The plaintiff was a 67-year-old woman who had a mechanical mitral heart valve implanted in 2013. Patients with these devices are at high risk for stroke and typically require lifelong anticoagulation – or blood thinning – therapy to prevent clot formation. The plaintiff in this case took daily doses of Coumadin. Her Coumadin therapy was monitored regularly by her primary care physician.
The plaintiff’s cardiologist (the defendant), whom she saw multiple times per year for various issues, scheduled her for elective peripheral catheterization to evaluate the veins in her legs. The plaintiff stopped taking her Coumadin seven days before the procedure, and she reported to the nursing staff at the hospital that she had done so on the instructions of the defendant cardiologist’s office. Her pre-operative laboratory studies showed that her blood was coagulating normally – in other words, she had no protection on board against clotting and stroke. The defendant cardiologist performed the catheterization and discharged her home with instructions to resume taking her Coumadin. On the third post-operative day, she suffered an occipital stroke which caused her to be legally and permanently blind in both eyes.
The plaintiff sued the cardiologist and the practice for medical malpractice alleging that it was inappropriate to instruct her to discontinue taking her Coumadin prior to the procedure and that she should have been hospitalized and immediately anticoagulated with heparin following her procedure. Coumadin takes several days to have a protective effect for a patient, whereas heparin provides protection immediately. The plaintiff alleged that the defendant cardiologist should have known that she would be at high risk for stroke for several days after she left the hospital.
The defendants denied that the plaintiff was instructed to stop her Coumadin. The defendant cardiologist claimed that he had offered to hospitalize the patient for heparin therapy after her procedure, but that she refused. They claimed that the plaintiff was generally an unreliable patient who had failed to follow instructions in the past.
The case settled several weeks after mediation.[18-T-162]
Type of action: Medical Malpractice
Injuries alleged: Stroke and blindness
Date resolved: Nov. 21, 2018
Verdict or settlement: Settlement
Attorneys for plaintiff: Jonathan Petty and Brielle Hunt, Richmond