wrapped up-3 more comments
- There are many unanswered questions that would hopefully be found in the
medical records. On the surface, it sounds like a case that the plaintiff should
try and settle. Taking this to court would likely go in favor of the MD,
presuming good experts and an educated jury. Three days with packing is not
unreasonable and there can't be a definitive plan until it is determined whether
the packing works to solve the bleeding problem, especially considering this was
a bleed that couldn't be stopped for the previous eleven days. If the same
ENT had cared for the patient the entire time, it might make a difference. The
bigger issue is what caused the problem to begin with and would that
condition have increased the risk for necrosis? Packing for eleven days is a long
time and that in itself would increase the risk for necrosis. During that time,
the tissue is becoming more inflamed and friable. Was there trauma or a
medical condition that caused the bleed? If it was a medical condition, was it
caused by drugs or alcohol? It is very unlikely that the final physician would
have documented any cause that could be attributed to the ENT guy. The
physician's insurance company is likely to vigorously defend their client, in order
to avoid lifetime costs and the facts presented don't deviate from the standard
of care, at least on the part of the ENT.
If it was a medical condition, was it caused by drugs or alcohol?
By this, I meant long term use of drugs or alcohol that may have caused
medical conditions that increase the risk of bleeding, such as liver problems,
hypertension, soft tissue damage in the nose [Cocaine], etc......Even if substance
abuse couldn't be proven or wasn't present, if those medical conditions
exist, which can easily be determined by current labs and past records, it's
another reason for the complication of necrosis in something that wasn't outside the
standard of care in the first place.
The defense can allege all they want that there is no clear evidence that the
balloon packing was over inflated or improperly placed but the evidence
speaks for itself. Necrosis does not JUST happen. Yes, there is overt
The doctor could not have been within the standard of care if necrosis
occurred, it's that plain and simple unless the patient violated every
If any nasal pack is placed too tightly, it can cause severe tissue death
and most often in nasal balloons. I'll wager quite a bit that there was a
CLAMP used on the outside to hold the pack in place. Usually the clamps are
right on the skin and the prolonged pressure causes the skin and the
tissue to die.
Necrosis CAN just happen with any impingement procedure - you almost assert
that yourself in this paragraph above.
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