Failure to order Venous and Renal doppler causing PE

This is a discussion on Failure to order Venous and Renal doppler causing PE within the Medical Malpractice forum, part of the HEALTHCARE LAW & MALPRACTICE category; Chronic renal failure and on Kidney transplant list for years, perhaps adding to the long wait time for kidney match ...

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Old Dec 13th, 2010, 01:03 AM   #1
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Confused Failure to order Venous and Renal doppler causing PE

Chronic renal failure and on Kidney transplant list for years, perhaps adding to the long wait time for kidney match was HIGH antibodies due to having blood transfusions for other surgeries ( that ALSO WENT WRONG) 2 unrelated abdominal surgeries ( at different times) different surgeons resulted in perforated bowels. The BOWELS weren't being operated on, but they were perforated in the process, not seen well due to scar tissue? The bowel perforations almost killed patient as they suffered severe infection and clergy was called in. Low and behold the patient survived. During admitting for one of the severe infections due to bowel perforation, the patient was crashing and Dr ordered 2 IV's and dopamine to raise Blood pressure, one of the IV bags was totally empty, so the Dopamine DRIP was going through both IV's at once, but when ONE became empty and relative alerted nurse of this several times, the nurse FINALLY came to replace the empty bag, but when she did the Dopamine that had filled up in the line ( because that bag was totally emptied) so when the new bag was placed all the dopamine that built up in the line was flushed full force into the patient and caused blood pressure to spike crazily 240 over 140, patient was screaming with immediate chest pain!

This patient had 3 near death experiences due to error, no lawsuits were ever filed, just continued to pray for some NEW KIDNEYS! Now because of surgeries and needing transfusions antibodies built up in patient and was taken off list many times, obviously if there are too many antibodies the risk of rejection is too great and so no kidney transplant will be done.

Fast forward.................get a call, there are 2 perfect kidneys and a perfect match, report to Hospital and they are all yours, albeit some tissue matching. Low and behold the tissue is a match as well, its full steam ahead this is going to be a CHRISTMAS MIRACLE!!! ( NOPE, NOT SO FAST) in fact its a nightmare!

Kidney transplant went fine, one of the patients own kidneys were removed, 2 donor kidneys placed on one side ( RIGHT) this was done because the patients family member noted prior complications ( understatement) see above ) scar tissue and making surgery risky as they very well know.... after this was verified from prior surgeons, the KIDNEY surgeon thanked the family member for the heads up beforehand. ( family member trying their best to be the best advocate to save patients life knowing what has happened in PAST!)


Dual kidney transplant goes well, no problems at all, Kidneys working great and patient moved to room about 3 hours after recovery.

At that time patient complained of RIGHT LEG PAIN, 8:30 P.M, nurse came over lifted gown, looked and said " Well thats to be expected, you did have surgery in that area. Said they would go see what kind of pain meds were prescribed and give some more, and then DID. Take note the Kidney transplant involves attaching the external illiac vein to the renal veins arteries and such, the illiac is just above the groin, patient complained of LEG PAIN. Nurse said its expected and goes to fetch more pain meds and patient goes into medicated sleep................No Venous doppler was ordered, not STAT , or otherwise, just ignored by giving more pain meds to induce sleep.


That was the FIRST MISTAKE and just a start of the Christmas miracle nightmare!



By 3:30 A.M it is noted that there is no longer urine output from the NEW KIDNEYS, NO ONE is alerted of this, so from 8:30 at night after complaining of LEG PAIN till 3:30 A.M a CLOT is forming and becoming larger and larger as the blood sticks to the forming thrombus and becoming larger and larger like rolling snow into a snowball.


By 7:00 A.M the Kidney team comes around making their morning rounds and notes the lack of urine output, leg pain and decides they need a VENOUS and RENAL doppler like right NOW ( YEP) The venous doppler and renal doppler are both positive for massive thrombus, Patient needs emergency surgery to try and save the donor kidneys.


The patient doesn't go in for the emergency surgery right away though because of an increased potassium level that has to get under control FIRST, so by 11:00 A.M the patient goes for exploratory surgery and to see if the Kidneys can be saved. This is the 2nd major operation in less then 24 hours!


A different surgeon performed the 2nd surgery, as the first was too tired from the kidney transplant the day before . The 2nd surgery revealed that there had been damage to the illiac vein from the clamp and that was the cause of the CLOT forming, it is not known yet if the pulmonary embolism had evolved before or AFTER the 2nd surgery, none the LESS during surgery the C02 stats led them to believe there WAS a pulmonary embolism and so the patient was kept sedated and on ventilator for 3 days. A CT scan could not even be done to SEE if there WAS a pulmonary embolism because of the patients guarded condition during surgery, patents can't get in CT scans while on VENTILATOR.


During surgery "2" 8 inch incisions were also cut into the patients right calf to release massive fluid build up and pressure, these incisions were left open and drained blood and fluid for 3 days, the patient also required 20 units of blood in those 3 days because of the incisions in the right calf as well as some bleeding into the abdominal area, where they almost did a 3rd surgery to investigate but did not because the patient was so unstable!


3rd day after patient is off vent, patient is taken to CT scan and in fact there is a medium sized embolism in the pulmonary arteries. The patient had been treated as IF there WERE a pulmonary embolism, and thats all they could DO at THAT point, watch and wait.

Family is hysterical, family members flying in from all over as can be expected when a family member has such devastating prognosis.


Both surgeons talked to family members and explained the damage to the Illiac VEIN when performing the 1rst surgery ( the donor kidney transplant) and explained was the cause of the BLOOD CLOT in leg as well as the pulmonary embolism, the surgeon who performed the kidney transplant did apologize for the error. Explained further that with all the blood transfusions over several days the chances of patient getting rid of antibodies that built up over this and to get a NEW kidney were very decreased and possible for several years to come!

It was also explained that the 2 , 8 inch incisions in the right calf would require much physical therapy,and most likely the use of a cane permanently because muscle and nerves would most likely be negatively effected!


Consultants for the Hospital contacted the family members to ask if they felt there had been any negligence, the family members kept mum.


They have been noting all the entire time!!!


Its important also to note that this patient remained employed FULL TIME in this condition PRIOR tot he kidney transplant to SAVE their private health insurance, because the anti rejection meds are so expensive and medicare, medicaid is not much help. This patient struggled to work full time for years, on all day dialysis 3 days a week with a wing and a prayer that ONE DAY they may GET 1 kidney and to learn they would get 2 , as there was a perfect match did seem like nothing more then a Christmas miracle......but it was NOT TO BE.....and WHY, WHY , WHY ???


As it NOW stands the patient will be forced to QUIT work, lose their private insurance, use a cane for life with no hope for a new donor Kidney for years to come. The patients life for the last 10 years has been HELL, but they persevered on in the struggle for LIFE, with a will to live so very strong and many prayers, only to land HERE.


There can be error due to surgical technique and even down right human error and in this instance, the surgeon apologized ( okay) but ALL work as a team to save patients life and the LACK of standard in care AFTER this surgical nightmare set the path for further destruction of this patients health and lively hood.


HAD the NIGHT NURSE alerted someone of the patients leg pain a STAT venous doppler could have been performed to discover the thrombus( blood clot) Had the NIGHT NURSE not brushed off the patients leg pain and just went to fetch more meds, the patient might have awoken through the night to protest further on the leg pain, however the patient was in a drug induced sleep!

Had the NIGHT NURSE alerted someone of the lack of urine output instead of just charting it, it would have occurred to someone with a BRAIN that there are 2 reasons new donor kidneys that were working WELL after surgery, were no longer working and those 2 reasons for simplicity sake are, either the patient is rejecting them OR there is an occlusion somewhere from a BLOOD CLOT ( thrombus) which was the case in FACT).

HAD the NIGHT NURSE alerted someone of THIS lack of urine output a RENAL doppler could have been reformed STAT, in addition tot he ERROR of not alerting anyone of the LEG PAIN, now " 2 " non invasive diagnostic tests were not performed in a timely manner under ANY standard of care, and the direct results are as followed:


The patient LOST both donor kidneys because they had blood clots occluding flow to them and they died.Both the kidneys could have been saved HAD stat renal and venous doppler been performed, but they were not. The indications were all there, the NIGHT NURSE just didn't alert anyone, instead just medicated the patient into a drug induced sleep. ( did I forget to mention the NIGHT NURSE, was very BUSY, seems there was a cute blond nurse that distracted him for his entire shift with many notes of the fratenizing going on up until the family member left for the night ( hindsight, sigh)

Now there is no hope for years to come to be put back on the transplant list due to antibodies formed from the 20 units of blood that were only required due to the massive incisions in the CALF to allow the massive swelling to escape, this did prevent the arteries from being compressed and allowed arterial blood flow ( oxygenated blood flow) to the leg so the leg didn't have to be amputated, but has resulted in the patient requiring a cane to walk for life due to damage to muscle, tendons and nerves.

Had a venous doppler been performed after complaints of pain in the leg, the clot in the leg would have been discovered, both saving the 2, 8 inch incisions in the LEG, saving the kidneys as well as saving the patient use of their leg, saving their JOB, and never losing BOTH donor kidneys, never having a 2nd surgery, never having the pulmonary embolism.


Had a renal doppler been performed after the lack of urine output alerting that the kidneys were blocked, by the blood clot, the kidneys would have been saved............

No matter how you slice this, all could have been prevented.


Could the surgeon have avoided damaging the illiac vein when attaching the new kidneys? This is what started the roller coaster to hell, but the surgeon apologized, the NIGHT NURSE well...........WHO KNOWS what he is doing, probably still chasing the little blond nurse around !


Should the family sue? They never did in the past, not even after 3 close calls of death prior with other medical errors.


No amount of money can undo what has been done and supplement the losses for this patient and their family, BUT what should they do, what would YOU DO?
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Old Dec 13th, 2010, 01:07 AM   #2
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Default Re: Failure to order Venous and Renal doppler causing PE

I would gather together the medical records and consult with a med-mal attorney. I would also take note of the statute of limitations for my state.

Generally speaking if an attorney won't take your case on contingency, you don't have much of a case.
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Old Dec 13th, 2010, 01:24 AM   #3
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Default Re: Failure to order Venous and Renal doppler causing PE

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I would gather together the medical records and consult with a med-mal attorney. I would also take note of the statute of limitations for my state.

Generally speaking if an attorney won't take your case on contingency, you don't have much of a case.

I am wondering if there is a need for an Attorney at this point. With the blatant surgical errors, and the subsequent ensuing errors ( failure to diagnose) Failure to order proper diagnostic tests, because of staff negligence it would seem the Hospital are already aware of the negligence and should step up and take responsibility. the hospital is liable for their staff. I only wonder since hospitals have gone to electronic charting, what can and can't be altered. There is a time stamp on the diagnostic machines that revealed the massive thrombus. There is no excuse not to have ordered those tests given the patient complaints of leg pain as well as the lack of urine output also a clear indicator to order doppler studies of both RENAL and LEG. The time stamp on the ultrasound machine show the tests were not performed or ordered in a timely manner, under any medical standard of care or protocol.
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Old Dec 13th, 2010, 01:49 AM   #4
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Default Re: Failure to order Venous and Renal doppler causing PE

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Originally Posted by Unregistered View Post
I am wondering if there is a need for an Attorney at this point. With the blatant surgical errors, and the subsequent ensuing errors ( failure to diagnose) Failure to order proper diagnostic tests, because of staff negligence it would seem the Hospital are already aware of the negligence and should step up and take responsibility. the hospital is liable for their staff. I only wonder since hospitals have gone to electronic charting, what can and can't be altered. There is a time stamp on the diagnostic machines that revealed the massive thrombus. There is no excuse not to have ordered those tests given the patient complaints of leg pain as well as the lack of urine output also a clear indicator to order doppler studies of both RENAL and LEG. The time stamp on the ultrasound machine show the tests were not performed or ordered in a timely manner, under any medical standard of care or protocol.


Are you a medical professional?

Are you qualified to ascertain whether or not any medical professional involved has deviated from the standard of care?

Can you afford to pay for expert witnesses?

I'm guessing the answer to these three questions are all the same: "no".

Med-mal suits are very, very expensive. It is NEVER recommended that you do this pro se (representing yourself).

Again, medmal attorneys take their cases on contingency if they think there's a) a viable case and b) a viable return in terms of damages. If you can't find an attorney to take your case, then you don't have a case.

And please remember - a mistake does NOT necessarily mean that malpractice or negligence has occurred.

Please, speak to an attorney.
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Old Dec 13th, 2010, 03:15 AM   #5
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Wink Re: Failure to order Venous and Renal doppler causing PE

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Are you a medical professional?

Are you qualified to ascertain whether or not any medical professional involved has deviated from the standard of care?

Are you insinuating that it takes a medical professional to ascertain deviation from the standard of medical care? If your assertions were anywhere remotely correct, no medical malpractice ( deviation from standard of care) case would ever be discovered, thus no litigation needed to expose the NEGLIGENCE.

However, as a medical professional it is readily apparent the standard of care has been grossly deviated from, as described by the family. ( I had them take notes) as per my qualifications to testify to same, I am not in the habit of being an expert witness in legal cases.

Can you afford to pay for expert witnesses?

If you HAD ANY knowledge of medical care, if you had READ the message thoroughly then you would have understood each act of negligence to the full extent. there are some errors that can be missed, covered up and made to appear other then what they are and again, IF you had ANY knowledge where this is concerned as it was spelled out; your response would not have been forthcoming as it was.

I'm guessing the answer to these three questions are all the same: "no".


Since you most obviously are in the habit of making premature assumptions, and get some kind of kick assuming your assertions are correct, let me reciprocate appropriately by alerting you of a little cliche you apparently aren't aware of either ( or you'd be more careful of putting your foot in your mouth)

Med-mal suits are very, very expensive. It is NEVER recommended that you do this pro se (representing yourself).


Yes, you are correct they are expensive. Again, you assume things and make assertions. Pro-se, would be necessary if one were to litigate this in a court room. Why do you assume this would need to be litigated in a court room? Let me answer that for you " because you have no understanding of the message presented here.

Again, medmal attorneys take their cases on contingency if they think there's a) a viable case and b) a viable return in terms of damages. If you can't find an attorney to take your case, then you don't have a case.


I am knowledgeable in all aspects of legal proceedings,how Attorneys work there fees. In addition, these Attorneys typically have a need to spend great sums of money to ascertain IF there is a deviation in the standard of care, because they have little medical knowledge. Again, ( back at you) if you had ANY knowledge in the content of the message posted you would be able to ascertain this for yourself.

And please remember - a mistake does NOT necessarily mean that malpractice or negligence has occurred.


Perhaps as well as not understanding the message and the content in it that revealed the gross deviation from the standard of care, you also would have made a mental note to yourself when reading the portion concerning surgical error. Now, perhaps you may go back and read it again and again, do some googling, and I'll chat with you when you get back.

Please, speak to an attorney.

Yes, I am a medical professional.
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Old Dec 13th, 2010, 03:31 AM   #6
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Default Re: Failure to order Venous and Renal doppler causing PE

I wish to inform you that you are completely clueless when discussing what does and does not constitute medical malpractice and/or negligence.

Have a lovely evening now, y'hear?
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Old Dec 13th, 2010, 11:57 AM   #7
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Default Re: Failure to order Venous and Renal doppler causing PE

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I wish to inform you that you are completely clueless when discussing what does and does not constitute medical malpractice and/or negligence.

Have a lovely evening now, y'hear?

No, quite the contrast to your statement. It is you having no concept of what constitutes medical malpractice/negligence.

In summary to break it down in for you ( its a deviation from the standard of medical care) that consist of permanent injuries resulting and contrived from medical care
( surgery, pre and post op care), in where the standard of medical care grossly deviates from the NORMAL practice and parameters that MOST or ALL OTHER medical professionals would follow a particular standard of protocol, given the same scenario. These standards of medical care were not followed or deviated from in a negligent fashion that caused the present injured state. ( which the law affords compensation as a result of, it includes monetary and other forms of compensation in an attempt to make the injured party whole )


Now if you'd like to show your bright side and knowledge you profess to have, get to the GUT of what your asserting here, go through the message and pick out what constitutes deviation from the standard and care and what does not. Raise any arguments you'd like to support your theory. I'll reciprocate and answer your questions afterward.

I think you merely like to watch letters appear on your PC screen as you type, you could do that anywhere. If I were you, I'd try this out on a different forum, this is beyond the scope of your profession or knowledge.
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