Woman still fighting after her husband dies of nosebleed
SEATTLE -- How does an apparently healthy man die from a nosebleed after he's gone to the emergency room five time in less than a day?
Inside this health horror story the Problem Solvers learn about a Seattle man who lost more than half his red blood cells and, according to his wife, didn't get a transfusion until it was too late.
"He was witty, funny, sharp as a tack," Amy Hines said of her husband, Bill. "He fought for the underdog his entire career."
Hines says Bill, a respected local attorney, had a lifelong commitment to helping others.
"He always fought the good fight," she said.
But on a May morning in 2008, Bill himself was in the fight of his life.
"I suddenly hear him yelling for help," Hines said of the morning she woke up at 4 a.m. To find bill bleeding in the bathroom. "He was leaning over the sink and blood was pouring -- a massive amount of blood was gushing from his face."
Thus began a 10 day ordeal that ended with Bill's death. But it started with a recurrent nosebleed and five trips to the emergency room in less than 24 hours.
"And it's really very simple," said Dr. Paul Weiden, a noted cancer and blood specialist. "This patient was feeling fine on Friday, he spent all day Saturday bleeding."
Nosebleeds are relatively common, and most are readily treated. But in rare cases, people can die. The Western Journal of Medicine reports nosebleeds can be fatal when a patient has an underlying health condition. In those cases the Journals recommends paying attention to the patient's health history, a careful physical exam, checking the patient's red blood cells and transfusing to stave off death.
"You're relying on the physicians to tell you what to do, to guide you and to set a plan and to make you safe," said Amy Hines.
The problem was, Bill had under-lying medical problems, including a mild heart murmur and an undiagnosed blood cancer. Amy Hines sued Swedish Medical Center and Ballard physicians in Seattle. She believes they should have done more tests including checking his blood count by at least the third trip to the ER.
"It became really clear that he wasn't being treated seriously," she said. "They were treating him as I think, the guy with the nosebleed."
Not until Bill's fourth visit to the Swedish Ballard ER did the doctors take a complete blood count; the test showed he'd lost nearly half of his red blood cells which are essential to carry oxygen to vital organs.
Instead of a blood transfusion, the doctor ordered IV fluids, which replace liquids in his body but not the red blood cells. But the bleeding continued that night and when Hines went back for his now fifth ER visit -- this time to the Swedish First Hill campus -- a blood count now showed he'd lost more than half his body's red blood cells.
In the trial, opposing experts argued both for and against a speedy transfusion.
"He suffered a heart attack related to not enough blood," said Dr. Paul Weiden.
Dr. Kathleen Jobe is head of the Emergency Department at the University of Washington.
"I don't believe it required transfusion, again this was a guy who as far as we knew had no underlying serious medical issues and who was hemodynamically stable," Jobe said.
But after he was finally admitted to the hospital, his condition deteriorated and he developed congestive heart failure.
"No matter what they did there was nothing they could do, he had great care, they did the best they could, but he just didn't survive it," said attorney Bill Leedom, who's representing Swedish Medical Center:
Jurors ultimately agreed that transfusion or not, Bill Hines' death was not related to his care at the Swedish ERs. Swedish Medical Center declined an on-camera interview but in a written statement said:
"Swedish offers condolences to Mrs. Hines for the loss of her husband five years ago. After the jury heard all the evidence, they found all the physicians whose care was questioned acted appropriately and met the standard of care in treating Mr. Hines. Subsequently, they returned a unanimous verdict on behalf of Swedish and Ballard Emergency Physicians."
"I went the distance," said Amy Hines, "and I know that Bill would have done the same thing for me."
In spite of the verdict, Hines believes she did the right thing. She wants to share her story and warn others to push for tests and to take nosebleeds seriously.
"I really just hope that there's a positive outcome from doing this," she said.