Need advice as to whether I can sue or not and on what grounds

[shadow1956]

What is the name of your state? North Dakota

I had admitted my 83 yr old mother into the hospital because she had been having chest pains. We had been to a doctor in November because she had a cold and then to the ER because she was experiencing chest pains. They gave her a shot, took Chest Exrays and blood work and sent her home. Before Christmas she started experiencing chest pains again. I took her in and they Xrayed, ran blood work and said there was nothing wrong. On January 4th I took her back because she was short of breath, having chest pains and diahrea. The doctor said the diahrea was caused from the antibotic in November. And she had fluid around her heart again. They admitted her on Friday. Changed her meds by taking her off Diovan and putting her on another blood thinner. Saturday shortly after I left her she had another pain and got sick to her stomach. The nurses called the Dr on call. Her regular Dr had the weekend off. When he got there he said there was nothing wrong with her. We requested a PE and a scan of her stomach. The dr said he did not have anyone on call for the weekend and would do it on Monday. We requested she be transferred to Bismarck Hospital. Which they did. I went up there and they ran the same test our hospital did to find out she had a mild heart attack. The Dr said it was not one to cause any muscle damage but they wanted to take her to CT to see if there was a blood clot. While at CT, two younger people a boy and a girl took her in. I heard a holler and went for the door. Only to see my mother turning blue. I ran in told the kids she was not breathing and they told me to sit down in the waiting room because they had a nurse coming. I refused and told them again she was not breathing. Finaly a nurse came in and confirmed that she was not breathing and asked for an AED the boy said they did not have one, She asked for a crash cart they did not have one. She asked if they had called a code blue, they had not. She told them to call a code blue which the girl did and everyone came running. Booting me out of the room they proceeded to work on mother which seemed like at least a half hour. They told me I could go in the room and speak to her but she was not coherent. They had a machine hooked up to her with picture of her stomach, anyway mom was already gone by that time and I am sure she was gone before they started working because I heard the nurse say they did not have pulse several times. Do I have a case on the hospital for negligence, or wrongful death?

 

[lya]

A claim of malpractice requires damage as a result of negligence and by no other cause.

Your 83 year-old mother was not in good health and did not function independently, else you would not have driven her to the doctor or to the hospital. Diovan is a blood pressure lowering medication and not a blood thinner.

Midsternal chest pain or complaint of pressure in the chest should be ruled out as being related to heart function before being evaluated for another cause.

Chest pain that occurs with coughing is evaluated for a respiratory cause.

Heart attacks do not always show up on an EKG and never show up on routine chest x-rays. EKG and cardiac enzymes (markers of damage) do not always show changes immediately. That is why serial EKGs and serial cardiac enzyme monitoring is done.

An area in which I have slight concern that malpractice may have occurred, is in the need to evaluate for a heart attack at each MD and ED visit. There is a national awareness in progress that focuses on improving the recognition of heart attacks in women. I'm sure all of the MDs and ED staff have been made aware of the presenting complaints and symptoms in women with heart attacks, stomach pain being one of the primary complaints.

That being said, if the patient presented with signs and symptoms of a heart attack, an EKG was done and if bloodwork containing cardiac enzyme monitoring was done, and no cardiac problem was identified, there is no apparent malpractice related to MD and ER visits.

The second hospital identified the patient as having suffered a heart attack, which means the patient's cardiac rhythm should have been monitored continuously, even during transport and CT scan, unless the physician determined and ordered that no monitoring was indicated.

The nurse who responded to the call for help and found the patient unresponsive, breathless, and pulseless should have initiated cardiac compressions while instructing the staff to call a code and to obtain a crash cart. Crash carts are required to be within reasonable access to all areas of the hospital. I believe the time of access must be 5 minutes or less.

A standard monitored by JCAHO and by several Nursing Associations is that family members are allowed to remain with the patient during a code. It is preferable to have one staff member stay with the family member(s). If space needed to work on the patient is a concern, it is acceptable to not allow the family member to stay. A family member may be removed from the area due to the family member's behavior, ie. interfering with access to the patient or with necessary treatments. (Code's are not neat and quiet; they are very chaotic in appearance though not necessarily chaotic in perfomance.)

While there may be identifiable areas of malpractice/negligence, I have serious doubts that malpractice was the cause of the patient's death. More likely than not, the patient died due to progressive coronary artery disease and death was the result of one or more effects of coronary artery disease.

If you are willing to pay for an attorney's obtaining of the medical records and pay for the time it will take the attorney to review the records (not a medical expert's review), you may find a medmal attorney willing to obtain and review the records. I don't think you will find an attorney willing to obtain and review the records at his/her expense.

 

[barry1817]

medical problems

What is the name of your state? North Dakota

I had admitted my 83 yr old mother into the hospital because she had been having chest pains. We had been to a doctor in November because she had a cold and then to the ER because she was experiencing chest pains. They gave her a shot, took Chest Exrays and blood work and sent her home. Before Christmas she started experiencing chest pains again. I took her in and they Xrayed, ran blood work and said there was nothing wrong. On January 4th I took her back because she was short of breath, having chest pains and diahrea. The doctor said the diahrea was caused from the antibotic in November. And she had fluid around her heart again. They admitted her on Friday. Changed her meds by taking her off Diovan and putting her on another blood thinner. Saturday shortly after I left her she had another pain and got sick to her stomach. The nurses called the Dr on call. Her regular Dr had the weekend off. When he got there he said there was nothing wrong with her. We requested a PE and a scan of her stomach. The dr said he did not have anyone on call for the weekend and would do it on Monday. We requested she be transferred to Bismarck Hospital. Which they did. I went up there and they ran the same test our hospital did to find out she had a mild heart attack. The Dr said it was not one to cause any muscle damage but they wanted to take her to CT to see if there was a blood clot. While at CT, two younger people a boy and a girl took her in. I heard a holler and went for the door. Only to see my mother turning blue. I ran in told the kids she was not breathing and they told me to sit down in the waiting room because they had a nurse coming. I refused and told them again she was not breathing. Finaly a nurse came in and confirmed that she was not breathing and asked for an AED the boy said they did not have one, She asked for a crash cart they did not have one. She asked if they had called a code blue, they had not. She told them to call a code blue which the girl did and everyone came running. Booting me out of the room they proceeded to work on mother which seemed like at least a half hour. They told me I could go in the room and speak to her but she was not coherent. They had a machine hooked up to her with picture of her stomach, anyway mom was already gone by that time and I am sure she was gone before they started working because I heard the nurse say they did not have pulse several times. Do I have a case on the hospital for negligence, or wrongful death?

From what you have said I would be interested in qualifications of the staff doing the CT, what code and regulations would be about CPR training for staff, whether they have drills to deal with emergency. And I am concerned that with the medical emergency you state and that no Code was called by the people that were treating or having any recognition of the problem.

I am sorry for your loss.

 

[shadow1956]

reply to lya

Thank you for your advice.
I did not think that malpractice was the cause but more like negligence. The nurse started CPR but the other two knew nothing and did not help. I was the one trying to help her get the ambian bag going. As far as a heart monitor being on her during transport there was none. She had a monitor on her at the hospital she was transported to when I got there. Bismarck ran some of the same test that Bowman did. In Bowman they showed a negative since their tests are positive or negative. In bismarck there are numbers. I believe if the Bowman hospital had an idea she was having a heart attack by the negative she should have been transported then.

They took her off Diovan which I am aware is a blood pressure med. They had her on Plavix and added another blood thinner, without knowing if she had a blood clot or not. This was the first hospital.

 

[lya]

I know this is a traumatic experience for you, being with your mother when her death occurred.

In response to your post, malpractice is negligence.

Heart attacks cannot always be diagnosed by an initial EKG. Serial EKGs are usually obtained every 8 hours for the first 24 hours. Sometimes, a heart attack does not show on an EKG until much later, even up to a year.

It is standard protocol to administer additional medications to prevent or resolve blood clots to patients admitted with a coronary artery disease, especially when the heart is not pumping efficiently enough to prevent fluid build-up around the heart.

If there was no person to perform or intrepret the tests until Monday, you had the right to request to be transferred. You requested; your mother transferred. Should the physician have offerred to transfer her without your having to request it? Maybe; but, no damage was done because you requested and received it.

From your description of events, whatever happened, whether it was a heart attack or a PE or something else, the result was going to be the same. Most likely, even if every person had performed at the level of your expectations, her death was going to be the outcome.

That is why I doubt there is a valid claim of professional negligence/medical malpractice--because the outcome was going to be the same, in the presence of negligence / malpractice or not.

My advice to you is to come back and read this thread, in a week or two, or later.

 

[shadow1956]

okay so what happens if the next person is not 83 yrs old and doesn't have a heart problem. Maybe that person is only 20 or 30 and there is no AED or crash cart in the CT and the CT Tech don't know CPR. What happens when that person dies? Would that be negligence on the hospitals part. I am not looking for money I am looking for justice. The next person may have a reason to live. I am not doing this out of grief. My mother was destined to die no matter how hard we worked to keep her here. We had two years more than what we could have. But like I said maybe the next person wants to live and doesn't get the opportunity.

 

[lya]

See, you still think there was negligence that resulted in damage (death).

More likely than not a review of the records will show proper timeliness in response to the code. Seconds seem like minutes in such a situation; two minutes seem like 15 minutes. I know; I've been on each side of such a situation, more than once. I've been the family member whose loved one coded and died; and, I've been the nurse who responded to the code.

Later, and I seriously stress the word "later", you may want to write a letter to the administrator and the chief nursing officer and tell them your concerns that your mother did not receive continuous cardiac monitoring and the attendance of an ACLS certified RN during transport to CT or during the CT procedure. Their adopting these measures would do more to provide immediate acess to rescusitative efforts than would any other action.

You may want to send a complaint to JCAHO; you can start the process online.

As I stated in my previous posts, there seems to be some areas of negligence, but there are no damages that can be directly assigned to only the area(s) of negligence. Therefore, you are left only with the options of writing letters.

Tomorrow is two weeks after your mother's death and after you suffered the trauma of seeing her die. Give yourself a couple of months before you start finger-pointing and sending letters. You will be glad you did.

 

[ecmst12]

okay so what happens if the next person is not 83 yrs old and doesn't have a heart problem. Maybe that person is only 20 or 30 and there is no AED or crash cart in the CT and the CT Tech don't know CPR. What happens when that person dies? Would that be negligence on the hospitals part. I am not looking for money I am looking for justice. The next person may have a reason to live. I am not doing this out of grief. My mother was destined to die no matter how hard we worked to keep her here. We had two years more than what we could have. But like I said maybe the next person wants to live and doesn't get the opportunity.

Lawsuits are not about justice, they are about money. Even when a valid case exists, and a suit is filed, and the hospital either settles or loses at trial, there is no justice, only compensation - money. It doesn't undo the damage caused by the malpractice.

Malpractice cases require more then just negligence. They require DAMAGES - a negative outcome that WOULD NOT HAVE OCCURRED if not for the negligence. You said yourself that you believe your mother would have still died even if she had received the utmost care. That means you have had no damages. If the patient had been young and otherwise healthy (except for whatever is causing the code blue), the situation would be the same - if there is evidence that the patient would NOT have died if the proper equipment/staff had been available, then a case exists. If the evidence indicates that the staff would have been unable to save the patient even if the crash cart had been in the room, then there would be no case.

 

[shadow1956]

Lawsuits are not about justice, they are about money. Even when a valid case exists, and a suit is filed, and the hospital either settles or loses at trial, there is no justice, only compensation - money. It doesn't undo the damage caused by the malpractice.

Malpractice cases require more then just negligence. They require DAMAGES - a negative outcome that WOULD NOT HAVE OCCURRED if not for the negligence. You said yourself that you believe your mother would have still died even if she had received the utmost care. That means you have had no damages. If the patient had been young and otherwise healthy (except for whatever is causing the code blue), the situation would be the same - if there is evidence that the patient would NOT have died if the proper equipment/staff had been available, then a case exists. If the evidence indicates that the staff would have been unable to save the patient even if the crash cart had been in the room, then there would be no case.

I want to make sure that the next time someone is in my mothers position the staff know what to do and the proper equipment is in place and everyone knows where it is. I did say that mom would have passed on no matter what we did to keep her with us. I did not mean she would have passed that day. She had been with me for 2 years after her husband passed on and had been doing great.

 

[ecmst12]

What you want is better accomplished through letters to the hospital's governing body and/or the appropriate regulatory agencies, not a lawsuit.

 

[Y-ME]

Sorry for your loss. You do not need an attorney to receive the medical records. You can go to the coroner's office and pay a nominal fee to retrieve autopsy. As far as the hospital records you have to have proof of legal rights Personal Rep/ Executor and go directly to hospital and put in request. Attorney's do not charge for a consultation, which you can do over the phone. I do not suggest you personally contact the hospital. And yes we all have to leave this earth but we shouldn't have to because of someone's negligence. It doesn't matter if she had one more day or 10 years left, it is your right to know what happened.