Nursing facility failed to monitor patient’s Coumadin therapy – $290,000 Settlement

The decedent, a 73-year-old woman, fell at home, breaking her leg and ankle. The injuries required hospitalization and surgical repair. Her orthopedic surgeon ordered anti-coagulation therapy/Coumadin (5mg/day) to start on post-op day number three, which was the day she was discharged from the hospital and admitted to a nearby nursing facility for rehabilitation therapy. The discharge orders from the hospital directed the decedent’s INR levels were to be checked twice a week and her INR levels to remain in the therapeutic range (3-4).

The decedent’s INR level was checked upon admission to the nursing facility, revealing a level of 3.0. The next day, the defendant physician and his physician’s assistant continued the daily 5mg dosage, but reduced the frequency of INR studies to one time per week. Five days later, defendant physician ordered the decedent’s INR levels were to be monitored every Monday and Thursday. The effect of this change in monitoring meant the decedent’s INR levels were not evaluated for a period of seven days, although continuing to receive her daily Coumadin.

In the morning of the eighth day in the nursing facility, the decedent was found in her room vomiting blood. Her INR level was checked and found to be greater than 17.8. The decedent was transported to a local hospital, where she was evaluated, given blood, and transferred to a regional trauma center. The decedent’s condition continued to deteriorate and she died approximately 24 hours later due to upper gastrointestinal bleeding.

Suit was filed and extensive discovery undertaken. The claim settled in August 2014, several weeks prior to the scheduled trial. The decedent was survived by her husband and three adult children.

Type of action: Medical malpractice
Injuries alleged: Death caused by failure to monitor Coumadin therapy
Special damages: Hospital and funeral expenses of $21,000
Verdict or settlement: Settlement
Amount: $290,000
Attorneys for plaintiff: T. Daniel Frith III and Lauren M. Ellerman, Roanoke