(L.A.) Lillian Whitfield, 57, Died in a Hospital

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Case Number: 2024-10187

Los Angeles County is reporting the death of a 57-year-old Black female that occurred in a hospital.

The coroner’s office has identified the woman as Lillian Whitfield.

Manner of Death: Accident

Cause of Death A: Complications of Fistulogram for Hemodialysis

Cause of Death B: End-Stage Renal Disease

Cause of Death C: Hypertension and Diabetes Mellitus

RIP LILLIAN WHITFIELD (December 26, 1966 – June 25, 2024)

Formal pronouncement of death was made on Tuesday at 4:26 p.m.

A fistulogram is a special X-ray procedure used to examine the blood flow in an arteriovenous (AV) fistula or graft used for hemodialysis access. It involves injecting a contrast dye into the fistula and taking X-ray images to check for any narrowing or blockages.

This was classified as an accident likely because it was iatrogenic.

Iatrogenic deaths are those that are induced or caused unintentionally by medical treatment or diagnostic procedures.

The key complications of arteriovenous fistulas (AVFs) for hemodialysis include:

  • Heart Failure: Large AVFs can lead to increased blood flow, causing the heart to work harder and potentially leading to heart failure over time.
  • Blood Clots: AVFs, especially in the legs, can cause blood clots to form, which can lead to deep vein thrombosis (DVT) and potentially life-threatening pulmonary embolism.
  • Leg Pain (Claudication): The increased blood flow through the AVF can block blood flow to the muscles, causing leg pain during activity.
  • Internal Bleeding: AVFs can sometimes cause bleeding in the stomach or intestines.
  • Infection: Infections account for about 20% of AVF complications, usually manifesting as localized perivascular cellulitis. More serious infections involving anatomical abnormalities like aneurysms may require surgical treatment.
  • Aneurysm: Repeated punctures of the AVF can lead to pathological enlargement of the blood vessel wall, requiring surgical intervention if there is risk of rupture or limited space for puncture.
  • Stenosis: Neointimal hyperplasia, or proliferation of smooth muscle cells, can cause vascular stenosis and lead to fistula thrombosis.
  • Congestive Heart Failure, Steal Syndrome, Ischemic Neuropathy: Other potential complications include strain on the heart, reduced blood flow to distal tissues, and nerve damage.