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, WVFK&N attorneys Keith Forman 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.