# What could the ER doctors have missed that caused this woman's death? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [December 7, 2015, 5:33pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718 "2015-12-07T17:33:10Z")\ **Posts on this page:** 15\ **Page:** 1
**Author:** ![Skald\_the\_Rhymer](https://avatars.discourse-cdn.com/v4/letter/s/ecccb3/32.png) [@Skald\_the\_Rhymer](https://boards.straightdope.com/u/Skald_the_Rhymer)\ **Post date:** [December 7, 2015, 5:33pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/1 "2015-12-07T17:33:10Z")
A friend of my wife’s died suddenly over the weekend. She was in a car accident on Tuesday, but while her vehicle was totalled she walked away in what seemed minimal distress, and so she did not go the hospital right away. The next day, feeling more pain, she went to the hospital to get checked out, but still didn’t seem in significant distress; she posted jokes from the hospital, complained that she had forgotten her cell phone charger, and wanted someone to record a TV show for her because she had forgotten to set her DVR, and left thinking that all was well. Friday afternoon she bitched amusingly about her insurance company, worried about the San Bernadino shootout causing a backlash against Muslims, and looked forward to the Doctor Who season finale. Friday night she suffered what someone called an “acute medical crisis” and perished. Assuming she took some hidden injury during the accident that caused her death (which of course is not certain), what might it have been, given that the paramedics and doctors all missed it? ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [December 7, 2015, 5:39pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/2 "2015-12-07T17:39:12Z")
IANAD and all that but what came to mind was a [thromboembolism](http://www.medicinenet.com/script/main/art.asp?articlekey=25032). What would have happened in that case would be that she had small internal wounds (small explains why the doctors didn’t find anything) and a clot in a vein eventually started moving (a traveling clot is called a thromb). At one point it reached a key organ or blocked a key vessel and she died. I know that’s one thing doctors worry about a lot after someone is in a crash or similar accident. ---
**Author:** ![USCDiver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/uscdiver/32/354_2.png) [@USCDiver](https://boards.straightdope.com/u/USCDiver)\ **Post date:** [December 7, 2015, 6:57pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/3 "2015-12-07T18:57:44Z")
In order to guess at what might have been missed. I’d have to know what was looked for during her ER visit. Did she have lab tests or imaging studies? ---
**Author:** ![Skald\_the\_Rhymer](https://avatars.discourse-cdn.com/v4/letter/s/ecccb3/32.png) [@Skald\_the\_Rhymer](https://boards.straightdope.com/u/Skald_the_Rhymer)\ **Post date:** [December 7, 2015, 7:28pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/4 "2015-12-07T19:28:34Z")
> [@USCDiver](#): > > In order to guess at what might have been missed. I’d have to know what was looked for during her ER visit. Did she have lab tests or imaging studies? X-rays, certainly. Beyond that I don’t know. Feel free to speculate. I do not actually _need_ a correct answer, just a possibility. I’m sure her family is looking for that, and she was only a friend-in-law. I am simply curious. ---
**Author:** ![mistymage](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mistymage/32/459_2.png) [@mistymage](https://boards.straightdope.com/u/mistymage)\ **Post date:** [December 7, 2015, 7:34pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/5 "2015-12-07T19:34:16Z")
We lost a friend a few years ago (drunk driving) to a tear in her liver. She was in the hospital because of abdominal pain and blacking out, she was a large woman and by the time they figured out what was wrong she had already slipped into a coma. ---
**Author:** ![Just\_Asking\_Questions](https://avatars.discourse-cdn.com/v4/letter/j/ba9def/32.png) [@Just\_Asking\_Questions](https://boards.straightdope.com/u/Just_Asking_Questions)\ **Post date:** [December 7, 2015, 8:49pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/6 "2015-12-07T20:49:09Z")
Subdural hematoma. Internal bleeding. ---
**Author:** ![xizor](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/xizor/32/102_2.png) [@xizor](https://boards.straightdope.com/u/xizor)\ **Post date:** [December 7, 2015, 8:59pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/7 "2015-12-07T20:59:30Z")
[Internal trauma](https://en.wikipedia.org/wiki/Natasha_Richardson#Injury_and_death) can be hard to diagnose when there are no obvious symptoms. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [December 7, 2015, 9:00pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/8 "2015-12-07T21:00:11Z")
Do they typically do an autopsy in “mysterious” cases like this? ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [December 7, 2015, 9:54pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/9 "2015-12-07T21:54:59Z")
Without knowing past medical history and record of ER workup any speculation is obviously uninformed. In addition to possible factors previously mentioned, it is not unknown for previously healthy people to die of existing, unsuspected pathology, like a myocardial infarction and/or arrhythmia unrelated to the accident. > [@Senegoid](#): > > Do they typically do an autopsy in “mysterious” cases like this? Sounds like a potential medical examiner case. Whether they’d do a post would be up to the judgment of the ME or coroner. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [December 7, 2015, 10:56pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/10 "2015-12-07T22:56:21Z")
> [@Jackmannii](#): > > Without knowing past medical history and record of ER workup any speculation is obviously uninformed. > > In addition to possible factors previously mentioned, it is not unknown for previously healthy people to die of existing, unsuspected pathology, like a myocardial infarction and/or arrhythmia unrelated to the accident.Sounds like a potential medical examiner case. Whether they’d do a post would be up to the judgment of the ME or coroner. Agreed. A while back, a co-worker had a relative who died unexpectedly after a brief illness (by brief, I’m talking about a matter of hours), and (long story made short) we all thought the family was sitting on a multi-million dollar lawsuit against the local hospital. Until the autopsy and lab results were all in. This person had a type of leukemia that is diagnosed about 10 times a year in the United States, and they’ve never come up with a chemotherapy protocol for it because nobody has ever lived long enough for them to devise one. :eek: ☹ ---
**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\ **Post date:** [December 8, 2015, 4:10am UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/11 "2015-12-08T04:10:00Z")
[Vertebral artery dissection](https://en.wikipedia.org/wiki/Vertebral_artery_dissection)? Can occur later on, [\*after \* the trauma](https://en.wikipedia.org/wiki/Vertebral_artery_dissection#Traumatic). ---
**Author:** ![Oly](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/oly/32/8255_2.png) [@Oly](https://boards.straightdope.com/u/Oly)\ **Post date:** [December 8, 2015, 5:22am UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/12 "2015-12-08T05:22:26Z")
A case like that really should be referred to the ME or coroner, whichever is operative in that jurisdiction. However, without any apparent symptoms for, what?, about 72 hours, then suddenly dropping dead, sounds like a “true, true, unrelated” situation. An autopsy would be the only way to sort it out. ---
**Author:** ![dizzee\_dee](https://avatars.discourse-cdn.com/v4/letter/d/7c8e57/32.png) [@dizzee\_dee](https://boards.straightdope.com/u/dizzee_dee)\ **Post date:** [December 8, 2015, 6:44am UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/13 "2015-12-08T06:44:24Z")
> [@Senegoid](#): > > Do they typically do an autopsy in “mysterious” cases like this? IME, autopsies aren’t done except in some cases of foul play or if the family asks for one. ---
**Author:** ![Earl\_Snake-Hips\_Tucker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/earl_snake-hips_tucker/32/3269_2.png) [@Earl\_Snake-Hips\_Tucker](https://boards.straightdope.com/u/Earl_Snake-Hips_Tucker)\ **Post date:** [December 8, 2015, 3:27pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/14 "2015-12-08T15:27:32Z")
Yeah, we’re not going to figger this out her, but in a news story from some years ago, there was [a highly publicized case](https://en.wikipedia.org/wiki/Death_of_Brittanie_Cecil) of verterbral artery dissection. ---
**Author:** ![Skald\_the\_Rhymer](https://avatars.discourse-cdn.com/v4/letter/s/ecccb3/32.png) [@Skald\_the\_Rhymer](https://boards.straightdope.com/u/Skald_the_Rhymer)\ **Post date:** [December 8, 2015, 5:38pm UTC](https://boards.straightdope.com/t/what-could-the-er-doctors-have-missed-that-caused-this-womans-death/739718/15 "2015-12-08T17:38:33Z")
> [@Earl\_Snake-Hips\_Tucker](#): > > Yeah, we’re not going to figger this out her, but in a news story from some years ago, there was [a highly publicized case](https://en.wikipedia.org/wiki/Death_of_Brittanie_Cecil) of verterbral artery dissection. I’m not trying to figure it out; just wondering about possibilities.