Final Verdict: Improper Monitoring Led To Death

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Final Verdict: Improper Monitoring Led To Death

Despite the epidemic of using Google or WebMD to self-diagnose, most people generally assume that doctors know more about medicine than they do. We trust doctors to diagnose properly, to identify the right course of treatment, to understand drug interactions, and to make sure that everything goes well. We also trust that doctors will look for possible issues or complications that we wouldn’t even know about.

This is particularly important when a patient presents with a combination of several different medical conditions. It may be difficult to monitor all the different interactions and keep a close watch on the entire range of symptoms, but it’s absolutely necessary. The treating physicians must be certain that the treatment for one particular condition or symptom will not adversely affect another. Doctors should be aware of what changes to look for and communicate clearly with their patients concerning the risks and challenges faced.

Often, adverse conditions show clear warning signs well in advance. The ordinary standard of medical care requires that physicians be aware of conditions that can worsen quickly. In many cases, the signs of a severe health risk will show early enough to allow correction if the ideal monitoring protocols are followed. If not, however, the condition may become so much worse than corrective action is impossible. A lack of proper care may include a lack of monitoring of known risks.

This was the case for Daniel Toussant, a 47-year-old airline mechanic from Lanham, Maryland. On January 7, 2013, he came to Doctors Community Hospital with diabetic hypernatremia. This is a condition where sodium builds up in the bloodstream. The physicians, including Dr. Enrique Samanez, treated Daniel at the hospital. However, as a result of the treatment, his sodium levels dropped lower and lower, far below what was safe. Sodium is a primary electrolyte used by the body to transmit nerve impulses. When sodium levels dropped too low, Daniel suffered a hyponatremic stroke, resulting rapidly in swelling on the brain, a cranial herniation, and death.

Daniel’s widow and children filed a lawsuit on behalf of his estate, arguing that Dr. Samanez had failed to properly treat Daniel and control his hypernatremia. They alleged that if he had continuously monitored the sodium levels, they would have had time to intervene well before the stroke took place. The estate sought medical damages, wrongful death damages, and non-economic damages for pain and suffering. Cohen & Cohen

The trial in Prince George’s County took six days, during which both sides presented arguments. Dr. Samanez argued that death was not the result of the drop in sodium, and claimed that even if it was, it was not his fault. Dr. Samanez said his care met ordinary standards within the practice of medicine and that Daniel’s death was not the result of any negligence, pointing to Daniel’s pre-existing diabetes, ketoacidosis, and metabolic problems. He also generally disputed the cause of the stroke. 

However, the jury did not agree. After six hours of deliberation, they returned a verdict of medical malpractice, awarding the estate over $2.4 million.