Kidney Failure as a Result of Medical Malpractice

Michigan Kidney Failure Cases Often the Result of Medical Malpractice.
Government data shows nearly 1 in every 10 adults experience difficulty with chronic kidney disease. The condition, also referred to as chronic renal disease, is characterized by the gradual loss of kidney function over time. Within the body, the kidneys continually filter waste products out of the blood for elimination through urination.  Chronic kidney disease can lead to an excess buildup of waste product, and may lead to many other serious health complications, such as high blood pressure, anemia (i.e., decrease in red blood cells), fluid retention, weakened bones, damage to the central nervous system, decreased immune function, or even life-threatening sudden increases in potassium levels. If left untreated chronic kidney disease can lead to complete kidney failure, which is the kidney’s loss in ability to filter waste products from the blood.

When kidney disease is detected early, patients may take steps to reduce the risk of their condition progressing further and even possibly prevent the ultimate loss in kidney function. For instance, patients in the early stages of kidney disease can significantly slow progression of the disease and reduce their risk for other complications by:

• Monitoring and controlling blood pressure levels
• Monitoring levels of protein, cholesterol, sodium, and potassium within the diet
• Quitting smoking

Symptoms of impaired kidney function are often subtle, and a careless healthcare professional may fail to recognize the condition until severe symptoms of kidney failure emerge. At that stage, treatment options include dialysis or kidney transplant.

Medical Negligence

Within the healthcare field, there are safety rules healthcare providers must follow to protect patients from unnecessary harm. The safety rules are referred to as standards of care, and exist to prevent patient harm. Within a busy healthcare practice, such as a hospital, there is often a team of healthcare professionals caring for the patient. An error by one of the members can cause severe harm.

Unrecognized or misdiagnosed kidney disease is one form of medical negligence that puts a patient in danger of loss of kidney function. Other examples of medical negligence known to put an individual in danger of kidney failure include:

• Use of Contrast Dyes in Radiology Procedures¹: Certain medical procedures, such as MRIs (magnetic resonance imaging), CT scans, and other radiology studies use a contrast dye to more clearly see blood vessels on an X-ray. These contrast dyes, which are typically injected into the vein before a procedure, are part of many radiology studies.  Contrast dye used in medical procedures accounts for 12% of hospital-induced kidney failure. This injury is called contrast-induced nephropathy. In patients with certain known risk factors, such as high blood pressure (i.e., hypertension), heart disease (i.e., cardiovascular disease), diabetes, or existing kidney disease, the chance of kidney failure increases to between 20 – 50%.

• Medication Errors³: Being given the wrong medication can cause serious harm and even death. In one case, a man was given ten times the vitamin D prescribed, and the overdose destroyed his kidney function.

• Poorly Treated High Blood Pressure or Diabetes: Patients diagnosed with high blood pressure or diabetes require regular treatment and close monitoring to keep them safe. The healthcare provider’s failure to monitor and treat the conditions at appropriate intervals violates patient safety rules. For a diabetic patient with high blood pressure, a doctor’s failure to prescribe a medication to treat the high blood pressure causes great danger of kidney failure. High blood pressure strains the heart and can damage blood vessels. If the vessels that supply blood to the kidney become damaged, the kidney does not work effectively and may lose total function. In the U.S. alone, high blood pressure is associated with over 25,000 new cases of kidney failure annually. Kidney damage can be prevented with proper treatment and follow-up.

• Failure to Diagnose Kidney Disease or IgA Nephropathy⁴: Symptoms of kidney disease can sometimes be subtle. A doctor’s failure to recognize or understand certain symptoms can deny a patient proper treatment. If appropriately caught early and treated, progression of kidney disease can be slowed and kidney failure prevented. Under patient safety rules, healthcare professionals are supposed to order adequate testing and provide the patient with information and referrals for abnormal test results.. If a healthcare professional fails to order a blood test or fails to follow up on an abnormal result, it is medical negligence.

• Use of Hydroxyethyl Starch²: Hydroxyethyl starch is a type of intravenous (IV) solution given to patients to treat and prevent shock following excessive blood loss from a trauma or surgery. This solution was approved in the 1960s for IV bags without undergoing proper clinical trials to ensure its safety. Later studies found it increases the risk for acute kidney injury and death.

Symptoms of Kidney Failure

Fortunately, simple blood tests will detect a kidney problem.  If a test shows mildly elevated creatinine, the patient should be monitored regularly by a healthcare professional. The consequences can otherwise be devastating.  Kidneys can lose up to 90% function before the condition is an end-stage renal disease, which requires dialysis.

Some of the more common symptoms of kidney failure include:

–   Fatigue

–   Overall feeling of illness

–   Itching and dry skin

–   Headaches

–   Unintentional weight loss

–   Loss of appetite

–   Nausea

Other symptoms of kidney failure can include:

–   Abnormally light or dark skin

–   Changes in the nails

–   Bone pain

–   Drowsiness

–   Confusion

–   Difficulty concentrating

–   Numbness in the hands, feet, or other areas of the body

–   Muscle twitching

–   Muscle cramps

–   Bad breath

–   Bruising easily

–   Frequent nosebleeds

–   Blood in the stool

–   Excessive thirst

–   Frequent hiccups

–   Loss of sex drive and impotence

–   Menstrual periods stop (amenorrhea)

–   Difficulty sleeping

–   Swelling of the feet and hands (edema)

–   Vomiting

Diagnosis of kidney failure typically follows a physical exam and blood tests. Loss of kidney function will affect the blood’s levels of potassium, sodium, albumin, phosphorous, calcium, cholesterol, magnesium, and electrolytes, affecting blood count. Typically, patients experiencing end-stage kidney failure produce little urine.

Resources Available to Those Who Have Suffered Kidney Damage or Failure

There are several resources available for individuals who believe they may have experienced an instance of medical negligence.

For more information on kidney disease, including the signs and symptoms of kidney disease and kidney failure, available treatment options, and the most up-to-date news and information please visit:

The National Kidney Foundation

The Kidney & Urology Foundation of America, Inc.

Also, the US Department of Health and Human Services has a website dedicated to providing the most recent research in kidney disease:

National Kidney and Urologic Diseases Information Clearinghouse.

Resources for Support and Advocacy of Kidney Disease

Social Worker: Social workers are available in most dialysis clinics across the country and are an invaluable resource for patients suffering from kidney failure. These individuals may be dialysis social workers or nephrology social workers. Their job assists patients every step of the way as they undergo dialysis treatment. They may be available to help answer questions, help patients understand what to expect, and provide expert guidance in navigating issues related to the financial, legal, emotional, or familial aspects that may arise when undergoing treatment for kidney failure. Social workers will have several resources available for patients on opportunities for financial assistance and will oversee the patient’s relationship with the healthcare providers at the treatment center.

The National Kidney Foundation also has several excellent resources for patients or their families, to become involved in advocacy efforts, such as tips on writing to congress or advocating through social media.

Financial Resources for Patients with Kidney Failure Due to Medical Negligence

Dialysis and Transplants Paid for by Medicare: Medicare is a governmental organization solely responsible for providing care to the elderly (those over 65) and disabled. However, in 1972, the federal legislature passed an act that broadened the population eligible for coverage through Medicare to include patients with permanent kidney failure, no matter their age. Typically, Medicare will pay for up to 80 percent of medical care associated with the treatment of permanent kidney failure⁵. To qualify for this coverage on the basis of kidney failure, patients must meet certain eligibility requirements:

• The patient’s condition must necessitate regular dialysis treatment.
  OR
• The patient must have had a kidney transplant previously covered by Medicare.

Further, the patient must meet one of the following to qualify for Medicare coverage under the kidney failure provision:

1. The patient has paid Social Security tax through an employer or is the child or spouse of someone who has.

2. The patient has worked under the Railroad Retirement Board or as a government employee, or the patient is the child or spouse of someone who has.

3. The patient is already receiving from Social Security, Railroad Retirement, or the Office of Personnel Management.

There are certain requirements for how long the patient must have been employed under Social Security or the Railroad Retirement Board. Patients are urged to contact their local Social Security office for more information.

Health insurance: Many private health insurance companies will pay for the entire cost of the treatment for kidney failure. Often, individuals with private insurance still apply for Medicare benefits to cover 80% of the cost. Then these individuals will file to have their private insurance company pay for the remaining 20% of the cost, allowing them to avoid paying anything out of pocket. Private insurance companies must cover the medications associated with the treatment for kidney failure⁵.

Patient Assistance Programs (PAPs) from Prescription Drug Companies: Many kidney failure patients require medication to treat certain symptoms of the condition. Some patients may not know prescription drug companies offer assistance programs to help patients cover the high cost of these medications. Patients interested in more information on these patient assistance programs can visit this website.

Filing a Medical Negligence Claim: A physician’s primary concern should be protecting the health and safety of their patient. However, sometimes an unnecessary error can injure the patient. These patients are left to cope with the stress of these injuries and often find themselves faced with a significant financial burden to receive treatment.

Physicians and healthcare providers may carry malpractice insurance. Filing a medical negligence claim is not an attack against the patient’s doctor or healthcare provider. It is the opportunity for patients to receive help and reimbursement.

If there is evidence of malpractice, it is important to immediately seek legal help. A legal professional can help you gather and preserve evidence, and determine if there was malpractice and how to proceed.  If you or someone you know has recently experienced kidney failure and circumstances suggest possible medical negligence, it is important you contact an experienced and knowledgeable medical negligence attorney without delay to protect your interests.  The best attorneys have medical professionals on staff and immediately investigate the claim to determine if caused by negligence.  Buchanan Firm’s team has Michigan medical malpractice attorneys, doctors, nurses, and paralegals to guide and help you in this difficult time.

For more resources see this fact sheet published by the US Department of Health and Human Services.

References

1. Yang D, Role of intracellular ca 2 and na /ca 2 exchangers in the pathogenesis of contrast-induced acute kidney injury. BioMed Research International. 2013; 678456. Epub 2013 Nov 18.
2. Mayor S. Exclusion of suspect data raises question mark over safety of common plasma substitute. BMJ. 2013; 346: f1132. doi: 10.1136/bmj.f1132.
3. Nasri H, Mubarak M. Renal injury due to vitamin d intoxication; a case of dispensing error. Journal of Renal Injury Prevention, 2013; 2(2); 85-7.
4. Bird S. Failure to diagnose – renal disease. Australian Family Physician. 2005; 34(11): 975-6. 
5. US Department of Health and Human Services, (2009). Financial help for treatment of kidney failure (09–4765). http://kidney.niddk.nih.gov/kudiseases/pubs/pdf/Financial-Help-Kidney.pdf
6. Madea B, Musshoff F, Preuss J. Medical negligence in drug associated deaths. Forensic Sci Int. Sept. 2009; 190(1-3): 67-73.
7. Cronin AJ, Douglas JF. Non-standard kidneys for transplants: Clinical margins, medical morality, and the law. Med Law Rev. 2013; 21(3): 448-73.