Abhi Kapuria: When VTE Prophylaxis Breaks Down in the ICU
Abhi Kapuria, CEO and Co-Founder at Neurology Legal Consulting, shared a post on LinkedIn:
“Most VTE prophylaxis failures in the ICU aren’t missed diagnoses they’re missed follow through.
A patient’s VTE risk gets flagged on admission.
Pharmacologic or mechanical prophylaxis gets ordered. Then it’s held for a procedure, a brief coagulopathy, or discomfort and never resumed.
Days later, that undocumented gap is the whole case.
What makes these cases different from most malpractice claims: the hospital’s own order set has already conceded the risk was foreseeable.
The dispute isn’t whether prophylaxis was advisable it’s whether the chart shows it was actually administered, and whether a ‘temporary’ hold was ever reassessed.
For attorneys evaluating a potential case, the records that matter most are the ones defense teams hope go unexamined: the medication administration record against the actual order, nursing flowsheets for compression device use, and any note (or absence of one) explaining why a hold was never revisited.
A credible expert has to read those records the way a critical care pharmacist would during a mortality review not just confirm the patient was at risk, but trace exactly where the protocol broke down.
More on evaluating these cases.”
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