Dilaudid is a powerful prescription opioid medication used to treat severe pain when other treatments aren’t enough. This medication acts on the central nervous system and is often administered after surgery via IV or patient-controlled analgesia (PCA) pump during the first 24 to 72 hours.
When in the hospital, there are protocols in place to ensure that the medication is safely administered. These protocols call for care teams to monitor breathing, blood pressure, and sedation levels closely because of the potency of some narcotics.
If a medication like Dilaudid is not safely monitored, severe complications can occur, including respiratory arrest, profound hypoxia, coma, pulmonary edema, cardiovascular collapse, and even death. In this case, our client died due to the mismanagement of his medication.
His breathing was suppressed and he went into respiratory arrest. The lack of oxygen caused irreversible brain damage, and he suffered anoxic encephalopathy and organ failure. Our client unfortunately did not survive.
The Townsley Law Firm represented his family and recovered a settlement of over $650,000.
Opioids Are Safe Only When They Are Monitored
Narcotic pain medications like Dilaudid are a normal and appropriate part of post-surgical care. They are also among the highest-risk medications given in a hospital because their most dangerous side effect is the suppression of breathing.
This is not an unpredictable or rare risk. It is a known, expected property of opioids, and it is the reason hospitals have protocols governing how these medications are dosed and monitored. Those protocols exist to catch respiratory depression before respiratory arrest occurs.
Safe opioid administration required an individualized approach; there is no one-size-fits-all dose. Healthcare providers must consider the patient’s unique circumstances and closely monitor sedation level, respiratory rate, and oxygen saturation as the medication takes effect. Excessive sedation is often an early warning sign of impending respiratory depression and can occur before a patient experience’s respiratory failure. Recognizing these warning signs promptly allows providers to intervene by slowing or stopping the medication, stimulating the patient, providing supplemental oxygen, and, when necessary, administering an opioid reversal agent (Narcan). However, these potentially life-saving interventions depend on one critical factor: someone must be actively monitoring the patient.
In this case, however, an inexperienced nurse administered excessive doses of this drug and failed to monitor our client’s level of sedation as those doses took effect.
Two Failures: Too Much Medication, and No One Watching
The negligence here had two parts, and each made the other deadlier.
Excessive dosing. The nurse administered excessive narcotic doses. Proper opioid dosing accounts for the individual patient and avoids stacking doses in a way that overwhelms the body’s ability to keep breathing. Excessive dosing pushes a patient toward the dangerous end of the opioid’s effects.
Failure to monitor. Even appropriate opioid dosing requires monitoring, which is a standard of care in every situation where medication is administered in a hospital. The nurse failed to monitor his sedation as the doses took effect. That failure is what turned an overdose into a death because the entire safety net for opioid administration is the monitoring that detects trouble in time to reverse it. Without it, respiratory depression progressed unnoticed to respiratory arrest.
An experienced provider following the standard of care watches for exactly this. The combination of too much medication and no one watching removed every safeguard that stands between a sedated post-surgical patient and a fatal outcome.
When a Hospital Assigns a Task Beyond a Provider’s Experience
Our client’s care involved an inexperienced nurse managing high-risk medication. That raises a question that extends beyond the individual provider to the hospital itself.
Hospitals are responsible for ensuring that the staff assigned to a patient are competent to provide the care that patient needs, and for having systems in place, supervision, protocols, and checks that catch dangerous situations before they cause harm. When a high-risk medication like Dilaudid is administered without the dosing care and monitoring the standard of care requires, responsibility can extend to the hospital that employed and supervised the provider and that was responsible for the protocols meant to keep patients safe.
Under Louisiana law, a hospital can be held responsible for the negligence of its nursing staff acting within the scope of their employment, and for its own failures in supervision and safe-practice systems.
