Patient Suffers Serious Injuries Due to Hospital Staff Negligence

This case takes place in Ohio and involves a male patient who suffered injuries from a fall in a hospital emergency room. The man first presented to the hospital after experiencing some shortness of breath and chest pains. The defendant physician requested an EKG and blood work. The EKG found no indications of a heart attack, however, the lab results revealed that his electrolytes were severely depleted. Despite these findings, no mention of the lab results was made to the patient. The patient presented to ER less than 24 hours later complaining of severe dizziness and disorientation. While waiting to be admitted to the hospital, he was using the restroom. Patient fell off the toilet and suffered a severe fracture of his left arm and wrist. It is alleged that the proper steps and protocols were not followed in order to prevent the patient from falling.

Question(s) For Expert Witness

1. Do you have experience treating patient who present with similar symptoms? 2. What are the necessary tests to conduct? 3. What steps should be taken if patients lab results reveal low chloride, potassium and sodium? 4. Would earlier intervention have prevented further complications?

Expert Witness Response E-001278

I am a board-certified emergency medicine physician who has been practicing for over 35 years. I have worked in many different hospital settings including a very busy urban emergency department as well as lower volume rural emergency departments. I also teach emergency medicine to medical students in emergency medicine residency and I am an Associate Professor at a major medical university. I have extensive experience with treating patients with electrolyte disorders and geriatric issues and while it sounds like fairly adequate tests were obtained, the sodium was low, so an MRI might be indicated to make sure that there's not a pituitary tumor. For serious cases of hyponatremia hypertonic, saline might be indicated along with fluid restriction and close observation in the hospital. Consulting a nephrologist or critical care specialist is often necessary. For a low potassium, supplementation is indicated with an IV, and under close hospital observation and cardiac monitoring. It is certainly possible that admission during the first emergency department visit may have prevented this patient from suffering more significant symptoms and falling and injuring her hip.