Narcan Induced Takotsubo

Tuesday, Sept 3 2019 

Arrived at 10 am to register my 75-year-old mother for surgery and she had to pay a copay for shoulder replacement

Went into outpatient by 11 am

Surgery by 12:30 latest

She came to the room after 4 pm

  When the Anesthesiologist brought her into the room she was relaying info to the nurse on duty and said that she had to give my mother a dose of Narcan to wake her up because she was a “hard wake”. I questioned her at the time because I knew that was the drug used to wake an overdosed person. I joked that I was going to kid my mom about it. 

Everything moved fast but I caught a few things that were said. One of them was that the anesthesiologist told the nurse on duty that she had not had time to document it yet and so she wasn’t going to see it on her chart yet and the nurse said that she was almost off of her shift. They told me to shake her to wake her and give her ice. Try to keep her stirred because she was still completely zonked out and so I did for the next three hours. 

  I took a picture of her monitor screen and as I was trying to focus for another shot on my phone the machine beeped and I could see through the screen a number that read 220 this was at 6:17 pm. At that moment my mom moaned through her sleeping state and it sort of freaked me out, so I felt bad about taking the pics and stopped assuming the nurses at the desk could read the readout that her monitor was showing us. Through the night this beep moan thing happened. We never saw the initial nurse that set her up in the room after that. Once the night nurse made her rounds she finally woke up and was saying that her foot hurt so bad. So I got up and pulled the covers to expose her leg which had the surgical hose, hospital bootie, blood pressure cuff and an alternating air pump sleeve for clot prevention. The nurse was upset that both were still going and pulled the sleeve and I pulled off the bootie only to reveal that it was acting as a tourniquet and her foot was completely swollen with about an inch indention where the sock band had been. All fluid. I expressed concern and told her about the monitor beeping and the 220 number at that time. She got her bedding cleaned up and tossed an iv bag that was never administered that the original nurse said she was going to let it run since we paid for it. It never ran. She attached the new bag and administered meds and the night went on from there fairly non-eventful other than the spikes in her heart that I was only hearing and when I had to get them to do a catheter on her bladder because she was in abdominal pain. I was sleeping I the cot next to her by the time they got there and it was her and another dr in a white lab coat doing the procedure together talking over it. I was in and out but they woke me at that time to ask me if she had a history of heart problems. The answer was no.  I think it is logged digitally in the machine. Better be. 

 The next morning we wake up and it is tough and I expected it to be tough because she had a total shoulder replacement. I was trying to mentally prepare for the ride home knowing it would be a tough one but we had prepared and were ready to take on this recovery period. 

Physical therapy came and went. She had discharge papers ready although nothing was signed and lunch was delivered. I cut up her vegetable medley and she took a bite immediately looking for the oxygen cannula. She isn’t an oxygen patient but had it all night. I put it on her and she continued to struggle for breath and was begging me for air. I pushed the button on the side on the bed rail which I later found out probably don’t work. I went into the hall and told a nurse there was an issue and she went down the hall to get her nurse while I went back into the room and pressed the remote nurse station button finally running down the hall yelling for help. The nurse then passed me saying she’s coming and I could clearly see the woman was on the phone still so I turned back and headed towards room where other nurses asked what was wrong and I told them that she could not breathe.  

The next thing I know she is a CODE BLUE I am kicked out of the room and they do an EKG and X-ray BiPAP and I have no other idea what else because I was in there. They stabilized her heart and lungs and let me back in telling me they were taking her into ICU. Several Dr.’s at that time asked me about her heart and one came to me with an EKG sheet talking to me about it looks like a heart attack and another nurse followed me into the stairwell saying it was pulmonary edema. I told them about the Narcan at that point.  

We get to ICU and I get in trouble for taking a pic with them in it. I left to clear out the room we were in and by the time I got back family was beginning to flow in. We were supposed to be home not ICU. Shoulder. We visited and we were told she was stable and she suffered a heart attack and were doing an ultrasound and scheduled a Cath for in the morning.
We left for the evening to let whatever just happened to be tended to. Through the night she had spiking in her heart rate and staff all over her telling her they were in control. Dr. Lichin told her at some point that she had suffered massive heart muscle damage and then later came back saying maybe it wasn’t as bad as it first looked. Backtracking. All the hospital could talk about was a possible pre-existing heart issue condition, talking about the blockages she had to have. I stopped the ICU nurse to tell him about getting Narcan in recovery. He said he didn’t know. I spoke to Dr. Luedke at that time and he wanted to know what had happened and his knees were knocking in his scrubs when we were talking. I can tell we are being discussed because I can tell I am recognized by the staff. In fact, I was just approached to see how I am doing by a staff member. Heads of departments just stopping by her room to say hello to her. Imagine that. 

 

 The next day was the cardiac catheterization Dr. Lechin performed at 9 am. We waited in the front lobby for him and when he came to talk to us I recorded his words because we are all traumatized and needed to hear it again. He confirmed that she suffered the results of a massive heart attack but there were no blockages that required stinting. No need for a heart doctor but the heart attack had affected the front lower portion of her heart and the damage is severe. It was a heart attack that was caused by a sudden rush of adrenaline. His words. He went on to say that he could not pinpoint the issue and went on until I interrupted to ask about the Narcan specifically and if it would have caused this. He said at that time that yes Narcan could cause this. We said goodbye to mom for the night and left her alone in the ICU. My niece called to check up and they informed her that she was sitting up drinking orange juice and in good spirits, they were moving her out of ICU to another room that takes visitors. So I headed back to College Station for another night in the hospital with her. I get there and she is in a dark room with no pulse ox, no cooling shoulder pad attached, slumped in her bed and hadn’t been cleaned up in days. This morning the head doctor of the hospital stopped by to say hi and ask if she had preexisting heart conditions. Look at her charts. NO. I asked about her heart and the meds and the damage, plan of care,, etc related to her heart and its damage and he said he wanted to talk about the shoulder surgery not the heart. So he didn’t. We are still here and I know that they want her out of here because she is dying and they don’t want her to on-premise. Dr. Lichin said the meds that she could take that might reverse what damage there is she can’t take because it lowers her blood pressure and as of this morning she is on it. But when we get home she can’t take it is pressure is too low or where hers pretty much sits. So she can’t even take the stuff that might fix her. 

I need her medical records. I need a malpractice lawsuit. They have changed the course of my mothers' life for the worse through this mistake. She will never be the same and will require 24-hour care as she is a wheelchair-bound elderly woman with arthritis all over her skeleton. I can look at her and see that giving her something like Narcan would be risky. And should be monitored but she wasn’t. Shift change.

I have pictures and texts through this time period as well as having recorded audio of Dr.’s explanations and deflections. This is medical malpractice on behalf of The Med and Anesthesiologist. I need answers and then some for putting this unnecessary amount of pain and suffering. My mother was my 82-year-old heart failure dementia dads’ caretaker. Now they both need it and I am that person. I can’t even work now. This is unreal. It was supposed to be a 2-week hard recovery from the shoulder. That is what we prepared for. 

At 1 pm on Wednesday at the advice of a lawyer I took my father down to medical records to request her medical records and was told she had to sign. I did so at that time.

Sunday, September 8, 2019

 Catscan and ultrasound performed to check for clots due to extreme pain in legs. 

She has yet to sit up

Still on O2

Cardiologist won’t stay in room long enough to get an answer or time to ask a question

Called family physician to see about having her moved. He suggested we suggest to have her moved. I asked the hospitalist and he said: “what could they do?” I have recorded the conversations 

We are still here a full week later and my story continues to amaze me. She would be dead if I had not been by her side as her advocate. She is being moved to an inpatient rehab facility and I can't seem to get her out fast enough. She is still on oxygen 2 liters per minute, She was never sat up or attempted to rehabilitate or even rotated for almost 4 days after her almost dying on Wednesday. She has 2 ulcers that have developed on her butt from the pressure of lying in the same spot all week with minimum care. It feels like they have tucked her away in here and are hiding their mistake. I just found out today they are moving her and ran into the nurse that was caring for her the night before she crashed that I personally mentioned as being witness to the swelling and the overnight in and out cath they were performing the night prior to the flash edema,  and she stopped me in the hall and said I looked familiar. I feel like a freak at this point going through this week of trauma and distrust that I whispered to her that she was our nurse that night, and she asked how she knew me so I told her what room and day and a basic rundown until she remembered and that my mom was a code blue after she had left for the day on Wednesday. She said " Oh yeah I heard about that" I am shocked because I figured staff had already inquired about the nights' events with her because the ICU nurse told me he would inquire through Risk about it. Lie after lie. Heart doctors want to talk shoulder surgery only not hardly addressing the actual diagnosis at all, (i have them recorded) or even better the lady Cardiologist Dr. Smith on for Lechin office over the weekend would not speak to us or my mom other than small talk. Period. Ask about the shoulder! She would come in the room and talk about nothing to do with anything and say alrighty then and leave. None of the dr.s like me, saying I but in on them asking questions, but I have recorded at least 3 different conversations with staff in white lab coats, Hospitalist and heads of departments, and asked directly questions about the possibility that the Narcan would have caused this and they all 3 answered with a yes it could be the contributing factor. But then they are treating her like an outpatient surgery patient that had a stress attack. Still even today 7 days later her Dr. is saying it wasn't really a heart attack just a stress thing. Yes, we know a stress thing. I have spent 7 days studying this stress thing and it has left my mother a different mother than when we walked in for her shoulder to improve her quality of life. She has been sponge bathed one time upon my demand in 7 days, they have her in a freaking diaper and still on oxygen. When I asked her dr today about the o2 he said " you know oxygen goes up and down up and down" That was his answer. 

Her heart rate is 59 right now on the monitor and I still fear she is not out of the woods. We should be out of here soon and I will call in the morning to let Medical Records know to get the process going as we are waiting to see what they actually reported. I just hope this fresh set of eyes on her will shed new light on the neglect and most of all set her on the road to recovery. She deserves that after living through this past week of hell. 

She had several episodes with her breathing and heart rate over the weekend prompting Drs to think she had developed a blood clot. They had her wait until the next day to take the blood test D-Dimer and then when results returned positive she had just received breakfast and I forced her to try to eat because she has not eaten hardly a bite in 7 days and was 5 without iv nutrition. They come in and cant do CATSCAN because she ate and they forgot to make her NPO so we had to wait another 4 hours for results. Everything has happened like that here. They are negligent at best. I am not sure what it is. Understaffed? Not sure but I personally believe they should have transferred her from ICU to St Joseph's in Bryan this past week instead of hiding her on the outpatient floor. Also when the lady came to do ultrasound on her legs to look for clots I was in the hall when she approached and she went to a different room looked in and looked at her chart then asked th nurses why her patient wasn't in the bed and they said something and she looked at me and then came to my room. What room do they have her marked as? I can not wait to have her out of here and we are counting down the minuted as my mom is lying here in her own urine knowing they don't want to change her or clean her up and agreeing that this place has not been treating her very well. She only lived because she was stronger than they anticipated. She came here to improve her quality of life with a new shoulder and now we have new heart Drs and medicines that her insurance won't cover and therapies as well as having to care for my elderly father who she was still caring for. They live off of SS each month and this is now going to be an added hardship on this that we are all wondering how we can make it work. We promised them we would never put them in a nursing home and were on a track to make that happen and I am not willing to accept that because the hospital screwed up that we have to pay. This is an unreal mess and we need someone to help us.  This entire weekend after 10pm until about 7 they would shut her door and not come in to check vitals or anything night after night. I feel like I am in the Twilight Zone 

Thank you so much! They are releasing her on Monday Dr. Lichin came in and confirmed. I told him to tell the staff to stop asking my mom if she was ready to go home. He said he would. She is still suffering arrhythmias as of now he said. She had her surgery on Tuesday at 12 pm and prior to this shot had no history of heart disease. I bet 15 different staff members have asked me that. I want the details from anesthesiology and made a specific note on that. I wrote out a timeline of events that I personally witnessed. I will share it with you here. 

Please let me know if you are interested in meeting about this matter. I have only contacted you but that is only because he had the best reviews on Google. I didn't want to call someone in the same town because I was afraid there would be bias. I was convinced there wouldn't be and my case would be considered. i would love to hear back from you on this so I can move forward immediately regardless. Please respond so I can feel comfortable knowing what my next step is. I am suffering now from anxiety over this and am in a constant state of depression. I can't stop crying and this is all new to me Nothing I have ever experienced before this traumatic event I experienced this past week

We discharged last night and The Med did not spare our feelings about how they felt about that. The Med had a form prepared for the EMS transfer that the woman doing the transport asked her partner if it was this specific for and he said yes and she said "I have never seen one of these". Well, the form was a sign off from all the employees and then once they sign and have it taken to administration they then use the form that is a "handover and get her out" type of form that when given to EMS there were no signatures required. 

They waited so long to with her meds for departure that when EMS demanded something to be given to her for the transfer the new nurse of the night wanted to order morphine through her iv. 7 days after surgery morphine was still an option. Just saying. I refused this saying she only needed her Tramadol like we had been asking for over the last 2 hours so we could prepare for the moment we were in. HE needed a good blood pressure and took it 4 times in a row to get the reading he needed for Morphine. He got the number he needed barely and I then told EMS that I would not want her to have morphine and the new nurse of the night said to the EMS "If she crashes you have Narcan on board, right?"

 I lost it and kind of begged EMS to get us out of there not sparing too many words and by looking at her pee soaked DIAPER and the actual fear and anxiety were in! She is not incontinent btw and the information I was sharing they agreed that loading her up and getting her out was past time. They were so nice to my mother and she has felt comfortable since that point. 

She is hopefully going to live and doesn't rebound from all the different meds they have been injecting to keep her stable. She is a 76-year-old woman with skeletal issues and no diseases or major health problems other than the pain from Osteo taking over her bones and being a pain patient that has its own issues but not these. 

Her mind is becoming clearer now as she is starting to recover and gain strength and she and I have talked over what the hell happened there. She is confused why they didn't want to care for her properly but I am not. They wanted as little documentation as possible that might show a continued proof that they did a bad thing and are covering their ass. I am afraid my mother is not the only person to experience this level of negligence on the floor. Too many things to do for each nurse and can never get around to what they know they need to be doing but are in all of the other rooms trying to do for them too. 

 I do believe she is alive by her own accord. Even as we wheeled out of the outpatient ward that we sat in for a week and made the turn towards E.R. which is about 300 or more feet down a hall full of patients, when I turn to look back the Dr. on the computer was still standing there looking at US. I nodded as we disappeared to what felt like safety. 

My mother was at Scott and White a few months ago with abdominal pains and stayed for several days being checked from head to toe and the results were all negative other than colitis. I want to get those records too because they kept trying to say she came in like this. I need to get the power of attorney because I have already signed and have been signing all week after a certain point. So many things and I need to take care of me too. I am experiencing anxiety and tightness in my chest over this stress and I don't have insurance to even explore. I swear to God if I croak over this, my family will own that facility. I have been writing non stop about this and recording more. This is not going unnoticed. I have to give up my job now to care for my mother once home who was my fathers' caretaker. They are an elderly couple that has lived in the same home for almost 40 years and they want to pass there. They have been married 58 years and my mother turns 77 in less than a week now. We have goals and lots of grandkids and great-grandkids that fill their home with life and love. So that means I am caring for both from here on out so we can continue to have these family experiences. We went in for outpatient shoulder surgery to improve her quality of life

This is our family. My mother and father on the left. I am standing in the middle with blonde hair and a black dress. This picture was taken recently after my father was diagnosed with Heart Failure and Congestive Heart Failure. For posterity, we said and did not know we would be looking at these in a completely different way. I have one question mostly looking at my mom and it is to the anesthesiologist, I would like to know what part of her made her feel like this woman looked like a candidate for a risky procedure used to wake her and then not monitor. I am stunned.