To,
Tish Eller, LSW
Patient Advocate
Edward Hospital, Naperville
Dear Ms Eller
Thank you for your letter. As you suggested in your letter, before bringing the matter to your attention I had indeed talked with my doctors and these were the responses I received:-
1. At the hospital, I was told by doctors that the radiologist has read the report wrong and reported three clots when there were none.
2. Dr Bajaj: Because mine had been such an uneventful and uncomplicated pregnancy, I had never gotten to test the medical acumen of doctor. Prenatal visits were all so routine and I believed that because I was visiting her regularly she would have discovered if something was wrong. At the question of low amniotic fluid levels going undetected unless the day I delivered she told me that “babies in my family always died”. My mothers are six sisters and one of them did had three neonatal deaths because she had an incompetent cervix and her 28-32 weekers did not survived 15 years back in India. She also has two healthy babies after then
All during my 14 weekly visits with her for wound care, the issue of false PE came up invariably and we both bad mouthed the radiologist together and it was she who suggested that I write a letter to Patient Advocate and Head of radiology describing what I had to go through and my complaint with radiologist. However she never told me the name of radiologist. Also my requests were records were denied for a long period of time. I wanted my records for any future pregnancy. During one of my last visits when wound was almost healed, I finally gave a written request for records. She again refused but I insisted I want to. She then opened my dressing to look at wound and then said she can’t dress it back. The single member in her staff will give me a gauge and I can cover it with my underwear. The wound was not fully healed with raw skin at that point. Mine is a bikini cut incision and she was well aware I cant dress it back myself.
I did talk to her on phone once after picking up records. When I asked her that radiologist is saying suspicion and limited motion exam, she said that the in CT reports clots are always reported as suspected and when there are no clots the report reads low probability. When I said that second reports says “no pulmonary embolism” and does not says “low probability” she refused to discuss it further and said that I should talk to radiology if I have any concerns. This behavior not only raises concern about the medical acumen but also about the ethical behavior of the doctor as instead of coming out clean the blame is put on one doctor whom the patient has never met and is unlikely to meet. I was also told by her “That what can you do about it”
3. Radiology: Naperville radiologists says that radiologists talk to doctors directly and rarely with patients
4. Dr Quezada: She says that starting Coumadin was decision taken by cardiology and OB and her job was just to check whether I had some genetic clotting disorder. She says that the decision to start or reverse thinners was to be taken by doctor who operated and couldn’t have been her.
I was also told that I was lucky I bleeded and insisted on CTA and thus second was done. They give long term anticoagulants to patients and if that fails they put in IVC Filters. I am also told that even if there is respiratory motion or an artifact as was in my case, they start the anticoagulation for a year without verifying if medication is truly needed. I am concerned that while Edward is treating many patients who actually need anticoagulation, many others are enduring years of medication without verifying even if it’s needed.
I shudder to think what would have happened had I not bleeded fatally. I would be taking Coumadin even today and getting INR testing weekly , bleeding on slight episodes, having thousands in medical bills and if I get pregnant later, I would have been injecting myself heparin all because I was breathing fast on a Friday Night
And had my husband not refused surgery, I would have been on these blood thinners for life and the havoc this would have played would have had coming me to hospital again and again as long as I lived.
If CTA is equivocal, MRI, VQ Scan, Venus Doppler, d-dimer could be done. I am sure doctors running the billion dollar cancer center and heart hospitals have tests to verify whether the medication is needed. The entire emphasis is on administering treatment not diagnosing whether that treatment is warranted.
5. Dr Davis \ Dr Clark: I haven’t talked with cardiology as I am too exhausted to do so now.
I have also been asked by my doctors not to make a noise about this episode because I did not die.
The point here is that a 27 year old girl with a picture perfect pregnancy and absolutely no health problems is diagnosed with DVT and Pulmonary Embolism, given blood thinners that were contraindicated with her recent surgery, allowed to bleed for 4 days before any action is taken and is later told that there was No DVT or no PE. And while she did not die, she walked around dripping bloody fluid from her abdomen for months, had severe weakness, anxiety and suffering. And during all this, it was her husband who was packing and cleaning her wound twice daily and it was while they both were trying to take care of their newborn baby.
And if the girl did died (which was entirely possible had the lab not come to draw blood since there was no telemetry), doctors could put the cause of death as Pulmonary Embolism and adverse effect of anticoagulants in therapeutic use. Whether that therapeutic use is warranted no one bothers to check. There wouldn’t have been a repeat CTA done on a dead body. Long term anticoagulation should be clinically correlated and undertaken with definitive diagnosis.
Respiration is being reported as PEs and filing defects as DVTs. Patients are being incorrectly told they have blood clots and they are dying. It is a crime to let patients being forced into unnecessary medication by not allowing them to make informed decision. Patients are not allowed to see reports and they have to make decision based on what is being is told to them by doctors. It’s a crime giving false information to patients about there condition. Radiologist is reporting them as suspicions and others are doing no clinical correlation and treating them.
While the physicians are not employee of your hospital, they do have privileges to practice at Edward and I would like to talk with the committee who grants these privileges to doctors or the Chief Executive of Edward or to the peer review\grievance committee. This is a serious concern and requires attention. My Admitting doctor made serious mistakes with my care and treatment and it needs to be warranted that this does not happen again
I am copying this letter to the doctors who treated me and if they would like to explain to me:
1. Why was I lied about my condition. ? Whenever I asked about where and how big the clots were, the answer was elusive as In there own words
a. “You have two blood clots in your lungs and one in your thigh. You could have died but I called the cardiologist and you are safe”
b. “You are going to get into cardiac arrest.”
c. “Be grateful that we caught you else you would have your son with you now, but not 25 years later when he becomes a doctor”.
2. Why was I not made aware of the bleeding effects of Coumadin.
3. There were 3 episodes of bleeding
i. On morning of 01\13, patient was placed on bed rest again with Foley.
ii. On morning of 01\15, entire wound was opened up with wound separation and indurations was noted
iii. On night of 01\15 there was wound drainage and patient was running a fever with increased indurations
b. Why was no affirmative action taken after three bleeding episodes? It was clear that keeping patient on strict bed rest, oral iron and intravenous antibiotics were not working/
c. Why was wound not checked regularly after bleeding and fever on 01\15 night? Why wasn’t a CTA ordered on 15th night. Even a couple of hours would have a made a great difference in my recovery
4. Why was I discontinued from telemetry in spite of very high Heart Rate especially as tachycardia was the only indication of the presumed PE?
The most important thing is that patients need to made aware of the correct facts about there condition. And had mistakes been made, an apology and making me aware of facts was enough rather than lying and putting blames on a doctor whom the patient had not met and was not likely to meet. This even raises ethical concern about the behavior. I did not wanted to bring these issues up unless really necessary and was sticking to plain simple facts about what happened. I am sure all the doctors would attest to the fact that whatever I am saying is true.
Thank you
Copy to:
1. Dr Vimi Bajaj
My ob\GYN
2. Dr Maria Quejada
My heamatologist. I think she actually allowed me to brestfeed when Dr Bajaj wanted to give me injections to dry out milk because of coumadin
3. Dr Ann Davis
The cardiologist who I saw first day and last day
4. Dr Stanley Clark
The cardiologist who treated me. But didnt see me after it was determined that PE does not exist
5. Dr Leonard Sherman
My god, the radiologist who determined no PE\DVT exists
6. Dr Paul Goldberg
The radiologist who said I had PE\DVT
7. Dr Giradot
Head of Radiology
8. Dr David McElligot
Pulmonary MD who was called on Day 7 instead of day 2
9. Dr Todd Singer
A very kind and compassionate doctor. Did second surgery to drain fluid from my abdomen
Friday 8 August 2008
Response from the Hospital
This is the response I received from the hospital
1. It was determined that my complain is mainly with the physicians who treated me. Doctors while an important part of the healthcare team are independent contractors and not employee of the hospital. So the grievence committee cannot do anything about it
2. That being said grievance committee did forward my case to peer review committee. The recommendation of peer review committee is confidential and cannot be shared
3. I should talk to my doctors about the care I received because they are the best persons to answer the question
4. Lastly, if there are any issues that are not to my satisfaction, I can contact them back or there are other institutions available as well
1. It was determined that my complain is mainly with the physicians who treated me. Doctors while an important part of the healthcare team are independent contractors and not employee of the hospital. So the grievence committee cannot do anything about it
2. That being said grievance committee did forward my case to peer review committee. The recommendation of peer review committee is confidential and cannot be shared
3. I should talk to my doctors about the care I received because they are the best persons to answer the question
4. Lastly, if there are any issues that are not to my satisfaction, I can contact them back or there are other institutions available as well
Incident Report sent to Patient Advocate
I was visiting Dr Vimi Bajaj regularly for my prenatal care and follow-up and ever so more regularly during my last 8 weeks of pregnancy. At none of the appointments she failed to diagnose that I had low amniotic fluid. Not one NST was performed during my entire pregnancy well being aware of the family history of neonatal deaths nor was the fundal height measured or recorded correctly. This was after I was assured that post 32 weeks we would be doing weekly NSTs. My concerns about baby movements being slow and irregular were dismissed as being said that baby has outgrown space to grow. On a routine appointment at 38 weeks after being dismissed from her office saying that there is no dilation and baby won’t be born for 5 days. However I returned back and on my insistence an NST and Ultrasound was performed which showed that baby was measuring 2 weeks small and fluid levels were 4. This was not detected or monitored during any of my prenatal visits. And I had to undergo an emergency c section the same day because baby was more than stressed at this point. The baby who was measuring exactly on target at 30 weeks was measuring two weeks small for his gestational age. Had my gynecologist had been able to determine my fluid and baby’s growth restrictions by measuring fundal heights correctly; I wouldn’t have been robbed out of the experience of delivering even with laboring. I was very fortunate that I insisted on NST because else the baby might not have able to make it.
Due to being anxious, tired and dehydrated based on my very negative birth experience and possibly as a reaction to anesthesia, I developed tachycardia .The next day, Dr Bajaj orders a cardiac consult for tachycardia. TSH, ECG, EKG were all normal so a CTA was ordered to rule out PE. I refused CTA telling that I am fine. However I was forced to get the CT Scan by the doctors. The CTA was severely degraded by respiratory motion and inconclusive in its findings. At that point, based on equivocal report and in absence of any symptoms, heparin was started being fully aware that the patient has just had a recent abdominal surgery.. In the CCU, my HR stabilized during the night. Dr. Bajaj arrives next morning and instead of ordering definitive diagnostic tests, took the decision to start me on Coumadin and anticoagulation for a year and 5 days on heparin moving me to the heart hospital. Dr Bajaj also asks me not to breastfeed and says she will give me injections tomorrow to dry out my breast milk. This was after that fact that I denied all symptoms and insisted I was feeling fine. I was also not told that CTA was inconclusive and I was not allowed to see the report in the hospital and all requests for confirmation CTA were denied for 5 days. I was also not made aware of the possibility of bleeding on anticoagulants.
On Post Op Day 3, there was significant bleeding from the incision site and wound was opened with 4 staples. There was copious amount of serum and blood drainage (almost to soak fifteen to twenty ABD Pads and bed sheet completely) However still no definitive studies were carried and anticoagulation was continued. Also Dr Bajaj tells me that I should never have any more kids because of the severe PE I had. On Post-Op day 5 the entire wound opened up, again large amount of serum and bloody fluid was extracted from the abdomen. Again fifteen – twenty ABD pads and the entire bed sheets were soaked with blood. And anemia kept on getting worst in spite of oral Iron medication thrice a day. WBC count keeps on rising daily in spite of intravenous antibiotics for past 5 days. The wound which was superficial is now almost a centimeter deep. Still heparin and Coumadin are continued in spite of recurrent bleeding and repeated absence of any symptoms (chest pain, shortness of breath, leg pain, swelling etc ). I am also discontinued from telemetry saying that my tachycardia is due to anxiety and anemia. At that point I again requested them that since I am having no symptoms and I am bleeding and telemetry is being discontinued saying tachycardia is due to anemia and anxiety (And since tachycardia was only indication of cardiac consult) why don’t we order another CTA and see where we are at clots. But they dismiss me. On day 5 nights, I start running a fever due to loss of blood and weakness. However still heparin is continued. On Post op day 6 finally wound erupts and massive hemorrhage occurs. There was enormous oozing through gauze despite significant amount of pressure. I was on vitals every 4 hours and when nurse came to check vitals she saw me covered with clotted blood and gradually diminishing blood pressure. Since I was not on monitor even my falling vital signs were not detected. At that point five days late Doctor Bajaj finally orders a second CT scan, VQ Scan, and Venus Doppler study all of which rule out DVT and PE. At the end of 6 days finally she refers me to pulmonary doctor who rules out PE and DVT. On Day 6, Dr Bajaj tells me that we need to do a CTA to drain fluid from the abdomen and also because first was inconclusive so let’s now order a CT scan again and see if clots actually exist. It was determined that there was no PE or DVT and there was no evidence of PE or DVT ever, I was never required to be on anticoagulants.
Had Heparin been started as a preventive dose, Coumadin and anticoagulation for a year should have been decided only after a definite diagnosis was made. Coumadin was started on 01\12 very well being aware that patient feels fine, CTA is inconclusive and recent abdominal surgery. Bleeding on 01\13 did not force them to take any necessary action till 01\16.Even on 01\15 when incision was draining serous material and patient developed a fever of 101.1 , heparin was continued. Pulmonary consultation, repeat CTA, Venus Doppler, VQ Scan should have been carried out much earlier instead of on 01\16. The patient had started bleeding on 01\13. In light of the inconclusive reports, repeat CTA or VQ should have been carried out before jumping on decisions for IVC Filter or Coumadin.
All during the course, I was kept in bed with a Foley catherator and asked to lie absolutely still without moving my legs. Once it was determined that no PE or DVT exists, I was to be transferred to the OB floor on morning of Jan 17. The baby was discharged on Jan 17 mornings and it would have been easier for us to keep the baby on OB floor. However she does not visits me till late in the afternoon on Jan 17. At around 3.30 p.m. She arrives, removes the Foley and asks me to go home without checking if I am able to ambulate or urinate. I was only allowed to get out of bed once during these 7 days to bedside. When I expressed my hesitation and discomfort on ambulation, she leaves me in the heart hospital room and we had to make the baby sleep in the hospital bed with us because there was no bassinet available on the floor. I was discharged with continuous bleeding and indurations from the incision site and only hours after I was allowed to ambulate after 7 days in bed. She does not even visit me on the day of discharge (Jan 18). After that I had to visit her continuously for 14 weeks for wound care and treatment. Wound drained purulent thick bloody serous material for 6 weeks enough to soak 8 ABD pads per day and there was a big clot over the right hand corner of the corner of the wound. After 6 weeks the drainage changed to yellowish and continued for another 6 weeks. The wound was 13 cm long and an inch deep. I faced great difficulties in walking and urinating during weeks after discharge. Even today there is a 0.5 cm gap from where the incision closes to the point where it meets the rest of the skin.
There was no home health care barring once a week and my husband had to dress and pack the wound twice daily for 14 weeks apart from taking care of my infant son. He had to suffer severe strain because of this. Also because of mother baby separation and anemia during the first week of his life, my baby lost on a lot of precious breast milk. Entire trauma all caused loss of bonding and breast milk for my baby.
All during the hospital stay my baby was kept away from me in the hospital nursery and allowed only 2-3 hours per day for the first week of his life. Moreover he was discharged a day earlier and we had to make him sleep with us in the heart hospital room before I was allowed to go home. Any planning for baby no 2 definitely needs to wait a great amount of time due to the ongoing physical and emotional trauma
Her carelessness is evident from the numerous mistakes in the hospital discharge summary:-
1. The wound has been mentioned to open superficially in the hospital records. The patient wound was 13 cms long and at its peak 2.4 cms deep and has taken 14 weeks to close. The patient had to undergo severe mental and physical trauma during this period.
2. The PT\INR was not therapeutic on Coumadin during the hospital stay
3. Coumadin was started on Post Operative day 2 i.e. January 12, 2006 and not Day 4 as mentioned in the records on being ok by Dr Bajaj.
4. Hypercoagulable workup was ordered due to clots and not due to lipids.
5. Heparin was discontinued only for an hour on Jan 16 due to super therapeutic levels and was to be restarted after an hour.
All during the hospitalization, I ask Dr Bajaj that I feel fine and I have no symptoms. I want to know how big the clots are. But all I am told by her is that I should be grateful to her for saving my life. I feel no symptoms and I would have never known about her PE and died had she not been proactive in saving her life. How lucky for me that she treated me although there were no symptoms. A girl like me who is generally logical, confident and smart is exploited in most vulnerable way. My coherent confident self turned nervous, anxious and scared as I was told that I am unable to feel symptoms of what is going wrong with my body.
Due to being anxious, tired and dehydrated based on my very negative birth experience and possibly as a reaction to anesthesia, I developed tachycardia .The next day, Dr Bajaj orders a cardiac consult for tachycardia. TSH, ECG, EKG were all normal so a CTA was ordered to rule out PE. I refused CTA telling that I am fine. However I was forced to get the CT Scan by the doctors. The CTA was severely degraded by respiratory motion and inconclusive in its findings. At that point, based on equivocal report and in absence of any symptoms, heparin was started being fully aware that the patient has just had a recent abdominal surgery.. In the CCU, my HR stabilized during the night. Dr. Bajaj arrives next morning and instead of ordering definitive diagnostic tests, took the decision to start me on Coumadin and anticoagulation for a year and 5 days on heparin moving me to the heart hospital. Dr Bajaj also asks me not to breastfeed and says she will give me injections tomorrow to dry out my breast milk. This was after that fact that I denied all symptoms and insisted I was feeling fine. I was also not told that CTA was inconclusive and I was not allowed to see the report in the hospital and all requests for confirmation CTA were denied for 5 days. I was also not made aware of the possibility of bleeding on anticoagulants.
On Post Op Day 3, there was significant bleeding from the incision site and wound was opened with 4 staples. There was copious amount of serum and blood drainage (almost to soak fifteen to twenty ABD Pads and bed sheet completely) However still no definitive studies were carried and anticoagulation was continued. Also Dr Bajaj tells me that I should never have any more kids because of the severe PE I had. On Post-Op day 5 the entire wound opened up, again large amount of serum and bloody fluid was extracted from the abdomen. Again fifteen – twenty ABD pads and the entire bed sheets were soaked with blood. And anemia kept on getting worst in spite of oral Iron medication thrice a day. WBC count keeps on rising daily in spite of intravenous antibiotics for past 5 days. The wound which was superficial is now almost a centimeter deep. Still heparin and Coumadin are continued in spite of recurrent bleeding and repeated absence of any symptoms (chest pain, shortness of breath, leg pain, swelling etc ). I am also discontinued from telemetry saying that my tachycardia is due to anxiety and anemia. At that point I again requested them that since I am having no symptoms and I am bleeding and telemetry is being discontinued saying tachycardia is due to anemia and anxiety (And since tachycardia was only indication of cardiac consult) why don’t we order another CTA and see where we are at clots. But they dismiss me. On day 5 nights, I start running a fever due to loss of blood and weakness. However still heparin is continued. On Post op day 6 finally wound erupts and massive hemorrhage occurs. There was enormous oozing through gauze despite significant amount of pressure. I was on vitals every 4 hours and when nurse came to check vitals she saw me covered with clotted blood and gradually diminishing blood pressure. Since I was not on monitor even my falling vital signs were not detected. At that point five days late Doctor Bajaj finally orders a second CT scan, VQ Scan, and Venus Doppler study all of which rule out DVT and PE. At the end of 6 days finally she refers me to pulmonary doctor who rules out PE and DVT. On Day 6, Dr Bajaj tells me that we need to do a CTA to drain fluid from the abdomen and also because first was inconclusive so let’s now order a CT scan again and see if clots actually exist. It was determined that there was no PE or DVT and there was no evidence of PE or DVT ever, I was never required to be on anticoagulants.
Had Heparin been started as a preventive dose, Coumadin and anticoagulation for a year should have been decided only after a definite diagnosis was made. Coumadin was started on 01\12 very well being aware that patient feels fine, CTA is inconclusive and recent abdominal surgery. Bleeding on 01\13 did not force them to take any necessary action till 01\16.Even on 01\15 when incision was draining serous material and patient developed a fever of 101.1 , heparin was continued. Pulmonary consultation, repeat CTA, Venus Doppler, VQ Scan should have been carried out much earlier instead of on 01\16. The patient had started bleeding on 01\13. In light of the inconclusive reports, repeat CTA or VQ should have been carried out before jumping on decisions for IVC Filter or Coumadin.
All during the course, I was kept in bed with a Foley catherator and asked to lie absolutely still without moving my legs. Once it was determined that no PE or DVT exists, I was to be transferred to the OB floor on morning of Jan 17. The baby was discharged on Jan 17 mornings and it would have been easier for us to keep the baby on OB floor. However she does not visits me till late in the afternoon on Jan 17. At around 3.30 p.m. She arrives, removes the Foley and asks me to go home without checking if I am able to ambulate or urinate. I was only allowed to get out of bed once during these 7 days to bedside. When I expressed my hesitation and discomfort on ambulation, she leaves me in the heart hospital room and we had to make the baby sleep in the hospital bed with us because there was no bassinet available on the floor. I was discharged with continuous bleeding and indurations from the incision site and only hours after I was allowed to ambulate after 7 days in bed. She does not even visit me on the day of discharge (Jan 18). After that I had to visit her continuously for 14 weeks for wound care and treatment. Wound drained purulent thick bloody serous material for 6 weeks enough to soak 8 ABD pads per day and there was a big clot over the right hand corner of the corner of the wound. After 6 weeks the drainage changed to yellowish and continued for another 6 weeks. The wound was 13 cm long and an inch deep. I faced great difficulties in walking and urinating during weeks after discharge. Even today there is a 0.5 cm gap from where the incision closes to the point where it meets the rest of the skin.
There was no home health care barring once a week and my husband had to dress and pack the wound twice daily for 14 weeks apart from taking care of my infant son. He had to suffer severe strain because of this. Also because of mother baby separation and anemia during the first week of his life, my baby lost on a lot of precious breast milk. Entire trauma all caused loss of bonding and breast milk for my baby.
All during the hospital stay my baby was kept away from me in the hospital nursery and allowed only 2-3 hours per day for the first week of his life. Moreover he was discharged a day earlier and we had to make him sleep with us in the heart hospital room before I was allowed to go home. Any planning for baby no 2 definitely needs to wait a great amount of time due to the ongoing physical and emotional trauma
Her carelessness is evident from the numerous mistakes in the hospital discharge summary:-
1. The wound has been mentioned to open superficially in the hospital records. The patient wound was 13 cms long and at its peak 2.4 cms deep and has taken 14 weeks to close. The patient had to undergo severe mental and physical trauma during this period.
2. The PT\INR was not therapeutic on Coumadin during the hospital stay
3. Coumadin was started on Post Operative day 2 i.e. January 12, 2006 and not Day 4 as mentioned in the records on being ok by Dr Bajaj.
4. Hypercoagulable workup was ordered due to clots and not due to lipids.
5. Heparin was discontinued only for an hour on Jan 16 due to super therapeutic levels and was to be restarted after an hour.
All during the hospitalization, I ask Dr Bajaj that I feel fine and I have no symptoms. I want to know how big the clots are. But all I am told by her is that I should be grateful to her for saving my life. I feel no symptoms and I would have never known about her PE and died had she not been proactive in saving her life. How lucky for me that she treated me although there were no symptoms. A girl like me who is generally logical, confident and smart is exploited in most vulnerable way. My coherent confident self turned nervous, anxious and scared as I was told that I am unable to feel symptoms of what is going wrong with my body.
Complaint process
I filed a complaint with the Patient Advocate at the Hospital. She was very supportive on the phone and asked me to send the letter. This is what I sent her
Dear Ms Eller,
Pls refer to our telephonic conversation. I am attaching my story as talked with you. I chose to deliver at Edward because of the excellent reputation I had heard about the hospital. Infact i chose my doctor based on edwards referral program. So I was naturally stunned when this happened to me. I believe that when this can happen to an educated, logical girl like me , there are many more who are subjected to unnecessary pain and trauma.
At the request of the Food and Drug Administration (FDA), Bristol-Myers Squibb has strengthened its US label for warfarin (Coumadin) to include a black-box warning about the risk for major or fatal bleeding. It says that bleeding is more likely to occur during the starting period. Among others, the risk factors for bleeding include trauma, anemia and concomitant drugs
Warfarin label also reads that warfarin is contraindicated with recent traumatic surgery resulting in large open surfaces. Potential adverse reactions to COUMADIN may include: Fatal or nonfatal hemorrhage from any tissue or organ. This is a consequence of the anticoagulant effect. Therefore, the possibility of hemorrhage should be considered in evaluating the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis. (Source: http://www.fda.gov/medwatch/safety/2006/coumadin_PI_april2006.pdf)
And yet I was given Coumadin following recent abdominal surgery (C section), in absence of any symptoms and inconclusive CT scan reports. And these were continued for next 5 days in spite of my repeated denial of all symptoms (Pls see hematologist initial report saying that patient says she feels fine ) bleeding from surgical site, drainage from c section incision, increasing anemia in spite of thrice a day oral iron, increasing WBC count on antibiotics, fever and complete wound separation. After 5 days, clarification CTA and other required tests like VQ Scan and Ultrasound of lower extremities were ordered to conclusively rule out PE and DVT. It was determined I had no PE\DVT and I was not required to be on anticoagulation ever. I had several thousands in medical bills, severe anemia, weakness and anxiety and a 13 cm long and 2.5 cm deep abdominal wound for 14 weeks.
The FDA Med watch announcement also notes that warfarin prescriptions will also be issued with a new patient medication guide warning about potentially serious bleeding with the drug. FDA regulations state that such medication guides are to be provided with each prescription that is dispensed for products that the FDA determines pose a serious and significant public health concern. I was also not made aware of the possibility of bleeding on Coumadin.
This incident happened under the treatment of Dr Vimi Bajaj following my C section on January 10, 2008. I was hospitalized from Jan 10 - Jan 18, first in the OB ward and then at the Heart Hospital. I strongly urge you, to take necessary action against the doctor so that no more patients like me are subjected to unnecessary trauma, pain and suffering. Such doctors should not be allowed to practice especially at big hospitals like Edward. At the very least they should be asked to undergo special continuing education classes before they are allowed to practice at Edward.
The other doctors involved in my care were Dr Ann Davis and Dr Stanley Clark from the cardiology department and Dr Maria Quejada from the Hematology department.
Thank you
Attached:
My incidence of what happened Before, during and after my delivery
Dear Ms Eller,
Pls refer to our telephonic conversation. I am attaching my story as talked with you. I chose to deliver at Edward because of the excellent reputation I had heard about the hospital. Infact i chose my doctor based on edwards referral program. So I was naturally stunned when this happened to me. I believe that when this can happen to an educated, logical girl like me , there are many more who are subjected to unnecessary pain and trauma.
At the request of the Food and Drug Administration (FDA), Bristol-Myers Squibb has strengthened its US label for warfarin (Coumadin) to include a black-box warning about the risk for major or fatal bleeding. It says that bleeding is more likely to occur during the starting period. Among others, the risk factors for bleeding include trauma, anemia and concomitant drugs
Warfarin label also reads that warfarin is contraindicated with recent traumatic surgery resulting in large open surfaces. Potential adverse reactions to COUMADIN may include: Fatal or nonfatal hemorrhage from any tissue or organ. This is a consequence of the anticoagulant effect. Therefore, the possibility of hemorrhage should be considered in evaluating the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis. (Source: http://www.fda.gov/medwatch/safety/2006/coumadin_PI_april2006.pdf)
And yet I was given Coumadin following recent abdominal surgery (C section), in absence of any symptoms and inconclusive CT scan reports. And these were continued for next 5 days in spite of my repeated denial of all symptoms (Pls see hematologist initial report saying that patient says she feels fine ) bleeding from surgical site, drainage from c section incision, increasing anemia in spite of thrice a day oral iron, increasing WBC count on antibiotics, fever and complete wound separation. After 5 days, clarification CTA and other required tests like VQ Scan and Ultrasound of lower extremities were ordered to conclusively rule out PE and DVT. It was determined I had no PE\DVT and I was not required to be on anticoagulation ever. I had several thousands in medical bills, severe anemia, weakness and anxiety and a 13 cm long and 2.5 cm deep abdominal wound for 14 weeks.
The FDA Med watch announcement also notes that warfarin prescriptions will also be issued with a new patient medication guide warning about potentially serious bleeding with the drug. FDA regulations state that such medication guides are to be provided with each prescription that is dispensed for products that the FDA determines pose a serious and significant public health concern. I was also not made aware of the possibility of bleeding on Coumadin.
This incident happened under the treatment of Dr Vimi Bajaj following my C section on January 10, 2008. I was hospitalized from Jan 10 - Jan 18, first in the OB ward and then at the Heart Hospital. I strongly urge you, to take necessary action against the doctor so that no more patients like me are subjected to unnecessary trauma, pain and suffering. Such doctors should not be allowed to practice especially at big hospitals like Edward. At the very least they should be asked to undergo special continuing education classes before they are allowed to practice at Edward.
The other doctors involved in my care were Dr Ann Davis and Dr Stanley Clark from the cardiology department and Dr Maria Quejada from the Hematology department.
Thank you
Attached:
My incidence of what happened Before, during and after my delivery
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