Mismanaged Coumadin Therapy Leads to Woman’s Death – $5 Million Settlement Reached in David v. Rush North Shore Medical Center

When undergoing a major surgery, as patients we tend to focus on the risks associated with the surgery itself: will the doctor cut something he shouldn’t, will I have a bad reaction to anesthesia, or will my body reject the new heart. However, in some instances the period following the surgery can be just as risky as the surgery itself.

Take for example The Estate of Shamiran David v. Rush North Shore Medical Center, et al., 07 L 8444, an Illinois wrongful death lawsuit involving the death of fifty-nine year-old Shamiran David. Mrs. David presented to Rush North Shore Medical Center in July 2005 for an aortic valve replacement and coronary artery bypass surgery. While the complex surgery went well, Mrs. David’s post-operative care was mismanaged, leading to her death less than six months later.

Following her heart surgery, Mrs. David was placed on Coumadin therapy, which is the common procedure following a mechanical aortic valve replacement. Coumadin is a drug that works to decrease your blood’s clotting ability in order to prevent blood clots from forming. However, it is important for patients taking Coumadin to be on the right dosage. If too much Coumadin is given, a patient is at increased risk for bleeding; however, if too little is given, then the patient is at risk for getting blood clots.

The David lawsuit was not critical of the way the hospital managed Mrs. David’s Coumadin therapy, but rather alleged that her primary care physician failed to maintain the proper dosage of Coumadin for Mrs. David. Within a month of her surgery, Mrs. David was back in the hospital with a significantly elevated pulse and high respiratory rate.

However, while the physicians at Rush might have managed Mrs. David’s initial surgery well, they did not manage her return hospitalization well. Mrs. David’s elevated vital signs indicated that her heart and lungs were working too hard. In an effort to try and find the source of her raised vital signs, an ultrasound of her chest was order. While the ultrasound clearly demonstrated that Mrs. David was suffering from pericardial effusion, this condition was not recognized by her physicians in a timely manner.

Pericardial effusion occurs when fluid builds up around the heart. This fluid then presses on the heart and surrounding structures and if untreated can lead to cardiac tamponade, a life-threatening condition that results from the build up of blood or fluid in the space between the heart’s outer sack and the heart’s muscles. This is in fact what happened in Mrs. David’s case – her doctors failed to recognize the presence of pericardial effusion and therefore did nothing to prevent the onset of cardiac tamponade in Mrs. David.

Even though shortly thereafter the staff at Rush attempted to surgically repair Mrs. David’s condition, the delay in treatment appeared to have diminished her chance of survival. While her initial heart surgery in July went very well, the August surgery did not run as smoothly – Mrs. David suffered a cardiac arrest and subsequent brain injury during the second surgery. She died six months later.

The Illinois wrongful death lawsuit of David alleged that Mrs. David’s medical providers failed to identify her pleural effusion in a timely manner and therefore neglected to treat the build-up of excess fluid in Mrs. David’s heart that led to her eventual death. The medical negligence lawsuit focused not on surgical errors during her initial surgery, but rather the medical mismanagement of Mrs. David’s resulting condition.

Rather than going to trial, both parties elected to settle the Illinois medical malpractice lawsuit for a total of $5 million. The breakdown is as follows: –

$3.4 million by Rush University Medical Center on behalf of Robert S. Higgins, M.D.;
-$600,000 by Rush University Medical Center for its own negligence; and
-$1 million by Audisho Khoshaba, M.D.

Mrs. David was survived by her husband and daughter.
Kreisman Law Offices has been handling Illinois wrongful death matters for more than 35 years in and around Chicago and Cook County, including surrounding areas such as Stickney, LaGrange, Oak Park, Cicero, Lynwood, and Niles.

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