On September 21, 2018, Painter Law Firm filed a medical malpractice wrongful death lawsuit on behalf of our client against three doctors with staff privileges at Cypress Fairbanks Medical Center. The hospital is located at 10655 Steeple Top Drive, Houston, Texas 77065.
The patient involved was a 60-year-old woman who had recently been diagnosed with end-stage renal disease and started on dialysis. Her dialysis physician recommended a simple elective surgical procedure to place a left-cited AV fistula, which would make her dialysis treatments easier.
In December 2016, she was admitted to Cypress Fairbanks Medical Center for the surgery, which was done under general anesthesia.
After the procedure, this lady was slow to recover from general anesthesia and was noted to have an alarming oxygen saturation that went all the way to 68%.
Anyone who has been a patient in a hospital has probably had an oxygen saturation device, called a pulse oximeter, placed on their index finger. In fact, oxygen saturation testing is often done in many physician offices.
Oxygen saturation measures the amount of oxygen in the blood stream. Normal pulse oximeter readings range from 95-100%. An abnormally low oxygen saturation is referred to as hypoxemia. According hypoxemic patients require supplemental oxygen until normal breathing and respiration are restored. Hypoxemic patients often have altered mental status and are not able to function normally because of their low blood oxygen levels.
As a result of her hypoxemia, this patient was transferred to Cypress Fairbanks Medical Center’s intensive care unit (ICU).
Patients are sent to the ICU to have an increased level of care by specially-trained registered nurses and physicians in the critical care specialty, called intensivists. This patient’s ICU care at Cypress Fairbanks Medical Center was managed by two intensivists.
As part of our thorough investigation of this case, Painter Law Firm hired a medical expert in the field of critical care medicine to review the medical records.
The expert provided his opinion that the intensivist physicians ignored this patient’s hypoxemia (low oxygen saturation levels) and breathing problems. According to the medical records, the intensivists waited until nearly 50 hours after the patient was admitted to the ICU before an arterial blood gas test was ordered.
An arterial blood gas test is bloodwork that measures the pH (acidity) of blood drawn from an artery, as well as levels of oxygen and carbon dioxide. This simple, fast test provides information about how the patient’s lungs are functioning and whether they are exchanging gases normally, including moving oxygen and removing carbon dioxide from the bloodstream.
Our critical care expert’s opinion is that when the intensivist doctors finally obtained arterial blood gas results, they showed that the patient was in respiratory distress. The expert’s opinion is that the standard of care required the intensivist doctors fto insert a breathing tube, called intubation, to help the patient breathe and get the oxygen that she desperately needed. Unfortunately, they chose not to do so.
Instead, the intensivists went down another path toward an invasive procedure called a thoracentesis. Our expert shared his opinion that thoracentesis was not indicated and the order showed that the intensivists were not properly evaluating this lady’s serious breathing problems.
On January 4, 2017, the intensivists ordered thoracentesis, which was done the next day by an interventional radiologist.
Our critical care medical expert has performed thousands of thoracentesis procedures in his career. To perform a thoracentesis, the physician uses ultrasound guidance to visualize the chest wall, lung, and any fluid in between the two. Next, a large-bore needle is inserted through the patient’s chest wall into the space between the chest wall and the lung. The needle is connected to a catheter, so the doctor can remove any fluid found in the pleural space. An excess amount of fluid in that area is called pleural effusion.
The standard of care requires a physician performing thoracentesis to avoid placing the needle into the wrong place, like the lung tissue itself, rather than into the fluid.
In our expert’s opinion, the interventional radiologist punctured the patient’s right lung base during the thoracentesis procedure. Given that the interventional radiologist did this procedure under real-time ultrasound guidance, our expert believes that he visualized the needle puncturing lung tissue.
After the procedure, the interventional radiologist observed the patient coughing up blood. Our expert explained that the only way that could happen is if the thoracentesis needle lacerated the lung and a pulmonary blood vessel. Yet, the interventional radiologist didn't notify any physician to make sure that the patient was watched closely upon return to the ICU.
Eventually, the doctors and nurses discovered that she was bleeding from that lung, which was confirmed by a CT scan.
In the opinion of our medical expert, the interventional radiologist got disoriented during the thoracentesis procedure and inserted the needle into the patient’s lungs, lacerating it and a pulmonary blood vessel. This led to a massive bleed into her chest cavity, called hemothorax.
Our medical expert explained that bleeding into the chest cavity made a bad situation even worse. In his opinion, the inattentiveness of intensivist doctors to the patient’s respiratory insufficiency left her in a compromised position even before she had the unnecessary thoracentesis procedure.
The medical expert believes that the botched thoracentesis caused blood to fill up space in the patient’s chest cavity, making it harder for the already-compromised lungs to breathe.
Even after the hemothorax and bleeding were discovered, the ICU doctors chose not to intubate this woman. Once again, they completed their decision-making without ordering a simple arterial blood gas test. Our expert believes that an arterial blood gas test would have provided valuable information that would have led to immediate intubation.
By the next morning, this woman who had walked into the hospital a few days earlier went into full-blown respiratory arrest. This triggered a cascade of heart problems that led to her death. Our expert believes that but for the mistakes of these three doctors, this lady would have walked out of the hospital and would still be alive and with her family today.
We are here to help
If you or a loved one has been seriously injured or even died because of poor medical, surgical, or hospital care, then the experienced medical malpractice attorneys at Painter Law Firm, in Houston, Texas, are here to help. Click here to send us a confidential email via our “Contact Us” form or call us at 281-580-8800.
All consultations are free and, because we only represent clients on a contingency fee, you will owe us nothing unless we win your case. We handle cases in the Houston area and all over Texas. We are currently working on medical malpractice lawsuits in Houston, The Woodlands, Sugar Land, Conroe, Dallas, Austin, San Antonio, Corpus Christi, and Waco.
Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2017, by H Texas as one of Houston’s top lawyers. In May 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.