Deep Vein Thrombosis (DVT)

There are two types of veins in the body: superficial veins and deep veins. Deep vein thrombosis (DVT) occurs when a blood clot develops in a “deep vein.” This can happen when the vein becomes damaged or if the blood flow within the vein slows down or stops. While superficial veins lie just below the skin’s surface, deep veins are located deep within the muscles and are not as easily accessible. DVT can occur in any deep vein, but most commonly occurs in the legs–typically in the upper thigh or calf. DVT can also occur in the arms and the pelvic area.

What are the symptoms?

After a blood clot forms, it can restrict blood flow and cause pain and swelling (edema) in the affected area. In addition to pain and swelling, other potential DVT symptoms include:

• Redness or discoloration of the skin
• Warmth over the affected area
• Tenderness or cramping in the leg (often starting in the calf)
• Distended veins
• A firmness or thickening of the vein called a “cord”

However, some people experience no symptoms of DVT at all.

If you are experiencing any of the symptoms above, you should let your doctor know right away. Having a conversation with your doctor can get the treatment process started quickly, and this can help you avoid other future complications.

What are the risk factors?

The most common risk factors for developing DVT are an injury to your lower body, surgery involving your hips or legs, and prolonged inactivity. Other factors which may increase your chances of developing DVT include:

• Genetics
• A Sedentary Lifestyle
• Smoking
• Blood Disorders
• Age Over 60
• Clotting Medications
• History of DVT
• Taking birth control pills or hormone therapy
• Pregnancy
• Certain illnesses and diseases such as cancer, heart failure, obesity, or inflammatory bowel disease

This is not an exhaustive list, and your doctor should be able to notice other signs of an increased risk for DVT and discuss how to best avoid it. In orthopedic situations (injuries or major surgeries to lower body) the three primary factors which contribute to the formation of blood clots in the veins are: slow blood flow (stasis), hypercoagulation, and damage to the veins.

How do you diagnose DVT?

After your doctor does a physical exam, there are a few tests that they can conduct to diagnose or rule out DVT. These tests are split into two categories: imaging tests and blood tests.

Imaging

• Duplex Ultrasound
• MRI
• Venography X-Ray

Blood

• D-Dimer Blood Test

How is DVT treated?

The proper treatment for your DVT will depend on the severity of your case as well as the risk of future occurrences of DVT. DVT is most often treated with medication but in some cases may need to be treated with surgery. Depending on your circumstances, treatment is implemented to stop the clot from getting bigger, reducing the chance of developing another DVT or other complications, and preventing the clot from breaking loose and traveling to the lungs.

Patients can be placed on medications known as “anticoagulants,” also called blood thinners, which may be injected or taken orally. Blood thinners are intended to prevent blood clots from getting bigger and reduce your clotting ability–thereby reducing the risk of developing more clots. The most frequently used injectable anticoagulants are unfractionated heparin, LMWH, and fondaparinux. Some of the most commonly prescribed blood thinners include:

• Edoxaban
• Rivaroxaban
• Warfarin
• Dabigatran
• Apixaban

For more serious cases, thrombolytics (often called “clot busters”) may be given through an IV or catheter placed directly into the clot. This method works by dissolving the clot but has a higher risk of causing serious bleeding, so it is typically reserved only for serious cases of DVT.

In rare cases, surgery may be recommended to remove the clot (often called a “thrombectomy” or “embolectomy”). Another surgical option includes inserting a filter into the vena cava–a large vein in your abdomen leading to your heart–to prevent the clot from breaking loose and traveling to the lungs. This option may be necessary for patients who cannot take anticoagulants due to certain medical conditions or when these medications are not working well enough.

What are the long-term effects?

DVT can cause permanent damage in the vein and can lead to long-term complications such as leg sores, pain, and swelling. In rare cases, DVT can be fatal when portions of the blood clot break free and travel to the lungs. If the clot reaches the lungs, it may block blood flow to the lungs and heart, causing a pulmonary embolism. This can occur right after the formation of the DVT clot or days later. When DVT and a pulmonary embolism occur together, it is called venous thromboembolism (VTE). Pulmonary embolisms are an extremely serious complication and are responsible for over 50,000 deaths per year in the United States.

Symptoms of a pulmonary embolism include:

• shortness of breath
• sudden tightness or pain in the chest
• heart palpitations or rapid pulse
• pain or discomfort when you take a deep breath or cough
• coughing up or vomiting blood
• anxiousness, lightheadedness, or dizziness.

Those who suffer from DVT can also develop a condition known as post-thrombotic syndrome (PTS). PTS is caused by venous hypertension (high blood pressure in the veins) after a vein has been damaged. This hypertension can further damage the valves of the vein that control blood flow and allow blood to pool in that area. PTS can cause long-term symptoms and impairment–typically in the calf–such as pain, swelling, leg sores, and other changes to the skin which may impact that person’s quality of life. Complications from PTS can ultimately impact a person’s mobility.

Diagnosing and treating DVT as early as possible is crucial for avoiding serious and life-threatening complications such as a pulmonary embolism or PTS. Communicating your symptoms with your doctor and requesting the relevant tests can help you avoid DVT.

Is there a way to prevent DVT?

Lifestyle changes may minimize risk or prevent DVT for those at risk or predisposed to developing DVT. These strategies include regular exercise to manage weight and increase blood flow, compression garments to aid circulation and prevent blood pooling, and movement–especially of the legs during prolonged periods of inactivity (e.g., when traveling or while on bed rest).Measures that a doctor may implement to prevent DVT may be a combination of several preventative measures called prophylaxis. For example, if the risk of DVT is due to an orthopedic surgery such as a knee or hip replacement, the doctor may prescribe preventative blood thinners, early physical therapy or movement, and compression stockings. If the risk of DVT is due to a traumatic lower body injury, additional prophylactic measures may be necessary. Treatment and preventative care depend on the level of risk and other individual circumstances.

Was my doctor negligent in diagnosing and treating my DVT?

Whether a doctor was negligent must be analyzed on a case-by-case basis. Still, there are some strong indicators that a provider fell below the necessary standard of care (the level of care that a similarly trained and skilled doctor would have demonstrated under similar circumstances). These include:

• Failure to Diagnose DVT
• Delayed Diagnosis of DVT
• Failure to Conduct Proper Testing
• Failure to Provide the Adequate Treatment (medication, surgery, etc.)

The standard of care varies by case but, in many cases, the standard of care may require a doctor to test for DVT, prescribe blood thinners, use compression stockings or sleeves, or direct their patients to walk or move as soon as possible following prolonged bed rest or surgery when appropriate. The harm caused by a medical provider’s actions (or failure to act) may include pain and suffering, loss of earning capacity, loss of enjoyment or quality of life, and other economic harms such as the cost of medical bills..

How do I file a DVT medical malpractice claim?

Reaching out to a medical malpractice attorney should be your first step. A lawyer will reach out to medical experts who will evaluate your medical records and determine whether your doctor fell below the standard of care when failing to diagnose or treat the DVT.

Medical malpractice cases are complex and can be emotionally challenging for the patients involved. However, finding the right attorney can make the process much easier. Michael P. Bonner has over 30 years of experience representing patients in medical malpractice cases all over Florida. Bonner Law has the knowledge and experience to represent you and navigate the legal and medical landscape to ensure that you receive compensation for damages, including medical bills, lost wages, and pain and suffering that you are entitled to.

If you or a family member experienced DVT or a pulmonary embolism due to the negligence of health care providers, hospital nurses, or doctors you may be entitled to compensation for your damages. Bonner Law can help you determine whether you have a DVT medical malpractice case. Call Bonner Law at 1-800-4MEDMAL or visit our page for a free consultation.