Case #1007: Amputation
On November 6, the Claimant, (32 years of age), was admitted to the Defendant Hospital after suffering with a subarachnoid hemorrhage. At the time of her admission, hospital personnel were informed that she had a medical history including scleroderma and Raynaud’s Syndrome. After examination and evaluation, the Claimant underwent a successful surgical clipping for the aneurism and hemorrhage, and was placed in the Intensive Care Unit post-surgery.
It is alleged that with scleroderma and Raynaud’s Syndrome, hospital personnel were required to utilize care to preserve the Claimant’s circulation. Heightened surveillance and precautions were required on a continuing basis to prevent compromise of circulation–particularly to the extremities.
Prior to the surgical procedure described hereinabove, it is alleged that duly authorized hospital personnel placed an arterial line in the left radial artery. In view of Claimant’s medical history and condition, it is alleged that placement of the line in the radial artery constituted a breach in the standards of care. Placement of such a line further compromised circulation to the extremity which can lead to such a diminution in circulation that necrosis can progress in the area. Under these circumstances, it is alleged that the standards of care required placement of a line in the femoral artery or other alternative site which would not have compromised circulation to the extremity.
On November 9, hospital personnel noted that the Claimant’s left hand was ice-cold with a sluggish reflex. Her right hand was not. It is alleged that the left hand was adversely affected because of placement of the line as described herein. The standards of care required immediate consultation with vascular surgery and removal of the line. However, in continuing violation of the standards of care, hospital personnel failed to consult with vascular surgery, and failed to remove the line. In essence, the hand was ignored.
Again, on November 10, the hand was evaluated and found to be cold with dusky fingers. Again, however, no consultation was forthcoming and no removal of the line in violation of the standards of care.
The Claimant’s condition was ignored on November 11, and most of November 12, until a physician finally removed the left radial arterial line and placed the line in the Claimant’s right femoral artery which should have been done in the first instance. However, this physician’s action was too little, too late as the Claimant’s left fingertips were noted to be shriveled and necrotic with the entire hand dusky and mottled by that time. Her other hand, which was not affected by the line, was normal.
It was not until November 13, that vascular surgery was finally consulted. Again, by that time, the consultation was too late. Notwithstanding any efforts that were made, the Claimant’s condition progressed ultimately resulting in a decision by hospital personnel to amputate the Claimant’s left hand on December 3.
On the same date, December 3, a rheumatologist at the Defendant Hospital advised and noted that no cooling blankets were to be used with the Claimant. Again, in view of her medical history and condition, cooling blankets were contraindicated throughout the course of the Claimant’s hospitalization. However, the hospital personnel ignored the consultation, and began utilizing cooling blankets on the Claimant–on an ongoing basis when the Claimant had a significantly elevated temperature and when she did not. It is alleged that the utilization of these blankets further compromised the Claimant’s circulation to her lower extremities so that her toes and feet became cold. This further compromise of circulation was for three days until the Claimant finally developed ischemia in both feet. The condition progressed to the point that she ultimately required amputation of the lower left leg and foot, and amputation of four toes on the right foot–all of which should have been avoided and would have been avoided had these Defendants conformed with the applicable standards of care.
It is alleged that had hospital personnel adhered to the required standards of care with the appropriate placement of a femoral line; with appropriate precautions to preserve circulation; without the utilization of cooling blankets with no necessary protection; and with appropriate intervention and treatment–all of the injuries, damages, amputations and disability would have been avoided.
It is alleged that the Claimant has endured unending physical pain, emotional anguish, fear, anxiety, humiliation and embarrassment over her condition. Additionally, she has lost her former state of emotional and physical well-being; is unable to engage in activities which she has previously enjoyed; is unable to seek and/or hold gainful employment; and has had the quality of her life destroyed through the negligence of these Defendants. She is now dependent upon others for even her basic needs.