Daniel M. Hodes and Jacob Brender/Andreeff v. Southern California Permanente Medical Group
IMPROPERLY PRESCRIBED MEDICATIONS LEAD TO A DISABLING STROKE
Matthew Andreeff suffered from neurofibromatosis, which caused him to develop skin lesions. He also suffered from chronic kidney disease. Immediately before undergoing elective surgery for the excision of a neurofibroma on his abdomen, he suffered an acute kidney injury. At the direction of a Kaiser hematologist, he was given two medications, DDAVP and NovoSeven. Andreeff also had chronic kidney disease. NovoSeven had never been tested for use in patients with acute kidney injury or chronic kidney disease, nor had NovoSeven ever been tested in combination use with DDAVP. Surgery was uneventful, but the next day Andreeff’s creatine level rose dramatically. He was transferred to intensive care and placed on a ventilator. Four days later he was taken off the ventilator but did not awaken, and a CT scan showed he had suffered a large stroke. He will need 24/7 care for the rest of his life. The elective surgery should not have gone forward with clear evidence of an acute kidney injury superimposed on chronic kidney disease; the surgeon should have postponed the surgery until Andreeff’s kidney function was optimized. Had surgery not gone forward, Andreeff would not have suffered his stroke. His surgeon testified that she was not responsible for clearing him for surgery, but his primary care physician and nephrologist both testified that she was. Also, the medications he received before surgery were significant contributing factors to his stroke. The hematologist who prescribed the medications testified that she believed Andreeff had an 8-10% chance of a blood clot that could lead to a stroke as a result of the drugs. During the arbitration hearing, Hodes and Kaiser’s attorneys argued over how many hours of care Andreeff would need each day, as well as what his life expectancy would be. The arbitrator ruled in favor of Andreeff and awarded him more than four times the amount Kaiser had offered.