Tied to a Bed at Walter Reed and Injected with Dilantin
Federal Case decided March 27, 2012. An 82 year old Blanche Porter was admitted to the emergency hospital because of a bacterial infection. When she was transferred to Walter Reed Army Medical Center (WRAMC), “restraints were used to secure Blanche to her bed”. Dilantin was administered and three days later Blanche developed a fever.
The same patient had been admitted to the same hospital (Walter Reed Army Medical Center) less than a year earlier and the “discharge diagnosis read ‘decreased sensorium due to Dilantin.’” In that instance a private doctor had prescribed the Dilantin but after about a week Blanche “appeared ‘zombie-like’” so at the hospital they discontinued the Dilantin and Blanche recovered.
A year later, 1995, Blanche is strapped to a bed and given Dilantin again by that very same hospital that had previously diagnosed her negative reaction to it. And this time just days after getting the drug, she entered into a fever. When all the medication was stopped (and there were other medications too), the fever subsided in about a week and Blanche was discharged to her daughter about two weeks later. However, Blanche was now permanently incapacitated and her daughter, Blanchita sued the hospital.
BLANCHITA PORTER, et al., Plaintiffs, v. HON. JOHN MCHUGH, Secretary of the Army and Walter Reed Army Medical Center, Defendants.
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA
Decided – March 27, 2012
Chief Judge Lamberth writes:
On September 9, 1997, plaintiffs submitted an administrative claim on behalf of their mother under the Federal Tort Claims Act, asserting that Blanche was given “one or more improper drugs, including Dilantin, that caused her to go into a coma and become permanently incapacitated.”
After spending eleven years in the administrative process, plaintiffs filed the present lawsuit on June 24, 2009. Id. In their complaint, plaintiffs assert that, by using restraints and administering Dilantin, defendants “failed and neglected to provide proper medical treatment” to Blanche.
Blanche died in 2001 of pneumonia but the long administrative process continued (an ironic sort of zombie process) and has just now been dismissed this past week by this district court. I do not know if Blanchita Porter intends to appeal this summary judgment decision. As it stands now, the Court holds:
guidelines on the use of restraints by the Food and Drug Administration and the Joint Commission on Accreditation of Healthcare Organizations … fall short of establishing a clearly defined national standard of care.
The plaintiffs lacked “expert opinions” about the “national standard of care” in 1995 regarding both restraints and the administration of Dilantin,
expert testimony is needed to establish that there was a deviation from the national standard of care.
Proving a national standard is required even here where the patient had a prior negative reaction to the medication, documented at the same hospital. Was there national standards of care for restraints or for Dilantin in 1995? If so, this could be a case of bad or unprepared lawyering. They pursued this case for eleven years but didn’t have experts to beat summary judgment? Also, perhaps the judge did not believe that the Dilantin actually caused the coma or fever. The “zombie-like” terminology may be a way of demeaning the alleged side effect to suggest that the fever was caused by other than the re-administering of that particular drug.
Dilantin and restraints is a common feature of lesser quality medical institutions and the Federal Court is perhaps unlikely to find malpractice in use of the treatment. The Supreme Court has this week allowed strip searches for all prisoners and so why not allow Dilantin and restraints for all hospital patients. Even if they aren’t admitted with a mental condition, the hospital has to be able to medicate the uncooperative and so they’ll call it Hospital Psychosis
See Also “One Flew Over the Cuckoo’s Nest” and the Wikipedia on Dilantin says “Dilantin made an appearance in the 1962 novel One Flew Over the Cuckoo’s Nest by Ken Kesey, both as an anticonvulsant and as a mechanism to control inmate behavior.”
Finally, I note that Walter Reed Army Medical Center was closed in 2011 following a 2007 Washington Post expose of alleged neglect and “complicated bureaucracy” causing major frustrations in the wake of the Bush wars. Though the wars certainly emphasized many institutional issues, it is unclear how long these administrative nightmares had been going on or what condition WRAMC was in when Blanche Porter was there in 1995. And without evidence of the national standards of care at that time, we also don’t know what condition it should have been.