Wrongful Death

Near $1 Million Award in Unauthorized Palliative Care Death

September 6, 2013 | Lebowitz & Mzhen

A Harford County jury recently awarded nearly $1 million to the estate and surviving family members of a woman who allegedly received excessive pain medication following a leg ulcer surgery.

According to reports regarding the case, the plaintiffs alleged that the doctors at the Harford County Hospital administered morphine, oxycodone, and other narcotics to the woman under the mistaken belief that they had received permission to provide palliative care to the woman, rather than attempting to strive for the woman’s full recovery. The hospital reportedly denies the allegations of negligence, and plans to appeal the judgment.

While only very limited factual information was reported regarding this case, it seems that the family is alleging that the hospital administered a form of unauthorized palliative care, which resulted in the death of the patient. Palliative care is distinct from assisted suicide, and as such is protected by U.S. Supreme Court case law. Essentially, it occurs when caregivers can no longer perform additional or helpful medical procedures to improve the patient’s prognosis, so they instead focus on alleviating the pain as best as they can. Oftentimes, these high levels of pain medications can lead to death.

Medical Malpractice Lawsuit Alleges that VA Doctors Overprescribed Antipsychotic Medications, Causing Woman’s Suicide: Grese v. United States of America

November 30, 2012 | Lebowitz & Mzhen

A woman’s lawsuit against the federal government alleges that incorrect diagnoses and incorrect dosages certain medications caused her sister’s suicide in 2010. The plaintiff in Grese v. United States is demanding $5 million in damages, claiming that doctors and other medical professionals with the U.S. Department of Veterans Affairs (VA) breached various professional standards of care by continuing to prescribe medications known to have harmful side effects after the decedent had already attempted suicide, and then by dispensing an excessive amount of a particular antipsychotic drug.

The decedent, Kelli Grese, committed suicide on November 12, 2010 by swallowing a large amount of the antipsychotic medication Seroquel. A few weeks before her death, according to the plaintiff’s complaint, doctors had increased her supply of the medication from thirty days to sixty days, and she almost immediately obtained a sixty-day supply. This gave her enough Seroquel to last 120 days under the earlier prescription, and it allegedly enabled her to commit suicide.

According to the Hampton Roads Daily Press, Grese was discharged from the U.S. Navy in 1997, and she began receiving treatment at the Hampton VA Medical Center during the 1990’s, with treatment for mental health issues beginning in 2008. She had diagnoses for post-traumatic stress disorder, depression, substance abuse, and attention-deficit disorder (ADD). The VA hospital treated her with counseling and medication. She received a diagnosis of severe depression in March 2009 after admission to a psychiatric hospital, with a designation as a suicide risk. She reportedly also suffered from paranoid delusions, recurrent psychosis, and major depressive disorder. After her discharge from the psychiatric hospital, the complaint alleges, the VA continued her existing treatment plan despite “obvious and clear deterioration in her psychological functioning.” Complaint at 4.

Insurance Company Denies Accidental Death Benefits, Arguing that Man’s Death from Medication Error Was Not an “Accident”: Estate of Paul v. New York Life Insurance Company

September 27, 2012 | Lebowitz & Mzhen

After a nurse’s medication error allegedly caused a man’s death, his executor claimed compensation under the Accidental Death Benefit (ADB) clause of his life insurance policy. The insurance company refused, arguing that the man’s death was not “accidental,” as defined by the policy. The executor sued, claiming in Estate of Paul v. New York Life Insurance Company that the insurer breached its contract with the estate. The trial court granted summary judgment for the defendant, and the New Jersey Appellate Division affirmed its ruling. The case offers a useful glimpse at how insurance companies view injuries caused by medication errors.

Richard Paul, the decedent, resided in a nursing home when he died. He was receiving treatment for multiple chronic illnesses, including chronic obstructive lung disease and chronic heart failure. A nurse at the nursing home accidentally administered another patient’s medication to him on December 27, 2007. The nursing home transferred him to an intensive care unit at a local hospital upon discovering the error, but his condition worsened. He died in the hospital on January 5, 2008.

Jeffrey Paul, Richard Paul’s son and the executor of his estate, retained a board-certified internal medicine specialist, Donald J. Corey, M.D., to review reports relating to Richard Paul. Although the death certificate identified lymphoma as the cause of death, Dr. Corey prepared two reports that challenged this conclusion. The first report said that the medication error had “a direct causative role” in Richard Paul’s death. The second report, completed a few months later, attributed his death to the nurse’s error and noted that Dr. Corey found no evidence of lymphoma recurrence.

Family of Woman Who Died After Receiving the Wrong Medication Sues the Pharmacy

March 22, 2012 | Lebowitz & Mzhen

The family of a Kentucky woman who died after allegedly receiving the wrong prescription medication has sued the pharmacy that dispensed the medication. The two medications have similar-sounding names but very different purposes. The family’s lawsuit alleges negligence and violations of state law that caused or contributed to the woman’s death.

Mary Moore, an elderly Louisville resident, had just been discharged from the hospital on November 10, 2010, where she had undergone treatment for congestive heart failure, kidney failure, and high blood pressure. She went to a Walgreens pharmacy to fill a prescription from her doctor for Hydralazine, a drug used to treat high blood pressure. The pharmacy instead gave her Hydroxyzine, an antihistamine considered unsafe for people over the age of 65.

Because of the alleged error, Moore’s high blood pressure was completely untreated for two weeks. The pharmacy discovered the error and gave her the correct medication, but by then the damage was done. Moore reportedly could not tolerate the prescribed dose of the blood pressure medication. According to the lawsuit, the medication could not control her blood pressure, and the stress on the heart caused “decompensation” of her congestive heart failure. This was followed by “decompensation of her chronic kidney disease.” Within a few days of starting the Hydralazine, Moore was hospitalized again. She died on December 6, 2010.

The lawsuit names as defendants both Walgreens and the pharmacist in charge at the time the medication was dispensed to Moore. Moore’s family primarily alleges that Walgreens and the pharmacist were negligent in dispensing the wrong medication. They further allege that, by not offering Moore counseling from a pharmacists when she picked up the medication, Walgreens violated state law. The law, according to their complaint, requires a pharmacist to offer a consultation with a patient picking up a medication for the first time. Had the pharmacist offered a consultation with Moore, the plaintiffs argue, one of them would likely have noticed the error with the medication
Hydralazine is a muscle relaxant used to treat high blood pressure and other conditions. It works by relaxing the blood vessels that allow blood free flow through the body. Hydroxyzine, on the other hand, is an antihistamine used to treat allergy symptoms of allergies such as itching, and to treat nausea-related symptoms resulting from conditions like motion sickness. The National Institutes of Health specifically recommend against the use of Hydroxyzine by people over the age of 65, noting that other medications offer similar benefits at a lower risk. In this case, though, the issue was not the treatment of allergies at all.

Hospital Patient Mistakenly Given Drug Used in Executions

December 7, 2011 | Lebowitz & Mzhen

The family of a south Florida man has filed a lawsuit against North Shore Medical Center in Miami. The man, 79 year-old Richard Smith, died in July 2010 when he went to the hospital complaining of shortness of breath and received the wrong medication. The nurse who administered the allegedly fatal dosage received disciplinary sanctions and paid a fine, which the family does not find satisfactory.

Smith told doctors he had shortness of breath and an upset stomach. His treating physician ordered Pepcid, an antacid available over the counter. The ICU nurse instead took a vial of Pancuronium from a locked cart and put it in Smith’s IV. Pancuronium is a muscle relaxant used by the ICU when intubating a patient. In larger doses, it is used by the Florida prison system in executions as part of a three-drug cocktail. The drug does not affect consciousness, but does significantly impair motor functions. At high enough doses, a person would not be able to breathe.

According to hospital records, no one noticed Smith’s condition for thirty minutes. When hospital staff finally recognized the problem, Smith’s heart had stopped. Resuscitation efforts did not succeed in reviving him. An investigation by the state found that the nurse on duty not only failed to read the label on the medication, but failed to scan both the drug label and Smith’s patient ID bracelet. These would have alerted the nurse to the problem. Another report indicated that the nurse did not follow safeguards established for the drug cart containing the Pancuronium. The state cited the hospital for this failure. The hospital has reportedly removed Pancuronium from most nursing areas in the hospital and created a new packaging system with clearer warnings.

According to local news covering the story, the nurse still works at North Shore. He reportedly received a reprimand, paid a $2,800 fine to the state, and attended remediation courses. The hospital described this as appropriate counseling and re-training. Smith’s family disagrees, saying through their attorney that the nurse should not still be permitted to work with patients. This Pharmacy Error Injury Lawyer Blog has previously reported on cases where medication errors causing death have led to criminal convictions for involuntary manslaughter. In this instance, the consequences apparently end at professional discipline.

Infant Dies of Accidental Antibiotic Overdose in Hospital

November 9, 2011 | Lebowitz & Mzhen

A six-month-old child died in a Brooklyn hospital on October 25, 2011 after receiving an incorrect dosage of intravenous antibiotics. An investigation determined the overdose to be an accident, but the child’s family is reportedly weighing their legal options regarding claims against the hospital. Amaan Ahmmad’s family brought him to the hospital for a fever of around 100 degrees. Hospital records suggest the child was otherwise “alert and responsive.” After an examination, the child reportedly received a diagnosis of clinical pneumonia. No beds were available at the time, so hospital staff hooked Amaan up, while in his stroller, to an IV for the antibiotic Zithromax, known generically as azithromycin. An appropriate dose for an infant is around 80 milligrams, but the nurse setting up the IV reportedly gave him 500 milligrams. This is an appropriate dosage for an adult, not a 17-pound infant.

After receiving the antibiotic, the child immediately fell into a coma. Hospital records indicate that hospital staff did not notice anything wrong for about thirty-six minutes. The child’s mother told the media that she tried to tell hospital staff something was wrong, but they assured her the child was just sleeping. Once they realized the mistake, hospital staff put the child on life support, but it was apparently too late. After less than 24 hours, the child was removed from life support and pronounced dead.

One day after Amaan’s death, the New York City Medical Examiner ruled his death an accident, identifying complications following an adult dose of azithromycin as the cause of death. According to family members of the child, the hospital fired the nurse who administered the lethal dosage of antibiotics. The hospital reportedly expressed condolences to Amaan’s family but declined to comment to the media. The family told reporters that they are considering their legal options. They laid Amaan to rest on October 27.

This Pharmacy Error Injury Lawyer Blog has previously reported on efforts in some Maryland hospitals to catalogue pharmacy errors in the hopes of preventing future catastrophic mistakes. At this time, not enough information is available to determine how the medication error in Brooklyn occurred. The child clearly received an extremely excessive dose of the antibiotic. The error could have occurred in the pharmacy, at the point of administration of the drug, or at any point in between. A combination of errors could have contributed to the tragic outcome, or the negligence of a single hospital worker could prove to be the cause.

Report Finds Medication Errors in Chronic Drug Therapy After Seniors Leave Hospitals

August 29, 2011 | Lebowitz & Mzhen

According to a recent study discussed in the Journal of the American Medical Association (JAMA), that our Baltimore medication error lawyers have been following, hospitalized patients are more likely to have medication errors than non-hospitalized patients—when drugs used to treat chronic conditions are unintentionally discontinued in hospitals, especially if the patients are in a hospital’s intensive care unit.

The study reportedly showed that transitions in healthcare can increase a patient’s chances for medical errors that stem from inaccurate or incomplete communication between the hospital staff, the primary care physician, and the patient—causing an interruption or discontinuation of medications that aim to help treat patients’ chronic diseases on a long term basis.

According to the authors, the problem of medication errors and the unintentional discontinuation of drugs can happen during hospital stays, transfers and discharge. Treatment in intensive care units can also increase the risk of medication errors of omission as the healthcare providers are focused on emergency care and may engage in the practice of discontinuing a medication used for chronic illnesses during a time of critical illness.

The medication error study followed nearly 400,000 patients who were older than 65, and who had over one year of experience continuously taking one of the following five drug classes: respiratory inhalers, gastric acid suppressors, statins, anticoagulant or antiplatelet agents, and levothyroxine, used to treat the thyroid gland.

WHO Claims Hospitals Are More Dangerous Than Airline Travel

August 18, 2011 | Lebowitz & Mzhen

According to a recent report in Medical News Today that our Baltimore medical error injury attorneys have been following, Professor Sir Liam Donaldson has been appointed as the new Envoy for Patient Safety for the World Health Organization (WHO). Donaldson recently stated, in an effort to highlight the fact that healthcare safety around the world needs to be improved, that going to the hospital is far more dangerous than flying on an airplane, as the WHO reports that millions of people die annually from medical errors associated with healthcare—far more, according to Donaldson, than accidents on planes.

In his striking comparison, Donaldson claimed that if a patient entered the hospital he would have a 1 in 10 chance of experiencing a medical error, with the chances of wrongful death due to medical error being 1 in 300. Donaldson then stated that in comparison, the risk of dying in a plane crash is far less—approximately 1 in 10 million.

Donaldson reportedly stated that in an effort to reduce the growing number of hospital related infections resulting in patient injury or harm that happen every year, patients need to ask questions and make sure that hospitals maintain the basic hygiene standards and conform to the WHO’s healthcare checklist to prevent medical error or patient illness or injury during surgical procedures.

According to the WHO statistics, 7 in 100 patients in the hospitals throughout developed countries experience infections linked to healthcare, whereas in developing countries this number increases to 10 patients in every 100. The risk of infection is directly tied to the length of time a patient stays in the hospital’s intensive care unit. The WHO figures show that risk of infection is lower in the United States than in Europe, but the death from hospital-acquired infection is higher. In the United States, 1.7 million hospital acquired infections reportedly happen every year, resulting in 100,000 deaths, and in Europe, 4.5 million hospital acquired infections happen every year, resulting in around 37,000 deaths.

The Benefits and Problems of Electronic Medical Records Systems

August 10, 2011 | Lebowitz & Mzhen

In a recent Baltimore County pharmacy misfill injury blog, our attorneys discussed a tragic medical error that caused the death of an premature infant, after a pharmacy technician accidentally entered the wrong information into the computer, causing the intravenous solution prepared buy an automated machine to contain a lethal dose of sodium chloride. This pharmacy error has reportedly brought the issue of electronic medical health records safety concerns back into the forefront of patient safety.

As our attorneys have reported in a related Hartford County medication error injury blog, the medical industry is shifting toward electronic medical records and computerized systems that make medical processes and prescription orders automatic, in an effort to reduce pharmacy error injury or wrongful death.

The Chicago Tribune reports that the federal government is also currently helping the digital shift by giving $23 billion in incentives to healthcare providers who purchase the electronic systems, with the hopes that these medical technologies will help increase access to patients’ medical information, help healthcare providers communicate better with each other, help doctors to see test results more quickly, and implement electronic safeguards to remind doctors about recommended medical practices, or to alert them about harmful drug interactions before prescribing.

With all of the benefits that come with electronic medical records and computerized systems, potential problems are also taking place, like crashing of hospital computers, or software bugs that interfere with important data, or even delete information from computerized records. Computerized systems also reportedly can produce data about patients that is disorganized or difficult to read, especially when a doctor is quickly looking for critical patient information.

Safety of Electronic Medical Records Questioned After Pharmacy Error Leads to Death of Infant

August 3, 2011 | Lebowitz & Mzhen

A recent Chicago Tribune article, that our Baltimore pharmacy misfill injury attorneys have been following, looks closely at electronic medical record safety, after a tragic medication error occurred, stemming from a computer mistake made at the Chicago-area Advocate Lutheran General Hospital, that caused the death of a newborn infant.

According to the article, Genesis Burkett, an infant born 16-weeks premature, was given a fatal overdose of sodium chloride last year, receiving over 60 times the dosage ordered by the physician. The hospital pharmacy error was reportedly made after a technician from the hospital pharmacy misread and inaccurately typed the doctor’s handwritten prescription orders into a hospital computer—a common source of pharmacy misfills and errors, as attorneys have discussed recently in a Baltimore pharmacy error injury blog.

The data entry mistake then caused a pharmacy misfill, as the automated machine prepared an intravenous solution containing a lethal overdose of sodium chloride that caused the infant’s heart to stop. Advocate Health Care’s chief medical officer, Dr. Lee Sacks stated that the pharmacy error could have been prevented by the automated alerts on the IV compounding machine, but at the time that the customized bag was prepared for the infant, the alerts were not activated and connected to the main pharmacy information systems at the hospital. The family’s attorney reportedly blamed the pharmacy error and wrongful death on a mislabeled IV bag.

After the medication error led to the infant’s tragic death, Advocate has since added electronic alerts to the IV compounders and initiated other medication safety measures to prevent this kind of pharmacy error from happening in the future.