most likely occurred after he aspirated bile and coded, ie. the bleeding.

Keep in mind that, except in certain instances in ICU, hospitals do not provide 1 on 1 monitoring and supervision of patients. It would have been impossible for someone to be with your husband during every minute of the day; and, even if someone had been with him, aspiration could not have been prevented. All that could have been done is to reduce the risks of aspiration.

The head of his bed may hve been ordered to prevent aspiration, to properly position the patient after surgery, to support the heart and the lungs, etc. Elevating the head of the bed to 30 degrees is standard care of most patients in the hospital, especially those who do not get out of bed independently and ambulate independently. Patients do not always keep the head of the bed at 30 degrees as most people are used to sleeping while lying down flat; it requires frequent intervention by the staff to keep these patients positioned properly.

Nausea and vomiting cannot be absolutely controlled, not even with an NG tube.

Give yourself a couple of months, then consult with a medmal attorney or make an appointment with your husband's surgeon and talk with the surgeon about the events that led to your husband's death. About three months after my husband's death, I met with his MD and talked about my concerns; it helped me a lot and I believe it may be just as beneficial for you.

Best wishes,

[bunswife]

Lya:

Unfortunately, I am very clear on the chain of events. It is confusing isn't it! Now you know why I am seeking some advice.

[Ozark_Sophist]

You may be clear on the chain of events but it does not across clear in your post. You admit you have gotten several different stories, so you cannot actual claim to have clear knowledge of what happened and when.

Lya gives excellent advice as she has for you.

[bunswife]

That is a good point. We cannot be certain what happened. The autopsy revealed that the starting point of the cardiac arrest and eventual death was the aspiration of bile. He actually drowned in it.

If he had been attended to as he should have been, hence the different stories by the staff, there is a good chance that he should have had assistance with not aspirating as the staff could have taken the appropriate action to prevent this.

All of the other things that happened to him after the cardiac arrest were concluded to have happened as a cause of the prolonged CPR, previous surgical status and the consequences of the aspiration of bile.

Three different medical professionals have given me the opinion that there was no "cause" or reason for the aspiration (he did not have a heart attack, stroke or PE) All have concluded that if he was being attended to properly, the aspiration should not have happened.

I suspect and have been indirectly lead to believe that if he was being cared for properly during the beginning of his medical crisis the outcome may have been different. Drowning in one's own vomit in 2008 in a well respected modern hospital is barbaric and uncalled for.

I would like to have this investigated and if for no other reason find the root cause so that another family does not have to endure the pain and suffering and extreme loss that we have all felt. If it is determined that medical neglect and errors caused ones death and it was preventable, then shame on them and someone should be held accountable.

I worked in a hospital setting working the floors every day and I know that there are some incredibly dedicated professionals who love what they do and do it well. I also know that there are some burned out bad apples that need to go out to pasture.

I also am realistic and know that no one can be everywhere 100% of the time and in an instant someone's condition can change, but this staff KNEW that he was at risk for this and KNEW that he was having a crisis and I feel did not take the appropriate measures to ensure that he was helped because he was not 100% able to help himself.

Also, prior to the event happening, I volunteered to come in and be with him and I was told not to as I was lead to believe that he was just having some pain that the pain meds would take care of. I went off to work, the next call I got is that he had a "change in status" and I was met at the elevators by the Chaplain when I arrived at the hospital.

Am I angry, you bet I am. Will it bring him back, obviously no. But I feel strongly from my clinical experience and the results of the autopsy that someone dropped the ball, causing a fatal mistake for my husband.

Again, if I can have the cause of events investigated and get the "true facts." Hopefully, there will be accountability and hopefully it will prevent the misery that we have had to endure.

I just don't know if there is a chance that I have a case to have reviewed for possible legal action.

[JessiesGirl]

I'm sorry for your loss. I cannot imagine what you are going through. I do feel, however, that you should take Lya's advice: wait a couple of months, then consult a medmal attorney to air your concerns. At the very least the consult should help make you feel better about the situation, and if the attorney feels your concerns should be followed up on, then he/she will follow up on them.

Bless you and take care.

Kathy