A critical care expert witness opines on a case in which a patient is left in a persistent vegetative state after suffering a cardiac arrest in an intensive care unit following valve replacement surgery. This case involves a thirty-four-year-old female patient with a past medical history of type I diabetes and aortic stenosis for which she was under the care of a cardiologist. The patient’s valve disease was causing her increasing morbidity and it was decided that she should undergo surgical intervention. The patient underwent a cardiac valve replacement surgery that was reported to have gone very well with no intra-operative complications. The patient was transferred to an intensive care unit for post-operative monitoring. Four days after admission to the ICU the patient suffered a cardiac arrest. The incident occurred after several days of bradycardia was noticed but no code was called until the patient was in asystole. The patient suffered from anoxic brain injury and was left in a persistent vegetative state as a consequence. It was alleged that the health care professionals responsible for this patient were negligent for failing to adequately monitor her. Additionally, it was noted in the patient’s chart that she may have experienced an acute episode of hypoglycemia as the blood glucose level measured 13 on finger-stick. The patient was on an insulin drip in the days prior to the cardiac arrest and it was believed that an inadvertent dose of insulin was administered due to human error. It was believed that the dangerously low blood glucose level caused by the unnecessary dose of insulin may have been what precipitated the cardiac event.
