medical error

What Is IV Extravasation?

April 1, 2024 | by Ethan S. Nochumowitz

An IV, short for “intravenous,” is a familiar medical device used by doctors and nurses to administer various medications and other fluids to patients by inserting a needle or tube directly into the patient’s vein. Once the IV is inserted into the vein, it typically is taped to the skin to prevent it from moving or otherwise coming loose. If an IV becomes dislodged from the vein but stays under the patient’s skin, the medication being dispensed can be harmful to the surrounding tissue. This is called an IV extravasation.

If the patient is awake when the extravasation occurs, they usually feel immediate pain or discomfort and can quickly notify a doctor or nurse of the problem before significant harm is caused. However, if the extravasation occurs while the patient is unconscious (for example due to anesthesia or other sedation), the harmful medication can be dispensed into the patient’s tissue for a long period of time, causing significant injury to the patient, including tissue damage and necrosis (death of the tissue).

As a result, it is important that when a patient who has an IV is unconscious, the doctors and nurses regularly check the IV to ensure that no extravasation has occurred and quickly stop the dispensation of medication if it does occur.

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Jury Awards $7.5 Million in Surgical Malpractice Case

October 2, 2015 | by Andrew G. Slutkin

This week, a North Carolina jury awarded $7.5 million to a gentleman whose botched colon surgery left him with severe and debilitating complications. In June of 2010, the patient underwent surgery to remove a portion of his colon due to a potentially cancerous mass that had been found. It was alleged that when the surgeon connected the new ends of the colon together, there was a leak. The patient in this case became extremely ill following the surgery. He suffered from a prolonged period of low blood pressure as well as kidney failure, infection and internal bleeding. He also underwent two additional surgeries during which his physicians were unable to locate the source of the infection. A colonoscopy later that same year revealed a leak in the area where a portion of the colon had been resected. A fourth surgery was then performed to repair the leak and mitigate the resulting internal damage.

When a perforation occurs in the gastrointestinal tract, substances such as fecal matter, food and bacteria can leak in to the abdominal cavity which can cause infection, organ damage and even death. Perforations of the colon can happen on their own but, more commonly, occur during surgeries in the abdomen. Symptoms of a colon injury include fever, pain, increased heartbeat, increased respiratory rate and distension of the abdomen. Generally speaking, a perforated colon can be diagnosed using the CT Scan technology that is available today.

Often times, the defense in these types of cases is that the perforation – and the resultant leak – in and of itself is not a breach of the standard of acceptable medical care. While the truth of this defense depends on the circumstances, a good medical malpractice attorney can get around this argument by showing that a delay in diagnosing the perforation and leak resulted in unnecessary harm and damages.

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New York Man Awarded $9.1 Million in Medical Malpractice Suit

March 25, 2014 | by Andrew G. Slutkin

A person who is injured expects to receive adequate care and treatment from doctors and medical staff. Patients certainly do not expect that they will walk out of a hospital or doctor’s office in a worse condition than when they arrived. Unfortunately, that is exactly what happened in a recent medical malpractice case in New York.

Almost ten years ago, a New York man slipped on some steps as he made his way into work as a public safety dispatcher, breaking one of his ankles. He subsequently sought treatment for his injury from a doctor at an orthopedic practice. Later, he began experiencing significant pain on the side of his foot near his little toe. This intense pain prompted him to seek treatment from another doctor. From 2005 to 2009, a surgeon at a knee center began performing surgeries on his little toe in hopes of alleviating the patient’s pain. Eventually, however, the surgeon amputated the patient’s little toe.

Sometime after this amputation, the patient developed an infection, and the doctor was forced to amputate the fourth toe. The patient’s pain persisted, and in July 2009 the knee surgeon amputated the leg just below the knee. Once again, the patient developed another post-surgical infection which required the amputation of the remaining leg above the knee. After these surgeries in 2009, the patient no longer was able to work. In all, the patient underwent twelve surgeries from various doctors in New York. Following all of these surgeries, the patient filed a medical malpractice suit against his treating doctors and surgeons.

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Orthopedic Surgeon’s Medical Negligence Leads to Paralysis

October 31, 2013 | by Andrew G. Slutkin

Patients expect that their doctors will take good care of them and do whatever necessary to stabilize or treat their condition. However, one doctor – an orthopedic surgeon – recently was found guilty of medical malpractice when his actions led to his patient becoming a paraplegic; the jury awarded the patient and his wife $2.85 million.

The patient presented to the emergency room in the spring of 2004 after he suffered numerous and severe injuries in an automobile accident. While being prepped for surgery to stop the bleeding in his forearm, the treating orthopedic surgeon ordered a CT scan of the patient’s knee, which he also injured in the accident. According to the trial testimony, when the physician ordered the CT scan, the patient’s blood pressure was at a dangerously low level. The CT scan caused a nearly 30-minute delay in the patient’s surgery. During this delay, the patient went into cardiac arrest and respiratory arrest. Although two physicians nearby – an emergency room doctor and an anesthesiologist – fortunately resuscitated the patient, the delay and resulting injuries led to the death of a portion of his spinal cord, also known as a spinal cord stroke. Tragically, he suffered permanent paralysis from just above the waist down.

According to the lawyers and experts who testified at the trial, the patient’s extremely low blood pressure should have alerted doctors and nurses that he was on the verge of a cardiac arrest and that to interrupt the necessary treatment of the patient’s arm was negligent. Several doctors further testified that the patient should not have been transferred from the pre-operative holding area when his vital signs were as low as they were – even the experts for the defendant physician. Various witness accounts and medical records also presented at trial revealed that the patient’s blood pressure and pulse remained at zero after the cardiac arrest, leaving his body without blood flow for approximately eight to twenty-seven minutes.

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Doctor’s Type 2 Diabetes Misdiagnosis Turns Fatal

October 23, 2013 | by Andrew G. Slutkin

A New York jury in a medical malpractice recently found that a pediatric endocrinologist was guilty of medical negligence that caused the wrongful death of a six-year-old girl, and awarded the mother an $8 million verdict. Sadly, the girl died shortly after a non-board certified pediatric endocrinologist misdiagnosed her diabetes.

This defendant doctor was recommended by the girl’s pediatrician, who thought she may have had diabetes. After administering a blood test, the specialist jumped to the conclusion that the girl had pre-Type 2 diabetes; she prescribed a regimen of weight loss and exercise. Following this initial misdiagnosis, the specialist failed to order a blood test at a second visit, and the girl became gravely ill about a month later. When the girl’s blood sugar eventually was tested at the ER, it was found to be five times higher than the normal limits. Unfortunately, all she really needed was insulin, but because her doctor misdiagnosed her with Type 2 diabetes, instead of Type 1 diabetes, she ended up not getting the insulin she needed and died.

At trial, doctors said there were other signs that the girl had Type 1 diabetes and asserted that the doctor’s negligence in failing to administer the girl insulin caused the girl’s wrongful death. One diabetes expert testified that when a six-year-old has diabetes, there is a 99.99 percent chance it is Type 1. This is crucial, as Type 1 require insulin; Type 2 normally can be treated with diet and exercise.

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Negligence Involving Bed Rails

June 11, 2013 | by Andrew G. Slutkin

There are many hidden and unknown dangers in the very places we expect to heal; for example, hospital beds. Many of these hospital beds have rails, typically made of metal, that run along the side of the sleeping space. These bed rails operate to prevent someone from rolling off accidentally.

Several months ago the Consumer Product Safety Commission released a review of bedrail deaths and injuries of adults. Using data from hospitals, the report cited 155 deaths involving bed rails from January 2003 to September 2012. In that same period, almost 37,000 people were injured in bed rail accidents and treated at hospital emergency rooms. According to this report, the deaths and injuries most commonly occurred when the victim became stuck in the bed rails, mainly with his or her head or neck getting caught. These alarming numbers triggered the CPSC to move forward in addressing bed rail safety.

Last week, the CPSC “merged” two petitions related to bed rail safety. Combined, the two petitions offer the CPSC an array of options: it can decide to do nothing, ban the use of bed rails entirely, or choose any various steps in between. Safety advocates are insistent that no intermediary step will eliminate all harm, suggesting that a ban likely is the best and safest option. The prevalence of these beds and bed rails in residences, nursing homes, and hospitals suggests that it is likely this petition will gain deep collective interest among a number of organizations.

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Malpractice litigation helps reduce medical error

May 21, 2013 | by Andrew G. Slutkin

The New York Times recently ran a fascinating op ed by Joanna Schwartz, a professor at UCLA. The subject was a study that Professor Schwartz did on the value of medical malpractice litigation in reducing medical errors. Professor Schwartz’s conclusion was that medical malpractice claims and lawsuits actually don’t result in doctors and other health professionals hiding problems and, in fact, such suits actually encourage improved practices.

In order to reach her conclusions, Professor Schwartz surveyed more than 400 people who are responsible for hospital risk management, claims management and quality improvement in hospitals in the U.S. She found that, although hospitals used to handle medical errors and lawsuits by taking an adversarial and secret approach, hospitals have begun changing that approach. Now, she reports, hospitals are more open with patients. In fact, she found that over 80 percent of hospitals that she surveyed now actually have a policy of apologizing to patients who are victims of errors. Most importantly, she found that most hospitals are willing to discuss and learn from errors with staff. This is a dramatic shift form the old days when health care providers kept from patients the fact of medical injury.

Contact Andrew G. Slutkin with further questions or inquiries at 410-385-2786

Failure to Timely Diagnose and Treat Heart Attack

October 4, 2011 | by Andrew G. Slutkin

In early 2003, a Pennsylvania pharmacist died of a heart attack while at work. In 2009, a jury found his family doctor negligent and awarded the man’s widow $4 million. Later, after determining the delay in the conclusion of the case was improper, the presiding Judge awarded the man’s widow an additional $1.2 million in damages. Last month, the Pennsylvania Superior Court upheld that $5.2 million award in the medical malpractice case.

This case is an example of the catastrophic results of a doctor failing to correctly diagnose and treat his patient. The man went to see the doctor four days before his death as a result of unexplained chest pain, jaw pain and anxiety. The doctor advised him that these symptoms were the result of anxiety. However, the man’s attorneys argued that the the doctor made a critical error by failing to take into account the following: the man was overweight, he had high cholesterol, he had high blood pressure and he had a history of heart disease in his family. On the day of his death, the man again contacted the doctor as a result of his symptoms persisting. By the time the doctor returned his call, the man was already in cardiac arrest.

Ultimately, jurors agreed that when the doctor analyzed the man’s complaints in light of the risk factors he had, the doctor should have immediately sent the man to an emergency room because the mans’ symptoms were suggestive of a heart attack. The autopsy results further confirmed this determination as it showed heart damage, specifically indicating that the man had a heart attack a few days before his death.

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Failure to Diagnose and Treat Infection Causes Amputation

September 23, 2011 | by Andrew G. Slutkin

A woman in Pennsylvania was recently awarded one of the highest sums ever recorded in a medical malpractice suit after an infection went unnoticed and nearly killed her. The lawsuit was based upon medical negligence and medical errors committed by a home nurse that was treating the woman, who was suffering from Crohn’s disease. The woman was receiving care from a home nurse when the R.N. failed to recognize that she had an infected catheter. As a result of the nurse failing to refer the patient to a physician to treat the infected catheter, both of the woman’s legs were amputated below the knee. This was a result of the infection spreading to the bloodstream.

The jury in this case awarded the woman $23.12 million after hearing about the failure of the nurse to treat the bacteria-infected catheter and found both the nurse and the employer negligent. The damages were based on compensatory awards of economic damages for medical expenses and lost wages, as well as non-economic damages associated with pain and suffering. A medical malpractice case requires a plaintiff to establish that a health care provider undertook care of a patient, and thus had a duty to the patient; the duty was breached by the health care provider upon their failure to perform at the standard level of care; and that damages to the plaintiff resulted. A finding of negligence means the jury thought that the evidence showed that the woman’s health care provider committed a medical error resulting from an omission which deviated from the standards of practice generally accepted in the medical community, and found that this failure caused injury to the patient.

We handle cases like these all of the time in my practice.

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Rare Bacterial Infection Leads to Severe Brain Damage in Infant – Who is at Fault?

July 21, 2011 | by Andrew G. Slutkin

When Myles Massey was born on September 1, 2007, along with his brother, Henry, a medical mystery began to unfold. The twin boys were born prematurely in a Washington state hospital, but it was only Myles who exhibited signs that something was wrong. It took years, but Myles’ family has finally determined the cause of the bacterial infection that overtook his small body, leaving him unable to walk or talk, while sparing his brother who developed normally.

The Massey’s initial medical malpractice suit filed in 2009, which named the doctor’s and hospital that treated Myles at the time of his birth for his contraction of the rare bacteria, cited poor infection control practices as the cause of his systematic decline. However, despite numerous tests, investigators were never able to link the bacteria to any of the doctors or the hospital.

In early 2011, a company by the name of Triad Group became the subject of an FDA investigation which found that the alcohol prep pads they were manufacturing and distributing were contaminated with the bacteria. It was then that the Massey’s mystery was solved. The hospital where Myles was born confirmed that their neonatal intensive care unit used the Triad alcohol wipes. It’s not clear why Myles was affected by this bacterium while his brother and other infants in the NICU were not, but the alcohol prep pads have been almost conclusively deemed the source of the bacteria found in Myles’ bloodstream. The Massey’s lawsuit, now amended, includes the manufacturers and distributors of the alcohol prep pads.

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