Prologue
Kevin was born in early 1960. He married Andrea in 1998 and the couple had two sons, currently aged 16 and 18. Kevin had a successful career as a private wealth manager with a Tier One Investment Bank. He and His Wife lived in London for 15 years prior to moving back to the US in 2010. Kevin and Andrea were very fit while in London, even regularly working out with an Olympic Gold Medal Winner.
After returning to the US, Kevin continued in good health until undergoing a flu shot in 2011 after which he developed endocarditis and transverse myelitis. He underwent a mitral valve repair in 2012, but as a result of the transverse myelitis he was disabled from his job in 2014 and thereafter began drinking to excess, as he did not want to take the pain meds prescribed for his neuropathic pain by his Neurologist, Dr. Brian Apatoff, Associate Attending Neurologist, NewYork-Presbyterian Hospital and Clinical Associate Professor of Neurology, Weill Cornell Medical College, Cornell University.
According to Mayo Clinic the symptoms of Transverse Myelitis include:
- Pain. Transverse myelitis pain may begin suddenly in your lower back. Sharp pain may shoot down your legs or arms or around your chest or abdomen. Pain symptoms vary based on the part of your spinal cord that's affected.
- Abnormal sensations. Some people with transverse myelitis report sensations of numbness, tingling, coldness or burning. Some are especially sensitive to the light touch of clothing or to extreme heat or cold. You may feel as if something is tightly wrapping the skin of your chest, abdomen or legs.
- Weakness in your arms or legs. Some people notice heaviness in the legs, or that they're stumbling or dragging one foot. Others may develop severe weakness or even total paralysis.
- Bladder and bowel problems. This may include needing to urinate more frequently, urinary incontinence, difficulty urinating and constipation.
Shortly before Kevin's St Vincent admission, Dr Apatoff thought that a cyst on Kevin’s spine was operable, and if successful, might relieve many of his neuropathic symptoms. He urged Kevin to go through alcohol detox, so that the surgery could be performed. In the interim, the Dr. Apatoff urged Kevin to take the prescribed Ativan and/or Oxycodone for pain relief instead of drinking alcohol for his severe pain and discomfort.
Soon after that, Kevin had an appointment with his primary care physician, Dr. Slava Kulikoff, on July 16, 2015. At that visit Dr. Kulikoff encouraged Kevin to stop drinking and to go the emergency room if he experienced any symptoms of alcohol withdrawal. The next day Kevin had some difficulty walking (although he drove his manual 1986 Saab that morning) and asked Andrea to take him to the emergency room at St. Vincent's Medical Center in Bridgeport CT, for an evaluation. Emergency room documentation states that Kevin’s laboratory findings were as follows:
- No evidence of acute pulmonary abnormality;
- Increased hepatic echotexture with diffuse fatty infiltration or hepatic fibrosis;
- Mildly distended gallbladder containing sludge.
- Ethanol level <10 mg/dL
At that point, Kevin had not had a drink in 2 days.
