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Cardiac Arrest Due to Avoidable Pulmonary Embolism

On August 10, 2020, WVFO attorneys Keith Forman and Cecilia Lavrin filed a medical malpractice claim on behalf of the family of a woman who died as a result of avoidable cardiac arrest due to the doctor’s failure to complete a full and accurate history.

The complaint alleges that on October 4, 2017, at approximately 5:37 a.m., the woman was admitted to Mercy Medical Center for a scheduled lumbar decompression and fusion procedure. At approximately 7:42 a.m., a venous thromboembolism (VTE) risk assessment was performed which found her to be at high risk of the development of a deep vein thrombosis (DVT). During the pre-operative assessment both the patient and her daughter informed the nurse that the patient had not been feeling well, that she thought she had fainted the day before, and that she had been experiencing unusual shortness of breath, chest tightness and chest pain. The nurse documented that she informed the doctor of these complaints and symptoms. At approximately 8:00 a.m., the doctor examined the patient. There is no documentation that he had any discussion with the patient about her complaints of shortness of breath, fainting or chest pain. In violation of the standard of care, the doctor did not further investigate the complaints, and failed to order appropriate testing to rule out any conditions which presented a contraindication to surgery or a surgical danger – such as DVT or pulmonary emboli. By 8:05 a.m., the doctor was performing an IV induction and subsequent intubation. By 8:08 a.m., the patient’s blood pressure began to drop and her heart developed an abnormal pattern as she developed hypoxia. Despite interventions the patient went into cardiac arrest. A “Code Blue” was called and cardiopulmonary resuscitation (CPR) with chest compressions, attempts at defibrillation, and medications were started in the operating room. She was transferred to the intensive care unit (ICU) with active CPR continuing. Chest compressions continued for over 70 minutes before a heart rhythm was restored. An EKG and echocardiogram raised the suspicion that the patient had suffered a pulmonary embolism. A lower extremity duplex doppler performed confirmed the presence of acute deep vein thrombosis. The patient’s condition worsened with multi-organ failure, acidosis and an increasing need for pressor agents to keep her blood pressure elevated. At 4:20 p.m. on October 5, 2017, the woman went into cardiac and respiratory arrest and died. The cause of death was determined to have resulted from pulmonary embolism.

The lawsuit alleges, among other things, that the doctor failed to complete a full investigation of the woman’s symptoms which led to the cardiac arrest during surgery that caused her death.

The action is pending in the Circuit Court for Baltimore City, Maryland.

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