Hello to all,

Please read this and if you have similar case so you can discuss with me. This is my father's wrongful death case. He died because of hospital negligence. Any practice firm or lawyer can contact me. It will be also appreciated. I can also provide day to day report.

Summary of Hospitalization
at Warren Hospital NJ and Robert Wood Johnson Hospital NJ

Deceased Name:
Muhammad Ashraf Bhimra

Date of Death:
December 7, 2010 (00:40 am)

Cause of Death:
Written on death certificate immediate cause GI bleeding
Other significant conditions contributing death: CAD, Renal failure & Emphysema
Comment: We don’t agree with emphysema as it was neither confirm in this admission that he has this, nor it was seen in their record that he has emphysema. Renal failure because he was diagnosed with Chronic kidney disease stage III.

Cause for hospital admission:
Coughing and wheezing. Taken to Warren Hospital NJ in emergency care.


CONCLUSION:

MI due to non-medication and lack of care (this can be evident from the vital reports – just to mention vital reports for the first two days are missings).
The dose of solumedrol was not decrease in 11 days and he was on the same dose and it can be one of cause of GI bleed. In different notes of pulmonologist advised to decrease the dose but it was never addressed.
Did not try to find out the root cause of the bleeding since he was admitted in the RWJ hospital other than trauma bleeding from angiography.
Post EGD, the patient was not medically managed properly in terms of q3 blood work up and transfusion. They did not maintain A line or central line except in the last night of death that was based on our insistence.
Post EGD care should be aggressive
The CCU unit of the hospital probably did not follow their protocol (or did not have a protocol) for those patients who got into multiple diseases by having all consultants meeting once a day to evaluate and treat patients with one line of action. What we have seen every day doctors from every faculty comes and evaluate. They change dosage and medication, which was ordered an hour earlier in day that was ordered by other faculty. I asked the same in family meeting conference from the attending but did not answer.
Dr. Vagescu (main attending doctor did not come to evaluate the patient or meet with the family after the patient was transferred to CCU. We asked so many times). The reason we don’t know. But we have some clues why.
It looks like there were rift between surgeon (Dr. Bedsides) and attending and admitting doctor Dr. Vagnescu (angioplasties and wants to do angioplasty).
There is no report/notes from Dr. Platt’s (who were the last three days doctor for CCU) for the last 5 to 6 hours before the deceased death. The report/note from the nurse are there and it is evident that she reported couples of times of the seriousness but she did not do anything. We have to watch her all records for all days when she was there like when I mentioned that she did not come to evaluate the patient when he was complaining the chest pain. She instead went to room 11 around 5.30 pm on December 3rd. Was there emergency in that room or what.
There are much more we can discuss with evidence.

NOTE:
I know the case is complicated but is not impossible to win. He had severe CAD and that is why he was on heparin that makes person to bleed and so he did. He died due to GI bleed. The point is - what did they do to stop the GI bleeding - absolutely nothing. Why I am saying this because we were in the hospital most of time including my wife (she is a Chief Resident in Warren Hospital), my sister (she is also a Doctor in UK) and have seen all this. What we are saying as to how he was treated in the RWJ Hospital based on our experience that was pretty evident from the medical record. He did not die because of severe CAD. He died because of bleeding which could have been stopped by the procedure. Not only this, it could have been prevented or isolated on the first place by taking into considering the risk and rewards of reducing the drugs and/or proper blood infusion. All is clearly evident from the medical record. You can see the blood count check/testing was done about 12 hourly which in his case should have been every three to six hourly after they knew he was bleeding from GI through vomiting and stool.

Not only this there are so many other clear evidence to prove why he was on heparin so many times on the first place. It was because they put him in a situation of ST elevation and depression that leaded to MI. Why I am saying this - since he admitted in the hospital his heart rate and BP was too high that leaded to MI in couple of days. This could have been prevented by controlling his heart rate by giving beta blocker. Yes if his BP was low then we can understand why he was not given the beta blocker. He got into a situation of MI because of his heart rate that was too high for quite a long time. For this cause a normal person can go on global MI and this is exactly what happened to him. It can be determined by his Thallium testing results of EF ratio. During this when he start losing more blood he was not even tested or determined the cause of his blood loss other than caused by trauma after heart cath. The blood loss seen in his CT - scan was about 30 CC. With this other caused bleeding of GI (unkown at that time) made his heart run very fast with low BP. That was clear cut sign of low volume in blood causing BP to drop that lead to another heart condition on his last Friday evening. That caused again to start Heparin lead to GI bleed that night. The question again is what did they do about it - nothing aggressive rather I should say they not even follow the normal protocol.

In a brief, there is lot to tell with evidences that it is a clear cut case of negligence, carelessness, personal rivalry and most importantly the culture and practices of CCU of the RWJ hospital (I don't think so they follow their own criteria or guideline of CCU - for instance I have not seen a single day that they make management plan to treat patients based on a meeting with representation from all involved departments doctors like Plumo, nepro, cardio etc.) It should be a must especially in patients with multiple diseases. I asked the same question when I called for the family meeting of doctors. They did not like it because they don't practice it. Let me say what I have seen their treatment management - the team of usually one senior and one junior/resident doctors visits and writes plan and medicine and then another team from other department visits and change/stop the same medicine and the course/dosage of medicine after an hour the same day. These are evidences based on the medical records. So what could happen in such cases - very obvious?

There are lot of evidences and reasons in his case which I even did not mention/discuss with you. I am enclosing again the summary of finding and observation for your second review. You can see how determined and confident I am on my father case that it will be a win. I want to say there is a need that the system should be improved for the sake of patients benefit and lives.

I responded to your other post.