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Failure to Diagnose Arterial Line Complication - $800,000 Settlement

This case involved over 30,000 pages of medical records and complex issues of medicine pertaining to the monitoring of arterial lines. It was settled largely because of the outstanding quality of the PowerPoint presentation and demand letter prepared by our staff paralegal, Kerry Hopkins. In select cases in which we feel confident that the defendants cannot present a viable defense, we will utilize PowerPoint presentations together with detailed demand letters that explain and illustrate the case that we are prepared to present at trial. In our PowerPoints, we address all the relevant facts of the case, the defendant’s failure of care, the medical literature that applies to the case along with medical drawings, videos and medical reports to address how the failure of care could and should have been prevented. We also explain why the amount of compensation that we have demanded should be paid. These presentations have helped to accomplish early resolutions in many of our cases.

Our client required hospitalized treatment for multiple serious medical issues. She underwent heart surgery and an arterial line was placed for the purposes of blood draws and blood pressure monitoring. Before the subject complication, two arterial lines were placed but had to be removed – the first because it became dislodged, the second because it became clotted. Heparin was used to treat the clotted line. Meanwhile, a third arterial line was placed in the brachial artery, an artery in the arm that provides circulation to the radial and ulnar arteries in the wrist and hand. While not prohibited by the standard of care, placement of an arterial line in the brachial artery is considered risky and requires particularly vigillant monitoring because the arteries in the wrist and hand rely entirely on the brachial artery for circulation.

Five days after placement of the brachial arterial line, nurses began to notice and document signs that the line was not functioning properly. Soon after, the line became blocked and had to be removed. After the line was removed, several of the healthcare providers who participated in the patient’s care ignored numerous warning signs that plaintiff had developed a problem with the circulation in her arm. When a Doppler study was eventually conducted, the radiologist documented no definite blood flow within the radial and ulnar arteries but failed to call the attending physician to advise her of this critical finding. Furthermore, the radiologist inaccurately stated in the summary portion of her report that arterial blood flow was found throughout the entire arm.

The condition of plaintiff’s arm continued to worsen, and her healthcare providers continued to ignore obvious signs of her critical condition. It was not until 40 hours after the first warning sign that action was finally taken to diagnose and manage the problem with plaintiff’s arm. By then, plaintiff had developed compartment syndrome, which is an acute surgical emergency. She required a four-compartment fasciotomy surgery with brachial artery repair.

In the months following the subject event, plaintiff also required three subsequent surgeries to debride skin, muscle and fat. Despite receiving artificial skin for the wound, plaintiff still suffered massive scarring of her entire arm that is severely disfiguring and interferes with the function of her arm and hand. She continues to suffer from muscle weakness, muscle loss and dysfunction, atrophy, contractures, asymmetric arm and hand use, chronic pain, and impaired gross motor function. She will require multiple plastic and orthopedic surgeries in the future.

Plaintiff’s counsel made demand against the facility, nurses and physicians involved in plaintiff’s care, citing the nurses’ repeated failures to act on plaintiff’s various changes in condition, the radiologist’s failure to properly communicate and document the critical findings from the Doppler study, the attending physician’s failure to follow up on plaintiff’s deteriorating condition, and one particular nurse’s alteration of the medical record in an effort to hide the fact that she had not been conducting assessments of plaintiff’s arm at required intervals.

The parties reached a settlement of $800,000.00 before suit was filed.