Negligent Prescription Of Lovenox And Negligent Performance Of Contrast Injection
Bleeding Causing Death – Lawsuit Against Sinai Hospital Of Baltimore, Inc. | October 19th, 2018 - Baltimore City, Maryland
On October 19, 2018, WVFO attorneys Keith Forman and Cecilia Lavrin filed a medical malpractice claim on behalf of a patient who died as a result of bleeding to death following negligent prescription of Lovenox and negligent performance of a contrast injection.
According to the complaint, in January of 2017, the decedent presented
to Sinai Hospital of Baltimore with worsening left leg edema and unresolved
cellulitis, which had been previously treated several days earlier with
antibiotics at Sinai Hospital. Several days after her admission in January,
the patient began complaining of shortness of breath and right sided chest
pain. An EKG found a cardiac arrhythmia which was determined to be normal
sinus rhythm with PVC’s. A D-dimer was ordered and returned elevated.
A cardiologist at Sinai Hospital subsequently determined that her shortness
of breath was either due to diastolic dysfunction or CHF exacerbation
or a pulmonary embolus. He ordered that Lovenox 100 mg, SubQ every 12
hours, was to be given as a prophylaxis for possible deep vein thrombosis
(DVT) or possible pulmonary emboli until it could be ruled out. This dose
was greatly in excess of the recommended dose for an elderly patient with
questionable kidney function, and who was at greater risk of bleeding
due to her comorbidities of age and her prior history of stroke and hypertension.
As a result of the elevated D-Dimer, a thoracic CT with IV contrast was
attempted on January 23rd, however, the radiology technician inappropriately
injected the contrast via powerjet, using the patient’s existing
peripheral IV in her right arm without first ascertaining that the IV
was fully patent or could withstand the forces of the contrast being injected
at higher velocity and power. As a result, the IV likely blew a hole in
her vein in the area of the right upper chest resulting in extravasation
of the contrast and her developing an area of active bleeding into her
right upper chest. Because she was on high doses of Lovenox and aspirin,
the patient could not properly form a clot in the area of the perforation
and continued to bleed into her chest. Within hours, the patient was complaining
of pain and swelling of the shoulder region and had an evident increase
in size of her right breast and chest wall and ecchymosis which was believed
to be due to the contrast extravasation at the time of the CT study. Eventually,
once a CBC was ordered, it was demonstrated that she was hypovolemic and
likely bleeding. The patient had to be intubated due to her increasing
altered mental status and her hypotension. Despite the efforts to improve
her anemia and perfusion, the patient died.
The lawsuit alleges that the defendants negligently prescribed Lovenox despite the risk factors and negligently performed the contrast injection which eventually lead to severe complications. As a direct and proximate result of the defendants’ negligence, the patient died
The action is pending in the Circuit Court for Baltimore City, Maryland.