Peggy's Case History

[Christian73]

My mother passed away on April 21, 2010 from Toxic Megacolon leading to sepsis. She was a 56-year old Kindergarten teacher who, while overweight, was otherwise in good health. She had not been hospitalized since she gave birth to my brother in 1976. This is the timeline of her treatment and death.

April 14, 2010: Peggy Lillis has root canal performed by her longtime dentist. He prescribes Clindamycin to treat an abscess.

April 15, 2010: Peggy tells her children and coworkers that she isn’t feeling well (diarrhea), but she attends her evening class at Touro College.

April 16, 2010: Peggy stays home from work due to nausea and diarrhea.

April 17, 2010: Peggy speaks with her primary care doctor by phone. He prescribes (by phone) prescription strength anti-diarrheal and tells her she should see a GI doctor on Monday. Her brother picks up the prescription and delivers it to her.

April 18 – 19: Peggy remains in bed. Her son, Liam, gives her soup, tea and other liquids but she has difficulty keeping food down.

April 19, 2010: Peggy speaks with her son, Christian, who is worried that she has been sick for several days. He agrees to take her to the doctor the next day.

April 20, 2010: Christian arrives to bring Peggy to doctor appointment. She is very pale, somewhat weak and dizzy. Suspecting dehydration, he, his brother and Peggy decide that she should be taken to the hospital for fluid replacement and further tests. They call an ambulance and take her to the hospital.

Upon arrival at the hospital, the emergency room physicians determined that Peggy had a massive infection, later determined to be caused by clostridium difficile infection, which was precipitated by antibiotic use. She is in shock and septic. They begin fluid and antibiotic therapy. Her family is informed that she is profoundly ill, and her life is in jeopardy. It is determined that her eldest son will make her medical decisions for her, in consultation with his brother and Peggy’s sister, Helen, who is a nurse.

The doctors started a central line for fluids and antibiotics, performed additional blood tests and scheduled Peggy for a CT scan. Following the CT scan, they performed a colonoscopy to determine if she had an obstruction. At this point, Peggy was sedated and intubated. Following the colonoscopy, the doctors told us that they were going to treat Peggy will IV antibiotics and IV immunoglobin overnight. If she didn’t respond they would perform a colectomy in the morning “in an attempt to save her life.” We were told to go home and get some rest. If surgery was necessary, Dr. Alter would call us in the morning.

April 21, 2010: Dr. Alter called Christian at 6:00 am and told us to get to the hospital. Peggy had not improved overnight and surgery was necessary. Dr. Alter told us that given how ill she was, he was afraid she wouldn’t survive surgery, but that she would very likely die from sepsis without it. Christian consented to the surgery. Peggy survived the surgery and was moved back to ICU. From late morning until the afternoon, it seemed that she was improving. But around 4 pm, her vital signs started to deteriorate. The doctors put her on 100% oxygen and provided additional drugs to support her blood pressure. Peggy continued to decline throughout the afternoon. At 7:20 pm, the ICU doctor informed us that Peggy had gone into cardiac arrest and they had attempt to revive her three times to no avail.