Patrick Stonich: Identifying Missed Signs of Postoperative Pulmonary Embolism in Medical Record Reviews
Patrick Stonich, Director of Consulting Services at HealthCare ConsultLink, shared a post on LinkedIn:
”A postoperative pulmonary embolism (PE) can be missed when expected recovery is used to explain away warning signs.
For plaintiff attorneys reviewing a post-surgical case, the clinical timeline matters:
Immobility increases thromboembolic risk. Unexplained tachycardia, tachypnea, or pleuritic chest pain should prompt focused reassessment: not automatic attribution to pain, anesthesia, or deconditioning.
A careful review should ask:
- Were relevant Wells score criteria assessed and documented as the patient’s condition evolved?
- Was D-dimer testing considered when clinically appropriate, recognizing that postoperative inflammation may affect its specificity?
- When clinical suspicion remained significant, was diagnostic imaging pursued?
- Was there a delay or failure to escalate to CT pulmonary angiography (CTPA)?
- Do the nursing notes, vital-sign trends, provider communications, and orders tell the same story?
The central issue is often not whether a symptom appeared in the chart. It is whether the developing pattern was recognized, communicated, and acted upon in a timely manner.
A medical record review by a clinically experienced legal nurse consultant can help identify missed signals, gaps in escalation, and inconsistencies across the postoperative timeline.
For case-focused medical record analysis and clinical clarity, visit OnPoint Legal Nurse Consulting web site or send us a direct message.”
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