Case #1080: Cardiology Errors
It is alleged that on August 17, the Plaintiff’s Decedent was a patient at the Defendant Hospital and received an aortic and mitral valve replacement. It is alleged that the valves utilized for the replacement at the Defendant Hospital were those known historically to have a high propensity for thrombosis postoperatively, while other valves available have a much lower incidence of thrombosis. Accordingly, the surgeons caring for the Plaintiff’s Decedent at the Defendant Hospital had an obligation in conformity with the standards of care to monitor the Plaintiff’s Decedent closely for signs and symptoms consistent with postoperative thrombosis of the valves. It is further asserted that this condition is life threatening, and therefore must be diagnosed in a timely fashion with appropriate surgical intervention to replace a valve should it become thrombosed. Failure to do so will, as in this case, cause death of the patient.
Postoperatively, it is alleged that the Plaintiff’s Decedent was being managed by the Defendants in conjunction with surgeons at the Defendant Hospital, as well as other duly authorized agents and/or employees of the Defendant Hospital. In the postoperative state, between August and December, it is alleged that the Plaintiff’s Decedent did not significantly improve. As indicated herein above, the Plaintiff’s Decedent required very close surveillance by surgeons at the Hospital, as well as the Defendants and others with respect to the Decedent’s cardiac status, as well as her coagulation profiles. As indicated, the heart valves selected by the physicians at the Defendant Hospital were prone to thrombosis which required the team caring for the Plaintiff’s Decedent to very closely monitor the coagulation status of the patient, as well as signs and symptoms consistent with thrombosis of the valves. Contrary to the standards of care, it is alleged that the named Defendants, as well as the surgeons at the Defendant Hospital failed to appropriately monitor the Decedent’s status, failed to perform necessary tests and studies in a timely fashion, and failed to make the diagnosis of thrombosis.
In mid-December, the Plaintiff’s primary care physician and cardiologist negligently discontinued the Plaintiff’s anti-coagulation therapy for several days prior to the performance of a colonoscopy. It is alleged that the standards of care required that the Plaintiff be placed on alternate anti-coagulation therapy during this time period to prevent thrombosis of the prosthetic valves from occurring. Contrary to the standards of care, however, the Defendants failed to place the Plaintiff on any anticoagulation therapy for almost one week which led to the development of mitral valve thrombosis.
It is alleged that an echocardiogram and/or transesophageal echocardiogram is the study which is necessary to rule in or rule out thrombosis of an artificial heart valve. It is further alleged that the Plaintiff’s Decedent exhibited classic signs and symptoms of thrombosis of the valves which mandated the appropriate tests and studies to be performed in a timely fashion. Had they been completed as required, it is alleged that thrombosis of the heart valve would have been diagnosed with the Plaintiff’s Decedent receiving additional surgery to replace the thrombosed valve. It is further alleged that the Defendant in conjunction with the Defendant Hospital personnel planned to perform the needed echocardiogram and even recorded same in her medical notes — but negligently failed to ever follow through and never conducted the study which would have plainly diagnosed the thrombosed condition of a valve, requiring replacement.
On December 25,(Christmas Day), the Plaintiff’s Decedent was admitted to the Hospital exhibiting signs and symptoms absolutely consistent with failure of the valves. However, the Defendant in conjunction with the other Defendants, failed to intervene with any tests and studies to diagnose the presence of the thrombosis from which the Decedent suffered. Predictably, as a direct result of the Defendants’ failure to intervene, the Plaintiff’s Decedent progressed on a downhill spiral ultimately and tragically dying on December 27.