A patient dies after bleeding from her dialysis site

The ER doc loses the malpractice case for failing to consult a vascular surgeon. With specialists increasingly failing to cover the ER, I wonder if this played into the case.

Comments

Anonymous
The bleeding was stopped. The article implies it was still stopped even by the next morning. I don’t see how that is malpractice. It is not at all uncommon for a patient to bleed from their dialysis “site” (the article doesn’t say if it was an AVG, AVF, or Quinton catheter). If the bleeding was controlled, vascular surgery consultation was unnecessary.
Furthermore, the award for “pain and suffering” seems odd. The patient apparently died in her sleep. Bleeding out causes neither pain nor suffering.
Gasman
The alleged negligent act was not obtaining a vascular surgery consult. However, this could only be considered negligent if, having obtained such a consult, something 1)different would have been done, and 2) it would have led to an improved outcome.
Since it is not postulated how a consult would have made a shred of difference, then ‘failing’ to obtain one was indeed sound practice.
Of course there could be more to the story, but a shrewd medical reporter would not have left any facts untold.
Anonymous
“I don’t see how that is malpractice.”
Easy scalpel in lawyerspeak bad outcome = malpractice.
SarahW
“but a shrewd medical reporter would not have left any facts untold”
Who are these shrewd men you describe? Reporters and/or their editors often leave out details that seem extraneous to the newsy aspect of the story; sometimes because the “rightness” or “wrongness” of the verdict is not the story. The fact that a verdict was reached verdict is the story, or some other aspect of the story is the story, or there is a need to be very brief, and so on.
There is almost certainly more the story, there generally is.
Anonymous
Oh come now. the bleeding has stopped. Vascualr would have offered NOTHING. Talk about BS.
Anonymous
There aren’t enough facts in the article to come to a conclusion. What type of access did this lady have? The article says that the lady had received dialysis for years without problem so I can only assume/infer that she had an AV Graft.
It is not uncommon to see bleeding post dialysis. After all, they do give heparin during dialysis, esp. for those with perm caths or Quentins. I treat patients with bleeding from newly place perm caths on a daily basis. They get their perm caths put in and get dialyzed through that cath on the same day. Heparin is then injected in these caths to keep them patent and patients comes in with bleeding from their cath sites all the time. I routinely inject some lidocaine with epi subcutaneously around the wound and dab on a li’l Dermabond. Works every time except for once on a lady whose on also on coumadin for mechanical heart valves. Her INR was 12.
If the bleeding stopped and she’s stable, if it was just oozing and then stop, not pulsatile…doesn’t sound like malpractice to me. The vascular surgeons would’ve recommended pressure dressing and clinic follow up anyhow.
Anonymous
I have NEVER had a vascular surgeon come to the ER when a Dialysis patient comes in with a bleeding catheter. ALmost 100% of the time the bleeding stops with pressure, you make sure infection isn’t the cause of the bleeding, send the patient home. Usually courtesy call the vascular doc who NEVER would come in if the bleeding stopped. Of course, a jury of our “peers” wouldn’t know this. Our jobs are ticking Time Bombs.
Anonymous
Actually, if what you say is true, then the jury would have been educated on that very fact.
Such is the danger of pontificating about things you know nothing about based on a newspaper article, eh?

A patient dies after bleeding from her dialysis site

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