Patient Told Heparin Is Mandatory

January 2, 2010, 8:00AM. By Jane Mundy

Seattle, WAAndie was admitted to the hospital for three days with a back injury and was given several shots of heparin. A nurse told her that heparin injections were mandatory, even though Andie said she didn't want them.

"I was admitted to the hospital in July 2007—my back injury was so bad that I had to get an ambulance, even though I live just one block away," says Andie. "At ER I was given painkillers and they admitted me that Sunday evening. The next day a nurse gave me a shot of heparin— she said it was a blood thinner and I had to have it. At the time, I was preoccupied with my job, so I just said whatever. I drive a school bus and had to get back to work the next day, but I was flat on my back.

"I was given a heparin shot in my abdomen twice a day until I left on Wednesday afternoon. Later I called the hospital administration and asked if the heparin was indeed mandatory, as the nurse had told me. The administrator said it wasn't and the nurse was wrong. So I got two different explanations—shouldn't the nurse know that?"

Patients usually take the blood thinner is before surgery, but Andie wasn't going to have surgery. It is possible that she was given the heparin injections to prevent deep vein thrombosis. "I think the idea was that if you are lying prone in bed for days, you might be susceptible to blood clots," says Andie. "But if I am going to take that risk, it is my concern."

Andie believes she has reason for concern. "I came down with chronic fatigue in 1994, and prior to that, I had a vaccination for hepatitis B," she explains. "I read later that there is a connection between the vaccine and chronic fatigue. It might be that the mercury in these vaccines is causing issues, so I try to avoid getting any kind of drug since that time. I have a problem getting injected with unnecessary medications, and I read the book 'Murder by Injection,' so heparin injections worry me. And I won't be getting a flu shot—it is my choice.

"I don't know whether I can sue the hospital if there is no damage that I can prove. I am in the process of getting my medical records and I'll find out how much heparin I was given. I think you ought to be able to refuse it.

"From what I read, heparin has even been given to newborns in hospital. And the dosages are a problem—they just give it to anyone who checks in."

At the very least, Andie should have been informed of the side effects. According to some health care professionals, even a small amount of heparin could cause more problems than good. And some professionals believe that heparin is based on "trial and error."

The advantages of heparin are its low cost and fast action (it anti-coagulates blood quickly). But there are many disadvantages. Frequent blood tests are required to check the levels of anticoagulation and hospitalization to get an IV drug.

Heparin side effects are numerous, from skin rash and headache to bleeding and Heparin Induced Thrombocytopenia (HIT), which causes worse clotting and can lead to stroke, heart attack, deep vein thrombosis, and death.

Patients like Andie have the right to know of these side effects.