Plavix Bleeding Lawsuit Against Johns Hopkins

Miller v. Johns Hopkins Hospital

This is wrongful death medical malpractice lawsuit filed on behalf of a man in Baltimore City. This case was filed in Health Claims Arbitration on January 12, 2017, and it is the 17th medical malpractice case filed in 2017 in Maryland.

Summary of Plaintiff's Allegations

A 61-year-old man consults with defendant doctor to discuss a transcatheter aortic valve replacement, after recommendations from his doctor. He has a history of paroxysmal atrial fibrillation with GI bleeding on Plavix. His medical history is unfortunate. He has had a history coronary artery disease after metal stenting, ischemic cardiomyopathy with ICD placement, COPD, diabetes mellitus II, hypertension, chronic kidney disease, hyperlipidemia, and Hodgkin's lymphoma.

Defendant doctor recommends that he has the aortic valve replacement. The doctor's note does mention the GI bleed that man suffered while taking Plavix, and aortic stenosis.

His other medical records show that he has a severe intolerance to blood thinners as well. Three years prior, the he had suffered a life-threatening gastrointestinal bleed, caused by blood thinners. His records from this event indicate that his life-threatening bleeding risk caused by blood thinners far outweigh his cardioembolic risk. Additionally, he also suffered a GI bleed while taking aspirin and Plavix, and was admitted to UMMS. So it is pretty fair to say the records showed he was a bleeder.

Despite his past medical records and his wife emphasizing that anticoagulants were contraindicated for him, the he is given 600mg of Plavix to prepare for the procedure with defendant doctor. That is a pretty big dosage. After Plavix is given to him, the procedure is cancelled and he is admitted to PCCU with acute renal failure and other symptoms.

The following day, he goes into shock. He is taken to the MICU and intubated, and various consults are requested. Labs reveal that he was given the standard amount of Plavix, and that he was allergic or had an intolerance to it due to a history of GI bleed. His white blood cell count spiked, and two days later, he is extubated. He undergoes a valvuloplasty heart cath. A week later, he is still in shock, and has worsening respiratory failure. His condition gradually worsens and he dies within a couple of weeks.

His family brings a claim on his behalf, alleging that Plavix should not have been administered to him in light of his history of severe GI bleeds resulted in his death.

Additional Comments
  • Thestandard of care for most surgeries calls for a patient on Plavix scheduled for a surgical procedure is to discontinue the administration of Plavix and to schedule the surgical procedure 3-5 days after the Plavix has been discontinued to allow the Plavix to dissipate from the patient's system.
  • The purpose of Plavix is to hinder the blood's natural ability to clot. Plavix increases the risk of bleeding in a postoperative patient because of the blood's inability to adequately clot. In fact, the manufacturer of Plavix recommends that the patient stops Plavix 5 days before surgery. Certainly, it would seem foreseeable that postoperative bleeding would occur. Accordingly, the need to monitor the patient is critical. The doctors and nurse need to be looking for signs and symptoms of a bleeding complication, such as a decrease in blood pressure, urinary output, hematocrit, or hemoglobin.
  • Plavix fights your platelets. There are two sets of systems that will prevent us from bleeding. One is the coagulation factor and the other are the platelets. Platelets are small microscopic cells that circulate in the blood. When the vascular system is injured, the platelets go to the area of injury and try to stop blood loss by forming a clot. Plavix shuts down this process and makes the platelets dysfunctional.
  • Informed consent was not pled. But it may be an issue. The standard of care mandates that if a patient on must be advised that the risk of bleeding when given a drug like Plavix.
Jurisdiction
  • Baltimore City
Defendants
  • Johns Hopkins Hospital
  • An interventional cardiologist at Hopkins
Hospitals Where Patient was Treated
  • University of Maryland Medical Center
  • Johns Hopkins Hospital
Negligence
  • Failure to ensure Plavix was not administered in light of a history of severe GI bleeds
Specific Counts Pled
  • Wrongful Death
  • Survival Action
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