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William S. Jacobson represented a woman in her early 30’s who died from a pulmonary embolism (blood clot) four days after giving birth to her third child. The lawsuit alleged that the home health care nurse employed by the hospital was negligent in her care and treatment of our client following her Cesarean section, resulting in the patient’s death.
Women in the postpartum state are prone to developing blood clots. The risk of developing clots is higher after a Cesarean section, as the patient will often be inactive following this major surgery.
The most common area for clots to develop is in the deep veins of the legs. The clots are harmless if they remain in the leg, but if a clot breaks free, it can lodge in the pulmonary arteries leading from the heart to the lungs. When this happens, the right side of the heart beats harder and faster in an effort to dislodge the clot. This will commonly cause the patient to go into right-sided heart failure and die.
When blood clots occur in the leg, the signs can be subtle. These signs, however, which include mild pain and tenderness, are well known to obstetrical personnel, including physicians and nurses, who must be wary of these sorts of complaints due to their potentially deadly consequences.
Two days after our client was discharged home from the hospital with her new baby, she was visited by a home health care nurse employed by the hospital. This nurse had been an obstetrical nurse for 20 years and had often worked with postpartum patients. Our client told the nurse she was experiencing some pain and tenderness in her right leg. The nurse was not impressed with these complaints, and simply advised the patient to call her doctor. She did not advise the patient of the potential consequences, or that she needed to call her doctor that day, right away.
The next morning the patient awoke and collapsed soon thereafter. She was taken to the hospital where diagnostic tests disclosed a large pulmonary embolism. The patient was already in shock, however, and died soon thereafter.
The plaintiffs’ experts included a board certified pulmonologist and obstetrician along with a PhD professor of nursing. It was their opinion that the patient should have been advised to call her doctor immediately, or that the nurse should have called the doctor herself from the patient’s home. Had this been done, the patient would have survived this event, in good health.
The hospital argued that because of the lack of an autopsy, it was unclear as to the source of the fatal blood clot. If the clot had come from the pelvis, which can occur in patients who have recently had a Cesarean section, a standard diagnostic test would not have detected it. The hospital also argued that the patient was advised to call her physician that day despite the fact that this was not noted in her chart.
The case settled shortly before trial for $2,000,000