Gannon Steven, Bell David, Jackmiczyk Kenneth, Moore Gregory
Baylor University Medical Center, Pulmonary and Critical Care Medicine, Dallas, Texas.
Maricopa Medical Center, Department of Emergency Medicine, Phoenix, Arizona.
Clin Pract Cases Emerg Med. 2020 Jan 24;4(1):12-15. doi: 10.5811/cpcem.2019.12.43675. eCollection 2020 Feb.
In this article we present a case of a patient who received reversal of anticoagulation therapy with factor IX in violation of hospital guidelines. As a direct result, myocardial infarction and ischemic stroke occurred, leaving the patient neurologically debilitated. Factor IX is indicated in the setting of warfarin-induced, life-threatening bleeding. The patient's care was provided by an intern with attending physician supervision. Delayed charting and questionable shared decision-making were present in the care. We discuss usage of factor IX, liability for supervision of physicians in training, and factors that can lead to plaintiff awards.
在本文中，我们介绍了一例患者，该患者违反医院指南接受了凝血因子IX抗凝治疗逆转。直接结果是发生了心肌梗死和缺血性中风，导致患者神经功能受损。凝血因子IX适用于华法林引起的危及生命的出血情况。患者的护理由一名实习生在主治医生的监督下提供。护理过程中存在记录延迟和共同决策存在疑问的情况。我们讨论了凝血因子IX的使用、培训医生监督责任以及可能导致原告获得赔偿的因素。
