“When I joined a private practice 18 years ago, our hospital and malpractice lawyers told us never to admit guilt. Risk managers were clear that we were to contact them in the event of an error. If patients’ families had questions, we were to be vague with our responses, essentially brushing them off.” --Manoj Jain, MD - May 27, 2013
As a patient, or the loved one of a patient, is this code of silence the treatment you believe you, or your loved one deserves. Is this code of silence what our community expects from its Hospitals? Sadly, not much has changed since Dr. Jain made this observation 18 years ago.
I currently represent a beautiful, caring family against a local hospital and physician because their mother died due to a clear medical error. The physician was not a specialist and chose to order a medication that should only be ordered by a specialist. The physician at issue was a Hospitalist Physician of the Hospital, no different in many respects than any other Hospital Employee with a supervisor who even determined his schedule. The condition for which the physician ordered the medication was not acute or severe, and the physician has all but admitted that there were safer ways to provide the treatment that was needed for the patient. The Physician did not follow the drug manufacturers instructions for how to use the drug, and there was no off-label use for the drug. No one at the hospital, including the Pharmacists, Physicians, or Nurses received any training on the drug. The drug had a black-box warning due to its potency and risk of causing death if not properly utilized. The Physician’s error, and the failure of the entire Hospital System to catch the error led to the death of a woman in her mid-fifties, who albeit sick, would have lived another ten years with her children and grandchildren.
A day before this patient's death, the physician told her family that she had improved and would be discharged shortly. The following morning, the hospital called the patient's adult daughters to inform them that their mother was in a coma after being “found down.” Their mother never awakened from this coma and died almost 30 days later. These caring and dutiful daughters had and continued to spend every day of their mother’s hospital stay with her in her room taking shifts in between working, and caring for their school aged children.
These ladies inquired, again, and again to the physicians and the Hospital staff about what happened to their mother, who, after all, had improved and planned to go home and see her grandchildren in a few days. They were also troubled by the fact that after their mother had gone into the coma, the treating physician who ordered the medicine was never heard from again. This physician never again showed up to check on their mother or give care, or even bothered to call them to apologize for what happened.
We went to trial on this case in September 2016, and the Defense Lawyers sought a mistrial, and even though the mistrial should never have been granted, it was. My firm, at great expense, flew one of our experts down the day of the mistrial and as I took him back to the airport he said, I only review 10 cases a year, in three instances I deny reviewing the case outright as there was no negligence, in three more I may render some advice simply to avoid the mistake happening again in the future, and in three instances the negligence is clear and the case is a “slam dunk.” “Barry, this case is a slam dunk.” The aforementioned highlights the fact that Malpractice Cases are very difficult and very expensive to pursue and some Hospitals will choose to do anything, and pay anyone other than the patient, even if their actions are morally wrong. Now the case is set for retrial on February 6, 2017.
Frequently Hospitals choose to spend money to defend a case where they are negligent rather than admitting they made an error and working to resolve them systemic problems that exist at their hospital. The next time you hear a report or read an article about lawsuits driving up the costs of care at Hospitals, ask yourself, what role the Hospital played in contributing to a lawsuit being brought in the first place. Maybe a simple explanation and apology could have avoided the lawsuit rather than choosing to "hide the ball" and provide innocent families with closure about how their loved ones died.
Several fundamental safety rules, which this Hospital did not follow, would have saved the patient's life:
Safety Rule #1 – A doctor must have adequate knowledge about medications they are prescribing to prevent injury or death to patients.
Safety Rule #2 - A Doctor and Hospital Staff MUST TEST, not guess, about a Patient's condition if a test would conclusively show the right treatment option to prevent injury or death to a patient.
Safety Rule #3 - A Hospital and its Nurses must inform a patient before giving them a new and dangerous drug to prevent injury or death - THIS IS THE LAW IN ALABAMA!
Safety Rule # 4 - A doctor and its Nurses must receive adequate training and supervision from the hospital to care for patients and prevent injury or death.
This is only a partial and relatively common sense list of rules that were not followed in our case.
UAB is the only Hospital in the metropolitan area that consistently, honestly, and ethically attempts to address mistakes with the goal of improving their systems.
See the article from a physician’s perspective about how the culture and ethics at Hospitals must change for the sake of the patients.
See also the following links to informative articles about your rights as a patient and how to be vigilant while receiving hospital care.
It is Wise to Apologize for Medical Errors
To Err is Human
Joint Commission on Health Care
WALKER LAW – THE CONSCIENCE OF THE COMMUNITY!
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