Jane Doe has settled her medical negligence case against a rural Missouri hospital arising out of a medication error and a cascade of other errors that led to permanent cognitive impairment. 71 year old Ms. Doe was only a few hours removed from a total hip replacement when a registered nurse of the hospital administered 10,000 units of heparin. A pharmacist had mistakenly entered an order for this on the medication administration record. Heparin, a blood thinner, was contraindicated for the patient. The errant order led to Ms. Doe receiving a quantity of heparin equaling twice the normal dose.
Ms. Doe alleged additional negligence on the part of the nurses and physicians who failed to respond properly to her deterioration that followed. Ms. Doe began showing signs of distress starting about one and a half hours after she received the heparin. Her condition continued to deteriorate steadily over the next three and a half hours but neither the staff nurse nor the charge nurse who participated in the plaintiff’s care contacted a physician until the patient required transfer to the hospital’s intensive care unit. Various calls were made to Ms. Doe’s attending physician but neither that physician nor another physician whom a nurse contacted came to Ms. Doe’s bedside until some two hours after her transfer to the ICU and after she experienced a cardiopulmonary arrest from her undiagnosed and untreated bleeding complication.
Ms. Doe also alleged that hospital personnel negligently performed the Code Blue resuscitation that began when plaintiff arrested. After 30 minutes of attempting to revive Ms. Doe, resuscitation efforts were halted because the hospital personnel, including two physicians, thought that Ms. Doe could not be revived. However, resuscitation resumed after a nurse noted Ms. Doe’s gasping for air. Three minutes passed between the halt and the resumption of resuscitation.
Ms. Doe was diagnosed with renal failure, shock liver and encephalopathy. Plaintiff alleged that the late response to Ms. Doe’s bleeding complication, which severely depleted her blood volume, together with the three minute interruption in resuscitation had caused these injuries.
Ms. Doe was transferred to a large urban hospital within 36 hours and she soon thereafter recovered kidney and liver function. Nevertheless, she remained in a near comatose state for nearly two weeks. An EEG revealed mild to moderate abnormality to her brain, but CT and MRI scans were normal. Various physicians at the transferee hospital charted that Ms. Doe fully recovered from her encephalopathy and had sustained no lasting cognitive impairment.
A neuropsychologist retained by Ms. Doe’s attorney tested Ms. Doe at 6 months and again at 20 months after her bleeding complication. Testing on both occasions revealed Ms. Doe to have above average problem-solving ability but showed her working memory to be in the lowest two percentile.
In addition to cognitive injury, Ms. Doe alleged that her brain injury had altered her senses of taste and smell.
Plaintiff entered into a $1.5 million settlement with a limited confidentiality agreement.