Misdiagnosed Pulmonary Embolism – A case study

Pulmonary embolism (PE) is a blockage in the artery by a blood clot in the lungs that has been moved from somewhere else to the artery of lungs. It affects blood flow which results in low oxygen level in blood, which damages other body organs.

As pulmonary embolism can be life-threatening and can lead to the death of 1-2 persons out of 1000 if remains untreated or undiagnosed. Thus people should be aware of symptoms of pulmonary embolism as getting medical help urgently can save one’s life and prevent extra suffering.

How Joseph’s Pulmonary Embolism was mistreated as Pneumonia

Joseph was a 14-year-old boy who was hit with “massive bilateral pulmonary embolism” on the morning of October 30th, 2010. His mother knew he was sick but she thought that it was an upper respiratory infection at that time. Joseph played football that season for his high school team along with running track and participating in Junior Olympics in Colorado that year. One-month prior Joseph was diagnosed with Pneumonia and his physician put him on strong steroids and antibiotics to fight pneumonia. He got better but he was not feeling 100% fit because often times he was out of breath. Joseph and her mother both thought that his breathlessness was because of pneumonia or because he was putting too much effort into his sports.

pulmonary embolism

He also noticed that his shins hurt badly during the track season. Joseph thought that it may be because he was running more than he used to and have recently changed his track shoes. The possibility of a Pulmonary Embolism or blood clot in leg never occurred to him as he was not aware of the Pulmonary Embolism symptoms. Joseph woke up on October 30th, 2010 and complained about the severe trouble he was having while breathing. He was continuously coughing and color of his lips turned blue and he couldn’t feel his arms.

He collapsed in front of his mother, His mother tried to give him CPR but she had no idea what was happening to Joseph. She called in an ambulance and he was rushed to the hospital. Joseph was given adrenalin 6 times in 2.5 hours but nobody suspected that it could be Pulmonary Embolism.

Joseph died at age of 14 of Pulmonary Embolism because nobody knew what was wrong with him. Doctor’s couldn’t diagnose the Pulmonary Embolism symptoms and neither did her mother. Her mother later recalled that her husband was also diagnosed with Pulmonary Embolism and had an inferior vena cava filter as a Pulmonary Embolism treatment and to prevent future Pulmonary Embolisms. It was realized after Joseph’s death that he had protein S deficiency, as does his father.

Nobody realized Joseph’s symptoms were Pulmonary Embolism symptoms and were due to blood clots. His first symptom i.e. shortness of breath, back in summer while running track was diagnosed as Pneumonia but instead, it was because of blood clots forming in his lungs and slowly killing him. Her mother didn’t know that tendency to clot is hereditary and a blood clot in lungs can be due to Pulmonary Embolism as well as Pneumonia, upper respiratory infection, or pleurisy.

Joseph’s story gives us a lesson that we should always consult with the doctor whether testing should be done if the symptoms of pulmonary embolism show and there is a history of blood clots in the family. Joseph’s massive Pulmonary Embolisms weren’t diagnosed until autopsy. Joseph didn’t have any blood clots in legs but according to his pathology report the blood clots that blocked his lungs were massive and developed near leg just above his hips.

Deep Vein Thrombosis and Pulmonary Embolisms can mostly go undiagnosed until an autopsy and are not very common in children. But both Deep Vein Thrombosis and Pulmonary Embolism can be deadly if untreated.

Some of the common ways to treat Pulmonary Embolism and Deep Vein Thrombosis are:

Thrombolytics (clot dissolvers/busters): are drugs that are used to dissolve clots for the treatment of Pulmonary Embolism. They speed up break down of clots.

Anti-coagulants: are also called blood thinners; they are the most common form of drugs that are used for the treatment of Pulmonary Embolism. They perform two functions. First; they keep the present clot from getting bigger. Second; they prevent the formation of new clots. Some common anticoagulants are aspirin, heparin, and warfarin.

Catheter-directed thrombolysis (CDT): It is an emergency treatment that doctor may use for dissolving blood clot (embolus). The doctor will insert a thin tube in the thigh or arm of the patient and continue to the lung, where medicine is released through the catheter to dissolve the clot. As medication is released through the catheter so its highest concentration is directly reached to clot making it more effective to dissolve.

Inferior vena cava (IVC) filter: IVC filter is implanted to prevent new or existing clot in deep vein thrombosis to move to the pulmonary artery and combining with an existing blockage.

Surgery: Chronic pulmonary embolism which may lead to pulmonary hypertension is treated by surgery known as pulmonary thromboendarterectomy.

Compression stockings along with Medshoola Compression Pump: Medshoola products are ideal for saving the lives of people at risk of developing blood clots.

Designed and backed by doctors and surgeons who realized the need for a portable, practical, and proven alternative that actually fits into everyday life, the Medshoola products bring over-the-counter prevention and treatment for people who are most at risk of pulmonary embolism (PE).

The Medshoola™ compression pump is a sequential compression device that can be used alone or paired with compression stockings for optimal results. It’s easy to use and customizable.

It is designed by physicians who routinely take care of patients with problems such as DVT or PE. The Medshoola sequential compression device (SCD) is the only compact, portable SCD on the market. It can dramatically decrease your risk of death from PE.