The Case
An insulin-sensitive patient was discharged from a hospital to a rehabilitation facility. The discharging physician provided clear, specific instructions: do not give this patient large doses of insulin, and do not give bedtime insulin. These instructions were necessary because the patient’s body responded strongly to insulin, creating a high risk of dangerous drops in blood sugar.
The rehabilitation facility ignored the individualized instructions. Instead, staff followed a generic sliding scale protocol—a standardized chart that dictates insulin doses based solely on blood sugar readings without accounting for individual patient factors.
The patient received an insulin overdose. Blood sugar dropped to dangerous levels, depriving the brain of glucose. This caused a hypoxic brain injury—damage from lack of oxygen and fuel to brain cells. The patient’s condition deteriorated, and she died ten months later.
The family pursued a medical malpractice claim based on the facility’s failure to follow clear discharge instructions and the resulting overdose, brain injury, and death.
The Defense
The defendants denied liability. They likely argued that the patient’s condition was complex, that multiple factors contributed to her decline, and that the insulin management met the standard of care.
Defense attorneys in these cases often try to create confusion about causation by pointing to the patient’s underlying health issues. They may also attempt to shift blame between defendants—in this case, the hospital and the rehabilitation facility could each argue the other was at fault.
When multiple defendants point fingers at each other, it sometimes benefits the plaintiff by showing that all parties recognize something went wrong, even if they disagree about who is responsible.
The Resolution
The case settled for $1,600,000. The settlement reflected the clear deviation from explicit medical instructions, the preventable nature of the insulin overdose, the severity of the brain injury, and the family’s loss.
Why These Cases Matter
Discharge instructions exist for a reason. When a physician writes specific orders that deviate from standard protocols, it is because the patient’s individual circumstances require specialized care.
Generic sliding scales for insulin dosing are common in facilities, but they are not appropriate for all patients. Facilities must read and follow individualized instructions, especially when a patient is flagged as high-risk.
Insulin overdoses can cause brain damage within minutes. Once brain cells are deprived of glucose, the damage is often irreversible. This injury was preventable with basic attention to the discharge paperwork.
Families dealing with the death of a loved one due to medication errors in nursing homes or rehabilitation facilities often feel that their family member’s individual needs were ignored in favor of standardized, assembly-line care. When clear instructions are documented and then disregarded, it demonstrates a failure of basic patient safety protocols.
If a family member suffered harm or died after being transferred to a facility that did not follow medical instructions, contact us to discuss whether you have a case. We handle medical malpractice and nursing home negligence cases on a contingency basis—there is no fee unless we recover compensation for you.