Thank you cowboy, because much of what was said above is crap. Oh yeah and they really didn't address the question.
You asked does this sound normal or was there a major mistake?
Although, we strive for better outcomes, sometimes things like this happen. It does not sound like any mistake was made.
I have sen this happen a number of times.
All medications behave slightly different for every patient. The blood thinner lovenox works stronger in some than it does in others. There is no good test to tell just how strong an affect lovenox is having. There's a little working in the dark with this medication.
Sometimes a change in kidney function can cause the levels to build up too high. Often times the cause is never found. But a rare and low percent of people given lovenox will have serious bleeds. Notabley retroperitoneal
hematoma and intracranial bleed.
So there's the situation, with an artificial [mechanical] valve you need blood thinners or you are likely to get a serious stroke, but the treatment is not without risk. Don't forget even driving a car has risk involved.
IT SOUNDS LIKE A RARE AND UNFORTUNATE SIDE EFFECT FROM THE TREATMENT.
But if 9/10 docs would have given the same treatment, than no its not a mistake and by definition its not malpractice.
OK all the other crap people were stating above...\
1) You really cannot overdose on these medications, they are not poisonous.
2) Yes people use coumadin as "rat poison". The rat does not eat it and die from poison,... they get hurt banged up just like you in every day life and they have uncontrolled bleeding that kills them.
3)
Pneumonia can 'thicken' the blood. Pneumonia in older people often times leads to
systemic inflammatory response. By defeinition the
cytokine cascade causes a hypercoagulable state.
4) Pneumonia is not caused by the heart. Passive congestion or edema is not infection. Infection is infection. You dont treat pneumonia with lasix do you, or are you a PCC doc?
5) You ALWAYS try to correct coagulopathies before going to the OR. Only
tamponade or
intracranial hemorrhage will kill you.
Internal bleeding is managed medically each and every day of the week.
6) Bleeding doesn't kill you. You need blood to live, but as long as it keeps being transfused you do all right.
I'm very sorry you lost your grandmother. Some of the sentiment above does have a point. Pneumonia itself is a leading cause of death in older people, they often times just don't have the physiologic reserve or immunocompetency to fight it off.
And with coronary disease her chances might not have been that good. Sorry.