I'll try to keep this short. My father passed away recently after years of struggling with COPD, pneumonia, and CHF He was in a nursing rehab facility for short term rehab and was not himself and not getting any better. I told the nurses that he isnt himself so they sent him out to ER. The ER did a chest xray and sent him back to rehab within an hour. The ER said that it was normal for him. This is the hospital that he always goes to and they know him there pretty well. He was not himself. He was not normal. And they sent him back. The next day his condition continued to worsen. So I had him sent out again to a different hospital. They found that his kidneys has stopped functioning and had to start him on dialasys as he was very toxic. This explains his sickness and confusion. The next day after a couple rounds of dialasys and later in the night he went into cardiac arrest. Most likely related to the strain on his body from his kidneys and the dialasys. Well he suffered brain damage and never recovered and was gone a few days later. My question is did the ER screw up by just assuming and sending him back to rehab and should I pursue legal action against them? Thank you

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I'm very sorry both for your loss and for how traumatic these past weeks must have been for him and your family.

Did the first ER screw up? They did a chest x-ray, presumably looking to see whether his pneumonia needed more aggressive treatment, and found no significant changes from the last one which, again presumably, they would have had on file. I'm surprised they didn't also do routine blood tests - are you sure they didn't?

Pursue legal action... For what? What different outcome might have been achieved if what had been done differently?

Your father had multiple serious chronic conditions. Treating his pneumonia would have involved a very delicate, complex set of clinical judgements about risks and benefits, and even if they managed this to perfection your father was still dangerously ill. I am only a lay person but speaking for myself I would be asking the second hospital to justify subjecting a man in his terribly frail condition to dialysis.
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If you want to add misery to grief, yes, go ahead and try to sue.
Your father was old, very sick, and already dying. The ER did what ER's do--quick diagnosis and then make the decision to admit or send home. They could not have looked down the road and seen that his kidneys would fail---as much as you want to blame "someone" for this, the EOL is often just what your father experienced...going along "stable" for some time, then suddenly, without warning, things go south. We're not prepared! We're confused!

Take a breath, get through the next few weeks of planning and coping and circle around back to this later.

Med mal suits are so depressing and awful. You are mourning right now, and perhaps a bit angry. I'm sorry for your loss, but you probably do not have a case at all.

Take care of yourself and try not to dwell on the last days of dad's life.
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My condolences on the loss of your dad. He was quite ill for a long time as COPD & CHF are overvtime illness’s.

By worth persuing, I’m assuming you meaning suing someone for causing dads death. Anyone can sue, but getting a wrongful death settlement due to medical malpractice probably a non-starter. He’s going to have a huge medical chart that shows all kinds of issues over years that are factors on mortality and morbidity scales. They all can be used to deduct from life expectancy. If he was over 76.1, he’s over life expectancy for men in the US. Yeah it’s harsh but lawsuits are a numbers problem. 

Wrongful death seems to work IF there are dependents, like wife and underage children, & settlements seem to paid to Estate of & in C/O of the spouse. So as it’s paid to Estate there’s ongoing probate involved.....

Also often ERs are a separate legal entity than the hospital & with the ER MDs there as contractors. Not employees of the ER or hospital. So who gets sued gets muddled. I’d imagine the dialysis paperwork states risk as well.

Anyone can sue... but getting big settlement not likely imo.
Perhaps your time can be better spent with bereavement counseling. 
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Also realize that if there is malpractice and you get a settlement, there will be Medicare and medicaid in line first to get a reimbursement of any monies paid to either ER, hospital, doctors, pharmacies, etc. on his behalf. Any settlement after lawyer fees and medical reimbursements would be small. You would be better served to request a review by the hospital board at both hospitals to see if proper procedures were followed, which costs you nothing and is a flag later for Medicare if your aim is to improve care. With long term illness, as igloo, mid and CM cite, it's hard to prove the last procedure was the "proximate cause of death".
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I've just been wondering: was the rehab team bound by an advance directive or anything like that?

It's terribly sad to think of, but I can't help feeling that they would have done better by both your father and all of you to make him comfortable where he was. Again, I'm very sorry for your loss.
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IMO, no, don't act on what you perceive as error.
You said your father suffered from multiple lung problems. That would have been the logical place to start. They took an X-Ray. Nothing changed.
The docs have a set of guidelines to follow to admit someone. If they don't follow these guidelines, the hospital won't get paid and they will have to "eat it". Do that enough times and your doctor no longer has a job or the hospital goes broke. Your father must not have met the criteria for admission.

You said your dad "was not himself, he was not normal ". You know your dad better than anyone. But, if the ER doc doesn't see that he's not "himself or normal", he wouldn't be ordering more tests. No case of negligence there.

Doctors are human and don't catch everything. They also make mistakes. In this case, it would be hard to prove substandard care.

If you're asking about the other hospital, they did blood work because they probably knew that it was his second time in an ER. Time to dig a little deeper. Dialysis has its risks too.

I, too, thought I had a case. My dad had a history of clots (DVT and a pulmonary embolism- serious stuff). A trip to ER for a fall and the doctor took him off blood thinners. Her rational was that he could "bleed out". He went home and didn't take the anticoagulant anymore. Long story short, he died from 3 strokes (probably caused by blood clots.) I was furious but realized she was between a rock and a hard place. If he fell and hit his head on blood thinners, he could die. If he didn't take the meds, he could have a stroke and be paralyzed or die. There was no GOOD answer.

It sounds like it may have been your dad's time to go. I'm sorry for your loss.
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Thank you for all your responses. I feel that some of you speak on emotion, either past or present experiences. And maybe Im doing the same thing. Im dealing with dads death fine, I know he fought for a while. Its not anger or grief, its just me having a nagging feeling that something was missed. Or that he was dismissed becuase of his history. Todays health care industry is a money grab and a complex system designed around gaining wealth. At all costs. So dont fault me for feeling like maybe something was wrong with the system, and my dad paid with his life. I probably wont pursue anything, but I will at least run the situation by an attorney and let them decide for me. Thank you again.
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Race, I'm so sorry for your loss.
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I certainly wouldn't blame you at all for wanting your father's care reviewed and any mistakes, individual or systemic, highlighted.

But, speaking of money grabs and systems designed to gain wealth... do choose your attorney with the greatest care, won't you.
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