This nursing home wrongful death claim was filed in Baltimore County after medical staff failed to appreciate the symptoms of deep vein thrombosis. It was filed in Maryland Health Claims Arbitration on February 7, 2018, and it is the 65th medical malpractice case filed in Maryland this year.
Summary of Plaintiff's AllegationsA 60-year-old woman went to Baltimore Washington Medical Center (BWMC) for an elective spinal fusion procedure to control her back pain. The surgery was completed without any complications and her postoperative instructions included TED stockings and a cardiac diet to prevent deep vein thrombosis (DVT) and gastrointestinal problems. An ultrasound performed several days after the surgery showed no evidence for DVT, so the woman was considered medically stable for discharge.
The woman was then admitted to Fairfield Nursing and Rehabilitation Center in Crownsville with discharge recommendations from BWMC for physical therapy. The woman's official care plan at Fairfield included a regular diet with thin liquids, TED stockings, physical therapy rehabilitation, and medications.
The day after her admission, the woman's attending physician at Fairfield called in a telephone order to increase her dosage of Oxycodone, a pain medication that can cause lethargy, drowsiness, and respiratory depression. He also increased her Baclofen, a muscle relaxant medication. The physician made another medication change two days later, replacing the woman's Baclofen prescription with Valium. On the same day as this change of order, the physical therapist noticed that the woman was "drowsy during the exercises and needed cues to stay on task." She was only able to sit for a few minutes before experiencing drowsiness.
Physical therapy continued to work with the woman daily. Some days, therapy was the only time she got out of bed. She continued to have difficulty walking and could only move with assistance. An occupational therapist also notified the nursing staff that the woman complained of weakness, shortness of breath, and wheezing while breathing, but the nurses never made any assessment or intervention.
After several days of therapy and medication, a physical and rehabilitation pain management specialist evaluated the woman. In the progress note, the specialist recommended that the medical staff elevate the woman's legs and keep her TED stockings on. This implies that the nursing staff hadn't been using the TED stockings, in direct violation of the care plan.
Additionally, nursing staff had been ignoring the doctor's orders by failing to assess the woman's vital signs and pulse oxygenation level every three hours, before each pain medication administration. Because the nurses were not consistently monitoring the woman's vitals, they did not recognize that the woman's critically low blood pressure was a sign of her worsening condition. They also failed to communicate with the physician about the woman's declining health.
On the morning of her eighth day at Fairfield, the woman was found unresponsive with no pulse or respirations. The staff performed CPR and called for an ambulance to take the woman to Anne Arundel Medical Center where she was pronounced dead. An autopsy revealed her cause of death to be a large pulmonary embolism due to her significant risk factors including obesity, recent orthopedic surgery, and immobilization.
Additional CommentsHave you suffered a hospital injury due to the negligence of a doctor? Miller & Zois can help you. Call us at (800) 553-8082 and speak to one of our medical malpractice attorneys who can help you or get an online case review.
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