Dealing with Depression

It was early morning on June 13th when my 26 year old son, Mark, woke up with severe chest pain and difficulty breathing and called me and told me he was on his way to the ER. I was almost there when he called again to say that they already released him (less than a 1.5 hour visit) and he would be waiting outside for me. He was told they found nothing wrong with him and that he was a healthy 26 year old:( Fast forward to June 26th when we took him back to the ER after he called us and told us he passed out at work and went to an Urgent Care Center and they told him to get to the ER right away because of a potential life threatening blood clot:( He was admitted to the hospital on on 26th with a very large DVT, encompassing his entire left leg, and 2 PE’s (one in each lung) were discovered, the CT scan also showed damage (necrosis) to his left lower lobe of his lungs, most likely the result of his chief complaint that took him for help in the first place on June 13th. I can’t even imagine his pain and how scared he was in between the time of his misdiagnosis:and his admittance to the hospital:( I heard later that he told his best friend Chris he feels like he is dying but they told me nothing is wrong:( So sad:( After being released from the hospital in just 2 short days of him being admitted it became our mission to find out why he developed blood clots in the first place since the hospital had no clue and would not draw clotting factors since he had no predisposing factors that would put him at risk., other that he smoked. Then I wrote this letter to William Beaumont Hospital: July 14, 2014

Dear Mr. Shane M. Cerone:
Our 26 year old son, Mark A. Shives, sought help at William Beaumont Hospital’s Emergency Center in Royal Oak when he woke up gasping for air accompanied with severe chest pain on the morning of June 13, 2014.

It is saddening to have to write a letter in attempt to make certain that his experience will not be shared by any others presenting to your facility with chest pain only to be discharged within 2 hours and return 13 days later with an Acute DVT the length of his left leg, 2 PE’s (one in his right upper lobe and the other in his left lower lobe), and with “Focal opacity in the base of the left lower lobe most likely representing Infarction measuring 2.2 x 1.5 x 2.6 cm”. This localized area of dead tissue is most likely the result of his chief complaint upon arrival to the WBH EC on June 13th. And if diagnosed properly, could have been the prevention of 2 other life threating and potentially fatal embolus and very large DVT that he is thankfully recovering from now. In his own words to one of his best friends, “they said nothing is wrong, but I feel like I am dying’. We are sad to know of his helplessness that transpired because of his misdiagnosis.

Chest pain is a source of major concern and not to be dismissed! As a former EC Registered Nurse, I understand that there are three huge acute life threats that present with chest pain that are Acute MI, Pulmonary Embolism and Aortic Disasters. These life threats represent the three conditions that must always be “ruled out” when the primary complaint is indeed chest pain, even if there is an absence of known risk factors and the patient appears, as your staff stated, ‘healthy’ otherwise.

Mark returned to WBH EC on the evening of June 26th after a syncopal episode at his employment late that morning followed by a visit to an Urgent care who advised him to proceed to the EC with a possible DVT. Once the complete bilateral lower extremity venous duplex ultrasound was complete, and the definite diagnosis of a very large DVT was confirmed, it truly was unreal the hesitance for the order of the CT scan to diagnose the impending PE’s and necrosis to his left lower lobe. We were told that he would take home a script to schedule his CT on an outpatient basis when he was discharged from WBH. Which was less than 48 hours! Mark’s Registered Nurses that were assigned to him during his stay and the Attending Physician that presented upon his discharge on June 28th were not in agreement with such a short observation period related to the severity of Mark’s case. Further investigation into his stay is being instigated.

There are other mishap’s that have taken place throughout this entire ordeal. Such as one of the discharge Diagnosis of Leukocytosis, which should have been picked up on his first EC visit that presented elevated WBC’s. Discharge on June 28th show normal WBC count that would discount a diagnosis of Leukocytosis at his time of discharge. Another diagnosis of Cannabis abuse is also listed. Mark admits to recreational use, but in no way has stated that he abuses any drug. Since his diagnosis of Acute DVT and PE’s he has discontinued his tobacco use, as listed in his discharge diagnosis as “Tobacco Abuse”.

It is our opinion, knowledge, research and experience, that if no cause is apparent for the sudden onset of chest pain and difficulty breathing and a patient is under the age of 45, a diagnosis of possible Thrombophilia and Leukocytosis, at the very least, should have been presented in his discharge diagnosis from his first visit on June 13th, ensuring further prompt assistance and professional care that could of lessened the severity of the present and future state of Mark’s health.

Additionally, having a letter placed on Mark’s bedside table after his admission to 9N stating he was being treating as an outpatient was certainly not expected, as he was being treated as an admitted patient to WBH with a Heparin IV drip and Dilaudid IV push for pain for the diagnosis of an extremely large DVT and 2 PE’s. The staff we spoke to about this were all in agreement that this additional burden of stress is affecting quality of life and care, this form is just dropped off by a hospital employee with no explanation to the patient. One would think William Beaumont Hospital would strive for better patient relationships and care management than what was exhibited in this instance.

Thank you in advance for your valuable time and consideration when looking into this important matter.
Regards,
Paul and Rhonda Nesbitt
***they have yet to respond to my letter other than it would take time to review his stay and that someone would get back with me by the end of August. It is September 22nd and still no response.

It took 3.5 weeks to get an appointment and gain results from his Hematology appointment and assessment to confirmed he had an increased factor Vlll level. Talk about a sudden life changing event for him! Our next step was to follow up in 3 months to identify if there was any permanent damage that may have occurred to the valves in his left leg because of the severity of the clot, recheck his blood and reevaluate the condition of his lungs.

Then he committed suicide by hanging on August 18th. I truly believe he was suffering from PTSD, and was so scared…I was and am, too. We spent so much time together these past months as I tried to research all that encompasses, the whole person, diagnosed with such a life changing disorder.

Thank you for writing this article, it helps make better sense of such a horrible ordeal.