Hospital Fails to Follow ICU Procedures and Causes Brain Death to Patient

This case involves a patient who was admitted to the hospital for pneumonia in her right lung. The patient’s condition deteriorated and she was later moved to the ICU (Intensive Care Unit). The patient’s condition worsened and her cardiac and respiratory functions were believed to have ceased. The doctors at the hospital decided to intubate her and they inserted an endotracheal tube so she could be given respiratory support by a mechanical ventilator. The patient’s condition improved and the doctors decided to extubate her. The doctors did not consult the hospital’s respiratory therapist about the decision to remove the endotracheal tube. During the process of removing the tube, the doctor noticed that the patient was unable to respond to questions or instructions. After the extubation, the patient was unable to breathe properly and there was no air movement detected when the respiratory therapist checked the patient’s airway. When the doctors tried to reintubate the patient, her heart stopped. The respiratory therapist tried to locate a medium Number 4 MacIntosh laryngoscope blade but found that the medical coding cart in the ICU had not been restocked. The patient was later found brain dead due to suffocation. The patient died in a vegetative state and her family sued the hospital claiming that they were negligent in causing her death. A medical expert testified at trial that the hospital had failed to meet the proper standard of care by not communicating about the patient’s extubation and by not having the ICU Code cart stocked prior to the extubation.

Question(s) For Expert Witness

1. Can the family of a brain dead patient sue the hospital if the staff did not communicate with the respiratory therapist about an extubation and failed to stock an ICU Code cart so that a reintubation could not be performed?

Expert Witness Response

This case involves the proper standard of care that hospital staff must follow in an ICU when they are extubating and attempting to reintubate a patient. The hospital staff in this case failed to follow proper procedures by failing to properly communicate with the hospital’s respiratory therapist before the patient’s extubation and failing to have the ICU Code cart properly stocked so that the respiratory therapist could have quickly reintubated the patient after he found she was unable to breathe. The delay in the reintubation probably caused the patient suffer a lack of oxygen and to suffocate in this case. For the hospital staff to have met the proper standard of care in this case, they would have had to get the respiratory therapist’s opinion about whether the patient was ready to be extubated before performing this procedure and would have had to stock the ICU Code cart with a Number 4 MacIntosh blade so that the reintubation could have been done quickly.