Man in 30s sent home from ER by nurse practitioner, dies of pulmonary embolism

Pulmonary embolism is commonly misdiagnosed in hospital emergency rooms (ER). Over 50,000 people die each year in the United States because of this dangerous medical condition.

• Over 25% of ER patients with pulmonary embolism are misdiagnosed.

• The numbers are even worse for those patients admitted to a hospital, where over 50% of patients who have a pulmonary embolism are misdiagnosed.

What is pulmonary embolism?

Pulmonary embolism is a potentially life-threatening medical condition where a blood clot forms and gets lodged in an artery going to one of the lungs (and sometimes both lungs). Most of the time, the blood clot originates in the deep veins of the legs, from a condition known as deep vein thrombosis (DVT).

When multiple blood clots form and travel to arteries supplying both lungs it’s described as bilateral pulmonary embolism.

What are the signs and symptoms of pulmonary embolism?

One of the reasons that pulmonary embolism is so often misdiagnosed is that the signs and symptoms are consistent with various other conditions. The classic signs and symptoms include:

• Chest pain

• Shortness of breath

• Cough

• Fast or irregular heartbeat

• Skin conditions, including clamminess, sweating, or discoloration

• Feeling faint or dizzy

When a patient has one or more of these signs and symptoms, physicians should consider the possibility of pulmonary embolism in their differential diagnosis.

Physicians are trained in medical school in the differential diagnosis process. This requires taking a thorough patient history and performing a physical exam, and then making a list of all potential diagnoses or conditions that could explain the patient’s medical condition. Then, through testing and reassessment, conditions are ruled out, starting with the most dangerous one.

Even though pulmonary embolism can be difficult to diagnose, if doctors (and physician assistants and nurse practitioners) follow the differential diagnosis process, they will usually arrive at the correct diagnosis. When diagnostic steps are skipped in favor of shortcuts, though, it places the patient in needless danger.

That’s what happened to a man in his 30s who went to a hospital ER in the Dallas area, where he was evaluated and discharged by a nurse practitioner. Let’s call him John.

John told the nurse practitioner that he had a history of DVTs from about a decade earlier, but hadn’t had problems with them since then. He went to the ER because of chest pain and shortness of breath, and when his vital signs were taken, he had high blood pressure.

Within two hours of arriving at the hospital, the ER nurse practitioner discharged without an appropriate workup. The nurse practitioner told John that his chest x-ray looked clear and that he was probably dehydrated and just needed to drink some water. Within a few hours, John went into cardiac arrest and was taken to another hospital, where they discovered bilateral pulmonary embolism. It wasn’t long until he was dead.

Treatment for pulmonary embolism

Fortunately, there are tools available to physicians to treat pulmonary embolism.

Anticoagulation medications prevent clot formation. Clot-busting medications, such as tPA, dissolve clots that already formed. In some situations, thrombectomy surgery may be necessary to remove a clot that’s blocking a blood vessel. After successful treatment for pulmonary embolism, many patients are placed on long-term anticoagulation medications because of the risk of another one forming.

If you’ve been seriously injured because of poor medical care in Texas involving a pulmonary embolism, contact a top-rated, experienced Texas medical malpractice lawyer for a free consultation about your potential case.

Robert Painter
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Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys 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 for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.