Patient Dies After Being Sent Home With Dysfunctional Pacemaker

Case Overview

This pacing systems case involves a fifty-eight-year-old female patient after receiving a pacemaker in 2011. The patient presented to her doctor with complaints of shortness of breath, weakness, and fatigue. During the visit, the patient had a pulse of 38 and an EKG that showed AV block with sinus bradycardia. Furthermore, the patient had a chest X-ray that showed displacement of the ventricular and atrial leads. The patient’s doctor chose not to admit her and sent her home. He also scheduled her for a procedure to reposition the pacemaker leads at another institution. The doctor ensured the patient that she had no real risk, but she went home and was found dead two hours later.

Questions to the Electrical expert and their responses

Should this patient have been admitted to the hospital or could this medical scenario have been followed up in the outpatient setting?

I would potentially admit this patient to the hospital based on a few factors. It would depend on what type of 'escape' rhythm the patient had i.e. where the level of AV block was localized. I would be wary to just send this patient home without knowing what the underlying cause of the AV block was. It would also depend on the severity of the symptoms, particularly if the patient had syncope. Additionally, I would evaluate the chest X-ray in more detail given that the ventricular lead was displaced, which can lead to a fatal arrhythmia.

About the expert

This qualified cardiologist is fellowship trained in electrophysiology and routinely implants pacemakers and defibrillators. He has received his medical education and training from among the nation's top medical institutions, and has published and lectured extensively in his field.

E-001200

Specialties:

Electrical

Michael Talve stands at the forefront of legal innovation as the CEO and Managing Director of Expert Institute. Under his leadership, the Expert Institute has established itself as a vital player in the legal technology arena, revolutionizing how lawyers connect with world-class experts and access advanced legal technology. Michael's role involves not only steering the company's strategic direction but also ensuring the delivery of unparalleled intelligence and cutting-edge solutions to legal professionals. His work at Expert Institute has been instrumental in enhancing the capabilities of attorneys in case preparation and execution, making a significant impact on the legal industry's approach to expert consultation and technological integration. Michael's vision and execution have positioned the Expert Institute as a key facilitator in the intersection of law and technology.