Failure to Manage Coumadin Leads to Deaths, Injuries in Nursing Homes

Failure to manage Coumadin (generic: warfarin), a decades-old blood thinner, leads to injuries and deaths in nursing homes. Coumadin is used to reduce the risk of blood clots in at-risk patients. While it is effective at lowering the risk of blood clots and related injuries, such as stroke and heart attack, proper management is needed to ensure patient safety. Coumadin reacts with certain medications and foods. Additionally, patients taking the anticoagulant need to undergo regular blood testing to make sure the blood is clotting fast enough. Too much of the drug can lead to uncontrollable bleeding while too little poses a risk of blood clots.

ProPublica and The Washington Post published an investigative report showing that Coumadin errors in nursing homes causes serious, sometimes fatal injuries. From 2011 to 2014, at least 165 residents were hospitalized or died due to Coumadin errors, a ProPublica analysis of government inspection reports found. Studies suggest that potentially thousands more injuries occur annually that are not reported.

“It’s an insidious problem,” said Rod Baird, president of Geriatric Practice Management, according to ProPublica. He said that because errors are easy to make, “Coumadin is the most dangerous drug in America.” Geriatric Practice Management is a company that creates electronic health records for physicians working in long-term care facilities.

Nursing homes are routinely cited for practices that put residents at risk. For example, government officials and patient advocates have criticized the overuse of antipsychotics, which has effectively reduced their use. Injuries from Coumadin errors, however, receive relatively little attention. One reason may be because the drug is clearly beneficial in patients who need it. However, poor management has undoubtedly caused suffering and deaths for some residents.

ProPublica looked at government inspection reports and lawsuits filed by residents’ families, which were settled for a confidential amount. In one case, an 89-year-old grandmother of eight was given an antibiotic that amplifies the effects of Coumadin at a San Diego facility. The facility also failed to inform her doctor that she needed additional blood testing. The woman died of internal bleeding. In another case, a facility failed to give Coumadin to a resident for 50 days in a row and failed to perform blood tests ordered by her doctor. She was hospitalized with blood clots in her leg.

Nursing home residents suffered 34,000 fatal, life-threatening or serious events each year related to Coumadin, according to a study published in 2007 in the American Journal of Medicine. Data suggests that North Carolina has the greatest number of Coumadin errors.
Newer anticoagulants have emerged in recent years, including Pradaxa, Xarelto and Eliquis. Although these medications don’t require blood monitoring or dietary restrictions, they have raised safety concerns of their own. If patients taking these drugs suffer uncontrollable bleeding, there is no antidote to reverse it. Conversely, the effects of Coumadin can be reversed with vitamin K.

from Parker Waichman http://www.yourlawyer.com/blog/failure-to-manage-coumadin-leads-to-deaths-injuries-in-nursing-homes/