Another question for the medical community

Ed1937

Before my wife passed, I thought she had a BM in the hospital bed. I pulled back the sheets, and found massive amounts of blood. I called the nurse, and two of them cleaned the bed, floor, and my wife. I was then told she would not make it. Her blood pressure dropped drastically.

Today I picked up the death certificates. The cause of death is reported as "complicated urinary tract infection". Is it even possible that a UTI could cause that kind of bleeding? I didn't think so, but I don't know. She did not have a UTI when admitted to MC on June 3. Her death was on June 24.

Jo C.

Will be good to hear from M1 regarding this.   Since the cause of death must be provided by the physician, it may be best to inquire of him why he put that diagnosis down as cause of death when she was hemmorhaging with all that entails and she was fairly new on anticoagulants.

I remember your stating that she had some bleeding from her mouth and that a stool sample wa positive for blood at the MC facility and she was transferred to the acute hospital.  You found the large bleed in her hospital bed and her BP was bottoming out.  We all seemed to assume it was a GI bleed and did not the physician address it as a GI bleed at the time it was happening?  Perhaps I am wrong.

Was the bleeding from the urinary tract or GI tract is a question I think you want answered.  As to the "bladder infection," that is confusing to me; perhaps M1 will have insight.  If there was a bladder infection and it was complicated and cause of bleeding by being on anticoagulants, that is a guess, but that is only a guess due to the cause of death diagnosis.  How would the MD have determined a GI bleed versus a Bladder Infection and bleed if no testing diagnostics were done.

You can ask the primary MD who managed her care in the acute hospital about the diagnosis and you can also read her medical record at the hospital; it is your right to do so; that may give you more information that you may not have had earlier.

It s about peace of mind.

J.

Ed1937

Thank you, Jo. The ER doc told me they suspected a GI bleed, and they could try to treat it with medication (which they did), or we could use a camera inserted in her stomach to see what was happening. I told them to try medication. They also did a stool sample which came back positive for blood in the stool. All of this was done before the major bleeding. She did have blood coming from her mouth earlier in MC, and was unresponsive. But by the time I got to the hospital, she was alert, and carried on a conversation for several hours before the major bleeding. She seemed pretty normal, without any obvious problem. They did no testing at MC, but called for ambulance.

M1

Ed I feel sure the cause of death was a massive GI bleed. That's pure fiction on the death certificate. I guess it s of little practical consequence, but it makes one wonder about death certificates in general.  one certainly can't do any long-term research based on death certificate entries, they're meaningless.

what happened to Carole is one of the risks of being on anticoagulants. But as we've discussed before, there were risks to discontinuing them too.  Rock and a hard place. 

Jo C.

Exactly!   Such blatant inaccuracy, to me, feels  disrespectful of the person who has died and seems actually insulting.  It is also a huge problem that is very important and has all sorts of significant ramifications.  The death certificate can be amended and here is how to get it done in Indiana:

https://secure.in.gov/health/vital-records/corrections-and-amendments/correctamend-a-death-certificate/

Information as to why it is so important to have accurate death certificates:

https://www.nytimes.com/2022/02/14/well/death-certificate-cause.html

The documented inaccurate cause of  Carole's death is so blatant, it really stumps me; it even leaves me wondering who actually provided the cause of death.  

You can let it be if you wish; but you do have the ability to get the certificate changed to indicate the accurate cause of death.   Mr. Keiper can in all probability assist with this.  Ed; if you want to have this corrected, do not let anyone minimize the effect and try to get you to let it go.  Your wishes are paramount and if it should be your wish, right is right.  If it does not feel importatnt to you, then no big deal as is.

I speak from experience.  My LOs cause of death was inaccurate on the death certificate.   I did speak to the doctor and requested the certificate be amended to be accurate, but the doctor minimized the effect of doing so, and me; being exhausted to the core, did not stand up for what was right and it never got changed. I am sorry I did not follow through.

Each person will have their own feelings about this.  You know what is right for your situation.

J.

Ed1937

Thank you both VERY much. It will be pursued. I agree that it's disrespectful. Not only that, but an inaccurate death certificate could possibly be detrimental to an ancestor who is dealing with certain medical problems, and is unaware of the true cause of death. Jo, thank you for the links.

I remember someone else recently had a post about an inaccurate death certificate, but can't remember who it was.

dayn2nite2

A number of people (including me) posted that our LO’s certificate doesn’t even mention dementia.  To get it corrected was a process I emotionally couldn’t deal with afterward so I didn’t.

Jo C.

If you wanted to, you can request the med center's department that manages the medical records to provide you with a full copy of Carole's medical record for that admission.  Cost is usually minimal, and one would have to be specific that a copy of the full and entire record is being requested with nothing omitted.

Yet; reading the enire record from the point of the ER to the final day may be upsetting and bring back more feelings of that day; so it may be something best left aside.

Being one of those curious and detail oriented people who leaves no stone unturned; sometimes it has not been to my benefit. 

I am so very sorry this happened on top of everything else.  It is so questionable it leaves me even wondering if somehow, at some point, someone was covering their backside.  However; being married to a police detective for lo these many years, I sometimes can suddenly, unbidden, have  a negative question for things pop up.

If you are going to request a change for accuracy re the death certificate, it would be best to do it soon as there may be time frame limits for when this can be done.

J.

June45

Ed I was not happy with my husband's cause of death was vascular dementia on his death certificate.  It didn't make sense because my husband had been diagnosed with Alzheimer's, not vascular dementia, by a neurologist over 4 years ago.  At first I was going to let it go but then I noticed that the doctor didn't use the 24 hour clock for time of death and the time was not correct.  Since I decided to have the time corrected, I figured I would talk to the doctor and ask why he put Vascular Dementia and not Alzheimer's.  The doctor was new to hospice and he said that my husband's records indicated that he has a history of stroke.  My husband had never had a stroke and his blood pressure was always excellent without meds.  The doctor agreed to change it to Alzheimer's; it is being amended.  If it were not for the mistake of the time, I probably would have let it go, but it really bugged me because it made me feel like I have been taking care of someone else all those years.  The funeral home said I could use the death certificates that I already have since the date was correct and he died of "natural" causes.

My thread: https://www.alzconnected.org/discussion.aspx?g=posts&t=2147561478