Sunday, October 13, 2019

My Wife Linny - Angiography Goes Wrong In 2019


My wife, Linny O’Hara, was scheduled for an angiograpy on Friday, October 11th, 2019.

A cardiologist who has been in practice for at least 30 years performed this procedure. He said that he cleared an 80% blockage in a stent that had been placed in her heart in 2016.  The stent had been clogged with plague and naturally occurring tissue.

He also found another blockage, and used a catheter with a balloon to enlarge and remove that blockage.

SHE WAS AWAKE DURING THE ENTIRE PROCEDURE, DESPITE BEGGING TO BE ANESTHETIZED!

After the procedure, the doctor came into the waiting room and told us he had intended to insert the cardiac catheter into Linny's radial artery, but she went into spasms. He had to instead insert the catheter into her femoral artery, which caused the procedure to be extended.

At that time she nor I were not aware of several things. One was, why did she not have anesthesia. We did not know the other issue either, which was in removing the catheter, the guide wire the physician was using had apparently punctured her femoral artery, and this puncture caused bleeding into her the rear of her abdominal perineum to occur.

Apparently doctor was not aware of the fact that he had punctured her artery.  He sent her to cardiac care for overnight observation before releasing her to go home. Which is the routine procedure.

That morning the nurses in the cardiac care unit monitored her blood clotting factor for the next four hours, before removing 'the plug'. This procedure required two nurses to perform. A blood sample from the site was taken and placed on a slide on the electronic device. This occurred multiple times prior to removing the plug.

Later that evening, Linny was still feeling weak and bad. A couple of nurses asked her if she could walk to the bathroom. She made it to the toilet, where she fainted and passed out. An emergency Code Blue was called.

At least 20 doctors, nurses, and lab technicians came running down the hall and into her room. They lifted her off the floor, revived her, and to make a long story short, much lab work was ordered.

After I pointed out that Linny's pain was radiating from her groin, above the incision one of the nurses yelled, "damn, she is bleeding!". As the nurse applied manual pressure to her groin, and it was noted that her blood pressure immediately improved. The head nurse put in a call to the cardiologist. An emergency CT scan was then ordered. That was when the site of the bleeding was discovered.

The order was placed for her to be immediately moved to cardiac ICU. And a vascular specialist was called in for possible emergency surgery. I overheard the nurse's phone conversation. It was late in the evening and he DID NOT want to come in to the hospital. Eventually he relented and showed up.

Over the phone this vascular doctor ordered an unusual tourniquet called a ‘Femostop’. The nurses had to call several different units before one was finally discovered. It was placed on her in the cardiac care unit, prior to her being moved to Cardiac ICU.

This Femostop device was placed around her lower abdomen. It consists of a plastic frame that has a large plastic ball on one side of it, with straps that go around the groin which can be tightened by inflating a manometer similar to that on a blood pressure cuff.   The ball was squeezed into the site in her groin where the cardiologist had made the large incision to insert the heart catheter into the femoral artery. This gave substantially more pressure than a nurse could manually apply.

After being transported to Cardiac ICU, Linny had to wear this device for over 3 hours. By the time I was allowed into the ICU, I found her screaming in absolute agony, and she was out of her mind in pain.

Weeks later, after later reading the literature, I do not believe the device was used following manufacture directions. The manometer was to be inflated to the systolic pressure and gradually deflated. In the ICU, the deflation occurred only after the 3 hour period had ended. Many institutions no longer use this device. However it appeared the hole in her femoral artery developed the desired blood clot.

Late that same evening a male nursing assistant and two male RN's made three unsuccessful attempts to put a 'straight' urinary catheter into her bladder. One RN even announced, "I cannot find the hole". This was not just embarrassing and painful, but intrusive for any woman. And due the trauma caused by the Femostop, and the blood loss made the cauterization incident much worse for Linny. She later developed a urinary tract infection, which was healed by medication.

The next morning a female nurse placed a Foley catheter in Linny without any problems. This achieved the desired results, and the container immediately filed up with almost 5,000 cc's of urine.

All night Friday and most of the day and night on Saturday she was in and out of consciousness. Around 4 am on Sunday morning she was given 2 units of blood, and then she began to perk up. Why did they wait so long?  We will never know.

The next day she was visited by another doctor in the cardiologist practice. Instead of apologizing, he explained that ‘it seemed the guide wire used by the doctor may have punctured her femoral artery. The was a known complication that occasionally occurs’. 

He did not explain anything about us incurring additional medical bills for her extended stay in the intensive care unit caused by the cardiologist error, or why little or no anesthesia was used during the procedure.  Why did that physician say, "You don't need it!"?  Seeing my wife in her semi-conscious state, I was too much in shock when I spoke with this man to ask him the questions that I later should have asked him.

She was released from ICU late on this Sunday afternoon, and moved to a step-down cardiac care unit where she was on Sunday evening October 13th. At that time, we were told a doctor has ordered another CT scan for October 14th, to check that all bleeding has stopped.

But the CT scan was later cancelled and we were told that "It was an expensive, and unnecessary test since her blood pressure is back to normal now, and her blood work shows that she is no longer low on blood". It was just assumed that the bleeding has stopped.

A different doctor visited her on Monday,  October 14th and released her from the hospital later that afternoon. He admonished her to "just take it easy".

On Wednesday, October 16th, that cardiologists office called our home to ask if she was feeling any better. She let them know that she was not, and was unable to do much other than sleep, and it was  now hard for her to breath. They ordered her to go the the emergency room right away.

She arrived at Saint Elizabeth Edgewood's emergency room around noon.  X-rays and blood work were ordered. We overheard a doctor in the hall ask someone, "I'm not going to get involved in a hornets nest for treating her?".  That doctor arrived about an hour later with the results, and stated that Linny had pulmonary embolism in both lungs. She was immediately put on blood thinner. He indicated this was an extremely terrible situation, and it was probably caused by the 'retro-peritoneal' blood that had pooled in her body, which was being absorbed.

Linny spent almost eight hours in the emergency room on intravenous blood thinner, and fluids. She was then transferred to a coronary step-down unit. She was released five days later on Sunday October 20th.

About a week later she was asked to come into the cardiologist office at 380 Centre View Blvd., Crestview Hills, KY 41017 to see Dr. Kami Tehrani. He seemed unaware of the situation. He reviewed her chart, examined her and noted that her blood pressure was very low. He reduced the amount of Carvedilol that she was taking, and suggested that she monitor her blood pressure. She already does this routinely.

Linny was put on Eliquis. The first month was free. However as she is on Medicare, any manufacture discount does not apply. This medicine, with her prescription health insurance would cost around $240 a month, which I was set to pay.  She was seen by our family doctor, Gigi Tcheng in mid-November. Dr. Tcheng had enough samples of Eliquis to give Linny a two month supply. We are very grateful.

Not only was my wife's life almost prematurely ended by some physician malfeasance, but I had to take off work for over two weeks, without pay, to take care of her.  On October 11th, 2019, I noted on the surgical procedure board in the outpatient waiting room for the Cauterization Lab well over 60 patients that were having procedures done. I doubt if any of those other patients were injured.

I am grateful that my wife is now on the mend. For anyone reading this, please keep her in your prayers.