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  • Jurydoctor@aol.com
    ... Any thoughts? thanks in advance.. you may email me privately if you wish. thanks, amy This case involves a 71 year old man who in March 2000 was sent to a
    Message 1 of 1 , Jul 7, 2004
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      Any thoughts?
      thanks in advance.. you may email me privately if you wish.
      thanks,
      amy

      This case involves a 71 year old man who in March 2000 was sent to a
      hematologist for treatment of a seriously high platlet count . This was discoverd
      on a routione blood test. His other blood counts were normal other than a
      slight elevation in his white blood cells. A high platlet count can cause the
      blood to clot and put him at high risk for stroke or heart attack. His past
      medical history included bypass surgery in 1982 and a number of minor medical
      problems but he was in otherwise good health and had not been hospitalized in
      15 years. He was at the time walking 2 miles a day but would eventually get
      chest pain at exertion including his walks and was feeling somewhat more tired
      the past few months.


      There are basically two drugs that are used to treat this condition. One
      called Hyrea has been used for more than 30 years. The other called Agrylin came
      on the market in 1998. He was started on Agrylin on March 14,2000. On March
      17,2000 a chest xray showed pulmonary scarring in the lungs. This is most
      often caused by environmental exposures. He was also seen by a cardiologist and
      given a stress test that was normal. He was not seen or referred to a
      pulmonologist.
      Over the next 3 months his Agrylin drug dosage was increased by the
      defendant from 1 pill to 9 pills per day. The platelets were rather quickley
      brought under relatively good control but over the next several weeks he became
      progressively weaker, developed a dry hacking cough and chest pain while at
      rest. His family doctor inquired of the defendant if hthe patients symtoms
      were related to the drug but was assurred the drug was appropriate. Eventually
      he was hospitalized at a local community hospital for those symtoms on June
      24.2000. A chest xray taken upon admission showed extensive lung infilltrates.
      For the next 5 days while in the hospital hedeteriorated until he went into
      respiratory distress, was put in ICU and intubated and placed on a respirator
      after developing and progreeing to a pulmonary edema. The local doctors
      unable to diagnose the cause of his problem had him helicoptered to a local
      university medical center on the 28th. He died on July4,2000 of multi organ
      failure. Upon arrival at the Center the doctors suspected a drug reaction to the
      Agrylin as the cause of the respiratory distress and immediately discontinued
      the drug. They also wrote that if he needed platlet meds in the future they
      would put him on Hydrea rather than Agrylin.Theyalso tested for an infectious
      or bacterial cause of his lung problem and all tests came back negative. No
      definative conclusions were reached but the suspeced most likely cause was
      Agrylin. This was also considered at the community hospital as a potential cause
      but he was not taken off the drug then because the defendant hematologists
      partner covering for him said he doubted it was the cause.


      The plaintiffs experts have opined that he should have been given Hydrea
      from the start because Agrylin has a greater chance of causing pulmanary and
      cardiac problems and given the plaintiffs prior bypass and chest xray he should
      have been started on Hydrea. In addition he should have had follow up xrays
      during the March-June period to see if the drug was effecting his lungs.As a
      result they opine that this negligence caused his death and by the time he
      was taken to the University hospital it was to late even though the drug was
      stopped.


      The Defense experts have opined that it was a judgment call as to which drug
      to prescribe as both had side effects and he needed to have his platlets
      come down as well as opining that the cause of death was an atypical pneumonia
      that developed from a cold. The doctors at the University center have no
      opinion as to whether the drug caused or contributed to his death when asked in
      testimony. An autopsy was not done . The wife testified she did not feel it
      neccessary because the doctors at the Center told her it was a drug reaction so
      she felt they knew the cause of death.










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