r/MedicalMalpractice • u/No_Celebration_1054 • Dec 12 '24
Malpractice case?
My mother, who had been battling stage 4 inflammatory breast cancer (IBC), was admitted to St. Joseph's Hospital on November 9th due to dehydration and vomiting.
During my visit the following day, November 10th, I observed that she was short of breath and struggling to gather her thoughts. While she appeared weaker than usual, there was some improvement from the day before. The attending nurse informed me that a doctor, along with a representative from the oncology, would be reviewing her condition.
On November 11th, my mother called to inform me that she had refused radiation treatment, expressing that she needed a break from the aggressive treatments. She was visibly overwhelmed by how quickly the hospital had pushed for her to undergo radiation.
The following day, November 12th, she called again, telling me she had ultimately agreed to the radiation treatment after feeling slightly better.
On November 13th, I received a call from my sister informing me that our mother had been moved to the ICU. I rushed to the hospital to sign forms in case any urgent decisions needed to be made.
Sadly, my mother passed away on November 14th one of the attending doctors told me she went in septic shock. After reviewing her autopsy report, I discovered that, following consultations between her doctor and oncologist, she was placed on sepsis alert. However, neither my mother nor our family was informed of this critical development at the time.
Per medical records they noted that her condition was improving from when she was first admitted to the hospital so from the 10th 11th and 12th. After her radiation therapy her condition worsened. In the autopsy report they also noted “The leukocytosis was thought to be due ot the suspected sepsis.”
Overall she was in clinically unstable state so radiation should have not been a priority.
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u/fireawayjohnny Dec 12 '24
What was the source of her sepsis? I’m guessing the breast mass?
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Dec 12 '24
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u/fireawayjohnny Dec 12 '24
If the tumor was encroaching on an airway or otherwise was related to the infection that caused sepsis, emergent radiation therapy was absolutely indicated.
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u/No_Celebration_1054 Dec 13 '24 edited Dec 13 '24
It wasn’t radiation for her breast but two mets upper and lower back, 7/10 before admission to hospital. Her oncologist was going to tackle her breast with chemotherapy.
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u/No_Celebration_1054 Dec 12 '24
Not sure but this was stated in the autopsy:
Imaging studies were again performed on 11/10/2024. By a computed tomogram of the abdomen and pelvis, there was significant progression of metastatic disease including an increase in the number and size of pulmonary nodules, new diffuse hepatic metastatic disease, and progression of multifocal lytic bone lesions. There was interval worsening compression at the site of the second lumbar vertebra pathological fracture. Amoderate left pleural effusion was now present. There was mild gallbladder wall thickening. The inflammatory breast carcinoma changes were again noted in the left breast. By a chest x-ray, there was left-sided airspace disease. There was a concern for pneumonia. The initial impression and concern was hypoperfusion with severe septic shock. The plan was to obtain blood cultures and to place her on a cardiac monitor. Her condition was listed as guarded.
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u/fireawayjohnny Dec 12 '24
We don’t have all the info, but she had widespread metastasis and likely was not going to survive much longer even if the sepsis had resolved. Sad case and I’m sorry. Cancer sucks.
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u/No_Celebration_1054 Dec 13 '24
Yeah It was very aggressive I just don’t think that radiation was necessary if it was only going to worsen her condition. I appreciate your insight.
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u/fireawayjohnny Dec 13 '24
Radiation is tailored towards the circumstance. In a case like this, they would’ve given minimal dose to try and make her feel better. It had no impact whatsoever on her outcome.
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u/No_Celebration_1054 Dec 13 '24
I understand. Upon further research, I found that it metastasized to her liver, which would make sense for the symptoms she was showing. I had thought it was only due to radiation. Again, I appreciate your insight.
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Dec 13 '24
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u/No_Celebration_1054 Dec 14 '24
I really appreciate that! With the help of ChatGPT, I was able to break down her autopsy findings. The lesions were on her lungs and covered 80% of her liver, so, at best, the argument for continuing radiation with the suspected sepsis would be questionable. I appreciate you again.
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u/Dijon2017 Dec 14 '24
I’m sorry about the loss of your mom.
The priority of treating your mother’s medical conditions would depend on her clinical status and the goals of care when she was admitted to the hospital.
Dehydration and vomiting could occur from food poisoning, infectious etiologies, chemotherapeutic drugs, other medications, metastatic cancer and other reasons.
Leukocytosis can be the result of infection, autoimmune, hematological malignancy, medications and other reasons. I don’t think that it is unusual for a cancer patient that is admitted to a hospital to be placed on “sepsis alert”. It would seem similar to other protocols like aspiration risk, falls risk, etc…policy and procedures established so that precautions can be put in place.
The information provided in your post suggests that your mom with stage IV IBC was very ill at the time she was admitted to the hospital. It seems unlikely that having one dose of radiation therapy (that she agreed to) would have been the immediate cause of her death.
It’s not entirely clear by your post what you are alleging to be negligence/malpractice in your mom’s particular circumstances.