He needed surgery.
Urological surgery.
It was a well-known hospital in New York City.
A prestigious hospital.
His doctor was well known.
His doctor was well-respected.
He trusted his urological surgeon.
The surgeon reassured him.
The surgeon told them this would be routine.
The surgeon told him he would be in the hospital for a few days afterward to recuperate.
The patient agreed to have the surgery.
One of the preoperative instructions was that the patient needed to stop his blood thinner medication a few days before the surgery.
He was on blood thinner medication to prevent blood clots from occurring.
He was at risk for developing a blood clot.
He had never had a blood clot, but was at risk for developing one.
He'd been taking this blood thinner medication for a while.
The blood thinner medication worked as intended.
The patient follow the doctor's instructions to the letter.
He knew that he had to be off blood thinner medication to undergo this upcoming surgery.
His surgeon told him if he were to stay on the blood thinner medication, during surgery it would be impossible to stop any bleeding.
He could actually bleed to death.
Immediately before the surgery, doctors checked his blood levels to make sure that they were safe to perform the surgery.
The doctor wanted to make sure that his blood was able to clot properly.
The blood levels came back normal. Meaning, the patient did exactly what he'd been told to do.
Meaning that the surgery could proceed forward.
The surgery was uneventful.
The surgery went as expected.
There were no complications.
The patient was sent back to the recovery room and then to his regular medical floor.
Two days later, the patient was dead.
The surgeon didn't know why.
The nursing staff didn't know why.
The patient's family didn't know why.
The family demanded an autopsy.
They wanted to know why he died.
This was supposed to be a routine surgical procedure.
What could possibly have gone wrong?
It wasn't his time.
The surgeon said the surgery went perfectly.
He came up with multiple theories about why this patient died.
None of them make sense. None of those theories were based upon any factual information.
The family hoped that an autopsy would provide the answers.
An autopsy is a clinical examination of a patient who died.
An autopsy is performed by a doctor known as a pathologist.
His goal is to try and identify the cause of death.
After the autopsy is done, the doctor performing the procedure prepares a detailed report explaining his observations and his conclusions.
After the family received the autopsy report they were confused.
They had questions about what the autopsy results meant.
One day while in my office, I developed a problem with my computer.
I called an IT specialist to come and look at my computer.
While he was looking at my computer, I innocently asked him how he was doing.
I was making small talk while he was looking into the problem with my computer.
I learned from this gentleman then his dad had recently died.
I learned he was a patient at a well known hospital in New York City.
I learned that his surgeon told him that everything had gone well with the surgery.
I then asked why he died.
This gentleman had no answer.
He told me an autopsy was done but neither he nor his family members could interpret the autopsy results.
I invited him to show me the autopsy report.
That prompted me to tell him I needed to review his dad's medical records from the hospital.
He agreed.
Since he was the executor of his father's estate, he was able to request his dad's medical records without delay.
You should know that in many death cases the person who died often has no will.
In that instance, one of the family members has to get permission from the surrogate's court in order to allow them to get the medical records for their family member.
In this case, the son did not need to request permission, since he had already been appointed as the legal representative of his dad's estate.
I then requested all of his dad's medical records.
After a few months, the hospital finally released the records and I began to study them page by page.
The autopsy results pointed me in a specific direction as I was scouring the patient's medical records.
The autopsy results were clear.
The reason why his dad died was because of a massive blood clot to his lungs.
Medically, this was known as a saddle embolus.
Let's go back to the beginning of this article for a moment...
If you recall, dad was on blood thinner medication because he was at risk of developing a blood clot.
Dad had been taking this blood thinner medication for a while.
The medication had successfully prevented any blood clots from actually occurring.
In order to do this urological surgery, the surgeon correctly told the patient to stop taking his blood thinner medication.
Otherwise, there was a good chance he would bleed to death during surgery.
As I was studying this patient's medical records, I was looking for a very specific order by the surgeon or doctor in the hospital.
I wanted to make sure that there was an order written for the patient to be restarted on his blood thinner medication after surgery.
After going through hundreds and hundreds of pages of medical records, I finally found the doctor's order.
There was an order directing him to be restarted on his blood thinner medication within 24 hours after his surgery had been completed.
This order had been written during the preoperative instruction phase as part of routine orders that would be followed at the conclusion of his surgery.
There was no ambiguity.
The surgeon indicated that this patient's blood thinner medication was to be restarted.
Within 24 hours.
The reason why is to prevent blood clots from forming and also to minimize the risk that this patient would develop a blood clot.
Once I was able to find the doctor's order putting him back on blood thinners following his surgery, my next challenge was to find the progress note showing that the patient was restarted on blood thinner medication.
The first place I looked was the medication chart showing what medications the patient was given after the surgery was completed.
There was no indication he ever received any blood thinner medication within 48 hours after his surgery.
I also went through every single line of every progress note written during those 48 hours.
I could find no entry by any hospital staff, nurse, technician, staff doctor, attending physician, surgeon or ANYONE who confirmed that blood thinner medication was actually administered to this patient within 48 hours after his surgery.
Let me recap for a moment...
Here's a patient who is encouraged by his surgeon to have a urological procedure done.
He is reassured.
He is taken off his blood thinner medication properly.
The surgery goes well and the patient now begins recuperating.
Everybody expects him to have a good recovery and head home in a few short days.
What the surgeon didn't know is that nobody followed his order to restart the patient on blood thinner medication.
What the patient didn't know is that the hospital staff failed to carry out the doctor's order to put him back on this necessary medication.
What the patient's family did not know was that the hospital staff failed to follow their own hospital protocol, guidelines and procedures in carrying out physician's written orders.
It was clear to me after reviewing the autopsy report and this patient's medical records that the doctors, nurses and hospital staff violated the basic standards of medical care.
It was also clear that as a direct result of these violations, the patient suffered a massive blood clot to his lungs.
You should know that in New York, the only way I can start a lawsuit seeking compensation on behalf of the surviving family is if I have a qualified medical expert review all the records.
He must confirm that (1) There was wrongdoing, (2) The wrongdoing caused injury and (3) The injury is significant and/or permanent.
Only then am I legally permitted to go ahead and start a lawsuit on the family's behalf.
That meant I needed to retain a board-certified urological surgeon to review the records.
I hired the best surgeon I could find.
I sent him all the records.
I asked him to review it and tell me what he thinks.
One month later, my medical expert confirmed that the doctors and hospital staff violated the basic standards of medical care.
He confirmed that those violations were a cause of this patient developing this massive blood clot.
There was also no doubt that this massive blood clot to his lungs killed him.
Importantly, I also needed to ask my medical expert whether the patient's outcome would have been different had he received blood thinner medication within 24 hours after the surgery.
His answer was a definite yes.
"With a reasonable degree of medical probability, my conclusion is that this patient would still be alive today had the doctors and hospital staff restarted his blood thinner medication within 24 hours after this urological surgery.”
The sad reality is that this gentleman would be alive today had the hospital staff followed their own protocol and procedure and given this patient blood thinners as directed by his surgeon.
To read actual pretrial testimony of a urology doctor involved in this exact case, I invite you to click here and read his answers to my probing questions.