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DVT and Pulmonary Embolism – One of the Leading Causes of Preventable Hospital Deaths

Pulmonary embolisms (PE) contributes 5 to 10 percent of deaths in hospitalized patients, making it one of the leading causes of preventable hospital deaths.  Some studies estimate a pulmonary embolism affects up to 1 million people in the United States per year with 100,000 to 200,000 of these events being fatal.  One way a pulmonary embolism can occur is when a blood clot (thrombus) forms in the deep veins of the body (most commonly the legs), breaks off, flows through the venous system, and gets lodged in the lungs.  The clot that forms in the deep veins is called a deep venous thrombosis (DVT).  If the clot breaks off it is called a venous thromboembolism (VTE). While a DVT is the most common type of clot in the veins, clots can form anywhere in the venous system.

Factors that can increase the risk of developing a blood clot include:

  • Pregnancy
  • Obesity
  • Smoking
  • Heart Failure
  • Having a prior DVT or pulmonary embolism
  • Increased age
  • Certain cancers
  • Kidney problems

Because of the large number and high risk of death having a DVT brings, it is imperative for hospitals to ensure their at risk patients do not develop them.  They can do so by having at risk patients wear compression stockings which squeeze their muscles and help keep their blood flowing.  They can also give patients 5,000 units of a blood thinner called heparin.  This is known as a prophylactic or preventative dosage.

Signs and symptoms of a DVT can include pain, swelling, warmth, and redness in the body part (such as your leg) that has the clot. The Wells Criteria has also been developed to risk stratify patients for DVT. The higher a patients score under the Wells Criteria, the more likely they have a DVT that needs to be diagnosed and treated. The factors that raise a patients score under this criteria are:

  • Active Cancer
  • Bedridden recently > 3 days or major surgery within four weeks
  • Calf Swelling > 3 cm compared to your other leg
  • Collateral (nonvaricous) superficial veins present
  • Entire leg swollen
  • Localized tenderness along the deep venous system
  • Pitting Edema (when a depression of your finger remains after pressing it against your leg), confined to the leg with symptoms
  • Paralysis or other recent immobilization of the lower extremity

A lab test called a D-Dimer can be used to test the likelihood a patient has a DVT.  If this test is positive, or in those patients that are considered to likely have a DVT based on a physical exam, an imaging study called an ultrasound can be done of the leg to see if there is a blood clot.  If you do have a DVT, typical treatment includes the use of blood thinners such as heparin.

If someone close to you died due to an undiagnosed and untreated DVT and resulting pulmonary embolism and have questions, the attorneys at the Thistle Law Firm are here to discuss your legal options at 215-568-6800.

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