Brain Injury Following Overdose of Seizure Medicine – Lack of Oxygen
Filed under: Brain Injuries
The Roland Case
Rhonda Roland was a 42 year-old registered nurse who had experienced seizures for which she was receiving treatment. In early 2006, she returned to work as a nurse, but began to experience nausea and other gastrointestinal problems. Because she was not absorbing her medications due to the gastrointestinal problems, her seizures returned. The doctors performed surgery and removed her gallbladder, hoping that it would help things, but it didn’t.
In early May, 2006, Rhonda was getting ready to work when she suffered a grand mal seizure. Her sister took her the local hospital for treatment, and at the local hospital, the emergency room doctor wanted to admit her for treatment.
Rhonda’s primary care physician, Dr. Eagle admitted Rhonda to the hospital with the understanding that Rhonda’s local neurologist, Dr. Mickel, was going to be the doctor to treat Rhonda’s seizures. Dr. Mickel was consulted and agreed to treat Rhonda.
After Rhonda was admitted, Dr. Mickel saw Rhonda but he did not do any testing or change any medications. Dr. Eagle saw Rhonda too, but she deferred to Dr. Mickel for her care.
Unfortunately, the next day, Rhonda suffered another severe seizure, and at that point, Dr. Mickel changed Rhonda’s medication to include the drug Depakote; a serious seizure medication. Depakote is used to treat seizures, but too much Depakote can cause ammonia to build up in the body, and can cause unconsciousness and death. To make sure that doesn’t happen, the doctor is to order blood tests to monitor the amount of Depakote in their patients. However, Dr. Mickel failed to order these tests, and in fact, increased the dosage of Depakote.
The next day, after several hours of not being monitored by the nurses, Rhonda was found to be unresponsive and in a coma-like state. Dr. Mickel saw Rhonda, and ordered an EMG or brain scan test, and not seeing an active seizure, he concluded that Rhonda’s unconsciousness was simply residual from the earlier seizure. Dr. Mickel failed to consider the medication that he had given Rhonda was having an effect on her.
Over the next day, Rhonda’s neurological state greatly declined, and she began to experience trouble breathing, and her heart rate increased. The following morning Dr. Eagle came to see Rhonda, and saw the condition that Rhonda was in, and began working on a transfer to a different hospital.
During this time that Rhonda’s condition worsened, Dr. Mickel did not see Rhonda again. When the paramedics arrived for the transport, they noticed that Rhonda was struggling to breathe, and asked whether or not she should be intubated. The nurses said that they did not know, and denied them access to any doctors to make that decision.
Rhonda was taken to another hospital where she was intubated immediately and cared for. She remained in a coma for another week before the medication was changed and the high ammonia level in her blood receded.
After investigation of the case, it was determined that Dr. Mickel had prescribed too much Depakote, which caused Rhonda’s ammonia levels to rise such that she was in a coma and unable to breathe. This lack of oxygen caused a brain injury, and after emerging from her coma, Rhonda began to feel the effects of the brain injury, and is no longer able to work as a nurse.
A lawsuit was brought against the local hospital and the nurses, as well as Dr. Eagle and Dr. Mickel. Dr. Eagle and Dr. Mickel defended the case based on the fact that Rhonda had a previous seizure history, and they did not cause any brain injury. The nurses at the hospital defended the case on the basis that they provided the proper care.
Before trial, a settlement was reached with the nurses at the local hospital for a substantial amount.
Trial did proceed against Dr. Eagle and Dr. Mickel, and after a week of trial, the jury found that Dr. Eagle and Dr. Mickel were not responsible for Rhonda’s harm. However, the settlement did allow Rhonda to deal with some of the issues of ongoing cognitive difficulties and inability to work as a nurse.