Case #1014: Medication Errors
Prior to November 2, due to a history of DVT, the Plaintiff was successfully maintained by the Defendant Physician on a regimen of Coumadin therapy which included 10 milligrams of the drug on every even day and 7.5 milligrams of the drug on every odd day.
However, on November 2, the Defendant changed the Plaintiff’s Coumadin regimen which involved taking different amounts of the drug when the Plaintiff was also taking Cipro and then changing it back again when the Plaintiff ended the Cipro. No new prescriptions were written to confirm this change in regimen and the Plaintiff alleged that the Defendant negligently failed to appropriately explain the complicated new regimen. The Defendant Physician also failed to check the Plaintiff’s INR after changing the Coumadin dosages in conjunction with the Cipro, as required by the standards of care, inasmuch as Cipro potentiates Coumadin.
On November 15, the Plaintiff presented to the emergency department at the Defendant Hospital groin pain and a change in urine color. Urinalysis revealed red blood cells too numerous to count. The Plaintiff explained that he was on a Coumadin regimen. However, his INR was not checked notwithstanding the detection of blood in the Plaintiff’s urine, and he was simply discharged with a diagnosis of urinary tract infection. On November 18, the Plaintiff re-presented to the Defendant Hospital’s emergency department with an increase in bleeding from his Foley catheter. Again, the Defendant’s personnel failed to check his INR and simply discharged the Plaintiff with a diagnosis of urinary tract infection with only a prescription for antibiotics. Predictably, on November 20, the Plaintiff was rushed to the Defendant Hospital with bleeding from all orifices. An INR was taken which revealed a level of 75 (the Plaintiff’s INR should have been in the range of 2-3).
The Plaintiff was confined at the Defendant Hospital for approximately one month, the majority of which was in the ICU. Subsequently, on December 21, the Plaintiff was transferred to a rehabilitation facility where he remained for approximately three months. Thereafter, he was discharged to his home where he has been confined to a hospital bed.
The Plaintiff alleged that the Defendant Physician negligently failed to instruct the Plaintiff on the medication change and failed to check his INR. The Plaintiff also alleged that the Defendant Hospital’s personnel failed to check his INR on two separate occasions. The combined negligence led to over-anticoagulation, massive spontaneous bleeding, organ failure and permanent debilitation.