Patient Undergoes Left Lung Lobectomy and Dies From Ruptured Pulmonary Artery

Case Overview

This case involves a 59-year-old male with a past medical history significant for lung cancer. The patient underwent a left upper lung lobectomy and mediastinoscopy. Four days after being discharged from the hospital, the patient was readmitted for an acute episode of shortness of breath. A CT scan showed fluid collecting in the post-resection space with air-fluid levels in the upper portion of the lobectomy space. The patient was subsequently transferred to SICU and then to a step-down unit. A portable x-ray of the chest showed the collection of fluid completely obliterating the left lung field. In the step-down unit, the patient continued to experience difficulty breathing. He was later transferred back to ICU at which point he was unresponsive, a code was called, and the patient was intubated. Shortly thereafter a bedside thoracotomy and chest tube placement revealed dark blood in the left pleural cavity. Approximately 5000 ml of blood was evacuated from his left chest but the patient did not survive. The surgical autopsy attributed death to focal necrosis and acute inflammation with rupture of the pulmonary artery.

Questions to the Pulmonology expert and their responses

Could a more prudent monitoring of this patient have changed his outcome?

If indeed a progressive fluid collection was not evaluated in a timely manner, this could indeed represent a deviation from the accepted standard of care. Bleeding and infection are both emergent and treatable conditions that must be excluded in a timely manner.

About the expert

This expert has ample experience with the ATS, OSHA/NIOSH, and ASHRAE guidelines to prevent sick building disease syndrome. He has published more than 20 articles and has received multiple research grants for pulmonary disease. He also has been an invited reviewed for medical journals such as the American Journal of Respiratory and Critical Care Medicine, and the Journal of Allergy and Clinical Immunology.

E-001199

Specialties:

Pulmonology

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.