Q: Hospitalized patient with A. Fib was not given anticoagulant and suffers debilitating stroke in hospital.
The patient's oral anticoagulant (Pradaxa) was held for pacemaker removal surgery. Two and a half days later, the patient continued to be in permanent A. Fib, he still had not been given any anticoagulant, and he had a stroke. The Pradaxa warning says, "Increased risk of thrombotic event, including stroke, when discontinued. Consider coverage with alternative anticoagulant unless discontinuing due to life-threatening bleeding." Risk of bleed vs. stroke? The night after surgery, he bled about 2 ounces into the wound vac container. After that no visible bleeding at all. I believe he should have been on Lovenox, and I think if he had, he would not have had a stroke. I asked the attending physician why he had not given any anticoagulant and was told, "I thought someone else was managing the medicine." How would you proceed with this case?
A: could be but not necessarily. Contact a member of the Tenn. Assn for Justice who handles medical cases.--they give free consultations.Malpractice cses are expensive, and will be brought only if it is clear that the standard of care a) was to have used different medication and b) if it had been used there wouldn't be a stroke --which is difficult to say.
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