Cardiovascular Surgery Delayed Due to Hospital Scheduling Error

Case Overview

This case involves a forty-seven-year-old male who presented to the ER with complaints of debilitating chest pain. The patient became hypotensive and bradycardic in the ER and developed seizure activity that lasted several minutes. The patient was given Atropine and Dopamine, was intubated, and taken to the catheterization lab. In the cath lab, the patient was found to have a 99% left main artery occlusion along with 100% occlusion in the LAD. At the time of the procedure, the patient’s ejection fraction was found to be 20% and it was determined that the patient required immediate open-heart surgery. He was temporarily placed on a balloon pump to bridge care as surgery could not be initiated due to a lack of an emergency operating room being available. Shortly after the catheterization procedure, the patient sustained prolonged ventricular fibrillation and a stroke ensued. The cardiovascular surgeon noted the cardiac event in his operative report. Following the CABG procedure, the patient was sent to a nursing home facility with a LVAD and an RVAD in place. While under nursing home care, the patient developed a clot in his LVAD and it took the staff more than 24 hours to transfer the patient back to the hospital after identifying trouble with the device. The patient died several days later due to complication from the LVAD implantation.