Multiple Medical Errors Lead To Death of 66 Year Old – Confidential Settlement

The Medical Malpractice and Wrongful Death Case Facts:

Mrs. Bee was 66 years old and had many chronic medical problems, including end-stage kidney disease, congestive heart failure, and obstructive sleep apnea.

In the summer of 2016, Mrs. Bee developed a rash on her neck. She went to an express care facility and was seen by a Certified Nurse Practitioner (CNP). The CNP diagnosed Mrs. Bee with shingles and prescribed the medication Valtrex (valacyclovir). Unfortunately, the CNP failed to adjust the dosage to take into consideration the fact that Mrs. Bee had kidney disease. The proper dosage should have been 500mg once daily; instead, the CNP prescribed 1,000mg three times per day.

A few days after starting the medication, Mrs. Bee began to experience shaking and jerky movements in her arms and legs. These are classic signs of a Valtrex overdose. Mrs. Bee called her physician’s office to report the symptoms. The physician’s assistant reviewed her electronic medical record and advised her to go to the hospital.

Mrs. Bee did as she was told and went to the emergency department. She was diagnosed with a Valtrex overdose and admitted to the hospital. After several dialysis sessions over the next three days, the Valtrex was flushed from her system, and the shaking and jerking movements went away. At the same time, however, Mrs. Bee’s vital signs became unstable, and it became very difficult for her to breathe. For that reason, she had to be intubated and placed on a mechanical ventilation, so that – essentially – a machine could breathe for her. She was transferred to the ICU, where she then developed pneumonia, which is common among patients on a ventilator.

Mrs. Bee eventually was extubated (because she no longer needed the machine to help her breathe) and transferred to the physical medicine and rehabilitation service of the hospital, but she did not do well there. She became weak and hypotensive (low blood pressure) during dialysis and had to be transferred back to the ICU, where her respiratory status declined, and she again required intubation with mechanical ventilation.

As a result of her compromised condition, other things began to go wrong. Mrs. Bee developed a blood clot in her leg and had to have surgery to place an IVC filter to stop the clot from traveling to her lungs, where it could kill her. She needed a tracheostomy (a surgical procedure to create an opening in the neck to the windpipe, so that the ventilator could be attached longer-term) and a feeding tube.

Mrs. Bee was then transferred to a long-term care facility, where she received multi-disciplinary rehabilitative care. Despite repeated attempts, she was not successfully weaned from mechanical ventilation.

Unfortunately, about a month later Mrs. Bee was found unresponsive. She was rushed to the hospital, where she died shortly thereafter.

Building Our Medical Malpractice Case

It was apparent from the records that this case involved extremely complex medical issues and would require a significant investment of time and resources.

The Eisen Law Firm initially consulted with a physician who is board-certified in Internal Medicine to discuss whether the CNP’s prescription of Valtrex met the standard of care, and whether it was a proximate cause of Mrs. Bee’s injuries and death. The physician was critical of the CNP’s prescription and believed that it did cause Mrs. Bee’s death. He agreed to provide an affidavit of merit for The Eisen Law Firm to meet the requirements of Civil Rule 10(D)(2) to file the lawsuit.

We also consulted with a physician who is board-certified in Critical Care Medicine and Pulmonology to discuss whether the care and treatment provided to Mrs. Bee after she was admitted to the hospital met the standard of care. This physician believed that the hospital care was acceptable, and he agreed to provide rebuttal testimony, in case the CNP tried to blame the doctors who cared for Mrs. Bee at the hospital after the Valtrex overdose.

The Eisen Law Firm then obtained and reviewed thousands of pages of Mrs. Bee’s past medical records and more than a dozen primary journal articles on the medical issues implicated in the case, including Valtrex overdose, neurotoxicity, end-stage renal disease, respiratory failure, congestive heart failure, pulmonary hypertension, liver injury, and more.

After completing the pre-suit investigation, The Eisen Law Firm approached the nurse practitioner’s employer (a local medical center) to explore a possible negotiated resolution. The Eisen Law Firm has developed a good professional relationship with the medical center’s attorneys and has had success with this strategy in the past.

In this particular case, however, the attorneys for the medical center took the position that while the nurse practitioner may have given too much Valtrex, the overdose only caused only a temporary injury. They felt that they were at most responsible for a few days’ worth of “pain and suffering,” but were not accountable for Mrs. Bee’s extensive hospitalization or her death.

Moving Our Medial Error Case Forward to Trial

Shortly thereafter, we filed suit in the Cuyahoga County Court of Common Pleas against the CNP and her employer. The Defendants denied all the key allegations in the Complaint.

Written discovery included the exchange of thousands of pages of medical records from various healthcare providers, as well as multiple sets of interrogatories, requests for production of documents, and requests for admission. Defendants eventually were forced to admit the Valtrex prescription was negligent but continued to deny that it caused serious injuries or Mrs. Bee’s death. Depositions then were completed of all the parties and key witnesses, and expert reports were exchanged.

The Eisen Law Firm focused on proving that the Valtrex overdose was the inciting factor that set into motion the cascade of events that ultimately led to Mrs. Bee’s death. On the other hand, Defendants maintained throughout the litigation that the injury from the overdose was limited to the shaking and jerking movements and had nothing to do with Mrs. Bee’s death. Specifically, Defendants argued that after a few dialysis sessions, the Valtrex was completely flushed from Mrs. Bee’s system, and all the injuries she suffered after that (including her death) were the result of her pre-existing co-morbidities (her other chronic medical problems).

In support of their defense, Defendants retained experts in the fields of Pharmacology, Cardiology, and Nephrology. These experts relied heavily on Mrs. Bee’s extensive medical history and produced reports containing complicated, technical analyses of her co-morbidities to show that her death had nothing to do with the Valtrex overdose. In addition, they argued that because of her other medical conditions, she would not have been expected to live very long, even if she had received the proper dosage of Valtrex.

The trial court set a tight discovery schedule, which gave the parties only a month or so to travel all over the country to depose all the expert witnesses, while simultaneously preparing for trial. As these depositions were proceeding, however, settlement negotiations began again.

Our Medical Negligence Case: Mediation and Settlement Phase

In an effort to resolve the matter, the parties conducted a lengthy private mediation. At the mediation, just weeks before trial, the parties agreed to a confidential settlement.

The Eisen Law Firm spent two years investigating and litigating this case, including beginning to prepare the case for trial. We believe that our thorough preparation and commitment to try the case if we did not get full and fair compensation was a driving factor in getting the case resolved. We have a well-earned reputation as zealous advocates who are ready, willing, and able to go to trial on complicated medical negligence cases, and in this case, Mrs. Bee’s family benefited greatly from that reputation.