Did dialysis delay cause her death?

Did dialysis delay cause her death?

Jeremy Cox, DelmarvaNow 4:06 p.m. EDT September 15, 2015

In her final days, Vernetta “Becky” Harmon had become a walking medical dictionary.

By April 2012, her heart was failing, her breathing was labored and fluid was building in her legs. After years of heart trouble and grappling with Type II diabetes, her kidneys, doctors told her, had stopped working.

She would need dialysis for the rest of her life. But at her first appointment, she was turned away for lack of a physician’s order.

That was on a Saturday morning. On the following Monday night, Harmon collapsed at her Fruitland home and died. She was 37.

A Wicomico County jury soon might end up deciding whether the mother of five’s death was preventable.

Several of Harmon’s closest family members are suing two of her medical providers: Peninsula Regional Medical Center, whose staff was in charge of writing the physician’s order for her dialysis; and Bio-medical Applications of Maryland, whose dialysis clinics bear the name of its parent company, Fresenius Medical Care.

The lawsuit, filed last month in Wicomico Circuit Court, asserts that the hospital and the clinic bungled her appointment and that she died needlessly because of it.

“It’s something that should never have occurred and this woman should never have died,” said the family’s attorney, Stuart Salsbury, in an interview. “We feel a number of things were done wrong.”

He declined to make Harmon’s family members available for comment for this story.

Attorneys for Peninsula Regional and Fresenius vigorously deny the charges.

Harmon’s death was caused by “pre-existing general health,” a Fresenius attorney argued in one written response. The attorney, Ryan Duffy, declined to comment for this story.

A spokesman for Peninsula Regional said he can’t talk publicly about the case while the litigation is pending.

The suit doesn’t specify a dollar amount sought in damages. Maryland caps non-economic malpractice claims at $887,500.

The lawsuit was filed on behalf of seven family members: Harmon’s two adult daughters, Diane and Shanetta; an adult son, DeShawn; two minor children; her father, Steve; and her mother, Diane Drummond.

Court documents give this account of what happened during Harmon’s last days:

Suffering from breathing problems and swelling in the lower half of her body, Harmon was admitted at Peninsula Regional Medical Center on April 10, 2012. She spent 10 days at the hospital during which she was diagnosed with end-stage renal disease, the last stage of chronic kidney disease.

A hospital employee made her an appointment for the day after her discharge at the Fresenius location on South Division Street in Salisbury. But when Harmon showed up that Saturday morning, a staff member told her that Fresenius didn’t have a physician’s order for the visit.

“We don’t know where the mix-up was, but there was definitely some mix-up within Fresenius,” Salsbury said.

She went home that Saturday morning with the promise that a spot would be available for her on Tuesday. A Fresenius employee called Harmon later that Saturday to say the clinic now had her referral in hand.

Instead of bringing her in immediately, the caller told her to still come in on Tuesday.

At 7 p.m. on Monday, April 23, 2012, Harmon fell ill and was rushed in an ambulance to the hospital, where she was pronounced dead.

Fresenius, the lawsuit claims, failed to make enough effort to look for Harmon’s referral. When staff members couldn’t find it, they should have checked to see if her condition required immediate care. At the least, the family’s attorneys argue, she should have been immediately referred to the hospital for emergency dialysis.

“In a patient like this, you can’t just send them away and hope for the best three days later,” Salsbury said. “There needs to be an evaluation made at the time to see what needs to be done.”

Salsbury also said he needs more information about what happened to the referral. If further investigation reveals that Peninsula Regional employees made no mistakes, Salsbury added, the hospital will be dropped from the suit.

Fresenius operates a network of more than 2,100 clinics nationwide, making it the largest provider of dialysis services in North America, according to the company’s website.

The Centers for Medicare and Medicaid Services publishes a website that offers information about the quality of care provided at dialysis centers across the country and ranks them on a scale of up to five stars. The Fresenius location on South Division, the site shows, has received one star.

jcox6@dmg.gannett.com

410-845-4630

On Twitter @Jeremy_Cox

http://www.delmarvanow.com/story/news/local/maryland/2015/09/15/fresenius-dialysis-lawsuit/72326478/