Personal Stories: A Loving Husband


Hi Brian,
Thank you for putting together such a terrific site on this subject matter -I am sure it will prove to be very beneficial to people dealing with this medical problem.  I came across your site while doing additional research on a medical malpractice case that is consuming me.  As you can see, it is nearly 1:30 am on Saturday morning and I am reading your articles and posting an email to thank you for taking on such a project.
I represent the widow and three surviving children in a failure to diagnose a dissecting (ascending) aortic aneurysm in a 40 year old man.  About an hour after eating lunch at a Burger King, he became ill at work and collapsed. He had severe abdominal pain. He was picked up by ambulance at work but some how the ambulance pre-hospital care report was not made part of his hospital chart as it ordinary practice. big surprise !!!  -So it is made our job very difficult to explain the symptoms prior to arriving at the hospital.)
He gets to ED at 14:40- the chart  hx reflects- sudden onset of mid abdominal pain with R leg numbness, diaphoresis, pallor, he began to vomit and actually vomited twice.
Upon arrival his b/p was 94/palp which is somewhat low-- he was shaking and shivering and complained of feeling cold--at that point the pain was intermittent  he was taken to x-ray-- the chest x-ray was interpreted as being normal by 17:25 his b/p is 143/66  at 18:05 the chart reflects that he is complaining of L shoulder pain and nausea he was given 25 mg Demerol for pain control despite the Demerol administration-- it is noted at 19:05 that he continued to have back pain.
By way of background- the history at the ED notes a history of SLE (lupus) and phlebitis in L leg-- he was going to be discharged but when he vomited the second time they decided to admit him. the ED diagnosis was acute gastritis
The Ed physician calls a family practice doc. to admit him-- She takes a history as 40 year old male felt absolutely fine this am ate at burger king for lunch 1 hr late acute onset, throbbing in neck, lightheadedness,abd. cramps, nausea no diarrhea
afet IV not feeling much better, still nauseated now with L flank pain  also tunnel vision usually predictive of migraine---she knows discoid lupus in remission--back and spine very tender her diagnosis is acute gastritis , possible food poisoning he was admitted at 20:19 OR SO  HIS B/P WAS UP TO 180/90.
He was given demerol a couple of times before midnight due to complaints of pain
his vitals are not taken between midnight and 7:42 am
at 9 am his b/p is 152/54 he is again given demerol at 10 am for complaints of back pain
--which he reports as decreased but present
the family practice doc- sees him at 11am notes some low back pain  but was not aware he was given demerol an hour before for acute pain and discharged him home
later that day he dies at home of cardiac tamponade due to the dissection
the autopsy revealed an 1 cm intimal tear horizontally about 1.5 cm above the aortic ring-- the dissection ran from the ascending aorta up the the right carotid artery and it also continued around the arch down through the descending portion of the aorta and also extended up the celiac trunk.
I have looked at this from every aspect --I do have experts lined up to testify.  All I keep hearing from the defense is this is a tough diagnosis and a defensible case--
my god --all they had to do is think of the diagnosis--which obviously they never entertained --and put him on a CT Scan with contrast-- and It is very likely he'd be here today (like you)  and you never be getting this e-mail
I don't know why I am obsessing like this but I can't get him out of mind and his wife and children that grew up without father-- I want to do right by them
thanks for reading this rant--keep up the good work--
if you have any comments or thoughts (other than I need a psych visit) --i'd love an e-mail--


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