Family member died in the hospital...too many questions

RiskManager · Feb 22, 2017

If you have questions about the care, I would start off with the facility ombudsman or risk manager. Given that you are the daughter in law, they will likely want permission from the next of kin before having any substantive discussions with you. If you need support in dealing with the FIL death, I would contact the hospital chaplain or social worker.

Double-Helix, BSN, RN · Feb 22, 2017

I'm so sorry for your loss. It is always difficult when a loved one dies, and even more so when they die unexpectedly in what is supposed to be a "safe" place. It's also normal to want answers. It sounds like your family members are trying to "let sleeping dogs lie" and not search for details surrounding your father-in-law's death. That is normal too. Both are methods of coping, and I encourage you to respect that, for now, your family members don't want to seek more information. While it may be therapeutic for you, the process may be quite traumatic for some of them at this point in their grief process. For you and those members of your family that feel like you would benefit from additional support, your family physician or the hospital's social work department may be able to provide referrals to a grief counselor. Also, if your employer offers an Employee Assistance program, you could take advantage of those benefits- they aren't only meant for job-related stresses.

Generally, if they family has questions about a loved one's care, the next of kin would need to initiate a discussion with the primary physician caring for that loved one. Of course, this can be very difficult to do when the family is still reeling from the shock of the loss. If the questions aren't sufficiently answered by the physician, the family can request to speak to additional members of the care team, request a copy of the medical records, and involve an attorney if it feels warranted.

CoffeeRTC, BSN, RN · Feb 22, 2017

I realize that we would need my mother in law to proceed. She was POA and the next of kin. She is a very reasonable woman and has relied on her faith to get her through this period and I think, for the most part, we are all dealing with this. I think I will always have those moments where I wonder "what really happened?" and I understand that those questions will go unanswered. She did ask the doctor and he sugar coated a lot. He is her doctor too and my husband also went to him. My husband is switching from his practice. (he had to beg for an EKG when he was having chest pain, dizziness headaches, fatigue.)

At this point, the questions to ask would be what benefit would it have to ask questions? What would it solve/ prove? We didn't have an autopsy done. We don't have a lawyer. I was just wondering what the process would have been.

RiskManager · Feb 22, 2017

The main benefit of asking these sort of questions, and it varies by the individual, is to gain understanding and closure as to the events. If the MIL does not want to pursue these questions, I think her wishes should be respected.

TheCommuter, BSN, RN · Feb 22, 2017

I understand that those questions will go unanswered. She did ask the doctor and he sugar coated a lot.

First of all, I am so very sorry for your loss. Having lost a parent six weeks ago, I know firsthand about the constant rumination, questions and "what-ifs" that occur after events of this nature.

I would not expect the physician to be radically honest about what occurred. After all, few providers freely divulge what truly happened if it paints them in a negative light or results in litigation. The majority of family members will never hear a healthcare worker blurt out, "I deviated from the standard of care! I committed malpractice!"

I will not engage in conjecture or speculation. I am not saying that malpractice or deviation from predetermined standards of care took place. I do not know all what happened and refuse to guess. I also have no advice on how to proceed, except to be there for your loved ones.

Good luck to you.

WKShadowNP, DNP, APRN · Feb 22, 2017

So very sorry for your loss. I pray you and your family find the comfort you seek.

AliNajaCat · Feb 22, 2017

You could, if you desired, contact an atty that specializes in medical malpractice. S/he would likely have a legal nurse consultant acquire (at expense) and review the records; she may or may not find red flags (was a known diabetic's blood glucose regularly tested? was he investigated for decreased SpO2 when he was agitated at 0130? / known complications of both come to mind...) Was an adequate nursing assessment done? Was a call to the MD or hospitalist done when he decompensated; was he seen by a physician or midlevel before they sedated him? Did the nurses re-assess him after the sedation (before hours later)? What are the policies on all those?

However, there may not be a definite answer. It may be that this wretched pneumonia that's been sweeping the country may have just been too much for him, and any opposition would certainly assert that, "reasonable doubt" and all.

There are four things that must be present to have a legal case: duty to care, error, damages, and damages proved to be result of the error. If you have only three, you don't have a case. Another thing the atty will look at is whether investigating and preparing a case will result in enough financial recovery to pay for the expense of bring it. Sadly, when an elder dies (i.e., no lost wages or other financial loss) it's uncommon to demonstrate financial damages, and may states do not allow money damages for "pain and suffering" and may discount loss of spousal companionship at that age. This means that even if there is a case with all four elements met, an atty won't pursue it because it's a net financial loss (and you may well pay for that)... and what good does that do to anyone?

This is a sad situation and I am so sorry for your loss. If it were me, I would probably lose a lot of sleep over it for a long time, and then come to the realization that there's nothing to be done for it anyway, he's gone, to mourn until it's not so painful as it is now, and love the rest of my family while I have them. Not a satisfactory answer, I know. {{hugs}}

I also agree with getting a new doc for your husband, and feel free to tell him why.

Susie2310 · Feb 22, 2017

Speaking just for myself, I think that if I was in a situation where my family member had an unexpected death in a facility, depending on the circumstances I would contact my state Medical Board and explain the situation and ask if they could review what happened.

Horseshoe, BSN, RN · Feb 22, 2017

We get a call in the AM from a friend (yeah, hippa break) to come in...dad is in the ICU. We get a brief report that he was belligerent and confused around 1am, nurse got an order for Ativan that was given around that time. Next time he was seen was 5:30 am and he was cold, blue, pulseless. Full code...cpr started. He was down waaaay to long.

Perhaps I'm not understanding your time frame very well. But I don't get how your FIL could be in the ICU, given medication around 1 am, then "not seen again until 5:30," at which time it was discovered that he was "cold, blue, pulseless." Patients don't go unseen for four hours in the ICU. Patients aren't discovered "down" in that manner. They are monitored constantly; decompensation would be noticed long before a patient could be cold and pulseless. The monitors would alarm with low heart rate, oxygen saturation, and BP, etc. What you are describing sounds like something that could happen to patients who are not on monitors and are not in close proximity to nursing staff.

My condolences on your loss. I hope you get answers to these questions if you wish to pursue that.

ETA: Okay, I just re-read your OP and realize your FIL deteriorated on another unit, not in the ICU. He was moved to ICU after the code. Got it now.

Been there,done that, ASN, RN · Feb 22, 2017

People die in hospitals all the time and no questions are asked.You have many questions, because you are a health care professional. You have more insight as to the shoulda, coulda wouldas.

My father died as a direct result of medical malpractice. I already knew that, got the chart and had the evidence. The hospital only wanted to prevent MONETARY DAMAGES, not learn from the event.

No lawyer would take the case, because he had reached the end of his expected life expectancy ( he was 76 also), and therefore any $$$ involved would be negligible.

Do NOT expect the hospital to provide you with answers, or emotional support, they just want you to go away.

My sincere condolences to all. Find the emotional support you need to LET IT GO.

I have been there, done that ...you are beating your head against a brick wall.. making closure harder to find.

KatieMI, BSN, MSN, RN · Feb 22, 2017

(((So sorry for your loss)))

The truth is, people do die and it usually happens without any kind of schedule or announcement. Someone who had triple bypass couldn't be named to be "in good shape" because atherosclerosis happens in all other places as well. The heart vessel blockades were removed, that was 4 years ago. Everything else, including non-touched heart arteries, brain, etc. stayed the same and a plaque there could wake up at any given moment.

Should autopsy be conducted, it could find something. Apparently, it was not done, so there will be no definitive answer, ever. That's sad, but, as I wrote just above, it most probably was an event which could be not prevented or treated with any reasonable expectations of prolonged benefits for quality life (I do not support an idea that being alive on chronic life support is beneficial).

Hugs again. Hold on, support MIL. Praying for peace for you.