Hi,
My father suddenly passed away on 17/2/2013. Its been a month and a half now and I still am unable to understand how exactly he passed. Here are the salient points:

1. He was diagnosed with T2-N0 oral cancer on his tongue immediately after his 70th birthday on 5th Jan 2013. He was a heavy smoker and had been smoking for fifty years.

2. He was advised "Hemiglossectomy and Partial Neck Dissection". The other option of radiation therapy was not recommended and chemo-therapy was strongly not recommended.

3. He got operated upon the 8/2/2013. The surgery lasted three hours and thereafter he was kept in the ICU for one day. Due to all parameters being normal, he was moved to the ward the next day with the doctors looking quite good and happy about his condition. He was given food through a feeding tube and he appeared to be in good spirits and eager to get discharged. He was advised that he would be kept in the hospital for five days and would be discharged on the 13th of Feb.

4. On the 12th, while sleeping, he somehow pulled his feeding tube out. The doctor came in and re-inserted a new feeding tube. He was scared during the procedure but he did not complain of any great pain. (He was a stubborn guy anyway and would never admit to pain to his youngest son)

5. Due to this we elected to stay in hospital one more day and got discharged on the 14th.

6. On the 17th, at home and after meeting the family, he woke up at 4AM, vomited a pint or two of blood, started heaving and passed out. The blood came out in great quantity, just like one throws up a big dinner and was reddish-black in colour. We rushed him to emergency but he was pronounced dead on arrival.

This procedure was done in New Delhi, India. The doctor who oversaw the treatment is quite famous and has taught oral cancer treatment in India's premier medical school for thirty years, so I think he was in good hands but....

I have been unable to figure out for myself exactly how he died when the doctors were so happy with the outcome of the procedure.

Could re-inserting the ryles' tube torn up an artery which ruptured a few days later?

Could the doctors have made a mistake in the procedure that led to him dying?

Was it something that this surgery started or was it something else entirely? My mother now remembers that he showed symptoms consistent with a prostate condition as well... could there be another entirely independent cancer in his body which the doctors did not discover and which eventually took his life?

I spoke to one of the doctors who operated on him and he expressed surprise at his demise. According to him, nothing was done which could have led to this. I did not press him too much as it might have come across as me accusing him of negligence, while all I want is some sort of closure.

Any pointers from the people here would help me a lot.

Cheers,
K

Hello K:

I am so sorry about your father. After all he had been through, and expecting a healthy recovery, it must be devastating to lose him. I can only guess, and you probably won't ever be able to get the exact reason for what happened, but I know I had trouble with my feeding tube PEG, and the area around where it went in became very sore. I called my gastro doctor and he basically told me something like "it's normal to be sore; it'll get better." Well, it didn't. Several days later while walking down my hallway, the tube just fell out of the opening and all of this brown gunk came pouring out. I went to the ER, after finally contacting the gastro doctor, and the nurse told me she would have to re-insert one because that is what the doctor ordered. It was so terribly sore, I would not let her do it, had her bandage it, and left the hospital with stuff still coming out. I had an appointment with my chemo doctor that day, showed him the hole/drainage, and he took a culture. I had a very bad pseudomonas infection which is hard to heal. I never threw up anything though, although I was very nauseous. You could research that, but it's just so terribly hard to pinpoint what happened to your father. I would be doing the same thing - looking for an answer, but it just may be something you'll have to accept. It's too late for an autopsy, and if one of the doctors he had suspected something hadn't been done right, they would not tell you because a lawsuit fear. Just know your Father is not having to suffer pain anymore and will always be with you and your family. So sorry, again.

julieann

Welcome to OCF. I am so sorry to read your story about your fathers illness and sudden passing. It must be quite a shock to your entire family. I cant imagine how hard it must be to accept when he was doing so well and then died seemingly out of the blue.

Only the doctors truly know what happened. It could be all kinds of small things that just added up to this. Since your father was one to not complain, maybe he had not been feeling good and kept it to himself. One thing that is certain, vomiting blood is not normal. It is even more unusual to hear about the large quantities of blood he threw up. I know a small amount of blood can look like alot when it is mixed with other liquids.

Im very sorry for your loss. May your father rest in peace.

Hi K, sorry to read about your father, may he rest in peace.

Selective Neck Dissection and Hemi-glossectomy is fairly common procedure in treatment of Oral cancer, but unfortunately, your father seemed to have developed some complication. It is very difficult to say if what exactly would have happened as neck has highly complex anatomy.

You could look for some clues or answers in final discharge summary (collect from hospital if you have not done it yet) as it would describe the exact procedure performed, whether carotid artery or Internal Jugular Vein (IJV) were impacted by tumour etc. Nasogastric tube causing a rupture seems to be improbable. It could be also due to pre-existing cardio-vascular conditions, which probably went unnoticed.

Hi there... so sorry for your loss and so sorry about the way it happened. It is very possible your father was bleeding internally and no one noticed it, or that perhaps him being an older man could have lead to a burst artery and thus a hemorrhage. It is horrible and scary did they autopsy him?

sorry to hear of your loss,l to lost my father recently,very suddenly.he was 4 days out of a 7 wk chemo/rads for tumour attached to back of tongue and voice box,inoperable but showed no signs of being sick at all other than a bit of tightening of the neck,and was doing well,no sickness no weight loss,still using peg,we were waiting on him getting test results to see if the treatment had worked.hes passing was sudden,out of the blue, got out of bed one morning fell,we got him back on his feet and put him to bed while went to call the nurse on call, he was a little muddled/confused with what had happened but ok,5 minutes later he was gone,not breathing and we still dont know what it was that took him from us so suddenly,we do know it wasnt the cancer or his heart so i understand how you feel,not knowing is terrible.it makes you wonder if the treatment or operation was worth the torture it puts on there body and with out it would they have had more time with us,with my dad it was hard as he couldnt speak clearly due to extreme swelling of the mouth from the treatment,so we wonder if he was trying to tell us something and we couldnt understand,mistaken his groan type noises for some kind of feeling he might of been experiencing... its the not knowing the wondering and all the what ifs....all i do know and am sure you can understand is they are no longer in any pain and are resting in a peacefull place somewhere having a beer and a bite to eat... my thoughts are with you xx