Fishbein death accidental, autopsy shows
Bill Scanlonand Berny Morson, Rocky Mountain News
Published May 2, 2008 at 12:05 a.m.
Leslie Ann Fishbein, 55, died two weeks after going into cardiac arrest.
Denver furniture magnate Leslie Ann Fishbein was suffering from low levels of potassium in her blood before she got the injections in her back that led to her heart stopping and to her accidental death, the Denver medical examiner said Thursday.
Those low levels, called hypokalemia, may have contributed to her death, Dr. Amy Martin said in her autopsy report. Hypokalemia can greatly increase the risk of arrhythmia and other serious heart conditions.
The autopsy couldn't find any reason for the potassium levels being low.
Fishbein, 55, appeared for more than two decades in television commercials for Kacey Fine Furniture, a family business.
Fishbein's heart stopped beating at a doctor's office on March 4 when she was getting pain trigger-point injections in her back with the medication bupivacaine.
The levels didn't indicate a massive overdose of the medication. Adverse reactions to lower levels of bupivacaine are uncommon but have been described in medical books, Martin said.
Fishbein went into cardiac arrest. She died two weeks later at Presbyterian/St. Luke's Hospital.
There is no evidence she had an allergic reaction to the medication.
Fishbein suffered from reflex sympathetic dystrophy, which is a condition of burning pain, stiffness, swelling and discoloration of the hand. In her case, it apparently arose from a horseback riding injury several years ago.
A common treatment for RSD is injecting pain medication into the spine. On March 4, she was getting injections of Depo-Medrol and Marcaine into the lumbar area. "She quickly became unresponsive," with possible seizures, Martin said.
She died March 19.
Featured
-
DNC in Denver
Complete coverage of the 2008 Democratic National Convention.
-
The Crevasse
A five-part series that examines one tragic day on Mount Rainier.
-
Deadly denial
Sick nuclear workers applied for government compensation but most haven't seen a dime.
-
Final Salute
The Rocky followed Maj. Steve Beck as he took on the most difficult duty of his career.
-
'Colorado's burning'
Coverage of the state's worst wildfires.
-
Columbine shootings
Coverage of the April 20, 1999, shootings at Littleton's Columbine High School.
-
The Crossing
Colorado's deadliest traffic accident killed 20 children on Dec. 14, 1961.
-
Osveli's journey
Osveli Sales left Guatemala for a better life. Two months later, he came home in a box.
-
Wake for an Indian warrior
Oglala Sioux bestow a tribute to the first tribal fatality in Iraq.
May 2, 2008
9:54 a.m.
Suggest removal
socialobserver writes:
Although I understand the mechanism of Ms. Fishbein's death, there is one important facet I've failed to read in any account of her unfortunate passing to date.
Did the office that treated Ms. Fishbein have an appropriately stocked crash cart at hand, replete with all the required cardiac arrest/arrhythmia medications; ambu-bag; and defibrillator? Was Ms. Fishbein’s physician and his/her staff properly trained in resuscitation procedures?
I would not only advocate further investigation into Ms. Fishbein's death, i.e., was the office prepared for such life threatening emergencies, I would advocate to ANYONE -- regardless of the procedure they're having performed in a medical office -- to query the office regarding their emergency response procedure. Do they have a crash cart? Do they have all the appropriate medications at hand; are such medications within their expiration date? Has their defibrillator been calibrated and checked per manufacturer schedule? What training has the staff received, i.e., CPR, to deal with such emergencies? Although any in-office procedure may appear harmless at face value, it still behooves all of us to know – should an emergency arise – an office is fully prepared and trained to handle such an emergency.
Was the office that treated Ms. Fishbein prepared to handle the adverse reaction she experienced from the bupivacaine injection? There has been no mention of this in any published media reports to date.
May 3, 2008
3:59 p.m.
Suggest removal
wordwoman writes:
I agree with socialobserver. I had six of those injections last summer in hopes of easing nerve pain in my legs and feet and this very brief procedure took a long time to set up - they had every kind of resusitation equipment and everything was lined up just so. I wasn't nervous about it before I got there (I've had injections in my back for years, including previous nerve root injections from another physician) but I was anxious by the time everything was set up. If all those precautions aren't taken, the outcome can be tragic, as in Ms. Fishbein's case. I would also like someone to ask those questions and investigate whether the doctor's office was properly equipped.