Hypoxia and Medicine

What are the chances of Hypoxia here?

My father was in the CICU at the hospital for pneumonia, he was getting better on the antibiotics that they gave him. I guess my real question is how fishy this sounds or if there were mistakes made, or something that could have been done to help him. Here it is: He was in CICU for pneumonia. The nurses didn't give him his antibiotics that the doctor ordered the first day he was there, but after he asked them about the antibiotics several times they finally gave them to him the following day. [This is the story we were given] 2 days later(The day he was supposed to be released) at 12:30AM he was talking to the nurse and told her that he was having trouble breathing, then he just stopped breathing. His heart was still beating for a little over a minute after the breathing ceased. The nurse administered CPR and Bag Oxygen and called the "Code" Blue. He was administered Bag Oxygen during the CPR and they got a heartbeat back quite quick, but it was irregular for 25 minutes. His vitals were stabilized at 12:55AM. The Nurse didn't call me (or anyone else in the family) until 5:45AM. I was told that he had suffered clinical death for a short period of time the night before but the nurse didn't go into any detail. [After all that] I went to the hospital immediately, but didn't get there until shortly after 7AM which is the shift change time. My father was having bad seizures at the time and I asked if there was something they could give him for them because I know seizures can damage the body. (They were every 5-10 seconds, were full body including eyes, and lasted about 1 second) They administered a tranquilizer to halt the seizures. The doctor that came to see him in the morning that we spoke with said that he didn't "know how this happened" and said that he did not have an explanation. He told us that our father was doing great the night before when he had gone home. Our father was then moved to another hospital immediately that had a neurology department. The department did a CT scan and an EEG. The Neurologist told us that he did not have any upper level brain function and that he had suffered from severe hypoxia or anoxia. He said that our father was gone and that we should "pull the plug and let him go" Aside from what we should do about our father, because that was already decided - he talked to us about his wishes before any of this ever happened... what I am asking here is: Was there more they could have done? Does this sound right? Did someone screw up and cost my family our father and my father his life? My father has 8 children. To my knowledge: They didn't intubate until after he was stabilized, didn't cool him to a hypothermic temperature during or after, and didn't give him any barbiturates at any point. And as far as the family can find out there is little to no information in his chart about the entire incident. Thanks for your well thought out answers in advance! My father is 57 years old. He has been on oxygen before after his open heart surgery, but never stopped breathing and his heart has never stopped before except during heart surgery when it is stopped by the doctors. My father has never had any hypoxia or problems like this before. The seizures did not start until after he was "brought back". I would imagine they are probably a result of the hypoxia or brain swelling?... He was in the CICU (Cardiac Intensive Care Unit) because of the fact that he had open heart surgery a little under a year ago. The doctors were worried that he might have COPD or CHF. He was not having any heart trouble at the time of this incident. (Well, until after the breathing stopped)

Public Comments

1. Well, first , I would DEFINITELY address the fact that his medicine was not administered the day it was ordered. If his pneumonia catalyzed his "clinical death" and cessation of breath, then I say it possibly could have been prevented from getting so bad if the nurses had given him his meds on time and you have a lawsuit! Also, if he was bagged right away and they were able to bring him back, I can't see why he'd have suffered hypoxia. Sounds like someone is lying. If he always had Oxygen circulating through his brain, he should not have hypoxia. Unless the seizures caused it...I'm not a doctor, but I don't see how they could. I'm very sorry this happened to your family, It sounds like the hospital screwed up, in my humble opinion
2. Firstly, my deepest condolences for your loss. It's a tricky situation because without having been there, I've no idea what was or wasn't done. It's would be really speculative on my part to suggest that the not giving him his medication on time had anything to do with his code. CICU patients are in a precarious situation and without having access to confidential records and his patient chart, I have no way of knowing whether he was hypoxic at the time of the code. Hypoxia at the time of the code Blue may have had been nothing more than a red herring (it's hard to say). In these situations, it's really difficult to find out if something should've been done differently to alter the outcome. With respect to the whole deal with the neurology consult, all the neurologist was saying was that during and after the code, there was insufficient oxygen being delivered to the brain as a consequence of the heart going into a weird rhythm (not so much an issue of how much oxygen he was getting). In short, I honestly don't think a strong case could be made that there was negligence and that even if there was negligence that it led to the damages. I wish you and your family well in this very difficult time.
3. First of all, the seizures your father was experiencing were most likely not seizures, but posturing. Posturing occurs when there has been significant damage to the brain. Decordicate posturing is when the arms are flexed up toward the body, and it rates a 3 on the Glasgow Coma Scale (GCS). Decerebrate posturing is when the arms are extended straight, and it indicates a worse score of 2 on the GCS. Severe hypoxia can cause all the symptoms you mentioned. It is possible that the medication was not administered in time, and your father's pneumonia worsened to the point of hypoxia and eventual brain death. It is also possible that your father threw a PE (a blood clot that travels to the lungs) and that is maybe why he had such a sharp decline in lung function. It could also be something else. Either way, you should hire an attorney. When someone calls a "code", there is a staff member on had who's sole job is to record the procedures, medications, and actions taken during the code. You need this record. The person who is your father's appointed next of kin or power of attorney should be the liaison with the hospital staff from now on. No more relatives talking to the nurses. Also, you need to request an autopsy. Contact the county coroner and ask for this. I have worked in several hospitals, and if your doctor has no idea why your father went downhill so fast, I would contact an attorney and subpoena your father's medical records ASAP before the hospital circles the wagons.