January 5, 2016

Question

My mother saw a union Doctor (Pcp) for chest pain. She was referred to a GI doctor who performed an endoscopy on her on Tuesday 12/28. The next day, she started passing black stools and felt fatigue and lethargic. She went back to the Pcp Doctor to see what was wrong with her. She complained of shortness of breath and her hemoglobin was 7. The doctor sent her back home with some medications. On 12/31, she continued to pass large amount of black stool. At this point, she is too weak to pick herself up to stand. She called the ambulance on her own. At admission to the hospital, a GI doctor told us that she had excessive bleeding in the upper GI tract possibly due to the endoscopy she had few days ago.

Answer

I've handled similar cases. Hemoglobin at 7 is considered "severe anemia" (normal levels for a woman is in the range of 12-16), and the black stool usually indicates a bleed in the intestinal tract. It seems to me there was perforation during the endoscopy, but that's just a hunch - the chart needs to be reviewed. This is a case definitely worth looking into, in my opinion. Improper technique in performing the endoscopy - if it can be established - would be malpractice.


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