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NON-HODGLIN'S LYMPHOMA PATIENT DIES DUE TO CONTINUED CHEMOTHERAPY.
This medical malpractice case involved a 65-year old female patient with a past medical history of rheumatoid arthritis, osteoarthritis, and irritable bowel syndrome.
The female patient began experiencing extreme fatigue, fever and night sweats. The patient initially sought treatment from alternative medicine sources such as acupuncture and homeopathy. However, when it became clear that her symptoms were not being palliated, she began experiencing drastic weight loss and she presented to the hospital for further investigations.
The patient received traditional treatment, however her disease did not respond well. Further tests were conducted and it was discovered that the patient was now suffering from a diffuse large B-cell lymphoma (DLBCL)--- a very aggressive tumor. The patient underwent several rounds of hyper-CVAD treatment through a peripherally inserted central catheter (PICC line) over a period of several weeks. Hyper-CVAD chemotherapy consisted of two combinations of drugs (courses A and B) which were administered in an alternating pattern.
Course A consisted of cyclophosphamide, vincristine, doxorubicin (also known as Adriamycin), and dexamethasone. Course B consisted of methotrexate and cytarabine.
The patient eventually required a splenectomy due to damage caused to her spleen as a result of the aggressive chemotherapy regimen. In addition the patient developed bilateral pleural effusions with areas of atelectasis across both lung fields. The patient developed an increased white blood cell count, fever and rising BUN/cr during this time frame and was started on Vancomycin empirically with infectious disease consultations suggesting that the fever was purely due to the chemotherapy. The treating physicians decided to proceed with the chemotherapy and the patient quickly developed severe fluid overload and ensuing cardiopulmonary failure resulting in her death.
EXPERT WITNESS ' OPINION : The patient's treating physicians should have chosen to delay the chemotherapy. There was negligence.
[http://www.theexpertinstitute.com/case studies/non-hodgkins lymphoma]
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