$20.5 Million Verdict: When Hospitals Discharge Patients Too Soon with Dangerous Prescriptions

The Case: A Preventable Tragedy

In October 2020, an 11-year-old girl was recovering from leukemia treatment when she attended a follow-up appointment at Advocate Children’s Hospital in Illinois. What should have been routine medical monitoring revealed multiple concerning clinical indicators that the family’s legal team argued demanded immediate hospitalization rather than discharge.

During her visit, the child presented with severe pain and mobility issues. Laboratory testing uncovered several alarming findings: significantly low platelet counts, reduced blood cell counts, elevated liver enzymes, and dangerously low blood pressure. Despite these multiple warning signs indicating medical instability, hospital staff discharged the patient with instructions to administer 15 milligrams of morphine every four hours, three times her previously prescribed dose. Healthcare providers also simultaneously increased her gabapentin medication. 

Within approximately 36 hours of returning home, the child died in her sleep. Medical examination determined the cause of death was acute drug toxicity, with autopsy results showing lethal morphine concentrations in her system. 

What Constitutes Medical Malpractice in Discharge Decisions?

Medical malpractice happens when healthcare providers fail to meet the accepted standard of care, causing patient injury or death. In situations involving premature discharge and medication management, several critical factors determine whether negligence occurred:

The Standard of Care in Pediatric Medicine

Hospitals and medical practitioners must adhere to established protocols when treating pediatric patients, particularly those with complicated medical histories involving cancer treatment. The standard of care requires healthcare providers to:

• Thoroughly evaluate all symptoms and laboratory findings before authorizing discharge
• Investigate and treat root causes of pain rather than solely managing symptoms with medication
• Carefully consider medication interactions and combined effects when prescribing multiple drugs
• Admit patients for medical observation when vital signs demonstrate instability
• Calculate appropriate medication dosing based on patient weight, age, and complete medical history

Understanding Opioid Toxicity in Children

Morphine belongs to a class of powerful opioid medications requiring meticulous management, particularly in pediatric populations. Children process medications differently than adults, making them especially susceptible to opioid toxicity. Several factors elevate this risk, including:

Body Weight and Dosing Calculations

Minor variations in dosing can have major consequences in children. A dose appropriate for an adult may prove dangerously excessive for a pediatric patient.

Drug Interactions

Combining morphine with other medications that depress the central nervous system, such as gabapentin, can amplify sedative effects and increase the risk of respiratory depression.

Individual Metabolic Differences

Genetic variations affect how different individuals process opioids. As such, identical doses can produce vastly different, and potentially dangerous, effects in different patients.

Lack of Opioid Tolerance

Patients who haven’t been taking high opioid doses regularly may be significantly more vulnerable to overdose when dosages are abruptly increased.

When Should Hospitals Admit Rather Than Discharge?

A central argument in this case centered on whether the patient should have been admitted for inpatient care rather than sent home. Hospitals have a legal duty to admit patients when:

• Vital signs remain unstable or fall outside of normal parameters
• Multiple concerning laboratory values require further investigation and active treatment
• New or substantially increased pain medication protocols necessitate professional monitoring
• The underlying cause of presenting symptoms hasn’t been identified or adequately addressed
• The patient’s medical condition could rapidly deteriorate without direct medical supervision

Premature discharge may constitute medical malpractice when a reasonably prudent physician would have recognized the necessity for continued hospitalization.

Finding Justice After Medical Tragedy

While no verdict can undo the loss of a loved one, legal action serves vital purposes. It provides financial resources to help families address unexpected expenses and compensate for lost future support. Perhaps more importantly, it holds healthcare institutions accountable and may prevent similar tragedies from affecting other families.

The $20.5 million verdict represents more than monetary compensation. It represents validation that this child’s life mattered, that her death was preventable, and that those responsible must be held accountable for their failures.

If you’ve lost a loved one or suffered serious injury due to suspected medical negligence in Illinois, consulting with an experienced medical malpractice attorney can help you understand your legal rights. To discuss your options for seeking compensation and accountability, contact our attorneys at Strong Law. Call 309-393-2928.