Emergency Department Death: $2.5M Settlement in Massachusetts

2023 Medical Malpractice Settlement Report
By Nicholas D. Cappiello, attorney for the plaintiffs

14-year-old dies in emergency department from cardiopulmonary arrest and hypovolemia, failure to administer aggressive IV rehydration

Case summary

Plaintiff’s decedent died at age 14 from cardiopulmonary arrest and hypovolemia. Decedent’s past medical history included Kabuki-like syndrome, global developmental delay, seizures, GERD, esophagitis, delayed gastric emptying, aspiration, Laparoscopic Nissen Fundoplication and gastric (Mic-Key) tube placement, persistent vomiting, and difficulty with weight gain. Decedent’s gastrointestinal issues were managed with liquid Omeprazole.

Decedent presented to the emergency department after vomiting blood at home. In triage, decedent’s vital signs were taken; however, a blood pressure was not able to be obtained. Defendant nurse was aware that decedent had been without his liquid Omeprazole medication for a few days because it was not available from the pharmacy, that Zantac had not been an effective substitute, that decedent had been vomiting for two days, and that morning began vomiting blood.

Decedent appeared to be in mild pain/distress and was fatigued, irritable, and weak. Decedent was mostly non-verbal and unable to describe his pain. Decedent’s last recorded weight was 60 pounds; however, he weighed 47 pounds in the ED.

The decision was made to transfer decedent to a tertiary care hospital and to aggressively re-hydrate decedent. However, throughout the afternoon while decedent was awaiting transfer, defendant nurse did not re-check his vital signs and administered IV bolus of fluids (IVF) over approximately 90 minutes, but did not administer any further IVF.

By late afternoon, an EKG showed sinus tachycardia with heart rate 175 and ST-T wave changes. Subsequently, decedent developed ventricular tachycardia and lost pulses. Coffee ground material was suctioned from decedent’s mouth and CPR was started; however, decedent suffered a PEA arrest and was pronounced dead.

Lawsuit claimed failure to administer rehydration and monitor patient

Plaintiff alleged that decedent was extremely dehydrated and hypovolemic as a result of the two days of vomiting and required urgent and aggressive rehydration with IVF at the time he first arrived in the ED, followed by additional IVF and liquid omeprazole, and that defendant nurse deviated from the applicable standard of care when she failed to administer aggressive IV fluid rehydration, failed to properly monitor decedent, including re-checking his vital signs, and that as a result decedent’s deterioration went undetected leading to increased demand on decedent’s heart and ultimately causing him to suffer cardiopulmonary collapse and a premature and preventable death.

The case settled for $2.5 million dollars.

Lubin & Meyer attorneys Nicholas D. Cappiello and Andrew C. Meyer, Jr. represented the plaintiff in this lawsuit.

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