This wrongful death claim was filed in Wicomico County when a woman on hospice care died after receiving a dangerous dosage of pain medication. It was filed in Health Claims Arbitration on January 22, 2018, and it is the 37th medical malpractice case filed in Maryland this year.Summary of Plaintiff's Allegations
Before her admittance to Coastal Hospice for end-of-life care, a woman was receiving treatment at Atlantic General Hospital for symptoms related to pneumonia. She received various pain medications, including Oxycodone and Acetaminophen-Oxycodone. The woman also suffered from congestive heart failure, dementia, and masses in her lung. She opted out of surgery, choosing to receive pain management care instead.
At the time of her admittance to Coastal Hospice, the woman was described as alert, calm, cooperative, and oriented. She underwent no additional evaluation or assessment, and the healthcare providers at Coastal did not consult with her to develop an appropriate pain management and treatment plan.
At Coastal Hospice the woman was treated with a medication schedule including Methadone, Ativan, Haldol, Roxanol, and Lorazepam. Soon thereafter, she became minimally responsive and her doctor decreased the quantities of her medication.
The next day, her doses of Ativan and Methadone were discontinued entirely after her family raised concerns, but she was later restarted on Methadone and Ativan and started on Phenobarbital when she became "agitated."
Nine days after her admittance to Coastal Hospice, the woman passed away. Her cause of death is listed as unknown, but a postmortem review conducted by the Maryland Office of Healthcare Quality found that the woman had been administered dosages of Methadone that significantly exceeded the recommended amount.
The review also determined that Coastal staff failed to properly assess the patient when she was admitted to hospice care, and so her treatment plan was not individualized to her specific needs. The only documented treatment plan was "peaceful death with dignity." The clinical record contains no evidence that the woman was adequately monitored, and although many references were made to her declining level of consciousness, she was never assessed for signs and symptoms of an overdose. There was also inadequate documentation providing justification for the initial dosing of Methadone in a patient who hadn't been on large doses of narcotics previously and who hadn't been experiencing pain or shortness of breath.Additional Comments
- The medications that the woman received in the hospital, Oxycodone and Acetaminophen-Oxycodone, are pain medications. Some of the medications she received at Coastal Hospice were pain medications, but others were used for less straightforward purposes. Ativan, Lorazepam, and Phenobarbital are used to treat seizure disorders and anxiety, and Haldol is used to treat certain types of mental disorders and control the symptoms of Tourette syndrome.
- This is a difficult case because the woman was already on hospice. The plaintiffs are claiming that her life was shortened by Coastal Hospice's negligent care, but no one is arguing that she would have gone on to live a long and healthy life if not for malpractice. It's tragic because the woman was certainly not treated with the care and dignity she deserved, but cases like this are not typically very valuable because of the short life expectancy. Hospice patients are expected to live for six months or less, so at the very most the plaintiffs can only claim a few months of damage.
- Wicomico County
- Coastal Hospice, Inc.
- 3 pain management doctors
- Atlantic General Hospital
- Coastal Hospice
- Failing to create an individualized care plan.
- Failing to provide proper assessments and supervision.
- Failing to administer a safe and appropriate amount of pain medication.
- Negligence: Staff at Coastal Hospice provided the woman with inadequate care and supervision.
- Wrongful Death: If it hadn't been for the Coastal Hospice staff's medical negligence, the woman would have survived beyond nine days on hospice care.
- Survival Action
- Respondeat Superior
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