Hyponatremia is one of the most common electrolyte imbalances doctors treat, and also one of the most difficult to correct.
When a patient’s sodium levels fall too low, the imbalance can cause serious and fatal complications. But treating the imbalance carries its own serious risk; treating too quickly can cause a patient to suffer permanent brain damage. That is why mismanaged hyponatremia is a recurring source of medical malpractice claims.
What Is Hyponatremia?
Sodium helps regulate blood pressure, nerve and muscle function, and the balance of fluid inside and outside the body’s cells. Hyponatremia is a condition that refers to abnormally low sodium levels in the blood. As sodium drops, water moves into the cells and causes them to swell.
In the brain, water-related swelling can produce headaches, confusion, seizures, and, in severe cases, coma or death.
Common contributors for individuals with hyponatremia include diuretics, certain antidepressants, organ deterioration, and drinking excessive amounts of water.
How Hyponatremia Should Be Treated
The guiding principle for hyponatremia treatment is to raise sodium slowly. For severe cases, doctors typically give concentrated saline through an IV at a controlled pace, while checking sodium frequently.
Many guidelines advise correcting the level by no more than about 8 mEq/L over a 24-hour period in most patients. At the same time, the provider must identify and treat the underlying cause, which could consist of dehydration, medication, or organ failure.
How Hyponatremia Mismanagement Happens
Errors tend to fall into a few patterns. Raising sodium faster than the recommended rate is the most serious error and the one most often tied to catastrophic injury.
Other errors include:
- Failure to diagnose or monitor. Not checking sodium in an at-risk patient can allow imbalances to persist and make corrections more difficult.
- Improper IV fluids. Giving the wrong type or volume of intravenous fluid can worsen the sodium levels, especially in children and surgical patients.
- Failing to treat severe cases. Leaving dangerously low sodium untreated can lead to brain swelling, seizures, and death.
Most of these errors are preventable and can be avoided through adherence to accepted medical standards.
The Consequences of Overcorrection
When sodium levels in the body rise too fast, the brain may not be able to adjust to the infusion. The protective coating on nerve cells in the brainstem can then break down. The effects of overcorrection are often permanent and may include:
- Slurred speech and difficulty swallowing
- Confusion and behavioral changes
- Muscle weakness, tremors, and loss of balance
- Partial or complete paralysis
- In the worst cases, a “locked-in” state, coma, or death
Survivors frequently face a lifetime of medical care and a serious loss of independence. Many of these individuals seek compensation through a medical malpractice claim to address the harm they suffered.
When Mismanagement Becomes Malpractice
A patient may have a possible hyponatremia malpractice claim when a provider’s care fell below the accepted medical standards and caused the patient harm. Overcorrecting is often a form of malpractice, as is failing to diagnose, monitor, or treat an individual with sodium imbalances.
If you or a loved one suffered serious harm from mismanaged hyponatremia, an experienced medical malpractice attorney can review the records and explain your options. Contact us today for a free consultation.