Georgia case library

Northside Hospital Forsyth complaint alleges a missed hypotension work-up before a fatal retroperitoneal bleed

The complaint alleges that a 78-year-old man on the anticoagulant Lovenox developed a retroperitoneal hematoma after a spinal procedure. Hospital staff allegedly did not investigate his falling blood pressure in time to prevent his death. His blood pressure dropped from 150/82 to 95/61 within four hours on November 7, 2022. A physician noted the reading without ordering a stat blood count, and a nurse later gave him a blood-pressure medication without alerting a doctor. Based on the records, his blood pressure was not measured again for more than seven hours, when it was 65/35. A CT scan then suggested a 12-by-19-centimeter hematoma with active bleeding, and he died the next day.

System
Northside Hospital, Inc.
Facility
Northside Hospital Forsyth
Providers involved
Northside Hospital, Inc. / Hiren Patel, M.D. / Betsy Sijo
Pattern
Alleged failure to work up new hypotension in a patient on anticoagulant therapy after a spinal procedure
Harm
Alleged retroperitoneal hemorrhage, cardiac arrest, and death

Overview

This page concerns a public complaint alleging that a hospital physician and a nurse did not investigate a patient’s dropping blood pressure. The delay allegedly kept a retroperitoneal bleed after a spinal procedure from being caught before his death.

Chronology

The complaint alleges as follows:

  1. A physician ordered the anticoagulant Lovenox for the patient every 12 hours beginning November 5, 2022, one day after a lumbar disc aspiration.
  2. His blood pressure fell from 150/82 at 7:48 a.m. on November 7, 2022 to 95/61 by 11:48 a.m.
  3. Hiren Patel, M.D. noted the 95/61 reading in a progress note at 11:56 a.m. that day but did not order a stat blood count.
  4. Betsy Sijo, a nurse, gave the patient a blood-pressure medication at 8:49 p.m. on November 7, 2022. She did not report his low blood pressure to a physician first.
  5. Based on the records, his blood pressure was not measured again until 4:07 a.m. on November 8, 2022, when it was 65/35. A manual check at 3:50 a.m. had failed.
  6. A CT scan at 5:25 a.m. suggested a 12-by-19-centimeter retroperitoneal hematoma with active arterial bleeding. Staff held his Lovenox and gave him protamine.
  7. He underwent coil embolization, received blood transfusions, went into cardiac arrest, and died on November 9, 2022.

Alleged failures

The complaint alleges the following failures:

  • Dr. Patel did not order a stat blood count when he noted a blood pressure of 95/61, which the complaint calls significant relative hypotension.
  • Nurse Sijo did not report the patient’s low blood pressure to a physician before giving him a blood-pressure medication.
  • The complaint alleges that these failures delayed diagnosis of the hematoma and caused the patient’s death.
  • The complaint pleads medical malpractice against Dr. Patel, Nurse Sijo, and Northside Hospital, Inc., seeking wrongful-death and estate damages. It attaches expert affidavits from a physician and a nurse under O.C.G.A. § 9-11-9.1.

Entities and tags

Northside Hospital ForsythHiren Patel, M.D.Betsy SijoRetroperitoneal hematomaAnticoagulant therapyCoil embolizationDisc aspirationFulton CountyMedication errorFailure to monitorDelayed or missed diagnosisCommunication or follow-up failureWrongful deathHospital medicineNursingInterventional radiology