Case Archive
Physical Medicine, Rehabilitation
Ref. # 96848

A Pennsylvania man suffered a work-related back injury, noted in his medical records as a disc herniation at the L4-L5 level. At a physical therapy session, a substitute therapist instructed him to perform a reverse-sit up after using velcro straps to keep his legs on the table. During this exercise the usual therapist had always leaned on the patient's legs and had never employed the straps. The man fell and twisted his neck. Anti-inflammatories prescribed for the resulting neck pain were ineffective. One month later an MRI, CT scan and myelogram confirmed a disc herniation at the C6-C7 level. Another month later a cervical discectomy was performed. A medQuest physical medicine specialist reported it was below standard of care to perform such a "risk exercise" which is not usually prescribed for patients with back or neck injuries, and always requires proper supervision.

Physical Medicine, Rehabilitation
Ref. # 72338

A 65 year old Michigan man was involved in a motor vehicle accident, suffering a right patella fracture and right tibial plateau fracture. Three days later the patient was started on 5000 units of Heparin twice daily. Two days later a duplex sonogram revealed a non-occlusive thrombosis in the left lower extremity. The patient was transferred to a rehabilitation center, where he received 7500 units of Heparin twice daily. He was discharged 17 days later. That afternoon he suffered a pulmonary embolism secondary to deep vein thrombosis and died. A medQuest rehabilitation specialist reported the patient was negligently discharged without anticoagulant therapy--in this case, Coumadin. There was no discharge summary as to why this occurred. The patient's death was preventable.

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