Death from Untreated Pulmonary Embolism:
$1.5 Million Settlement
2025 Medical Malpractice Settlement Report
By Attorney Willliam J. Thompson
Plymouth Superior Court, Massachusetts
Patient death from pulmonary embolism following inadequate anti-coagulation (Heparin dosages)
The plaintiff’s decedent, age 56, died as a result of a pulmonary embolism (PE). Two days earlier, she had presented to the hospital with shortness of breath (SOB), chest pressure, and multiple syncopal episodes. Due to concern for an acute myocardial infarction (MI), she was transferred to the cardiac catheterization lab for possible stent.
She was found to have 85% stenosis of the proximal left anterior descending artery (LAD) and a bare metal stent was placed. Post procedure, her oxygen saturation on 2 liters of oxygen was initially 87% but improved to 97-98%. There was concern she may have a pulmonary embolus since her troponin was negative, and her left ventricular end-diastolic pressure (LVEDP) was low. Of note, blood work reported a D-dimer of 4.97 (normal range <1.6).
She was started on IV Heparin 1000 -1500 units. Her first PTT returned at 64.5 (normal range for anticoagulation 60-100) and per Heparin protocol the Heparin dosage was increased by 150 units for a total of 1650 units per hour. Her next PTT returned at 54.3 and the Heparin dosage was again increased by 150 units for a total of 1800 units per hour. Of note, no Heparin boluses were administered after the PTT results. Throughout the day she remained on 2 liters of oxygen with her oxygen saturations between 93%-98%, RR 11-25, and HR 93-100.
On 8/15/15, at 8:00 a.m., her PTT was 52.3 and her Heparin dosage was increased by 150 units for a total of 1950 units per hour. At 3:00 p.m., Heparin dosage was again increased by 150 units for PTT 52.2 for a total of 2100 units per hour. She received no additional Heparin boluses. Later that day, she became acutely SOB, and she was placed on a non-re-breather mask. She acutely decompensated was intubated and lost her pulses. CPR was administered, however she never had return of spontaneous circulation and was pronounced dead. Her cause of death was a PEA arrest due to a massive pulmonary embolus.
The plaintiff claimed the standard of care required additional bolus dosages of Heparin to achieve a therapeutic range and the Heparin protocol was not sufficient to adequately treat her PE and as a result essentially left the PE untreated.
The case settled prior to trial for $1,500,000.
Lubin & Meyer attorneys Andrew C. Meyer and William J. Thompson represented the plaintiff in this medical malpractice lawsuit.
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