Case Archive
 
Geriatrics
Ref. # 85928

A wheelchair bound 62 year old Louisiana woman with MS was at a nursing home for two and a half years, when she complained of nausea, vomiting and temperature. The managing physician was on vacation. The covering physician, who had been recently hired out of a training program, declined to examine the patient and, over the phone, prescribed treatment with IM Compazine, enemas and Reglan. The patient's illness continued for two days. The nursing staff called the managing physician repeatedly, with the resulting treatment of SSE and mineral oil enemas. The next day the patient was confused and hypotensive. She was sent to the ER, where she was diagnosed with small bowel obstruction. A surgical consult took place eight hours later. The patient was transferred to the ICU, where she was unresponsive with no bowel sounds. She expired due to fibrous adhesions to the distal ileum and ischemic bowel with early infarction. A medQuest geriatrics specialist reported that the managing physician, covering physician, and nursing staff were all negligent in failing to appropriately examine and treat the patient. Additionally, there was a negligent delay in care at the hospital. The patient's death was preventable.

Geriatrics
Ref. # 22028

A 75 year old Missouri woman with probable heat stroke was sent from her nursing home to the ER. The patient was unresponsive and her skin was mottled. She was intubated, iced with saline lavage, and placed on inotropic support for metabolic acidosis, shock and coagulopathy. The patient made DNR and expired the next day. A medQuest geriatrics specialist opined that more likely than not the patient died from a heat stroke. The air conditioners in the nursing home had not been functioning due to a power outage, therefore the nursing home violated HICVA regulations by failing to provide a safe environment.




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