This case involves a sixty-one-year-old male patient who was diagnosed with a stage 1 renal. The surgeon performed a partial nephrectomy procedure on the patient that was met with great difficulty in the immediate, postoperative period. Approximately one hour after the patient was transferred to the PACU, it was noted that a small amount of blood was pooling around the surgical site. The physician noted the bleeding in a progress note and specifically stated that the bleeding was due to oozing from the wound and that there was no concern for internal bleeding.
Several hours later, the patient became unconscious and had no pulse. He was transferred to the ICU, where he was given IV fluids and six units of packed red blood cells. The patient was rushed back into surgery for exploration of the previous surgical site, and it was revealed that there was significant clotted blood behind the kidney and adrenal gland. The surgeon determined that there were no active bleeds and that the patient was slowly oozing blood due to a coagulopathy. The patient was given four more units of blood and 3 units of FFP but did not survive through the night. The autopsy stated that the patient died of hemorrhagic complications following the partial left nephrectomy. It was revealed in the patient’s chart, however, that the medication etodolac (Lodine) was not stopped prior to the procedure.