Patient Is Killed by Mismanaged Anticoagulant Therapy

Case Overview

This case involves a female patient who underwent cardiac catheterization in order to perform an angioplasty. Before the treatment was performed, the patient had been on a longstanding regimen of the anti-coagulation drug coumadin. Immediately prior to undergoing the procedure, the patient had been switched to Heparin, a shorter-acting anticoagulant in order to “bridge” the gap between her cessation of coumadin for the procedure. Several weeks after this procedure, the patient was scheduled to undergo surgery to repair a malfunctioning heart valve. During standard pre-operative testing, it was discovered that the patient’s PTT and INR were abnormal for someone on a anti-coagulant medication. Prior to undergoing surgery the patient was again given Heparin. A few days after undergoing surgery, the patient developed a low platelet count which indicated Heparin-induced thrombocytopenia. This eventually progressed to disseminated intravascular coagulation, which caused necrosis in the patient’s extremities. Despite attempts to save the patient’s life, including multiple amputations, the patient eventually died in the hospital. It was claimed that the patient was improperly monitored while receiving Heparin, resulting in her death.