Description of Event or Problem · 1
A 71 YEAR OLD MALE CONSENTED TO PARTICIPATE IN A TRIAL COMPARING LOW MOLECULAR WEIGHT HEPARIN, EXTERNAL PNEUMATIC COMPRESSION, AND THE COMBINATION OF LOW MOLECULAR WEIGHT HEPARIN AND EXTERNAL PNEUMATIC COMPRESSION IN THE PREVENTION OF DEEP VEIN THROMBOSIS FOLLOWING TOTAL KNEE REPLACEMENT. PT WAS RANDOMIZED TO RECEIVE THE COMBINATION OF LOW MOLECULAR WEIGHT HEPARIN AND PNEUMATIC COMPRESSION. PT CAME TO THE HOSP FOR A RIGHT TOTAL KNEE REPLACEMENT WHICH WAS DONE ON 07/14/97. ON 07/15/97 AT APPROX 17:00, PT WAS FOUND TO HAVE A CHANGE IN MENTAL STATUS AND LEFT SIDE WEAKNESS. THE PT SUBSEQUENTLY DEVELOPED A LEFT-SIDED HEMIPARESIS WITH LEFT-SIDED FACIAL DROPPING. THE PT WAS FOUND TO HAVE A RIGHT-SIDED PARIETAL TEMPORAL INFARCTION. AT THAT TIME, THE PT WAS ON A MORPHINE PUMP WHICH WAS DISCONTINUED. THE LOVENOX INJECTIONS AND EXTERNAL PNEUMATIC COMPRESSION WERE ALSO DISCONTINUED. THE SYMPTOMS IMPROVED SOMEWHAT AFTER NARCAN INJECTION. THE PT WAS TRANSFERRED TO INTENSIVE CARE UNIT THEN NEUROLOGY AND STABILIZED. THE PT WAS STARTED ON HEPARIN AND LATER COUMADIN WHICH WERE ADJUSTED AS PER PROTHROMBIN TIME/PARTIAL THROMBOPLASTIN TIME. PNEUMATIC COMPRESSION, EXTERNAL: 7/14/98 AT 16:30, TO 7/15/97 AT 17:00.