A man went to a local New Jersey hospital’s emergency room to be examined and treated for chest pains and shortness of breath that he feared might be serious. He was seen in the emergency room by a doctor who diagnosed the man as having a virus. The emergency room doctor discharged the man to home without even offering him a prescription.
That night, the man’s condition worsened to the point that he thought that he was dying. He quickly wrote and signed his own will, naming his best friend as the executor of his estate. Early the next morning, the man lost consciousness and collapsed. His girlfriend called 911 but by the time the man arrived at the emergency department, he had died. It was determined that the man suffered a pulmonary embolism that lodged in the main artery of his lung, causing his death.
What Is Pulmonary Embolism?
Pulmonary embolism (“PE”) is a sudden blockage in a lung artery. The most common source of the blockage is a blood clot that traveled from a deep vein in a leg to the lungs, often due to deep vein thrombosis that involves the formation of blood clots in deep veins (most often in the deep veins of the legs). PE can cause death if the blood clot is large enough or if there are multiple clots. PE can also cause lung damage due to the lack of blood flow to part of the lung, which may result in a serious medical condition known as pulmonary hypertension (increased pressure in the pulmonary arteries). PE can also result in reduced blood oxygenation that can lead to damage to various organs in the body.
PE and deep vein thrombosis affect between 300,000 and 600,000 people in the United States each year. About 30% of people with PE die if not treated promptly. Prompt diagnosis and treatment of PE is essential in order to prevent complications or death from PE.
How Is Pulmonary Embolism Diagnosed?
Blood clots in deep veins may be diagnosed using ultrasound before they can travel to the lungs and cause PE. CT scans may be used to look for blood clots in the legs or lungs. A VQ scan (a lung ventilation/profusion scan that uses radioisotopes that shows both air flow and blood flow through the lungs) can help determine blood oxygenation to the lungs. In some cases, pulmonary angiography may be performed (pulmonary angiography involves inserting a catheter through the groin or arm into the lungs during which a dye is injected and x-rays taken to determine blood flow through the lungs).
How Is Pulmonary Embolism Treated?
Blood thinners (anticoagulants) such as heparin and/or warfarin may be used to make it more difficult for blood to clot (anticoagulants do not break up clots that have already formed; most blood clots are dissolved over time). In emergency situations, thrombolytics may be given to patients that quickly dissolve large blood clots although thrombolytics can be dangerous because they can cause sudden bleeding. A catheter may be inserted to either remove the blood clot or to deliver drugs directly to the area of the blood clot to dissolve the blood clot.
What Are Some Of The Symptoms Of Possible Pulmonary Embolism?
Some of the more common signs and symptoms of possible PE include unexplained shortness of breath, problems breathing, chest pain, coughing, or coughing up blood.
In the New Jersey man’s case, the man complained of shortness of breath and chest pain while he was in the emergency room (two of the signs and symptoms of PE). Nonetheless, the medical malpractice defendants argued that the man did not have PE until the next morning, shortly before he died.
The medical malpractice jury evidently did not believe the defense because it awarded the man’s estate $1,065,000 on January 31, 2012, after three weeks of trial.
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