Tom was diagnosed with esophageal carcinoma in February of 2015 and following chemotherapy and radiation treatment, underwent resection surgery in July of 2015. In August of 2016, a reoccurrence was discovered in his lymph nodes and he was treated with a regimen of chemotherapy and radiation. On March 21st he was given an endoscopy that revealed gastric cancer. During this time, Tom also came down with a severe case of the flu and became very anemic. We were also informed that based upon a PET Scan that was done on March 28th Tom would require a liver biopsy for a suspicious area found on the scan.
On April 12th, the children and I travelled with Tom to the hospital where, because of his severe anemia, he received a blood transfusion to prepare him for the biopsy. As it was Easter week, our family plans were to spend one night in New York City for the biopsy, before we all travelled to Rhode Island to celebrate the Easter holiday.
On April 13th, an ultrasound guided liver biopsy was performed on Tom. Four samples were taken from the right hepatic lobe lesion. He had a hemoglobin of 8.1 and platelet count of 82k. On April 14th, Tom’s hemoglobin was noted to be 7.2 and his platelets were 63k. Despite his falling hemoglobin and platelet levels, there was Patient Safety Movement Foundation | patientsafetymovement.org no investigation into the cause of the drop. Rather, the entire staff and physicians assumed it was due to a gastric bleed. In fact, radiation therapy was provided that evening in an attempt to stop the gastric bleed. Tom continued to complain of abdominal pain. He was transfused as a result of his falling hemoglobin and platelet count. The last reading of Tom’s hemoglobin and platelet count on April 13th was 7.4 and 44k respectively.
The following day on April 15, Tom continued to deteriorate. His condition continued to worsen and he soon became unresponsive. There was discussion whether the bleeding was from the liver biopsy site or the intraperitoneal from the tumor. No investigation was done to determine the location of the bleed. He died in the early hours of Easter Sunday morning.
I believe that the doctors and staff failed to aggressively pursue my husband’s falling hemoglobin and platelet levels the day after his liver biopsy, even though his hemoglobin continued to fall while he received numerous transfusions. They assumed it was due to gastrointestinal bleeding, but did nothing to confirm the source of the bleed. In the face of the falling hemoglobin and platelet count, an investigation should have been done, including an image of the liver and a check for blood in the stool to determine if the cause of the bleed was the liver. For the doctors and staff to just have assumed it was a gastric bleed, and not investigate further, was incomprehensible to me. Immediately after his liver biopsy on April 13th, his level dropped drastically sending clear signals that an acute event occurred to cause such a dramatic drop. The only possible explanation was the liver biopsy and despite it being right in front of their faces and my pleas, they did nothing.
A proper check would have determined that the source of the bleeding was from the liver. This would have led to proper management to control the bleed, and prolong Tom’s life, for how long we will never know. Tom was determined to beat his cancer despite the odds. The hospital didn’t give him the chance.