Case #4054 Failure to Monitor Patient With an Irregular Cardiac Pattern Resulted in Death




On August 12, at 10:53 p.m., the patient was a 59-year-old male who presented to the Defendant Hospital’s emergency department with a fever. He was evaluated and admitted for treatment of a urinary tract infection. During the course of his initial evaluation, the patient underwent an electrocardiogram (EKG) which presented an obvious, dangerous cardiac pattern. The EKG demonstrated a clear Type I Brugada pattern. The Brugada pattern is indeed significant, and represents a serious condition that can result in arrhythmia in conjunction with conditions such as fever and must be monitored appropriately so that care, treatment and intervention can be provided in a timely manner.

Under these circumstances the standards of care required immediate admission to the hospital in a monitored hospital bed so that 24-hour continuous telemetry could be provided while appropriate cardiac examinations are completed and any treatment is provided. In violation of the standards of care, no cardiac consultation was provided, and the patient was never placed on any monitored bed whatsoever. Subsequently, the patient suffered a cardiac event. When a nurse entered the patient’s room to provide the patient with Tylenol at 5:45 a.m. on August 13, the patient was not breathing and had no pulse. A Code Blue was called and the patient was noted to have bleeding from the mouth and nose during cardiopulmonary resuscitation. Resuscitation efforts failed, and the patient was pronounced dead at 6:05 a.m. on August 13.

The patient’s EKG was significantly abnormal with a Brugada pattern upon arrival at the emergency department. The EKG showed sinus tachycardia, a right bundle branch block, in addition to the Type I Brugada pattern. Had the patient been placed on a cardiac monitor as required by the standards of care, an immediate response would have been provided when he began to show signs of cardiac arrhythmia. The patient would have been defibrillated in an appropriate setting, stabilized, and provided any additional cardiac treatment necessary. Additionally, had the patient been provided with a timely cardiac consultation, the cardiac event resulting in his death would have been avoided.

The defendants denied all allegations of negligence, causation and harm.