Saturday, September 25, 2010

Why I'm Not Suing

I’m getting angry emails from a reader who is sure that if I don’t sue the hospital that nearly killed my husband that the hospital will endanger future patients.

She imagines that a lawsuit will make them rethink their policies, and change their evil ways.

Instead, mal-practice lawsuits have led to an increase in the rate of caesarian deliveries, and an increase in x-rays and other potentially harmful and / or painful testing.

The problems that nearly killed my husband are
1) a mistake-prone suture system that is used with laparoscopic abdominal procedures that caused intestinal occlusion
2) a surgeon who delayed readmitting my husband until he was dehydrated and in kidney failure.
3) a drug reaction that caused atrial fibrillation
4) a drug prescription that was in conflict with a drug he had been given by IV the night before.  (He refused the drug, so this mistake did not affect his health.)

Of these for errors, only the prescription error could possibly be affected by something the hospital has control over.

We have talked with the surgeon and she states that she will be quicker to readmit in the future.

Surgical procedures are not decided at the hospital, but rather by national medical boards.  Drug reactions are risks every patient is subject to.

A lawsuit could potentially change the way in which drugs are prescribed within the hospital to reduce the likelihood of contra-indicated drugs being prescribed, just as computer programs at pharmacies are programmed to flag conflicting prescriptions.  But since my husband was not harmed, and we have no expenses based on this error, we are not in a position to sue.  Our job is to educate the doctors and thereby prevent such errors in the future.

To that end, my husband wrote to the chair of cardiology:

Please allow me to share an insight gained from my recent stay at [hospital]
(8/16-8/25) to reverse an occluded small bowel caused by a hernia
repair (8/11).

On  the night (8/24) before my release from [hospital], I was given a
potassium drip, which is specifically a contraindication for

Yet, on the morning of my release (8/25), despite normal blood
pressure (124 / 80) and the potassium drip, a cardiology resident
ordered that I should resume my lisinopril prescription.

Although I knew enough to refuse it, the nurse tried to convince me to
take it.  Anyone less informed than me would have taken it.

I think it would make sense to discuss with cardiology residents why
they should check for contraindications before resuming
anti-hypertensives. It would be ideal to deploy a program to read new
orders entered into charts and catch contraindications in real time.

I authorize you to study my record in order to review all aspects of
my care. Good luck with your work.


In response, the chair of cardiology wrote back:

I really appreciate your comments and input. I am going to review the record
and discuss medication use with the resident. We will then put this issue on
the agenda for one of our cardiology education conferences. It is attended
my students, residents, fellows, attendings, nurses.

The state of California (where my correspondent lives) has a procedure to ensure that patients can file grievances and protect the safety of future patients:

In theory a patient could sue instead of following these procedures, but any court would tell the patient to follow these procedures first and only if they fail, is a lawsuit considered.


Medical care is Russian Roulette.  Every time we let somebody cut into our bodies to repair or remove a disease situation, we are gambling that our lives will be better as a result, but we acknowledge on the informed consent form that we know we are risking potentially life-threatening outcomes.

The goal is to improve the educations of the people to whom we entrust our health.  We are their partners, not just their clients.  I consider it crucial that we treat them with respect and help them improve in a supportive manner, just as we expect to be treated when they help us.

Suing hospitals will have no effect whatsoever on patient safety.  Hospitals have budgets that include money to pay people who sue them. The legal department is not connected to the training of surgeons. No matter how effective we are, surgeries and hospitals will always endanger future patients. We can minimize that risk best by explaining errors that threatened us to doctors and nurses and hospital administrators. 

1 comment:

  1. Medicine is as much an art as a science. We too often forget this. Many times there is a correct answer, but often there are only several possible answers to try. The Chair of the Department showed true concern and gratefulness for the input and appears to be prepared to help his staff improve the care they offer in the future.

    I suspect that the way you are handling this situation will actually do much, much more to help future patients than a law suit. You and your husband’s actions will lead to a positive learning experience for the entire medical team. A law suit would have only created more distrust between patients, doctors, nurses and administrators. And to make it worse, the only ones to gain financially would have been the lawyers.

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