- Joined
- Sep 17, 2014
- Messages
- 773
- Reaction score
- 1,456
http://www.kansascity.com/news/local/article82946017.html
Hughes had learned many years before, directly after her first daughter was born, that she suffered two blood-clotting disorders: Factor V Leiden, which could cause clots in veins, particularly during pregnancy, and Protein S deficiency, which also causes blood to clot quickly.
After three children, Hughes understood the care she needed to take. She went to her obstetrician, who had previously treated her high-risk pregnancies. She followed the recommendation to use a blood thinner. A lab monitored her blood readings.
“I knew what I was doing,” Hughes said.
Then, at about 35 weeks, agonizing pain struck her right side. She’d been coughing because of bronchitis and had been put on antibiotics and given an inhaler. But this went beyond coughing pain.
“I could hardly move, it hurt so bad. I could hardly stand it,” said Hughes, who called her doctor. “He said, ‘You probably pulled a muscle.’”
But by 10 p.m. that Sunday, Sept. 19, Hughes was in such intense pain that she telephoned her mother, Harriett Ellis, who drove from her home in Excelsior Springs. Soon they were on their way to the E.R.
In the hospital
Hughes was worried about her baby when she arrived at North Kansas City Hospital.
Questions arose over whether she should first be seen in the E.R. or, because of the pregnancy, immediately go to labor and delivery to be checked and monitored.
The E.R. took the case. Sunday night rolled into Monday. Shortly after 1 a.m., Niedens, the E.R. physician, examined Hughes and ordered lab tests and a sonogram. She was made aware of Hughes’ clotting conditions and knew she was on a blood thinner. Tests showed her blood was not clotting quickly at all.
The doctor correctly diagnosed the problem: Hughes had gallstones and a hematoma, essentially a pocket of blood, on the inside wall of her abdomen.
“That was exactly right,” said Hagen, one of Hughes’ lawyers.
The issues of medical malpractice and wrongful death would arise from what happened next. In court, Hagen and Dameron argued that the standard way to know whether a hematoma is expanding or receding is to check its size with one or more additional sonograms.
“You have to monitor the mom,” Hagen said.
Instead — after a consultation with the doctor on call at Hughes’ obstetrical group — Niedens discharged the expectant mother with a prescription for pain pills. Tackling the gallstones would have to wait until the baby had been born.
Hughes arrived home about 5 a.m. Monday. She had an ob/gyn exam scheduled for 9 that morning. But because she was exhausted and had just left the hospital, she missed the appointment, a point the defense would raise in court.
Hughes remained in tremendous pain.
The next morning, Tuesday, Sept. 21, she failed to answer the phone. Brooke, her stepdaughter, became worried and headed to the home. She found her mother ashen, almost unresponsive. A short time later, an ambulance was speeding Hughes back to the E.R. at North Kansas City Hospital.
“She had lost more than 50 percent of her blood volume,” Hagen said. “She was dying. Her kidneys were shutting down. Her brain was affected.”
The hematoma on her abdominal wall had not shrunk. Instead, it had grown from the size of a fist to about the size of a volleyball; her tissue was filling as she was bleeding internally. From the E.R., she was admitted to the intensive care unit.
“She was fighting for her life,” Hagen said. “A minister came and gave her last rites.”
Hughes lived, but she was told her baby was dead.
“Chayden died of asphyxiation,” Hagen said. No blood flow, no oxygen.
Hughes’ labor, induced, lasted eight hours.
“I have a foggy memory,” she said recently. “When he did come out, I waited for him to cry. He didn’t. I waited, and waited and waited. He was so perfect. He looked so normal.”
“But even doctors make mistakes,” said lawyer Kathy Hagen, who represented Hughes with colleague Russell Dameron of the firm Watson & Dameron. “When they make a mistake, there has to be justice.”
