Mr Jackson Coumadin Case Summary

Mrs. Jackson had amputations and needed transportation in order to get to the hospital or her doctor visits. Mrs. Jackson was physically incapable of driving herself or caring for herself without the help of Jackie. As mentioned before, Jackie family is poor and Jackie nor did her grandmother have the funds to get her to the doctor appointments. Jackie physically had to scrape together money to get her grandmother to see her primary care physician. Usually, for the round trip to Mount Sinai, it costs seventy dollars and Jackie just did not have the money every time to get her grandmother to her scheduled appointments. For that reason, Mrs. Jackson missed some of her important doctor visits. However, that is not the only reason why Mrs. Jackson could not make it to her
appointments. Jackie’s family just does not seem to have some of the best resources or understanding of Medicare and Medicaid. Mrs. Jackson was covered by Medicare, which paid for her visits to the doctor. In addition, Mrs. Jackson had scheduled appointments with various doctors. On Monday’s, her appointments were with Dr. Steinberg and on Thursday’s with Dr. Gurevich. With the lack of education and resources, Jackie was under the impression that she could not get her grandmother to her scheduled doctor appointments because she did not have the funds. However, ASC is a Medicar company that would provide transportation for patients with Medicaid. If Jackie perhaps had the resources, asked questions or for assistance, then her grandmother would have been able to get transported to her doctor visits via ASC. In addition, it would have been helpful if a social worker could have provided these resources to Jackie so that Mrs. Jackson can get to her appointments. Unfortunately, when Jackie realized all of the information about ASC, it would have been too late because her grandmother was put on the spend-down program meaning that she was not eligible for Medicaid every month.
The cause of Mrs. Jackson getting Coumadin poisoning As mentioned before, Mrs. Jackson is chronically ill and Jackie does not always have the funds of $70 to get her grandmother to her doctor appointments. This caused Mrs. Jackson to miss many of her scheduled appointments during the week including necessary follow-up visits. On this one particular day, Jackie brought in her grandmother to the emergency room due to her grandmother’s leg edema that had swollen up really bad in her right leg. After Mrs. Jackson was discharged after 8 hours, they discovered in her lab results in the emergency room that she was suffering from a dangerous reaction to Coumadin. Coumadin was the drug that she was given to keep her blood from basically coagulating and trying their best to prevent it from flowing to her leg as well as what was left of her foot. If a patient would overdose on Coumadin, they would bleed uncontrollably.
However, there is a test called prothrombin time that would measure the patient’s coagulation level. The normal level for coagulation is an 11. Mrs. Jackson doctor did not want her level normal, instead, he wanted it to do more so of preventing the blood clots that came from her circulatory system causing the Coumadin to be one and one-half to at least two times of the proposed normal reading of 11. So, for Mrs. Jackson’s prothrombin time level, it was 35. That was over what Dr. Gurevich projected. It was necessary for Mrs. Jackson to be closely monitored, unless, she would bleed to death. Due to Jackie not having the expenses to bring her grandmother to an earlier doctor’s appointment, it got worse. Mrs. Jackson had to spend a week in the hospital to manage the Coumadin poisoning which also caused the government several thousands of dollars to cover her hospital stay. In addition, Mrs. Jackson doctor, Dr. Gurevich was not informed of her lab results or received them and did not have a nurse give Mrs. Jackson a prothrombin time test. This can also show that Dr. Gurevich did not have the patient’s best interest at
heart.