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Respiratory distress risks and medical malpractice

There's limited time for intervention before the body wears out

It’s scary to see someone who’s having problems breathing. Maybe it’s happened to you. There’s an anxious, frantic awareness that something is terribly wrong and a struggle to get more air.

That’s what happened to “Vanderpump Rules” star LaLa Kent when she realized that her 18-month-old daughter was gasping for air like she couldn’t breathe. Kent rushed her to a packed hospital emergency room (ER).

Fortunately, the triage nurse, who’s responsible for deciding which patients need to be seen first, recognized the medical emergency and got her to a doctor quickly. It turns out that Kent’s baby had an upper airway infection that was obstructing her breathing. They were able to treat her with steroids, which opened her airway.

Mismanagement of respiratory compromise

We’ve handled many Texas medical malpractice cases where patients weren’t so fortunate to have good nursing and medical care when they were having trouble breathing.

One of our clients from the Dallas, Texas area was in his 30s when he needed surgery to replace one of his heart valves. Let’s call him Tim. As happens to many patients who have this type of procedure, Tim had bouts of pleural effusion in the months that followed. Pleural effusion is a build-up of excess fluid between the lung and the chest wall. It can make breathing difficult.

The solution that Tim’s doctors provided was thoracentesis, which involves inserting a needle through the chest wall to remove the extra fluid. Tim had five of these procedures done in the six months after his heart valve surgery. Eventually, his surgeon hoped that Tim’s body would adapt and he wouldn’t need the procedures.

One night, Tim had a tight feeling in his chest and was having difficulty breathing, so he drove to a hospital ER. The nursing and medical staff evaluated him and noted that he had an abnormally high heart rate (tachycardia) and abnormally high respiratory rate (tachypnea) and was in moderate respiratory distress.

These vital signs are consistent with the body’s efforts to compensate for the medical emergency and maintain blood flow to the brain and vital organs. Competent doctors and nurses know that the compensatory mechanisms can’t last indefinitely, though. Eventually, the body shuts down and the patient crashes. That’s why it’s so critical to intervene fast.

The emergency physician ordered a CT scan of Tim’s chest, which revealed a hydropneumothorax. This is a condition where there are abnormal amounts of air and fluid in the chest. In Tim’s case, it prevented his affected lung from fully expanding and explained his difficulty breathing. The ER doctor initially planned to place a chest tube to remove the fluid and air. He changed his mind, though, and decided to admit him to the intensive care (ICU) and have a surgeon see him in the morning. 

Our medical and nursing experts who reviewed the case believe these were serious mistakes. Tim still may have survived the poor care but for another fateful mistake.

The ER doctor and nurse decided to give Tim an opioid painkiller (Fentanyl) and Ativan, an anti-anxiety medication. Both medications are known to cause respiratory suppression, and the drug manufacturer for Ativan warned against giving both types of drugs together to patients with breathing problems.

The ER physician and nurse said they were concerned that Tim was anxious.

Really?

It’s easy to see why he was having anxiety—he couldn’t breathe. Instead of proceeding with inserting a chest tube—an intervention that would help him breathe—they gave him medications that shut down his body’s compensatory mechanisms that were keeping him alive.

Within 10 minutes of giving Tim Ativan, he went into respiratory arrest and developed a permanent brain injury.

Diagnosing, managing, and treating respiratory distress are serious responsibilities and fast action is key. If you’ve been seriously injured because of medical or nursing errors in Texas, then contact a top-rated, experienced Texas medical malpractice attorney for a free strategy session about your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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