Widow Needs Help With Dic

[Blessedmom]

Hi Everyone

I posted this somewhere else and did not get any responds--not sure if I posted in the right place. Please forgive me if I have not posted this in the right place or I am posting wrong. I have been lurking for quite a while and join a few weeks or month ago. If it is in the wrong place, please be so kindly and let me know. I really need help.

I am a recent widow with 4 small children ranging in the ages of 11 years old to 1 years old. My husband passed away last year at the age of 33 years old. His death was sudden. There are many questions unanswered. Here is his background.

He served in the military from August 1994-August 2004. He was a dental tech and had never been deployed. He does not really have anything in his military records except for a few stomach complains (2 times), latent tb, allergic reaction to amoixicillian, and cyst on his eye. He was really never sick. For 10 years, he only has 156 medical pages.

As mentioned he was discharged from the military in August 2004. He received a VA physcial in May 2005 which is 8-9 months after discharged. His blood work was abnormal. His hematocrit was slightly elevated and he had a low white blood count. His kidneys had a creatintine level of 1.4 and eGFR of 77. In 2008, he was diagnosed with chronic stage 2 kidney disease. His blood levels mentioned above stayed the same in 2005, 2007, 2008, and 2009. He was never on any medication for blood disorders. In 2009, he began to complain about stomach pain. He went numberous times to the VA hospital and they kept sending him back home telling him that nothing was wrong. When they finally admitted him into the hospital a day or so later, he had to be rushed into the emergency room. They found 2 feet of his intestines was dead. He was placed into a coma induced state by the doctors. Upon waking him up a week later,he had passed away. Listed on his death certificate is

1. Immediate cause Pulmonary Embolism

2. Hypercoaguable state (btw on set and death) is listed as years. Meaning he had the hyperocoaguable state (blood clotting disorder for years)

3. Superior Mesenteric Venous Throbolism.

4. Ischemic bowel.

Listed on the autopsy also is infarct of kidneys and cardiomegaly.

In summary, he died 4 years and 9 months of getting out of the military.

Questions:

1. Isn't there a way I can connect his blood disorder to the abnormal blood work which was conducted 8-9 months after service?

2. What about the kidneys?

3. Also in his autopsy, his spleen weighed 430 grams which is double the size.

I know all what happen to him did not happen over night. Please help me.

Thanks

[Blessedmom]

Hi Berta

No, he was not a Southwestern Asia Veteran. We were stationed in England for 4 years, but he was never deployed anywhere. What do you think about allegeric reactions to drugs and affecting organs? I am thinking that is the only way he possible could have received the kidney disease? Do you think it is worth hiring a IMO that specialize in that field? I know when I was speaking to one of the doctors and I mentioned the enlarged spleen (it had picked his interest) Will we see.... I was trying to see what type of IMO (what kind of speciality) I needed....I have a lot of work to do. Thanks for all the help

[deltaj]

REVISED 12 HOURS AFTER INITIAL POSTING. My condolences to you on the death of your husband. Review your husband's service medical records to see if he had any symptoms of hypertension while he was in service since this can be an early symptom of a kidney problem. (See 38 CFR 3.309). Untreated hypertension can cause cardiomegaly (englarged heart). Your husband had latent tb shown in this record. Latent tb can cause hepatomegaly (enlarged liver) and/or pleural effusion, which is a lung condition in which excess fluid developed in the lungs. Your husband may have died in part because of a pulmonary embolism which is a blood clot from a lung. Liver problems, if I recall correctly can cause clotting factors in blood to be off. I'm wondering if a liver problem could have caused complaints of "stomach pain." Your husband's complaints of stomach pain in service may indicate that he had a problem in service that led to his death. I think if I were in your shoes I would have his service medical records reviewed by Dr. Craig Bash or another sympathetic doctor for an IMO (Independent Medical Opinion) to see if your husband had a problem while he was in service that led to his death. Search online under Dr. Craig Bash and veteran ; you will find a link to some of his cases. If your husband had repeated episodes of hypertension in service or symptoms of a heart problem in service or liver problems in service then you may be able to service connect his death. Untreated hypertension can be cause cardiomegaly and hypertension can be an early symptom of kidney disease. Also review your husband's service medical records carefully for any unusual symptoms which could indicate kidney problems, heart problems, or liver problems in service. Also you need to get copies of your husband's V.A. medical records showing his treatment at V.A. medical facilities. Make a written request to each V.A. medical facility for copies of his medical records and list as a reason for personal use. You also need to read 38 USC 1151 and consider filing a claim under 38 USC 1151 for your husband's death.

Edited August 23, 2010 by deltaj

[Berta]

http://www.emedicinehealth.com/drug-amoxicillin/article_em.htm

Amoxicillin is usually contraindicated in any patient with a clotting disorder and/or kidney disease.

I used Dr. Bash for 2 IMOs.

His web site has his email addy and phone number

http://www.veteransmedadvisor.com/

He is a NeuroRadiologist so I am not sure if this situation would fall within his expertise.

I also used a Forensic firm-in Texas- forget their name but I googled fporensic specialists to find them. I ordered their IMO but my award came before their doctor prepared the IMO.

Their contact person can help seek the best type of doctor for the opinion if you contact them with some info.If I can find their web site ( it is on my old PC) I will post it .

When I contacted Dr. BAsh-I emailed him a very brief rendition of some of my evidence.This was not for my FTCA but for another misdiagnosed condition I dfond years later.

He emailed me back right away that 'if you have what you said you have, this is a good case' and then he called me later in the week, we discussed the evidence further and he gave me a fee amount.

If he cannot handle this type of case he might be able to refer you to someone else.

Was all of your husband's medical care from the VA?

I just caught this-sorry-

"The extensions in which I mention was for additional 30 days. The first time it was due on August 6, but I was still waiting on the doctor. So I called again and asked for another 30 days. Now I have a doctor looking at the records (IMO) and he told me to ask for another additional 30 days. I didn't know if this was the right move or did not. Just thought I had to try and do something. I just check his other numbers for his lab results and they are all within normal range."

Merck is always a good medical reference cite and the VA uses it.

You can send them anything at all to stave off their deadlines.You could even raise the issue that the VA's administration of amoxicillin was contraindicated by his known medical conditions and send them a print out from the above cite-and better yet send them a letter from this doctor asking for more time to review his medical records.

What do you mean here?

"the medicine he had taken for tb can cause kidney disease."

Do you mean he had tuberculosis too?

[Berta]

PS forgot to add-

His medication list could be very critical to any IMO.My husband had very few meds to take but I researched every one of them.

The VA prescribed a med to my husband to take 4 times a day for 6 years prior to his death.

I raised this issue in my 1151 claim and they knocked this part of my claims down numerous times- even at VACO.

When I finally prevailed the VACO Strategic Health Team report concurred that this medication

(which I also proved he did NOT even have the condition they prescribed it for)

was contraindicated by his inappropraite HBP meds and it also contributed to his death due to a sudden heart attack.

The medication was Sudafed. He had no sinus condition -as a VA sinus X ray I found -revealed.

[Blessedmom]

Thanks Berta and deltaj

I researched his medicine, but I will research it again. Well, he had latent tb in which he took Isoniazed medication for 6-9 months. I will also check or do more research about the liver (his liver was also enlarged 2200 grams. It was hard trying to find out how much your liver weighed....Your liver should weigh for a male about 1500-1600 grams.

As far as the kidney disease--he did not have the disease coming in the military, but he had it coming out of the military and the blood clotting disorder . I will look at all meds again carefully and also about the latent tb and liver--I checked records for hypertension and there were none that were considered high. What is If I find something about allergic reactions? Do you think I can also used that?

Let me make sure I understand everything. If I can connect either a drug, symptom or perhaps, the (latent tb) to the kidneys or blood disorder, then it would be considered direct service connect. Is that correct? Are there any other good sites besides the ones menitoned for good medical info that I can use.

Thanks again

[Berta]

"If I can connect either a drug, symptom or perhaps, the (latent tb) to the kidneys or blood disorder, then it would be considered direct service connect. Is that correct? "

There is a some association medically with TB and kidney disease but these are the regulations for DIC, direct and also 1151 DIC:

Service Connection for Cause of Death

In order to establish service connection for the cause of the

veteran's death, there must be a service-connected disability

that was the principal or a contributory cause of death. 38

U.S.C.A. § 1310; 38 C.F.R. § 3.312(a). A service-connected

disability will be considered the principal (primary) cause

of death when such disability, singly or jointly with some

other condition, was the immediate or underlying cause of

death or was etiologically related thereto. 38 C.F.R. §

3.312(b). A service-connected disability will be considered

a contributory cause of death when such disability

contributed substantially, or combined to cause death-e.g.,

when a causal (not just a casual) connection is shown. 38

C.F.R. § 3.312©.

Generally, minor service-connected disabilities, particularly

those of a static nature or those not materially affecting a

vital organ (e.g., those disabilities affecting muscular or

skeletal functions), are not held to have contributed to a

death that is primarily due to unrelated disability.

Service-connected diseases or injuries affecting vital organs

should receive careful consideration as a contributory cause

of death, the primary cause being unrelated, from the

viewpoint of whether there were resulting debilitating

effects and general impairment of health to an extent that

would render the person materially less capable of resisting

the effects of other diseases or injury primarily causing

death. 38 C.F.R. § 3.312©(2), (3).

There are primary causes of death which by their very nature

are so overwhelming that eventual death can be anticipated

irrespective of co-existing conditions, but, even in such

cases, there is for consideration whether there may be a

reasonable basis for holding that a service-connected

condition was of such severity as to have a material

influence in accelerating death. In this situation, however,

it would not generally be reasonable to hold that a service-

connected condition accelerated death unless such condition

affected a vital organ and was of itself of a progressive or

debilitating nature. 38 C.F.R. § 3.312©(4).

Source (my BVA decision) May 2009 Direct SC death regulations

DIC may be payable for death resulting from VA

hospitalization, medical or surgical treatment, or pursuit of

a course of vocational rehabilitation under 38 U.S.C.A.

§ Chapter 31. 38 U.S.C.A. § 1151; 38 C.F.R. § 3.358 (1999).

With the exception noted in Brown v. Gardner, 115 S. Ct. 552

(1994), upholding the decision of the Court in Gardner v.

Derwinski, 1 Vet. App. 584 (1991) invalidating 38 C.F.R.

§ 3.358©(3) on the grounds that that section of the

regulation, that included an element of fault, did not

properly implement the governing statute, 38 U.S.C.A. § 1151,

the provisions of 38 C.F.R. § 3.358, excluding the sections

dealing with fault, remain valid. The provisions of

38 C.F.R. § 3.358 implement 38 U.S.C.A. § 1151.

Source: my 1151 award.

------------------------------

Basically SC direct deaths involve a direct SC disability or a secondary disability that stems from the primary SC one and contributed to death.(contributed as being listed on the Death Certificate as contributing cause of death or contributing as found by medical evidence in an independent medical opinioner's review of the clincial records,stated with full medical rationale.

Sec 1151 DIC involves proof of VA negligence and with proof the disability or death is granted an "as if" service connected status.

I used John Hopkins, Merck, MediLexicon, Mayo Clinic,the ADA, Diabetologica,etc all on line-web sites and considerable medical texts on cardiovasclar disease and Neurology for my claims.

Right after I read your post I found a medical association between TB and kidney disease. I didnt save the link-

These medical sites and print outs from them can certainly help shape a claim or a FTCA case but they have little weight with the VA unless a real doctor references them in a IMO.

There is no easy way to do this- you search for any associations- I put TB and kidney disease into google and much popped up

and it takes time to find the best and most medically accurate sites.

"If I can connect either a drug, symptom or perhaps, the (latent tb) to the kidneys or blood disorder, then it would be considered direct service connect. Is that correct?"

No- his death must have had a direct medical link to his Service-

or fall into the criteria that Pete was talking about here-

or the VA itself ,through medical care, caused his death.

I studied the above regulations over and over again for my claims.

The regs are the blueprint for awards.

Are there any other good sites besides the ones menitoned for good medical info that I can use.

Edited August 24, 2010 by Berta