Medical Malpractice Case Report: $1.3 Million for Failure to Treat Vitamin B1 Deficiency After Bariatric Surgery Resulting in Wernicke’s Syndrome
Firm Partner Peter A. Schmit succeeded in obtaining a $1.3 million settlement for his client in a medical malpractice case for failure to timely identify and treat a vitamin B1 deficiency resulting in Wernicke' Syndrome. Read the following Minnesota Case Report, Vol.30, No.1, Summer, 2011.
(Excerpts taken with permission from Minnesota Trial Lawyer Association’s (MTLA) “Minnesota Case Reports”)
K.N., age 30, underwent bariatric surgery in October of 2007 in an effort to treat her morbid obesity and accompanying physical limitations. After initially doing well, K.N. began to report an inability to eat and retain food, no vitamin intake, nausea, vomiting and then dizziness and blurred vision. On December 26, 2007, Dr. B. readmitted her to the hospital for a full assessment and monitoring. As part of the admission orders, Dr. B., through a nursing assistant, ordered K.N. to receive fluids and undergo laboratory tests, including a vitamin B1 test. The hospital records indicate the test was ordered on December 26, 2007. There is no indication in the medical records as to when the test result was returned or posted so that the care providers could see it. The record indicated that the hospital sent the sample to a lab in Utah for analysis. During discovery, it was learned that the laboratory performed the test and transmitted the result to the hospital electronically on December 30th.
The vitamin B1 lab test was abnormally low and, during discovery, Dr. B. testified that if he had learned of this low value, he would have treated her vitamin deficiency. (Plaintiff's expert opined that Thiamine should have been given based on her symptoms.) There were several residents responsible for caring for K.N. during this hospital stay and they also testified that had they been informed of the abnormal lab results, treatment would have been initiated. Despite acknowledging that it is part of their job as residents to look for abnormal lab results, no one saw and acted on the abnormal result. The residents claimed the B1 result was either not in the electronic medical record system or not reasonably accessible. Defendant hospital produced a computer screen shot that the hospital contends correlated the lab result with an entry in the hospital system of December 30th. The hospital witnesses testified that the lab result was available in the electronic system while K.N. was still hospitalized.
K.N. was discharged from the hospital on January 2, 2008, and by January 4, she was incoherent and was transported to a local hospital and, under the care of physicians there, she did receive vitamin B1 therapy. Unfortunately, K.N. is left with some vision, balance and memory difficulties. She has been diagnosed with Wernicke's Syndrome, a neurological disorder due to abnormally low levels of B1. Despite improvement over time, K.N. still has cognitive difficulties. K.N.'s hopes were to begin working at a refuge for battered women where she had been a client after recovering from the gastric bypass surgery. It is unlikely K.N. will be able to work, at least at a full-time capacity based on her current physical condition. She remains obese and the cause of her inability to retain nutrition/vitamins remains unknown.
The case presented several interesting issues regarding the accessibility of lab results in an electronic medical system; the interplay between the attending physician who seemed to rely almost exclusively on residents to provide day-to-day care; and the training of residents and attending physicians in the use of the electronic medical record system. Ultimately, all defendants contributed to a settlement. Medical specials totaled approximately $89,000. A structured settlement company was utilized to create a very attractive lifelong source of income for K.N.
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