The physician ordered a CBC, CMP, cardiac panel (CKMB and troponin), BNP, chest x-ray, and EKG. The labs relevant lab results are a glucose of 418, negative cardiac biomarkers, and a BNP of >5000.
The EKG is shown below for MedMalReviewer subscribers.
An x-ray was obtained. The actual images are almost never included in court documents, but the x-ray interpretation is shown below.
The physician recognized the patient’s hyperglycemia, and gave a dose of insulin. The patient also received Zofran 4mg IV and Dilaudid 1mg. She was given an initial dose of Dilaudid 1mg IM due to vascular access issues, then a second dose of Dilaudid 1mg IV later in the course of her care.
On recheck, the blood glucose had improved from 418 down to 313.
Multiple repeat vital signs were obtained.
The physician reassessed the patient, and she seemed improved. Her vitals were noted to be normal, and the results of her tests were reassuring. Therefore she was discharged from the ED with instructions for follow-up. The remainder of the physician’s note is shown here.
What do you think the bad outcome will be?