A doctor's outrageous claim

 Here’s another extract from the book:

Answers for Lisa

The extraordinary story of one avoidable hospital death and the people who helped those responsible avoid accountability

David Baker

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   In October 2008, Saratoga County Supreme Court Justice Stephen A. Ferradino dismissed my wrongful death claim against Samaritan Hospital and four nurses after the hospital paid Dr. Matthew Leinung at Albany Medical Hospital to provide an affidavit stating that the hospital was not responsible for Lisa’s catastrophic brain injury and subsequent death.

    But one of the claims Leinung made in his affidavit goes to the heart of the wrongful death claim, and is truly astounding. That he would make this statement in a sworn affidavit should question his fitness to ever have practiced medicine.

   The allegation in the lawsuit was that the hospital staff had failed to properly treat an episode of hypoglycemia - low blood  - glucose by neglecting to follow up a quick acting carbohydrate with a longer lasting protein, such as bread or cheese and crackers. Without that, blood glucose will rise immediately from the danger level but then rapidly fall.

   Entries made in the medical chart by the nurse treating Lisa that evening, show that she did not give her patient the required protein.  

   Four hours later Lisa was found unresponsive with a blood-glucose level recorded in her chart at an almost non-existent  level of 2 mg/dL (2 milligrams of glucose per deciliter of blood).

   Explaining away this fact, Leinung, without presenting any evidence, then made the following extraordinary claim:

  “Although defendants’ standard hyperglycemia protocol recommended that 1 protein should follow the administration of  juice, I can state with a reasonable degree of medical certainty that the administration of protein is no longer the standard of care for for the treatment of of hypoglycemia. Therefore, defendants’ failure to follow the administration of carbohydrates with 1 protein according to its protocol is not a deviation from the standard of care.”

   The hypoglycemic protocol was a printed document. The issue  current at the time of Lisa’s November 2003 admission to Samaritan Hospital was created on Dec. 10, 1997 and revised on Sept. 17, 2002 — 14 months before Lisa was found in her bed at 2 a.m., “unresponsive” and near death.

   On page 2 of the three-page protocol is the following instruction for treating moderate hypoglycemia (emphasis added).

“Give 15 grams simple carbohydrate i/e, 4 oz juice, skim milk or three tabs. Retest in 20 minutes. Repeat above treatment if symptoms persist and/or glucose is (less than) 60 mg/dL

  “If more than 1 hour remains before next meal [it did],  follow up above treatment with 15 grams complex carbohydrates and one protein serving: 6 oz milk with 3 graham crackers or 1 oz cheese with 6 saltines.”

   That’s what’s Lisa’s nurse should have done. But according to her own entries in the chart, she didn’t do it. 

  This nurse also was failing to comply with a doctor’s specific order; a telephoned instruction from Dr. Rajinder K. Jain, written into Lisa’s chart the previous afternoon that said:  “Follow hypoglycemia protocol if patient comes hypoglycemic.” 

   Apparently Dr. Jain, the consultant for Lisa’s diabetes, was unaware that the standard treatment for hypoglycemia specifying that a protein be given had been abandoned.

   But after acknowledging Dr. Jain’s order in his affidavit, Leinung then states that the nurse who ignored the protocol and Dr. Jain’s order to apply it was not negligent because “…the protocol itself did not set forth the standard of care.” 

  So Leinung blames the hospital’s management partly responible for the death, suggesting that only having detailed hypoglycemia treatment instructions in the protocol was not sufficient for the nurse to know how to treat her vulnerable patient.  

   

   The only conclusion to come from all of this is simple: Samaritan Hospital killed Lisa Baker, then went to extraordinary lengths to escape responsibility for her totally preventable and excruciatingly painful death, steps that included paying an unethical doctor at Albany Medical Center Hospital to state under oath whatever Samaritan Hospital’s management wanted the judge to see.

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