What a devastating feeling it must be to go in to the hospital for a fairly routine surgery, and when all is said and done, you end up having one of your arms amputated above the elbow because of medical negligence.
The victim in this case, a 71 year old mother and grandmother, went into the hospital to have an endarterectomy on the left side, which began at approximately 7:00 a.m. and was in surgery for approximately two and a half hours. At approximately 9:30 p.m. that evening, she complained of numbness in her left arm and hand, difficulty moving her fingers and a note in the medical records indicated that the A-Line in her left wrist was related to her increased numbness, as well as the forearm IV, and both were discontinued at 9:45 p.m.
At 1:00 a.m. there was a request for consultation regarding high blood pressure, but the patient also complained of left arm pain, weakness and numbness since 10:30 p.m. last night, which she attributed to a painful A-Line. At that time, it was noted that she had neurological weakness in her left grip, wrist, biceps, and decreased sensation. She complained that her arm was still numb and had not changed at 1:45 a.m., 3:10 a.m., and 4:10 a.m. At 6:00 a.m., the nurses noted edema, red blotching of the left arm, and swelling. Her doctors were notified. At 7:30 a.m., she had numbness in her mid-forearm, and her left arm was noticed to be swollen and it was mottled. She was unable to move her left hand or wrist and areas all along the length of the arm were mottled with a line of demarcation being on her upper arm above her elbow.
By 8:00 a.m. that morning, the operating surgeon came in to see the patient and immediately called a neurosurgeon regarding her left hand and arm. At this time, the patient’s arm remained entirely numb. She was unable to move her fingers, hand or wrist. Hematomas were noted where the IV site was located.
When the neurosurgeon arrived at 8:30 a.m., he immediately performed tissue measurement studies, ordered an ultrasound of the left arm and had the patient transported to the operating room by 10:10 a.m. for emergency surgery. During the emergency surgery, it was determined that this patient had compartment bleed with nerve compression, increased fluid throughout the forearm, dead tissue so extensive that she required three operative procedures on her arm and she ultimately had to be transferred to another hospital for hyperbaric care with prognosis for her left arm as “poor”.
A review of the medical records in this case determined that there was negligence in both the administration of the IV medication in the hand, particularly after the patient complained of excruciating pain upon entry, and then by the failure to recognize, in a timely way, that problems were developing with compartment syndrome for nearly 12 hours after the initial complaints were made. As a result of this neglect, this lady had to suffer excruciating pain, literally watching her own arm be carved down to tendons and bone, and then had to endure the ultimate pain of having that arm surgically removed above the elbow as a result of significant muscle and tissue death rising all the way up to a point almost midway between her elbow and shoulder.
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