From a stomach ache to asystole.....

[justoneme]

What is the name of your state?What is the name of your state? Texas
It's been two months since my mother has died and the pain and yet to go away. For fear of losing interested readers, I will try my best to be as detailed but as brief as possible.
My mother was direct admit from her MD to our little po' dunk hospital for stomach pain. Several tests were done and it was concluded that a surgon would need to do exploratory laparoscopy to rule out cancer. Well initial test was performed and mom underwent procedure. Surgon admitts he took out pieces of "tumor" to send off to lab for further results. He pushed that although surgery wasn't emergent, we needed to get it out immediately. This was on a Thursday and he wanted to do the surgery on Monday. I insisted that b/c although mom was 58 and in fair health, she had been a smoker and has high b/p, she needed a second opinion. I pushed for a referral for a cardiologist b/c of what I saw on a copy of an inital EKG test that looked abnormal. He agreed that indeed it was abnormal and said he would send a specialist to see her. Mom had another EKG and a stress test b/f surgery. The cardiologist was to meet my mother after the test were ran but we never met him. Supposedly the cardiologist gave the go ahead and when the surgery was complete, the doctor stated that the tumor was actually a periforated bowel and that he only had to staple it up. Hummm??
Well, she comes out and has a massive heart attack and in the meantime has developed septicemia. Her b/p plumets and they scramble to find another hospital to send her to. The doctors when we get to the new hospital, are reluctant to take my mom and tell me that it will be hard to find a doctor who will be willing to "fix another's mistake". Well, they find one. All the while she is on and off a ventilator because she now has severe CHF and has pulmonary edema so bad that they can't even do a cath to detect just how bad her MI has affected her ejection fraction.The CCU nurse mentions to me at this point and time that b/c of her dead bowel, it made the situation that much more dire. Just out of pure luck does she get well enough to come off the vent. Immediately the doctors start talking about a CABG and a Pulmonary Aortic Valve replacement. (Uh? Hello? She isn't even a cannidate for surgery.) Well they convince my father that without it she will surely die but wouldn't give statistical figures of what the likelyhood she could even pull through with or without it. My mother maintained her infection the entire time and even into the heart surgery. They never address the dead bowel issue and had her up and eating solids after her surgery. Guess they forgot?
Ugh, I am so angry. There is so much more but I tried to hit the key points. Sorry it's a rambling mess. The code when she died was a horrible mess. My father had the lovely pleasure of witnessing the terrible ordeal b/c no one thought to take him somewhere else. Things went wrong and there is still so much more.
As you can tell, I am still reeling. My father has finally started to see the light when we had to start threatening to get a lawyer just so that the death certificate could even be filed!! The physicians were disagreeing and apparently there was a mixup. I am 100% certain we have a case, but what to do first is unclear. We live in a small town so to go to a local lawyer is completely out of the question. It's small town folk if you know what I mean? Well, any advice or help to lead me in the right direction would be really appreciated. Thanks for reading such a long post.

 

[ellencee]

I hate to start off with you may not have a valid claim, but you may not have a valid claim because of the requirement that signifcant damages must be the direct result of negligence and from no other reason. You will probably be able to add some information after my response and if so, maybe it will help to determine if there is likely any reason to be encouraged or discourgaged about a medmal lawsuit.

Well initial test was performed and mom underwent procedure. Surgon admitts he took out pieces of "tumor" to send off to lab for further results. He pushed that although surgery wasn't emergent, we needed to get it out immediately. This was on a Thursday and he wanted to do the surgery on Monday. I insisted that b/c although mom was 58 and in fair health, she had been a smoker and has high b/p, she needed a second opinion. I pushed for a referral for a cardiologist b/c of what I saw on a copy of an inital EKG test that looked abnormal. He agreed that indeed it was abnormal and said he would send a specialist to see her. Mom had another EKG and a stress test b/f surgery. The cardiologist was to meet my mother after the test were ran but we never met him. Supposedly the cardiologist gave the go ahead

The diagnostic test results are needed--what did the preop x-ray report show? What were the preop bloodwork results? (those two questions relate to the bowel issue) Just because no cancer was found does not mean tissue should not have been sent for analysis; that is common and usual procedure regardless of cancer or no cancer. The cardiologist does not have to meet with the patient or the family members in order to clear a patient for surgery. About the only way I could opine on the EKG is to have you scan a copy of the EKG to me and let me interpret the EKG. (You may not be aware that a 12 lead EKG reveals tons of information about the heart and the coronary arteries.) A cardiac stress test would have revealed whether or not your mother had adequate bloodflow and adequate cardiac output.

and when the surgery was complete, the doctor stated that the tumor was actually a periforated bowel and that he only had to staple it up. Hummm?? Well, she comes out and has a massive heart attack and in the meantime has developed septicemia.

There is nothing negligent about the tumor's actually being an area of perforated bowel that required stapling. Did she have a massive heart attack in the recovery room? after what length of time did she have a heart attack? How long after surgery did she develop septicemia?

Her b/p plumets and they scramble to find another hospital to send her to. The doctors when we get to the new hospital, are reluctant to take my mom and tell me that it will be hard to find a doctor who will be willing to "fix another's mistake".

BP usually plummets after an MI. Sending her to a larger hospital is not negligent. What mistake needed fixing? Did anyone say?

All the while she is on and off a ventilator because she now has severe CHF and has pulmonary edema so bad that they can't even do a cath to detect just how bad her MI has affected her ejection fraction.

OK--nothing wrong with that; normal, expected status.

The CCU nurse mentions to me at this point and time that b/c of her dead bowel, it made the situation that much more dire. Just out of pure luck does she get well enough to come off the vent. Immediately the doctors start talking about a CABG and a Pulmonary Aortic Valve replacement. (Uh? Hello? She isn't even a cannidate for surgery.) Well they convince my father that without it she will surely die but wouldn't give statistical figures of what the likelyhood she could even pull through with or without it. )

OK--nothing wrong with that, either. Somethings got to be done to get blood circulating to her heart and to her gut--CABG is the way to go; without it, bowel is going to continue to die and septicemia isn't going to go away (think gangrene, which lives/grows where there is no oxygen--no blood). She's a goner without the surgery and chances of recovery after the surgery are getting slim to none. No wonder they wouldn't give statistical information; this was a last chance at survival operation.

My mother maintained her infection the entire time and even into the heart surgery. They never address the dead bowel issue and had her up and eating solids after her surgery. Guess they forgot?

The infection wasn't going to clear without restoration of circulation. The dead bowel issue was definitely addresses; you just did not understand how it was being addressed and that's OK considering the emotional stress of the situation. She ate solids after she was on the ventilator? After the MI? or, before the MI (which is more realistic)?

The code when she died was a horrible mess. My father had the lovely pleasure of witnessing the terrible ordeal b/c no one thought to take him somewhere else.

Codes are messy events. Family members have the right to stay during codes, which I totally disagree with because family members do not understand what is going on and codes appear to be violent and chaotic events, though they are not.

Things went wrong and there is still so much more.

What went wrong? About all that could have gone right would have been a successful CABG at the bedside and that just isn't done.

Tell us what more there is so the information can be evaluated. At this point, I'd have to opine that your mother had a significant coronary artery occlusion or had a silent MI that had damaged her heart, which led to bowel death (perforation) and septicemia, and somewhere along the path, she suffered a massive MI which sealed her demise unless she received a miracle--not a mircle from medical science but a true miracle intervention from the Almighty.

Please answer the questions I've asked and provide as much additional information as you have and try to keep the timeline in order as the sequence of events is utmostly important.

I am sorry for your loss,
EC

 

[justoneme]

Thanks for your reply

The diagnostic test results are needed--what did the preop x-ray report show? What were the preop bloodwork results? (those two questions relate to the bowel issue)

The Xray indicated an enlargement that was initally thought to have been her appendix but was r/o b/c she had it removed thirty years ago. Some elevated (not significant) WBC but was placed on general IV antibotic b/f surgery. I am not disputing the fact that they needed tissue samples if they thought it might be CA. I am just wondering if the biopsy he did caused the preforation.

The cardiologist does not have to meet with the patient or the family members in order to clear a patient for surgery.

Yes, however how can a Cardiologist make a proper asessment of a patient he has never seen before without even stepping foot into her room?

About the only way I could opine on the EKG is to have you scan a copy of the EKG to me and let me interpret the EKG. (You may not be aware that a 12 lead EKG reveals tons of information about the heart and the coronary arteries.)

Yes and thank you. My specialty is Cardio and I interpret EKG's on a daily basis. This is why I asked for the Cardiologist in the first place b/c her initial EKG strip revealed a elevated ST segment. Since this wasn't emergent surgery, I thought it was important to investigate it further.

There is nothing negligent about the tumor's actually being an area of perforated bowel that required stapling.[QUOTE/]
No tumor or cancer indiacted after surgery, just a perforated bowel only. It was never mentioned again. If tumor had been in place, why wouldn't he have removed it and sutured together the healthy bowel?

Did she have a massive heart attack in the recovery room? after what length of time did she have a heart attack? How long after surgery did she develop septicemia?[QUOTE/]

Her MI was undetermined b/c they didn't actually catch it until the day after the surgery. She wasn't on telemetry, so they didn't notice it until her b/p crashed. Her Troponin levels were elevated before surgury but we didn't find that out until we had to move hospitals.

Sending her to a larger hospital is not negligent. What mistake needed fixing? Did anyone say?[QUOTE/]

This hospital is and never was equipped to handle serious complications from this surgery. It is well known that this hospital does procedures well beyond it's scope and then when the patients become critical, they ship. The hospital we wanted her to go to wouldn't even accept her b/c she was so critical. We had to take the next best thing.

The infection wasn't going to clear without restoration of circulation. The dead bowel issue was definitely addresses; you just did not understand how it was being addressed and that's OK considering the emotional stress of the situation. She ate solids after she was on the ventilator? After the MI? or, before the MI (which is more realistic)?[QUOTE/]

My mother was never a canidate for heart surgury and should have been put on comfort care at this point. Her septicemia was full blown and wasn't being managed well by her body. They wouldn't even look into going back into her stomach to see if that was were the problem was at. All the physicians agreed she was too sick to have this done but yet well enough for heart surgury? How can a patient make an accurate decision on their healthcare if they have no idea what the chance of survival are? They withheld solids until after the heart surgury but I can't understand where the food was suppose to go if the doctors all agreed she had a leaky bowel. It was if it suddenly was important any more.
The day my mother started to get worse, she nor my father wasn't aware of how bad the situation had turned. They were supposed to have been sending her home that following day. She had been having bouts of atrial flutter and had developed a decubitus on her backside that they say they wanted to treat. Her hr was running kind of fast so they decided to give her a medication to help and slow it down. This was in a step down unit I might add. Well apparently it dropped too low b/c immediately my mom started complaining of being weak and tired. She slept most of that day. The nurse finally came in about 700 and asked when she had last urinated. She couldn't recall b/c it hadn't been at all that entire day. (Beginning of kidney failure) She got up to go but my father said he isn't even sure if she actually went. At 800 my mother developed a sudden onset of dyspnea and couldn't breathe. The nurses were made aware and my father was told they would contact her doctor. She went into panic mode b/c she couldn't catch her breath. No ABG's were ordered to determine what her C02 levels were at this point, they just put her on a non-rebreather. It wasn't until 2:30 that morning did they finally transport her to ICU and she was placed back on a ventilator. When I got the call from my father to come at 6 that morning, I was on the phone arguing with the nurses b/c they didn't want to give me information. I was told she was stable 15 min b/f she died.

Codes are messy events. Family members have the right to stay during codes, which I totally disagree with because family members do not understand what is going on and codes appear to be violent and chaotic events, though they are not.[QUOTE/]

At this point my mother was transferred to ICU and my father had to wait in the waiting room. The nurse came out and said there was a problem and he needed to come right away. They had the door open for all to see as my father stood literally inside the doorway while they coded her. At this point they were doing chest compressions and bagging her. My father could hear her groan and moan as if she was in a lot of pain. It was so much that my father had to walk away. Well, my father was so distraught he asked the doctor when he finally came out of the room if she had been in any pain before she had died. The doctor's response was, "Oh yes I'm afraid so. We tried to give her as much medication as we could allow but b/c of the circulation problem it couldn't be helped."

 

[ellencee]

The Xray indicated an enlargement that was initally thought to have been her appendix but was r/o b/c she had it removed thirty years ago. Some elevated (not significant) WBC but was placed on general IV antibotic b/f surgery. I am not disputing the fact that they needed tissue samples if they thought it might be CA. I am just wondering if the biopsy he did caused the preforation.

Have you seen the xray or the report? An enlarged area is suspicious, for sure. I wonder if it was an area of bowel leakage that was not cleared during the surgery. One or more biopsies is usally taken during surgery, whether or not cancer is suspected. It is possible the biopsy caused the perforation but if the perforation was appropriately closed, there is no problem.

Yes, however how can a Cardiologist make a proper asessment of a patient he has never seen before without even stepping foot into her room?

Although most cardiologist would see the patient, it is not unheard of for clearance to be made on review of H & P and the tests that were performed.

Yes and thank you. My specialty is Cardio and I interpret EKG's on a daily basis. This is why I asked for the Cardiologist in the first place b/c her initial EKG strip revealed a elevated ST segment. Since this wasn't emergent surgery, I thought it was important to investigate it further.

An elevated ST segment alone is not enough to be alarmed unless you are seeing an elevation develop in the presence of chest pain. An ST segment can elevate with angina and then resolve when the angina is treated. One can not depend on the accuracy of an automatic printout from an EKG machine and a simple rhythm strip is just about worthless as a diagnostic tool. What did the cardiologist document for the results of the 12 lead?

Her MI was undetermined b/c they didn't actually catch it until the day after the surgery. She wasn't on telemetry, so they didn't notice it until her b/p crashed. Her Troponin levels were elevated before surgury but we didn't find that out until we had to move hospitals.

Was she on hormone replacement therapy? Estrogen replacement causes an elevated TRO-I level and negates the TRO-I as a test for cardiac damage. In the absence of hormone replacement, the TRO-I should have been serial before nonemergency surgery. Was it serial? In proving negligence, there is one huge obstacle in all of this--50% of all active MIs do not show up on EKG; some EKG changes, such as Q wave, take up to a year to develop.

At this point my mother was transferred to ICU and my father had to wait in the waiting room. The nurse came out and said there was a problem and he needed to come right away. They had the door open for all to see as my father stood literally inside the doorway while they coded her. At this point they were doing chest compressions and bagging her. My father could hear her groan and moan as if she was in a lot of pain. It was so much that my father had to walk away. Well, my father was so distraught he asked the doctor when he finally came out of the room if she had been in any pain before she had died. The doctor's response was, "Oh yes I'm afraid so. We tried to give her as much medication as we could allow but b/c of the circulation problem it couldn't be helped."

Patients being bagged and receiving chest compressions do not moan and groan; your father probably heard sound of air being compressed and released by the ambu bag.

Damn if I wouldn't take this to a medmal attorney just to find out what in the heck happened. I can't tell you there is even a remote chance of a valid claim, but I see too many red flags not to tell you to take this to a medmal attorney at your earliest convenience.

EC

 

[Debi Richardson]

My mom went through the same thing

The Xray indicated an enlargement that was initally thought to have been her appendix but was r/o b/c she had it removed thirty years ago. Some elevated (not significant) WBC but was placed on general IV antibotic b/f surgery. I am not disputing the fact that they needed tissue samples if they thought it might be CA. I am just wondering if the biopsy he did caused the preforation.

Yes, however how can a Cardiologist make a proper asessment of a patient he has never seen before without even stepping foot into her room?

Yes and thank you. My specialty is Cardio and I interpret EKG's on a daily basis. This is why I asked for the Cardiologist in the first place b/c her initial EKG strip revealed a elevated ST segment. Since this wasn't emergent surgery, I thought it was important to investigate it further.

There is nothing negligent about the tumor's actually being an area of perforated bowel that required stapling.[QUOTE/]
No tumor or cancer indiacted after surgery, just a perforated bowel only. It was never mentioned again. If tumor had been in place, why wouldn't he have removed it and sutured together the healthy bowel?

Did she have a massive heart attack in the recovery room? after what length of time did she have a heart attack? How long after surgery did she develop septicemia?[QUOTE/]

Her MI was undetermined b/c they didn't actually catch it until the day after the surgery. She wasn't on telemetry, so they didn't notice it until her b/p crashed. Her Troponin levels were elevated before surgury but we didn't find that out until we had to move hospitals.

Sending her to a larger hospital is not negligent. What mistake needed fixing? Did anyone say?[QUOTE/]

This hospital is and never was equipped to handle serious complications from this surgery. It is well known that this hospital does procedures well beyond it's scope and then when the patients become critical, they ship. The hospital we wanted her to go to wouldn't even accept her b/c she was so critical. We had to take the next best thing.

The infection wasn't going to clear without restoration of circulation. The dead bowel issue was definitely addresses; you just did not understand how it was being addressed and that's OK considering the emotional stress of the situation. She ate solids after she was on the ventilator? After the MI? or, before the MI (which is more realistic)?[QUOTE/]

My mother was never a canidate for heart surgury and should have been put on comfort care at this point. Her septicemia was full blown and wasn't being managed well by her body. They wouldn't even look into going back into her stomach to see if that was were the problem was at. All the physicians agreed she was too sick to have this done but yet well enough for heart surgury? How can a patient make an accurate decision on their healthcare if they have no idea what the chance of survival are? They withheld solids until after the heart surgury but I can't understand where the food was suppose to go if the doctors all agreed she had a leaky bowel. It was if it suddenly was important any more.
The day my mother started to get worse, she nor my father wasn't aware of how bad the situation had turned. They were supposed to have been sending her home that following day. She had been having bouts of atrial flutter and had developed a decubitus on her backside that they say they wanted to treat. Her hr was running kind of fast so they decided to give her a medication to help and slow it down. This was in a step down unit I might add. Well apparently it dropped too low b/c immediately my mom started complaining of being weak and tired. She slept most of that day. The nurse finally came in about 700 and asked when she had last urinated. She couldn't recall b/c it hadn't been at all that entire day. (Beginning of kidney failure) She got up to go but my father said he isn't even sure if she actually went. At 800 my mother developed a sudden onset of dyspnea and couldn't breathe. The nurses were made aware and my father was told they would contact her doctor. She went into panic mode b/c she couldn't catch her breath. No ABG's were ordered to determine what her C02 levels were at this point, they just put her on a non-rebreather. It wasn't until 2:30 that morning did they finally transport her to ICU and she was placed back on a ventilator. When I got the call from my father to come at 6 that morning, I was on the phone arguing with the nurses b/c they didn't want to give me information. I was told she was stable 15 min b/f she died.

Codes are messy events. Family members have the right to stay during codes, which I totally disagree with because family members do not understand what is going on and codes appear to be violent and chaotic events, though they are not.[QUOTE/]

At this point my mother was transferred to ICU and my father had to wait in the waiting room. The nurse came out and said there was a problem and he needed to come right away. They had the door open for all to see as my father stood literally inside the doorway while they coded her. At this point they were doing chest compressions and bagging her. My father could hear her groan and moan as if she was in a lot of pain. It was so much that my father had to walk away. Well, my father was so distraught he asked the doctor when he finally came out of the room if she had been in any pain before she had died. The doctor's response was, "Oh yes I'm afraid so. We tried to give her as much medication as we could allow but b/c of the circulation problem it couldn't be helped."

Debbie - California

I'm so sorry about your loss....my mother, age 61 went through the same exact thing a year ago while under the care of doctor's in ICIU. I tried to sue but she also had diabetes and no one likes to take a case that contains patients that are diabetic. My mother went into the hospital to have her lower intestine operated on due to blockage of her bile duct. The doctor seemed to of twisted her insides so badly that eventually her oragans just shut down as her body filled up with bile. She weighed 116 lbs. when she arrived to the hispital and when she passed she weighed over 267 lbs. I to this day, cry and think of my mom everyday as if it was yesterday. She was not only my mother but my best friens as well. We did everything together and my poor father (together for 45 years) is still distraught and always sad after one year has gone by. I was referred to the "Law offices of Andrew J. Tuteur" in which they specialize in these procedures mostly. Good luck hun and again sorry for the loss of your mother. It sure doesn't seem like it will get better and it really doesn't too too much, but it does feel a little better down the road.....hang in there, your momma would want you to be strong. Take Care! Please email me if you would like to talk......there is soooooo much more to be told.

Debbie R.

 

[rmet4nzkx]

Debbie - California

I'm so sorry about your loss....my mother, age 61 went through the same exact thing a year ago while under the care of doctor's in ICIU. I tried to sue but she also had diabetes and no one likes to take a case that contains patients that are diabetic. My mother went into the hospital to have her lower intestine operated on due to blockage of her bile duct. The doctor seemed to of twisted her insides so badly that eventually her oragans just shut down as her body filled up with bile. She weighed 116 lbs. when she arrived to the hispital and when she passed she weighed over 267 lbs. I to this day, cry and think of my mom everyday as if it was yesterday. She was not only my mother but my best friens as well. We did everything together and my poor father (together for 45 years) is still distraught and always sad after one year has gone by. I was referred to the "Law offices of Andrew J. Tuteur" in which they specialize in these procedures mostly. Good luck hun and again sorry for the loss of your mother. It sure doesn't seem like it will get better and it really doesn't too too much, but it does feel a little better down the road.....hang in there, your momma would want you to be strong. Take Care! Please email me if you would like to talk......there is soooooo much more to be told.

Debbie R.

Debbie, please start your own thread and remove the reference or solicitation from your post.