Ramirez Case Summary

Details: On October 9 ^th, Diego Ramirez came to the emergency room complaining of flu like symptoms. Specifically, Diego Ramirez complained of fever, chills, dyspnea, cough, and nausea. Diagnostic studies revealed a DVT present in the left popliteal vein.

Later that afternoon Mr. Ramirez’s labs came back with a slightly elevated creatinine level. The attending physician requested a hematology consult who ordered Lovenox 80 mg every 12 hours because at the time Mr. Ramirez had the probability of developing a pulmonary embolism. A pulmonary consult was also requested. The pulmonary consult ordered that if additional diagnostic testing were negative, that the Lovenox should be decreased to 40 mg once a day. Later that day a CT scan with contrast was performed which did, in fact, come back negative as there was no mention of any type of embolic event.

The following day Mr. Ramirez’s creatinine levels had risen to 2.0. That morning the hospital administered 40 mg of Lovenox per the pulmonology consult which would have been the only dose of Lovenox Mr. Ramirez would have received. However, Dr. Smith indicated that she never saw this consult note and ordered the Lovenox at 80 mg twice a day. The following day, Mr. Ramirez’s creatinine levels continued to remain high. Later that night, Mr. Ramirez passed out and he was transferred to ICU 90 minutes later where it was determined that he had developed a retroperitoneal bleed. The following day Mr. Ramirez went into cardiac arrest and was subsequently resuscitated. His health continued to deteriorate and his kidneys continued to fail as a result of the over medication of Lovenox. Eventually, Mr. Ramirez succumbed and passed away.

Outcome: The case was mediated where a settlement of $1.4 million dollars was reached.