[NP-Clinical] Cardiac Questions

[Priscilla Merrill]

Wow, how sad.  I’m so sorry.  That PCP sounds like a bonehead.  Assuming
it’s not NP, wink-wink.  I’m no cardiac whiz HOWEVER .. . This all sounds
very suspicious.  While not litigious myself, I would strongly encourage
wife to contact a lawyer who will get to bottom of it.  I don’t see how this
can be a normal complication of a routine procedure.  Was this in the
consent, that it could involve gallbladder and colectomy or did they just
agree to a polypectormy.  There is usually a clause of course for them to do
what is necessary. LVH would not cause death.  It’s a common finding usually
per EKG.  I wonder if they could get second opinion from another coroner?  I
smell something rotten in Denmark (wonder how that phrase got its origin). 

 

Priscilla Merrill FNP

 

   _____  

From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]
On Behalf Of Christine Smith
Sent: Wednesday, February 14, 2007 6:37 PM
To: np-clinical at nurse.net; ACC-Circle at listserve.com
Subject: [NP-Clinical] Cardiac Questions

 

Need some cardiac thoughts please....

 

70 yo friend went in for some colon polyp removals. Was told it was
elective, did not have to occur but advised. Ended up coming out with
incision from xyphoid to low abd with gall bladder taken out and partial
colectomy. "just took the gall bladder out to prevent future problems".
Uneventful hospital course except significant pain that he did not express
real well to staff and MD. Dc'd home nauseated but taking PO. Came back 3
hours later dead.

 

PMH - COPD, Old Prostate CA now in remission. Had a Stress test and Echo in
September which was good "benign ventricular ectopy" and Ejection Fraction
of 53%. CXR and a CT scan of the chest done in Sept ((chest pain, R/O PE
episode) was negative. Never any documentation of LVH on 12 leads, CXR or
anywhere else. Not on any meds, no hx of HTN. Got regular health care. COPD
was so controlled not even on meds. Still smoked less than 1 PPD. Patient
was very active, retired and fit.

 

Reviewed the autopsy report yesterday with family - coroner states he died
of LVH. All the other findings were benign - lungs showed some adhesions, as
did abdomen, and some sclerosis to the kidneys. No infarction.

 

So, can LVH never be diagnosed previously? Is that the sole reason for his
death? Family very upset - PCP refuses to talk to them or explain anything.
He did not even offer condolescences.

 

Patient came home from the hospital, told his wife "I am not going to make
it". She thought it was his pain that made him like that. She reassured him.
Three hours later he collapsed in his chair and said call 911 and the kids.
10 minutes later, still waiting for 911, his wife told him the kids were
there. He immediately went unconscious. Enroute and initially at the ER he
was in a rapid Afib and unconscious. Shortly after arrival, despite repeated
cardioversion enroute and in ER, he went into asystole and died. 

 

He only was on Vicodin when he left the hospital. Prior to that he was on IV
abx.

 

Thoughts? Family is still in shock and close friends of mine.

 

Christine Smith, NP

 

 


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