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Did Early Discharge Cause Child's Death After Tonsillectomy?

Family alleges hospital was negligent in sending still-unconscious son home.

Published: May 4, 2012

Timothy and Lynn Armstrong can proceed with a lawsuit claiming their son's early discharge from a Delaware hospital led to his death just hours after undergoing a tonsillectomy, according to a state court.

On April 7, 2010, 5-year-old Thomas Armstrong underwent a tonsillectomy and adenoidectomy at A.I. Dupont Hospital in Wilmington. Steven P. Cook, MD, who performed the surgery, had recommended the procedure after diagnosing Thomas with large tonsils, snoring and obstructive sleep apnea with acute otitis media in the left ear a month earlier.

Before beginning the procedure, Dr. Cook issued a discharge order stipulating that Thomas must be able to tolerate post-operative care, show stable vital signs, meet criteria for transfer to PACU and experience no bleeding, emesis or respiratory distress in order to be discharged, court records indicate. According to the Armstrongs' lawsuit, however, their son was transferred to post-op and subsequently cleared to return home despite remaining unconscious after being administered Lortab.

Shortly after being moved to post-op, a nurse twice administered the synthetic opioid Nubain as an analgesic, followed by doses of IV morphine and Lortab over the next hour. Court documents show that Thomas fell asleep sometime shortly after being given Lortab at 3 p.m.

Upon the boy's discharge around 3:50 p.m., Mr. and Mrs. Armstrong were "concerned and outraged" that their son had been taken from post-op despite not regaining consciousness after receiving Lortab, according to court records. Their son was "unresponsive and dead weight" as he was wheeled to the family's car to head home, where his parents carried him inside and placed him on a bed.

Around 6 p.m., the Armstrongs placed a call to 911 after finding Thomas unresponsive and not breathing. After attempts at resuscitation at the Armstrong home, EMS personnel transported Thomas to the emergency room at DuPont, where he was pronounced dead. According to the death certificate, the cause of death was "respiratory arrest associated with opioid analgesia (morphine and hydrocodone) status post-tonsillectomy." Timothy and Lynn Armstrong ultimately filed a medical negligence and wrongful death lawsuit targeting DuPont as well as Dr. Cook and Samuel Earl Wilson, MD, the physician that provided anesthesia services for the surgery.

Attorneys for both parties did not immediately respond to requests for comment.

Mark McGraw

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