A significant post-operative risk of a craniotomy is blood clots. Generally, these clots fall into two categories: intracranial clots or deep vein thrombosis and pulmonary embolism. Managing these clots is highly complex because of the delicate balance surgeons must manage due to the risk of bleeding in the brain.
Reduced mobility, bed rest, surgery, and illness all slow the movement of blood through the legs, and slow-moving blood is prone to clotting. This risk is so well recognized that clot prevention is a routine part of hospital care, and hospitals are expected to assess each patient’s risk and put appropriate measures in place. To prevent DVT, specifically, doctors often use methods involving compression stockings or intermittent pneumatic compression devices on the legs.
TED hose and sequential compression devices work by keeping blood circulating in the legs, so it does not pool and form clots. For these hose to be effective and safe, they must be worn as prescribed. There are also specific protocols that hospital staff must follow for the hose to work properly including sizing, contraindications, and other daily care operations, again to prevent further injury and clotting in patients.
In this case, our client did not receive proper post-operative treatment. The clot that ultimately developed and its consequences cost her the amputation of her left leg.
The Townsley Law Firm represented her and recovered a settlement of over $1,250,000.
Why Clot Prevention Is a Hospital Basic, Not an Extra
Some of the most devastating hospital injuries come not from something the staff did, but from something basic they failed to do. This is one of those cases.
Our client was admitted into the hospital and underwent a craniotomy for either a mass or stroke and bleeding. Nearly 15 days after this surgery, she was noted to have experienced shortness of breath and was readmitted into the medical center for suspicion of DVT and pulmonary embolism. Despite these symptoms, our client’s doctors administered one subcutaneous injection of Lovenox and underwent percutaneous placement of a vena cava filter. The clot in the left leg remained.
After another 11 days in a rehabilitation center, where she was supposed to be getting better, our client developed extreme pain in the left lower extremity, paired with swelling of the limb. She was admitted to the hospital, again, where her left leg had to be amputated.
Preventing dangerous blood clots in a hospitalized patient is routine, well understood, and built into standard care through two simple tools: TED hose, the compression stockings that help keep blood moving in the legs, and sequential compression devices, the inflatable sleeves that gently squeeze the legs to prevent blood from pooling and clotting. These methods are standard, low-cost, and used every day for at-risk patients.
When that safeguard is missing and a clot forms, the consequences can be severe. A deep vein thrombosis can block blood flow, damage the leg, and in the most serious cases lead to tissue death requiring amputation.
From a Preventable Clot to an Amputation
Deep vein thrombosis is a preventable complication. A deep vein thrombosis that is allowed to develop and progress, however, can destroy a limb. In this case, the absence of the standard preventive measures allowed the clot to form, and the resulting damage to our client’s leg could not be reversed. She lost her left leg.
The negligence of her medical providers caused extreme and long-term suffering to our client. The standard of care after her surgery was not upheld and consisted of failing to institute any DVT prophylaxis, failing to utilize compression stockings, failing to utilize sequential compression devices or foot pump, failure to elevate her lower extremities and to passively exercise her lower extremities, and leaving her in a sitting position.
The distance between those two outcomes, a patient who goes home intact and a patient who loses a leg, was measured in standard procedures that should have been practiced and were not. That is what makes a case like this both tragic and clear: the harm was catastrophic, and the step that would have prevented it was routine.
