Failure to Identify and Diagnose Bleed in Lower Leg Results in Amputation and $700,000 Settlement
A man visited his local Emergency Room complaining of extreme pain in his lower leg. This plaintiff was an African American male, aged 36 years. He could not connect the pain with a specific injury. In providing his medical history, he reported an embolic stroke several years before this ER visit. He also reported a recent history of DVT of the right leg that was being treated with an oral anticoagulent medication.
Upon physical examination of the painful leg, the ER physician made note of a “rock hard” calf muscle. He noted that the surrounding muscle segments were “soft.” The ER physician also noted palpable pulses in both legs and no evidence of neurovascular compromise. Blood tests were ordered. The blood tests indicated unusually low levels of hemoglobin, hematocrit, and red blood cells. Each of these levels should have indicated that plaintiff’s anticoagulant was not working properly and that there was an internal bleed. In addition, the INR was elevated, indicating that the patient’s blood was not coagulating properly. This also indicates an internal bleed. No diagnostic studies were conducted to determine the cause of the leg pain.
The ER physician prescribed valium, IV pain medication, and suspension of patient’s anticoagulant medications for 24 hours. The patient’s was then discharged. The diagnosis recorded was acute leg pain, acute muscle spasm and Coumadin coagulopathy. [Read more…]