On December 12, 2012, a 63-year-old man went to a Connecticut hospital’s emergency room after a chicken bone got caught in his throat. An endoscopy was performed to remove the chicken bone, after which he experienced left hemiparesis, mumbling, and slurred speech while in recovery. At the time he went to the emergency room and had the endoscopy, he was taking Coumadin and aspirin daily for chronic atrial fibrillation.
The man had a CT scan of his head that revealed no evidence of acute or chronic infarct, with no intracranial mass, hemorrhage or hydrocephalus. Lab tests revealed that his INR was 2.7, which is a therapeutic INR, and his PTT was 41.7. Despite the man’s therapeutic INR level, the hospital’s medical staff ordered a Heparin drip to be administered to the man, which began on the evening of December 12, 2012 and continued through the night of December 12, 2012 and into the morning hours of December 13, 2012 despite the man’s rising INR, which was recorded on December 13, 2012 at 6:41 am at 3.2.
On the morning of December 13, 2012, a follow-up head CT showed that the man had suffered a massive left temporo-parietal intracerebral hemorrhage and intraventricular hemorrhage in the third and fourth ventricle. He was unable to recover from this massive intracerebral bleed and, on December 14, 2012, he died due to cerebral hemorrhage.
The man’s wife filed a Connecticut medical malpractice wrongful death case on behalf of her husband’s estate and herself, alleging that the medical malpractice defendants breached the standard of care and were medically negligent by failing to promptly and appropriately treat the man’s condition; by failing to properly diagnose his condition; by failing to properly, adequately and timely administer diagnostic testing and/or laboratory work so as to determine his condition so that it could be properly and appropriately treated; by failing to properly determine and consider the man’s INR prior to administration of Heparin; by ordering the administration of Heparin to the man when the defendants knew or should have known he was already receiving a therapeutic regimen of anticoagulant medications; by ordering the administration of Heparin to the man when they knew or should have known he was already receiving a therapeutic regimen of anticoagulant medications and that administration of any additional anticoagulant medication could and/or would result in complications; by failing to recognize and appreciate the man was on Coumadin and aspirin therapy prior to administration of Heparin; by failing to properly and correctly interpret his CT scan; by failing to promptly recognize the nature and origin of his symptoms and treat them accordingly; by failing to adequately monitor his condition and the administration of additional anticoagulant medications; by failing to administer safe and appropriate medications to treat his condition; by failing to promptly cease administration of medications upon deterioration of his condition; by failing to recognize the level of coagulation in his blood prior to administering Heparin; by failing to adequately recognize and appreciate the risk of bleeding associated with administration of Heparin; by failing to adequately recognize and appreciate the risk of bleeding associated with administration of Heparin in a patient with a therapeutic INR; by failing to adequately recognize and appreciate the risk of bleeding associated with administration of Heparin in a patient on Coumadin and aspirin therapy; and, by failing to administer appropriate treatment for his condition.
The defendant physician who ordered the Heparin settled the Connecticut medical malpractice claims against him in July 2017 for $2 million paid by his medical malpractice insurance company. An additional medical malpractice settlement payout in the amount of $650,000 was paid by an undisclosed entity in mid-September 2017.
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