Settlement for Insulin Dosing Error Death: $2M
2015 Medical Malpractice Trial Report
Lawsuit claimed ER doctor and nurses were negligent when they ordered and administered excessive doses of insulin and failed to properly monitor blood sugar levels post-administration of insulin — resulting in death of 46-year-old woman
The plaintiff’s decedent died in October 2010 at age 46 from a hypoglemic coma and hypoxic brain injury.
The decedent’s medical history included Type 1 insulin dependent diabetes, diabetic retinopathy, hypertension, congestive heart failure, coronary artery disease, and peripheral vascular disease. Her surgical history included cardiac bypass grafting, femoral-bypass grafting, and a kidney transplant in 2001. She was legally blind from her diabetes.
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On 10/10/10, the decedent presented to the emergency department at approximately 6:00pm with a blood sugar level of 498 (normal range 70–100 mg/dL). The defendant ER doctor ordered 10 units of regular insulin, which the defendant nurses administered. The ER doctor’s plan was to recheck the blood sugar levels 4 hours after administration to assess the insulin peak activity level and to determine if and how much additional insulin she required. Instead, the second defendant, a hospitalist, wrote additional insulin orders for the decedent to receive short acting insulin at 7:00pm. At 7:10pm, the hospitalist also ordered sliding scale insulin and a bedtime dose of 10 units of insulin.
By 9:30pm, the decedent’s blood sugar was 335, indicating that the initial insulin dose ordered by the ER doctor was bringing down her blood sugar as intended.
At 9:46pm, the defendant nurse administered all of the defendant hospitalist’s insulin orders. Moreover, despite administering excessive amounts of insulin, the decedent’s blood sugar levels were not checked again that night.
At 12:40 a.m., the decedent was stable, calm, and cooperative, with normal vital signs.
At 2:52 a.m., she was found unresponsive, became pulseless, and a code was called. During the code her blood sugar was recorded as 7mg/dL. She was diagnosed with anoxic/neuroglycopenia (shortage of glucose to the brain leading to brain damage) encephalopathy in the background of profound hypoglycemia and arrest.
On 10/17/10, she was pronounced dead.
The plaintiff was prepared to show that the defendants were negligent when they ordered and administered excessive doses of insulin to the decedent and when they failed to properly monitor her blood sugar levels post-administration of insulin, thereby causing the decedent’s blood sugar to drop to a level incompatible with life.
The defense was prepared to argue that the insulin administration was not excessive, that they did properly monitor the decedent throughout the night, and that she did not die from the insulin she received but rather from the significant underlying medical condition which had necessitated her hospital admission.
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