They killed my patient. Then they tried to hide it.
A maternal death is an extraordinary tragedy. Until recently, it was all too common. In 1900, almost 1% of pregnant women died in and around childbirth. The advent of modern obstetrics has dropped the maternal mortality rate by 99% since then, so most people have no direct acquaintance with a woman who died in childbirth.
Most maternal deaths are due to serious complications of pregnancy, or serious underlying medical problems, such as heart disease, that are exacerbated by pregnancy. Like any obstetrician, I’ve been involved with several maternal deaths, though never as the primary physician. Each one has been a searing experience, but in retrospect, an unavoidable event.
All but one, that is.
The patient died because of a series of unfortunate anesthetic complications, compounded by inadequate medical response. I cannot tell you when, where or how, since the case is so unusual that any details might lead to identification and compromise of privacy.
Because maternal deaths are now so rare, my state, like most states, mandates an official investigation. The investigation is conducted by the hospital, and evaluated by the Department of Health. As a participant at a critical juncture in this woman’s care, I was interviewed extensively by a senior member of the obstetrics department and a member of the hospital administration.
I was very angry at the care the patient received from the anesthesiologists, because I believed that her death had been entirely avoidable. I did not hide my anger during the interview, going to so far as to say that I felt that the anesthesiologists had essentially killed the patient. The people who interviewed me seemed uncomfortable with my conclusions and with my anger. They repeatedly suggested alternative explanations for the unfortunate incident, but I was not swayed. Others might reach different conclusions, I acknowledged, but this was my conclusion.
Several years later I was contacted by my medical malpractice insurance carrier and advised that a malpractice case had been filed against the anesthesiologists. This was not surprising. Virtually every maternal death is followed by a malpractice suit, even when the death was unavoidable. As a participant in the patient’s care, I would be deposed by the patient’s lawyer. Consistent with its obligations, the malpractice insurer had hired a lawyer to defend me during the deposition.
Shortly thereafter, I heard from the lawyer’s office. The deposition was scheduled in several weeks, and I was given an appointment with the attorney for “deposition preparation” a few days in advance of the deposition itself.
At our meeting, the lawyer seemed both competent and affable. First, he wanted to hear the story directly from me, in as much detail as I could recall. I carefully recounted the events of that day. When I finished, the attorney was frowning.
“Do you realize,” he asked, “that your recollection is very different then the testimony you submitted at the time?”
“No, it isn’t,” I replied. “It’s exactly the same story.”
“Well,” he continued, waiving a sheaf of papers, “I have your testimony right here, and that’s not what you said.”
I was stunned. I knew that was exactly what I had told the interviewers. If anything, I had been much harsher back then, because I was closer to the event and very angry about what had happened.
I held my hand out for the papers, and re-read my testimony. By the time I finished, I must have been ashen.
“This is not what I said! This is nothing like what I said.”
The lawyer was dubious.
“No one is going to believe that,” he warned. “Unless you have proof, it’s as if it never happened.”
On the day of the deposition, we met in a conference room where the patient’s lawyer, the anesthesiologists’ lawyers, the hospital lawyer and the court stenographer were waiting. Everyone seemed friendly and relaxed. This was just a small, routine part of the case. I was only one of a dozen doctors they planned to depose, and not even a subject of the lawsuit.
I had been told to plan for a deposition that was several hours in length, but it didn’t take nearly that long. After recounting my memories of the day in question, I was met with the inevitable accusation.
“But that’s not what you said when you testified for the official investigation,” the patient’s lawyer said sharply, holding up the official report.
“Actually,” I replied, “that is what I said. The report you are holding is not my testimony.”
Every lawyer in the room was now alert. The deposition was not longer the routine task they had expected.
The patient’s lawyer looked very eager.
“Do you have proof?” he demanded.
“Yes, I do have proof,” I replied.
My husband is a lawyer, and he makes me keep everything I have ever signed. Shortly after the official interview, the interviewers had sent me a transcript of my testimony, beneath which was a place to sign acknowledging that this was a true representation of what I had said. My husband had insisted that I make a photocopy for my records before I sent it back.
After my meeting with my lawyer, I had gone home and dug it out from the bulging file cabinet. I had given the photocopy to my lawyer before we entered the conference room, and now he produced it and handed it to the patient’s lawyer.
Despite the somber nature of the proceedings, the patient’s lawyer looked gleeful. The lawyers for the anesthesiologists and hospital looked shell shocked. The lawyers handed my photocopy around. Not only did it have my signature at the bottom, but it also had the signatures of the senior department member, and the hospital administrator who had interviewed me. The document that the hospital had represented as my testimony had no signatures at all.
The patient’s lawyer was so happy, that it took several minutes for him to pull himself together and continue the deposition. The rest of the questions focused on my original testimony and my discovery that the testimony in the hospital report had been altered.
If I had been angry about what happened to the patient, I was even angrier after learning of the deception. The hospital had deliberately lied to protect its staff members. They lied to cover up medical negligence, with the assumption that the doctors in question would continue to practice at the same hospital, free to make similar mistakes.
The hospital had been remarkably foolish. In a malpractice case, an attempt to alter the record is practically an admission of guilt. There was no limit to the millions of dollars that a jury would be willing to award in a case of avoidable death of a young mother where the hospital had attempted to hide the truth. The lawyers for the anesthesiologists and the hospital knew this, too.
My lawyer called me several days later.
“There isn’t going to be a trial,” he said. “The hospital offered the patient’s family an 8-figure settlement, and they have accepted.”
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That's all I can really say.
"Wow."
I'm a pretty cynical person, but even I was surprised.
"And we are to pity the hospitals for having to cover the costs of the un and underinsured when this sort of malfeasance is practiced?"
I'm not sure what one has to do with the other. The actions of the staff in this case were reprehensible, but that doesn't justify not paying the hospital for the care it delivers.
I am happy that you weren't threatened and worse, yourself, Amy.
As for patients, the default mode is to consider yourself at great risk and to demand to have an advocate with you at all times from the time you enter the door until the time you arrive back home. While there are still many people trying to do right by patients, the tipping point has been reached where they are in the minority and are for the most part unable to protect you adequately.
I've been in way too many meetings where cover ups were plotted, and there are absolutely no good guys in power. Employees don't stand a chance in hell of being able to advocate for patients, and they know their lives will be ruined if they do try to do anything.
First, there's the outrage. Uncontrollable outrage, in fact:
"I did not hide my anger during the interview, going to so far as to say that I felt that the anesthesiologists had essentially killed the patient. The people who interviewed me seemed uncomfortable with my conclusions and with my anger."
Uncomfortable with your anger, you say? I find that very hard to believe.
Second, there's the easy moral victory to accompany that outrage:
"If I had been angry about what happened to the patient, I was even angrier after learning of the deception. The hospital had deliberately lied to protect its staff members. They lied to cover up medical negligence, with the assumption that the doctors in question would continue to practice at the same hospital, free to make similar mistakes."
No one is going to argue that the hospital was right and that Dr. Amy was wrong. Dr. Amy 1, Lying Immoral Enemy, 0.
And lastly, Dr. Amy comes out on top, looking like the hero.
Yes, this one's a classic. Formulaic, even.
"Did they actually change what you said?"
They actually changed what I said. I can't imagine what they were thinking when they did it. They had to know that the report was a public document and would be used extensively in any malpractice trial. It was virtually inevitable that I would find out.
For all I know, they could have changed the testimony of other providers, as well. I was not informed as to whether the rest of the document was accurate.
It would be nice if the hospitals could focus on patient care instead of litigation. When I divorced, I was told that the Accounts Receivable by physicians and hospitals could only be valued at 50% of their book value. Why was that when I had to pay 100% of book value to "buy-in?" Either, (1) they were as a practice CHEATING the long term spouses out of their share of assets by undervaluing assets, or (2) they were sending ALL of their Accounts Receivable to Collection Agencies, where they would receive $.50 on the dollar. Thus, when someone can't pay, the hospital doesn't "eat" the loss, they just sick the dogs on the hapless patient. Or possibly both. (3) Or maybe I'm wrong, and they normally 'forgive' half of the payments owed to them by medicare, insurance, and patients.
Most, or at least many, physicians have integrity, are caring, and socially responsible. The system that supports the physicians is okay with cheating everyone else. It has become the norm I'm afraid. I was one of the luckier ones since I knew about finances, and hired an excellent out-of-town lawyer, and I had married a man with integrity who believed that I should not be cheated even though his lawyer fought him about it. It is sad. I believe the system is broken, and agree that you MUST have an advocate every minute, AND you must stay out of the system as much as possible.
Dr. Amy, if you can say, is there anything that the patient or her family could have done to bring attention to the situation sooner or prevent this from resulting in this woman’s death? Patients can usually check out a doctor/ surgeon, but we don’t get to check out the anesthesiologists, etc. In your experience, do most surgeons encounter other people that they have to cross their fingers about or are hospitals pretty willing to keep questionable people away from the operating room? In other words, what happens when doctors don’t have complete confidence in another doctor or medical professional?
BTW, I bet you were grateful to your husband!
"I have never heard anything this blatant, but I have heard of malpractice by a surgeon that was patently and consistently ignored."
Malpractice is a very serious problem. It's not that other doctors ignore it; the problem is that the legal protections are so elaborate that a doctor who reports the malpractice of another risks being sued for libel.
It is legally almost impossible to get rid of an incompetent doctor, no matter how desperately his or her colleagues want to do so.
"is there anything that the patient or her family could have done to bring attention to the situation sooner or prevent this from resulting in this woman’s death?"
As it happens, there are things that could have been done, but, unfortunately, I cannot write about them because of privacy concerns.
"In your experience, do most surgeons encounter other people that they have to cross their fingers about or are hospitals pretty willing to keep questionable people away from the operating room?"
No, hospitals are virtually powerless when it comes to keeping doctors with questionable skills away from the operating room. Often, the best thing they can do is provide them with highly skilled assistant surgeons who can monitor them.
Really? Hospitals can't get rid of lousy surgeons? That's not very comforting.
No suit from me or my kin -- I chose the best I could, and I know you make mistakes. And some WILL be fatal. To me. But it's OK, we are all "Dead Men Walking" anyway.
Glad your insurance preimums didn't go up-- you have the highest of all -- you at least deserve your Yougo to drive and your Yurt to live in.
"Fiction."
Moron.
Something like this happened to me 2 months ago. I wrote a story based on a report issued by a company, and I used their exact phrase - "troubled insurer AIG". Two days later the company that wrote the report complained to my boss that I'd used the phrase and said that it wasn't in the report. I checked the report on their website, and the phrase was missing. Then I checked the original report, which I'd printed off on the day that I wrote the story. The phrase was there.
Classic gotcha moment, and I admit to feeling smug.
"Two days later the company that wrote the report complained to my boss that I'd used the phrase and said that it wasn't in the report. I checked the report on their website, and the phrase was missing. Then I checked the original report, which I'd printed off on the day that I wrote the story. The phrase was there."
Good for you. You always have to protect yourself.
"Not only hospitals, but large organizations generally have tremendous capacity for deception such as this."
It's amazing, isn't it?
On the one hand, officials and organizations can plan elaborate deceptions. On the other hand, they don't seem to realize that some of their deceptions are easy to prove.
Great post. And you wonder why I don't want to have my baby in a hospital when this type of thing can and does go on! (Or get an epidural, because then I have to trust a anesthesiologist I have never met before and did not vet in the same way I vet my OB professionals). Being up against an entire establishment bent on protecting themselves is very scary! Recently when I was in the hospital, I tried to argue for a different method of admin of a drug based on about 6 pages of references on PubMed, and the nurse and my CNM were both like 'we've never heard of that' and 'you just read that on the internet' (like I read it on someone's blog and not PubMed!). And so I had to settle for a method of Admin that I knew had been established to be dangerous and even implicated in some maternal deaths! (I insisted on a lower dose though). It is hard to argue with professionals as an equal even when you KNOW they are doing something outmoded or dangerous!
However, lets just all remember that the rate of Maternal Death went UP when birth moved into the hospital at first, not down. OB has come a long way, but at first, they were definitely killing more mothers than they were 'saving', due to Childbed Fever. Midwives at this time were killing less, just because they weren't as into vaginal checks. (And although gloves and handwashing have come on the scene, I would maintain that OB as a profession, is STILL way too into vaginal checks. :?)
"doctors should be able to say I'm sorry we screwed up"
I agree. However, what happened here was not a simple mistake. Unfortunately, I cannot share the details but it called into question the basic abilities of the physicians involved.
"And you wonder why I don't want to have my baby in a hospital when this type of thing can and does go on!"
I do wonder.
First, the mother in this case would have almost certainly died at home and the baby would have died with her; at least, in the hospital, the baby survived. Second, even in low risk pregnancies, homebirth triples the rate of neonatal death.
This is not a story about medical care causing someone's death. This is a story about the failure to provide appropriate care.
I understand appropriate medical care saves lives, but when it is not provided, I fear the cronyism that prevents patients from normally having any recourse. Even this woman, so her family got a settlement: so what, she died! She had no recourse even if her family did.
"she died from a complication of anesthesia"
Because of other medical issues, she needed to have anesthesia. That part was unavoidable. I wish I could say more about why her death was avoidable, but, unfortunately, I cannot provide any details.
I don't understand what is so different between settling out of trial or not, as far as "putting a monetary quantity on the gross injustice caused this [sic] hospital. " If they had gone to trial, they may have won a larger sum of money, that is all (well, and they would have had higher costs to pay to their lawyer, as well as the pain of going through the trial process). It's not like someone would have gone to jail or been punished in some way if they had only gone to trial. This is a medmal case, not a criminal case.
My mom had a new anesthesiologist working on her, and he gave her 9 epidurals after the previous 8 didn't work properly. She demanded another anesthesiologist, but they didn't allow her to have anyone else. She died on the operating table when they were performing the c-section, and the doctors had to rush to get me out alive, cutting my head with the scalpel in the process. My mom was revived, thankfully, but we both suffered major complications because of the traumatic birth. I'm unable to work as an adult, and the government has denied me disability twice.
When my mom accidentally got pregnant again a few years later, the family and her doctors urged her to get an abortion because they thought she would surely die for good if she gave birth again. But because of my mom's religious convictions, she went through with the pregnancy. The child had a severe stomach ailment in infancy and required surgery, but I don't know if that was caused by the prior complications or not. Thankfully, though, my younger brother is alive and well today, successfully serving as a US Marine.
To my knowledge, my parents never filed for malpractice for some reason, although I really think they should have. It could've been avoided so easily.
The T stands for "Tuteur," doesn't it?
Greed and money win out.....always.
"she died from a complication of anesthesia"
Because of other medical issues, she needed to have anesthesia. That part was unavoidable. I wish I could say more about why her death was avoidable, but, unfortunately, I cannot provide any details.
AmyTuteurMD
March 31, 2009 12:31 PM
Maybe because you haven't written the details yet? Good way to keep anyone from verifying that your 'story' is true... I agree with Shaggylocks. (This post is a classic Dr. Amy post, and has all of my favorite Dr. Amy hallmarks.)
It is legally almost impossible to get rid of an incompetent doctor, no matter how desperately his or her colleagues want to do so."
It is not a good thing that hospitals and other docs have trouble getting bad health care professionals out of the system. It would seem the legal system that helps keep bad doctors in the system also gets a lot of malpractice work when those doctors screw up. Unfortunately, the good doctors also get slapped with higher malpractice insurance rates to cover for it.
From a patient perspective, this isn’t good at all. I don’t ever want to have a reason to sue anyone so I’d like to see more transparency in these kinds of situations to encourage more prevention. Maybe settlements and or malpractice suits should not be so hush, hush. I don’t know what all the implications of that would be, but it’s a thought.
I was reading recently on CNN that people are going abroad to get expensive surgeries more cheaply. If the impression that our American hospitals aren’t safer or better, it would be hard to argue with an individual or insurer who wants to go to India and spend $10,000 instead of $175,000.
http://www.cnn.com/2009/HEALTH/03/27/india.medical.travel/index.html
Keep up the great work!
And as for anesthesiology - like medicine in general, it is not an exact business. I once witnessed an epidural being administered which inadvertently became a spinal, probably fairly common mistake I am guessing, but this girl's respirations almost stopped and she had to be given Narcan to reverse the problem. Another anesthesiology had to be called in and it became an emergency situation. Consider how complicated the treatment of a pregnant girl or woman already is. Add to that the fact that many patients do not tell the truth about what medications they are taking or tell their doctor how much drugs and alcohol they use.
After the short time I have been in health care (about 1 1/2 yrs), I have been stunned at how ill the general population is with chronic conditions and drug/alcohol use, and I believe most people outside of health care have no idea how this complicates treating patients in the hospital.
I've had the same thing happen to me over the deposit on an apartment - we all signed the sheet saying there was no damage and then six months later (giving me plenty of time to lose my copy) they tried to dun me for damages with a falsified document. Too bad for them, I had the original.
I was pretty outraged at the time. I can't imagine how much more outraged I would have been had it been a life and death situation like this one. For what it's worth, I find this tale completely believable, and what's more, I believe it happened to Dr Amy. As objectionable as she often is, objectionable people have one strong point - they aren't afraid to speak up and make enemies. And so this sort of thing often happens around them whereas it would not around a more affable person.
However, due to the power and wealth of the AMA, the oldest pac in the nation, dedicated to preserving its members' incomes above all else (read the bi-laws), and not dedicated to preserving human health above all else, such incidents as you describe rarely come to public attention.
The American Medical Establishment kills and damages on a daily basis, and then deceives the public with lies, mainly of omission.
There should have been some significant fallout from that, no? If I had been the patient's attorney I would have gone right to the press.
I also wonder what your relationship is with the hospital in question. Have they revoked your privileges, either explicitly or constructively? Have the powers that be that authorized this coverup been properly chastised and replaced by more trustworthy administrators? Has the anesthesiologist faced professional censure or loss of license?
Have you experienced any sort of black balling from other hospitals as a result of your going against the official party line in this instance?
I am always interested in what happens to whistle blowers.
No one was looking out for me when I could not look out for myself. I hope everyone that reads this realizes NO ONE is looking out for you in the hospital.
The incident you describe is not routine. It is criminal. I mean that literally. I'm not a lawyer, I'm a former pathologist, but it is clear that outright forgery, in addition to massive violations of many health care related regulations, was committed.
Your position is a difficult one, but by relaying the incident in an anonymous way, you create the impression that this sort of thing is common. You also cause all medical centers and physicians to be viewed with suspicion.
For example, one of the posters above uses this article as an example of why she does not wish to give birth in a hospital. A healthy birth at home is an excellent option where appropriate, but not because negligent deaths of young mothers followed by criminal cover ups are common enough to be a reasonable concern.
By the way, malpractice cannot be "common". I strongly support serious reform of the way mistakes are handled in medicine, but "malpractice" does not mean "lack of perfect outcomes in every case". Complications, side effects, and unavoidable mistakes are part of medicine. "Malpractice" is practice that is below the established professional standards of competence. I have both caught and made mistakes during my training and career - in all cases, clinical harm was avoided because physicians were able to work together and advise one another in a collegial way. There was never any malpractice.
Physicians who suffer from genuine competence problems, not due to greed or poor character, but due to some personal incapacity that was not discovered during training, are in a very difficult situation. Long years of training must be abandoned or repeated, unless some correctable factor like can be identified.
In the end, I think that this should be publicized, but that the medical center and individuals involved should be named. The response of the medical center to this incident should be documented as well - did they cooperate with criminal charges against whoever prepared the forged documents, or at a minimum terminate them?
I'll also note that even if the anesthesiologist was incompetent, there is a vast difference between innocent incompetence and outright lying and forgery. However, if he or she agreed to conspire to lie in this case, then that behavior is incompatible with a license to practice medicine and sounds as if it may constitute a criminal offense as well.
I seldom put a direct attack on another writer, but here goes:
shaggylocks: you are so full of shit you are an idiot. Your attack was lacking in fact, uncalled for, and showed that you don't even understand the problem or how deep and how often this does
happen.
TTLawyer: If possible, remember that your profession is the modern equivalent of Robin Hood. Sure, many physicians, hospitals, and insurance companies will try to discredit you. But without malpractice law, think of what product safety would be in this day an age. The health care industry has a terrible record of trying to bury its mistakes. I know, I was one of them.
Thanks again Amy.
"This is so heartbreaking to read because something very similar happened with my birth, and I have to deal with the consequences of it everyday."
I know that some people would like to believe that I make up the stories in my posts. Unfortunately, as you know, there is no need. There are many too many people who have to deal with the consequences.
I just want to say I read your latest comment and, as the son, nephew, and cousin of an entire family full of attorneys, and someone contemplating law school myself, I found it perhaps disproportionately heartening to read your description of lawyers as "modern day Robin Hoods." My mom doesn't work in medical malpractice anymore, but she did for a long time, and it's amazing the depths to which insurance companies will sink in order to try to avoid honoring the terms of their service. No other service sector in the world tries so hard to make money by reneging on its promises to its clients. And then we hear talking heads on TV and in the papers going on and on about how malpractice suits are ruining the medical profession, how it's all greedy lawyers making something out of nothing. It absolutely drives me up the wall. People make mistakes, sure. That's what insurance is for (though the insurance companies seem not to believe it). And when people commit malpractice, that's not just a mistake: They need to be held accountable, and not just financially. Doctors who hurt or kill patients out of negligence or incompetence ought to have their licenses to practice removed.
I also wanted to comment that my mother (who is an attorney) and my aunt (who is now a family court judge) both firmly believe that their father was killed by malpractice on the part of an anesthesiologist, and as a result they have never trusted members of that profession. To this day when my parents need to use the hospital for any reason, they point-blank demand the head of anesthesiology or someone otherwise reputable. I find it strange that patients are more or less allowed to shop around for their primary caregivers or surgeons, but have almost no choice in the people whose job it is to essentially put the patient down and attempt to revive them later.
"the incident you describe happens every day in this country"
Not exactly. The incident only happened once in my career and most doctors I know have never been involved in an incident like this.
There is a real difference between medical errors and medical negligence. Medical errors happen because doctors and nurses are only human beings and make mistakes just like other human beings. That's why systems should be put into place to catch human error, just like they do in other industries. Medical negligence happens not because of human error, but because of poor training, out of date training, drug or alcohol abuse, or incompetence. An error is forgivable; strong measures are needed to deal with incompetence.
"There should have been some significant fallout from that, no? If I had been the patient's attorney I would have gone right to the press."
Unfortunately, not significant enough in my opinion. Although some people lost their jobs, to my knowledge, no one lost his or her license. Moreover, it is all too easy to start over again in another state.
"Any and all details related to your deposition and the details related to the anesthetic complication (in your deposition or the depositions of any of the other witnesses) are part of the public record. We'd be interested in the details."
I can't share the details. I have a legal obligation to preserve patient confidentiality. Because the case is so unusual, the details will make it much easier to identify the patient.
I wish I could share the details. The story of the cover up is scandalous, but it pales in comparison to the story of the incident.
"In the end, I think that this should be publicized, but that the medical center and individuals involved should be named. The response of the medical center to this incident should be documented as well - did they cooperate with criminal charges against whoever prepared the forged documents, or at a minimum terminate them?"
I can't tell you what happened. To my knowledge, the case was not publicized. However, since this incident, a similar incident of tampering at this institution was discovered by a patient's lawyer in preparation for trial. The judge exacted serious penalties and made that incident public.
You also said that I "don't even understand the problem or how deep and how often this does happen." Really? How did you determine this based on what I wrote? But I guess you're right. In my mind, this is a relatively rare thing. Let's let Dr. Amy weigh in on this:
Dr Amy says: "The incident only happened once in my career and most doctors I know have never been involved in an incident like this."
Hmm. Yeah. There you have it.
"I also wanted to comment that my mother (who is an attorney) and my aunt (who is now a family court judge) both firmly believe that their father was killed by malpractice on the part of an anesthesiologist, and as a result they have never trusted members of that profession."
I don't doubt it. As I have written about in the past, my own father was the victim of egregious malpractice at the institution where I trained and was on staff at the time. A small cancer was noted on a routine pre-operative chest X-ray, and properly reported in the chart. No one bothered to tell my father, however, and he was entirely unaware until 7 months later when he showed up coughing blood. At that point the tumor was the size of his fist and filled his chest. He died 8 weeks to the day after the large tumor was discovered, despite aggressive treatment.
In addition, they lied (my own colleagues) about the fact that the small tumor was seen on the original X-ray. I still can't imagine why, since I was on staff, and I walked down to the radiology department and got the film.
1) if this unnamed hospital didn't recognize that she was NOT EVER going to fold and back off from her opinions, no matter what, then they must be seriously, seriously stupid,
2) if they didn't know that her husband was a lawyer and therefore likely to advise his wife to keep copies of important legal documents, then they weren't paying proper attention, and
3) if they thought that by forging a document (without also forging signatures), and that Dr. T wouldn't fight them tooth and nail, especially after showing SO MUCH UNRESTRAINED ANGER in her original testimony about who was in fact to blame, then they are incredibly clumsy and stupid and foolhardy.
I'm not saying that this story is fiction because I don't have any way of knowing one way or the other. I'm just saying that at a minimum, this hospital's administrators had to have made an unbelievable series of wrong assumptions and taken an extraordinary risk. They had to know that there was a decent chance that they would get caught in the forgery or at least that Dr. T would fight them all of the way. If they knew this, then they also had to have known that the potential downside for punitives in this case, where they are caught FORGING documents, was HUGE and they should have known, I would expect that they would know, that the damage wouldn't be financially worth it.
http://www.gaspasser.com/unique.html
Sleep well!
Rated & Cheers!
This blog is a sham
If it happened then it is a truly stunning story. And sad, for the woman's family quickly jumped on that eight-figure paycheck rather than defending her honor and life in a court of justice.
If it didn't happen (which I suppose it may have but this story has been grossly over-told so the author can stand as the heroine) than it did what it should have done for this last twenty minutes: offer a good read.
"And sad, for the woman's family quickly jumped on that eight-figure paycheck rather than defending her honor and life in a court of justice."
Legal trials almost never produce vindication. The best you can hope for is that they produce compensation. Having been involved in the malpractice suit my mother filed after my father's death, I can tell you that a settlement is almost always the way to go. My mother insisted on vindication, and turned down the settlement. She ended up with nothing but 10 years of aggravation: the time between my father's death and the actual trial after years of delay.
Just like medicine bears little resemblance to medical TV shows, law bears very little resemblance to legal TV shows. There is precious little drama, precious little satisfaction and almost no vindication.
Once a lawsuit is filed, the general legal obligation for confidentiality dissipates. If there was a deposition, it is a public record. The details of the general case were laid out in the summons and the complaint. HIPAA rules follow that paradigm as codified in the Federal Register.
Did you sign some type of confidentiality agreement which would create new obligations above and beyond HIPAA and state privacy laws. I don't mean to belabor the point, but the law allows you to disclose given that this was already a legal case with a public record.
As safe it may be however, it is naive to think that adverse events cannot occur when a patient is being anesthetized. As others have correctly pointed out, it is a critical care specialty and our daily work involves bringing patients to the verge of death only to bring them back at the end of their surgery.
People's nature is to point fingers at others and the author of this poster fails to describe details that could help elucidate what really happened. Without understanding the timeline and the cause of the patient's demise it is difficult to giver her account any credibility.
If the hospitals and physicians involved in this patient's care did attempt to hide their mistakes, then I am glad they were held responsible. My concern with this post is that it vilifies an entire medical specialty without any concrete evidence.
To Ben Refling:
You should be aware that many times when patient undergo surgery, they ARE NOT getting physician anesthesiologists to provide their anesthesia. Many hospitals now rely on nurses with a community college degree with some technical traning in anesthesia (CRNAs) to anesthetize patients. If you are concerned about having the best trained provider for the job, you should be aware this is happening is many hospitals across the US unbeknownst to the patient.
My suggestion to all readers is to ensure you have the person with the most amount of education provide your anesthesia. This person will undoubtedly be a physician anesthesiologists.
Contrary to what some believe, you do have a choice when choosing who anesthetizes you or your family member and it is either: A physician anesthesiologist or a Nurse (CRNA)
I find your story wholly credible.
"Did you sign some type of confidentiality agreement which would create new obligations above and beyond HIPAA and state privacy laws."
No.
Are you a lawyer with a specialty in patient confidentiality? If not, why are you giving legal "advice" about doctors' obligations?
"I happen to be an attorney with a specialty in healthcare, including patient confidentiality."
What's your real name and where do you practice?
I have more questions, too. The hospital's investigation of this sentinal event would have been conducted under Peer Review, in which case all of the documents prepared for the Professional Liability Review Committee would be privileged and confidential. They are not subject to discovery. Or, the investigation was conducted in reasonable anticipation of litigation by the hospital's lawyers and risk management folks, in which case the documents are also not subject to discovery.
So how did they get any your narrative?
why dont you go over the specifics of the case. was there hypoxic brain injury? did the case go to csection and dic? was there an Anniotic fluid embolism? It would be great because many people are having trouble understanding the whole story since you are leaving,umm, the crux of the story out. To protect privacy, use fiction.
In particular there is this:
The malpractice insurance lawyer who interviewed Amy before her deposition discovers that Amy's testimony has been forged. She tells him so. He says in response:
“No one is going to believe that,” he warned. “Unless you have proof, it’s as if it never happened.”
She doesn't say in her story that she told the lawyer at this point that she had a copy of her original statement.
Why not? Why would she keep this to herself? Why wouldn't she immediately tell him that she had proof positive that the other document was a forgery? Why doesn't the lawyer, furthermore, prior to this point, wonder why the alleged forged document has no signatures? He's an attorney after all.
She doesn't tell him that she has a copy of the original document right away because this would spoil the drama of her John Grisham story.
If she had behaved as any normal person would have, she would have told the lawyer on the spot that she had her own copy of her original signed statement, and the lawyer would have then ALERTED the lawyers for the hospital and the hospital administrators of this.
He would NOT have sprung this on the hospital the way she describes it at the deposition to the shock and amazement of everyone. After all, as an attorney for physicians' malpractice, he does not have an overall adversarial relationship with the hospital.
Iago
Jayson Blair
Janet Cooke
Amy Tuteur
"Why not? Why would she keep this to herself? Why wouldn't she immediately tell him that she had proof positive that the other document was a forgery?"
I did tell him at the time. I didn't mention it at that point in the story because it would have given the punch line away.
I don't care whether you believe me or not. I'm not writing to convince you. I told my story. It happens to be true. The fact that you don't believe tells us that you don't have good instincts for figuring out the truth.
"Unfortunately, more complications will arise if we continue to dumb down medicine and allow nurses who dont require basic chemistry classes with labs taking care of patients and thinking they have the educational backround to make independent decisions."
Only one resident and several anesthesia attending were involved in this case.
Tell us why your attorney didn't alert the other attorneys BEFORE the oh-so dramatic deposition, the showdown at OK Corral, that you had this document?
"I will tell if you send me a private message. I'll even give you my bar number."
No, no, no. If you feel confident giving me legal advice, then do so publicly with your name and location. Then, as long as you indemnify me (in writing of course), I can tell you the details.
Are you sure enough of your advice to put your name to it, and to agree to bear any financial or legal responsibility if you are wrong?
"Tell us why your attorney didn't alert the other attorneys BEFORE the oh-so dramatic deposition"
The entire point of a deposition is to share information with the other attorneys. That's the appropriate place to inform them.
As neither a doctor nor a lawyer, you are in no position to evaluate either the medical or legal details of this case. As I said before, you don't have to believe me, and I certainly don't feel compelled to violate patient privacy merely to satisfy your curiosity.
I was a paralegal for nine years so I know something about the law. I arranged depositions, attended them, summarized them, helped to prepare witnesses for depositions, etc., etc. You say:
"The entire point of a deposition is to share information with the other attorneys. That's the appropriate place to inform them."
I find it interesting that you, a non-attorney, are so certain of this non-fact. Perhaps you should ask your husband the lawyer if what you say above is true before you make such a claim before the Internet. A deposition is NOT the appropriate place to inform attorneys of the facts of the case in a situation such as this. The hospital, according to your tale of fiction, forged a document claiming you said things you didn't. Your attorney had a duty to inform the hospital of this immediately. His silence in the face of this knowledge is not credible and it would have been wrong for him to remain silent.
You are not telling the truth.
"Your attorney had a duty to inform the hospital of this immediately."
Can you quote the relevant section of the Mass law, please?
"I was a paralegal for nine years"
Which means that you are not a lawyer.
You really ought not to get too carried away with your rather juvenile desire to discredit me.
The deeper you dig the hole the more insane you sound.
Facts:
-'Amy Tuteur' never attended Harvard or BU medical school
-She was never an instructor at Harvard
-She is not a licensed MD
-She will never provide proof of any of her credentials because she can't
Your excuses get lamer and lamer. I'm supposed to cite Massachusetts law to you? (So we're getting warmer here, this was a Mass hospital where these alleged events occurred?)
You STILL haven't explained your attorney's silence about your killer document before the deposition. HINT: You can't explain it by engaging in your usual MO of heaping calumny on your critics.
"Facts:"
All that demonstrates is that you can't do research.
http://www.reddit.com/r/WTF/comments/88urn/they_killed_her_patient_you_wont_believe_the_way/c08ktyl
Oh, and here's what the anesthesiologists think of you on SDN..
http://forums.studentdoctor.net/showthread.php?t=615388
I think an apology is in order.........Dr. Amy
"I guess I have a rather juvenile desire to determine the truth."
I told you the truth. You'd rather pretend that you've found an opportunity to discredit me. Go ahead, live it up, pretend all you want.
Really? I can't do research?
It would be extremely simple for you to post a link to a SINGLE DOCUMENT that will verify ANY of your credentials! I never had a college professor that didn't have a website, or at least you could google them and get their journal articles.
This wasn't a bad story! Whoever wrote this can write good FICTION! The problem is when you misrepresent yourself as an authority figure, with experience and years of hard work.
A. Everything I write is true until proven false.
B. Everything you write is false until proven true.
C. I am the judge of all that is true and false.
A+B+C = Bad Fiction
She Killed the Truth, and She Tried to Hide It.
"It would be extremely simple for you to post a link to a SINGLE DOCUMENT that will verify ANY of your credentials!"
Hey, if you're so sure you're right, call up the institutions involved and ask them. Then you can come back and apologize.
After I do this, will you admit you're a fraud, or will you say I'm a forger?
It's very similar to the "oh yeah, says who?" move, which she adeptly deploys here in this very comment thread:
"As neither a doctor nor a lawyer, you are in no position to evaluate either the medical or legal details of this case."
"Are you a lawyer with a specialty in patient confidentiality? If not, why are you giving legal "advice" about doctors' obligations?"
AND THEN (and this is the really beautiful part) when a lawyer who specializes in health care and patient confidentiality DOES step forward with more questions (the answers to which may very well prove her point and vindicate her in front of the naysaying rabble), she demands that he publicly identify himself, where he works, AND agree to bear any financial or legal responsibility if he is wrong! FUCKING BRILLIANT!! If he can prove to you privately that he is, in fact, a lawyer who specializes in health care, why would you fear what he has to ask? Why make him jump through hoops? The facts are on your side, because this is a true story, right?
Right?!?
GregorMendel, (if that is your real name!) I share Dr. Amy's skepticism. Please provide your SSN and photographic evidence that you can walk on water, as well as signed statements from at least 20 people who saw you walk on water, and then maybe you can get some answers from the good doctor.
Dr Amy: you keep fighting that good fight.
"Amy, how about a new title for your dramatic story:
She Killed the Truth, and She Tried to Hide It."
You know, a young woman is dead. She died an avoidable death, in my judgment. Her child is growing up without a mother. Her husband is devastated.
It may be a joke to you, but it's not a joke to me.
You are dead-on correct. There is no way a malpractice attorney would not let the hospital (the hospital that, one would assume, is paying his/her fee on Amy's behalf for this deposition) know that it was about to get screwed, albeit rightly so, by Amy's having maintained a copy of her statement. Amy wasn't a defendant in the case, so she says, so the attorney truly represented the hospital's interests and not hers. As such, they would damn well have gotten on the phone about this long before the deposition. And that's the part that makes this whole thing more unbelievable by the second.
Shaggylocks: I might just have to leave my husband and run away with you! You are killing me tonight!
My imaginative title for your tall tale ("She Killed the Truth. Then She Tried to Hide It") wasn't a joke, even though admittedly it was meant in part to amuse. It was, in fact, principally an attempt to render more truthful what you have done here, to give it a truthful title, both for the original fairy tale and for your fervent and prevaricating defense of that tale.
Trying to convey more truth isn't your bag I realize so perhaps that is why you can't handle it properly or understand it.
Well, Radcliffe, anyway, which is the same thing.
I know it's not super compelling proof, but I did find this: http://www.hr1980.com/Photos.html
I'll verify it on the post.harvard.edu alumni database tomorrow.
"as usual you misrepresent .."
I misrepresent?
You've just accused me of lying, as have several others. And what do you have for proof? Absolutely nothing. In fact, you haven't even bothered to check anything. You have literally no idea of whether or not my story is true, nor do you intend to find out. You have accused me of lying simply because it amuses you and feeds your vanity. You should be embarrassed.
teendoc,
You're no better. You also have literally no way of knowing whether or not I am telling the truth, and you haven't even tried to find out. You have accused me of lying simply because it amuses you and feeds your vanity. You should be embarrassed.
"I literally am going to devote precious time to exposing you"
You are simply pathetic.
And, why not describe more details of the case?
Um Amy, Vain Teendoc here, and yes, I am amused and still have my popcorn. So what to know is this...how is anyone supposed to find out whether you are telling the truth when you won't give any information? All that's left in that case is speculation based on your, uh, history and the deficits and items that don't add up from your story. But the peeps on Reddit are having much more fun than we could ever have here dissecting the things that don't add up in this post.
Maybe I'm amused and vain, but at least I still can make a logical progression in thought and not get lost in tautology.
Be well.
"how is anyone supposed to find out whether you are telling the truth when you won't give any information?"
How is anyone supposed to find out that you are really a doctor when you post under a screen name. Don't you owe it to us to post under your real name and tell us your credentials?
If you're so concerned about transparency, here's a chance to prove it. What's your real name? Where do you practice? Prove that you really are a specialist in adolescent medicine?
What's that? You're not going to do that? Does that mean you are a liar and everything you have written is a lie?
This one takes the cake: "In fact, you haven't even bothered to check anything. You have literally no idea of whether or not my story is true, nor do you intend to find out."
This statement makes me think that you are actually a computer program that is designed to spit out a set of pat phrases. You say this every time someone disagrees with you. You can fill in the blanks: Substitute "Palestine" or "Israel" or "organic foods" or "drugs" in the places where you refer to someone not trying to find out something and not bothering to check anything.
Do you even READ what you write?
This is precisely what we have been trying to do - to check the veracity of what you are claiming and to find out what's true and what's not. The reason we're having trouble is because YOU stonewall everybody's inquiry and you claim that you can't divulge any real information or details. When lawyers have pointed out that you can so divulge, you counterattack and try to intimidate them by threatening damages.
Are you a real person? Or are you just a computer program designed to write fiction? Do you even know what the truth is from one moment to the next? Doesn't it bother you at all when you blatantly contradict yourself from one minute to the next?
(I'm signing off for the night.)
She's a liar, fraud, and she will never admit it.
Me? I post about my cute kid, my photography, some ethics, and humor. I'm not trying to be The OS Doctor like some BU med school grad you might know.
So do not play silly games with me. The people who need to know what is listed on my CV will get that information. But it is not relevant to what I am asserting here. I could be Suzie StreetSweeper and I would still say the same things about this post.
You challenged me and I posted my real name in my profile.
What is YOUR real name New Blog? Hmmm?
Amy has no point here, except to paint herself in a favorable light, no matter how ridiculous the yarn she has to spin to do it.
Amy?
WHAT HOSPITAL WAS THIS?
Our Lady of Unimaginable Incompetence?
Our Mother of Bureaucratic Evildoers?
Lies, damn lies, and secrets.
"The people who need to know what is listed on my CV will get that information."
As it happens, I know exactly who you are, and what you list as your professional qualifications, as well the stuff you've written (pre-menstrual syndrome, etc). It is very difficult to be truly anonymous on the web. Just a few minutes of basic research makes it possible to find almost anyone.
I didn't realize until recently, though, that K Shecter is your husband.
YUCK. How can you treat people like this and sleep at night?
"This statement makes me think that you are actually a computer program that is designed to spit out a set of pat phrases."
She may not be a program, but she sure is formulaic. This is the thrid time I've posted this, but it never ceases to amuse me (probably no one else, but it does amuse me):
The Dr. Amy Guide to Winning an Argument:
1. Start with extreme contrarian and/or judgmental opinion
2. Support with unrelated anecdotes, often of reprehensible behavior
3. Challenge others to prove opinion wrong
4. Deny validity of all arguments and evidence provided by those who disagree, AND
(a) Launch personal attacks against "critics"
(b) Support personal attacks with Jerry Springer defense
"You don't know me! You're just jealous! Talk to the
hand!"
5. Proclaim victory
6. Run away
If what the lawyer AND paralegal says is true about depositions, that they are a matter of public record, then why not direct us to said deposition?
And, why not describe more details of the case?
Yay! Goody for you! The truth is that I'm not anonymous on the web. I'm just anonymous here. But since my most recent post listed that I practice adolescent medicine at CHOP until 2005, finding me is not too difficult, unlike the issues that Jack D is having in finding info about you. And yes K. Schecter is my hubby (since that is a picture of me with him and Zara in his icon, also not much of a stretch). So what's your point? What does that have to do with the issues raised about this post of yours, my fellow Hippocratic Oath taker?
I'm me. You're you. And this story still doesn't add up.
I can't find out more information. The lawyers posting on Reddit are trying their damnedest to find out more information about this case since they think there are enough holes to drive a truck through. But you're keeping mum while in the same breath saying that we're not trying to find out the truth. It's all making this amused and vain woman very tired.
Night, night!
"I can't find out more information. The lawyers posting on Reddit are trying their damnedest to find out more information about this case"
I'm glad that no one can find out. That was my intention. That's what protecting patient confidentiality requires.
What I'm finding difficult to understand is why it means so much to you. Why are you so invested in discrediting me? That's really all it's about. Nothing else is at stake here for you or for anyone else. Whether I'm telling the truth or lying is of no importance to anyone; it doesn't change anything for anybody. It's only important if you are obsessed with me.
Here's the way I see it: You're asking me to violate my duty of patient confidentiality to satisfy your curiosity. Not curiosity about the patient, but curiosity about me. You want me to prove I am telling the truth so you can either slink away mumbling "nevermind" or so you can triumphantly accuse me of fabricating the story.
Is it really worth that much to you that you think I should violate the privacy of a dead woman so you won't be deprived of a potential opportunity to criticize me?
Maybe we should call you "Dr. Cheney." Your relationship with the truth is about as strong as the former veep's.
I'll let you do your own work though. Much as I love tooting my wife's horn and shouting her praises to all who will listen, she doesn't like to lead with her resume. Unlike you, she doesn't try to bully others into submission with her credentials.
Pathetic.
If what the lawyer AND paralegal says is true about depositions, that they are a matter of public record, then why not direct us to said deposition?
And, why not describe more details of the case?
And I'll add to that by saying...
Are you insinuating that they are not telling the truth or that there is some patient confidentiality thing we're all unaware of? If so, could you tell us what this stipulation might be?
"I don't care whether you believe me or not. I'm not writing to convince you. I told my story. It happens to be true. The fact that you don't believe tells us that you don't have good instincts for figuring out the truth."
"I told you the truth. You'd rather pretend that you've found an opportunity to discredit me. Go ahead, live it up, pretend all you want."
"You have literally no idea of whether or not my story is true, nor do you intend to find out. You have accused me of lying simply because it amuses you and feeds your vanity. You should be embarrassed."
"You also have literally no way of knowing whether or not I am telling the truth, and you haven't even tried to find out. You have accused me of lying simply because it amuses you and feeds your vanity. "
and FINALLY
"WHETHER I'M TELLING THE TRUTH OR LYING IS OF NO IMPORTANCE TO ANYONE; IT DOESN'T CHANGE ANYTHING FOR ANYBODY. IT'S ONLY IMPORTANT IF YOU ARE OBSESSED WITH ME."
3. Challenge others to prove opinion wrong
4. Deny validity of all arguments and evidence provided by those who disagree, AND
(a) Launch personal attacks against "critics"
(b) Support personal attacks with Jerry Springer defense
"You don't know me! You're just jealous! Talk to the
hand!"
5. Proclaim victory
There ya go!
"The T stands for "Tuteur," doesn't it?"
Oh no. My great secret is revealed. Honestly, what does it matter?
My name is MAJ Michael Bentley, a Nurse Anesthetist in the US Army. I understand that surgical and anesthesia problems are rare but occur.... however, I also believe in transparency. In order for YOU to have credibility you should provide some evidence to your credentials. Otherwise this story while dramatic cannot be taken seriously.
So please offer some evidence of your credentials or else this story has no foundation.
Regards,
Michael W. Bentley, CRNA, PhDc
Major, US Army
I have searched the name Amy Tuteur in several physician locators and on the AMA physician finder utility and no such name appears. Again while the story is compelling, the anonymity reduces the impact.
Regards,
Michael W. Bentley, CRNA, PhDc
Major, US Army
Let's clear up some issues in the comments, shall we?
"The hospital's investigation of this sentinal event would have been conducted under Peer Review..." No, it wouldn't have been, not as she described it. The post said it was a Department of Health investigation, a completely different ball game, and one that is discoverable. Just last year I had a trial where much of the proof involved materials from a DOH-investigation. Moreover, Peer Review isn't the same thing as a hospital's review of an incident, the latter of which is discoverable. Peer Review in most states applies to a very limited, particular procedure.
"The hospital, according to your tale of fiction, forged a document claiming you said things you didn't. Your attorney had a duty to inform the hospital of this immediately. His silence in the face of this knowledge is not credible and it would have been wrong for him to remain silent." Really? Anyone acting as Amy's lawyer has duties only to Amy and to the Court. He's more than entitled to watch the hospital's phony defense and then give it that extra little push over the cliff whenever he feels like it. Indeed, in the post, it appears that the hospital lawyer had Amy's real statement, but withheld it until the deposition itself, and even then withheld it until the issue arose. That's not unusual in my experience; I've had plenty of defendant-related witnesses show up with documents contradicting everything else I received prior to that.
As for HIPPA, state privacy laws, or the settlement agreement, these might not prohibit Amy from referencing the case since, after all, the proceedings there were public. But that's just my opinion. There are opposing opinions, and very little case law one way or another. I haven't seen too many doctors talk much about cases, even those that went to trial, and if I were Amy's lawyer, I'd tell her to be quiet, too.
Parts of this story don't make sense to me, but I don't practice in Massachusetts, so it could be a little different. Our DOH investigations aren't transcribed, though a statement is made. The odd part to me is that the DOH should have received that statement and would have it in its own files, open to subpoena, which the plaintiff's lawyer would have served in a case of this magnitude.
That might be explained by how this is an investigation first done by the hospital, then reviewed by the DOH. In that case, the switch would occur prior to submission to the DOH, and would be a felony. That still doesn't quite add up, since I've never seen a hospital transcribe an interview in the course of an investigation. They generally write up statements at the most.
Perhaps Amy could clarify the details of this investigation and the statement.
Normally, when a lawsuit is filed, the attorney will ask for all relevant documents. As you took care of the patient, I assume you were asked to provide all records, which would include your signed statement. While you might not have remembered you had this statement, certainly at some point you did, and you and your attorney would have had an obligation to provide all of the material. The purpose of discovery is to prevent Perry Mason moments- which have all but disappeared in civil trials.
Next, if I understood your post correctly, you were never a named party. That would mean the medical record spoke for itself. In which case the additional material was unnecessary to change the result. In a complex case, it would be unusual for an attorney to avoid naming all participants in a patient's care (including you) unless the medical record made it clear. Once discovery proceeds, the parties who did not contribute to negligence would be dropped.
Finally, you state "Medical negligence happens not because of human error, but because of poor training, out of date training, drug or alcohol abuse, or incompetence." Actually, negligence is often caused by errors by extremely talented individuals, well trained, who are not drunk. It can happen because one's judgment was temprarily clouded by managing ten things at once. Or the doctor just got into a fight with his wife. Or hundreds of other reasons. If you use malpractice settlements or judgments as the metric for negligence (yes, I know, neglgence often occurs without any litigation), the Data Bank shows that the majority of entries are "single events." Patient safety still challenges the healthcare system. But, negligence is but one type of avoidable error. And our goal should be to prevent all avoidable errors, not just negligence.
Aren't settlements and judgments posted online in Massachusetts?
Perhaps, but I really didn't want everyone jumping down my throat about me being related to Dr. Amy. There's already enough morons screaming FRAUD when they so much as see the name Tuteur.
Anyway, since it's going to come out sooner or later, to all those who are saying, "I can't find you in a physician locator, HA I GOT YOU!": my mother hasn't been a practicing physician for over a decade. So you're not going to find her in any recent records.
What we DO have here, however, is her story about her patient and the hospital and the lawyers. What we can examine is the internal consistency of the story and its details and we can compare the behavior of the parties in this action to what we know through experience about how individuals, groups and institutions operate.
What you find about her story upon close examination is that people are behaving in ways that are shocking and strain credibility. Several of the elements in the story are outright unbelievable. I have already mentioned some of them previously and other people have also added their assessments likewise.
I want to add/underscore to that list the fact that the hospital, by forging Amy's statement, was behaving incredibly recklessly for at least two reasons:
one, they were doing so after ALREADY experiencing the wrath of Amy right after the alleged preventable death of the mother and AFTER Amy had already had been working at this hospital for a while and therefore establishing for everyone around her her reputation for being utterly immune to the opinions of others (this is apparent to any reader of any of her reactions on any given post of hers or posts she places to others' posts);
two, they were putting not only the reputation of the hospital on the line here by forging this document, but they were running the risks of criminal prosecutions and huge financial damages, not only in the specific lawsuit in question, but in the very viability of the hospital itself going forward. What kind of hospital could remain in business if it got out that in a death case they FORGED a document?
Furthermore, what kind of forger thinks that they can pass a document that is lacking in signatures on the bottom? Who would do such a thing? Why would the conspirators at the hospital allow this to happen? How many people would have to have been in on the conspiracy? Why wouldn't, as I said before, Amy's attorney have noticed the lack of signatures on the forged document and questioned the hospital about it immediately? What kind of incompetent would fail to notice this right away?
A deposition the likes of which Amy describes in her story involved several different lawyers and a court reporter. The lawyers in particular charge hundreds of dollars per hour each. We're talking a lot of money here folks. You mean to tell me that Amy's malpractice lawyer knew ahead of this deposition that the hospital had forged the central document in the case and HE DIDN'T tell anyone? He knowingly went into the deposition knowing there was a bomb that was going to go off? What would this do to HIS reputation as a lawyer going forward? How would the malpractice insurance company that retained him feel about his services and competence? What would the hospital think? Why would an attorney behave in such a manner that risked his own career with those who paid for his services?
"What you find about her story upon close examination is that people are behaving in ways that are shocking and strain credibility."
Sure, everyone knows doctors are perfect and they NEVER harm or kill patients through negligence.
Second, everyone knows that multimillion dollar businesses like hospitals would never alter records to avoid paying legal penalties.
Phew. Glad we've settled that.
http://www.reddit.com/r/WTF/comments/88urn/they_killed_her_patient_you_wont_believe_the_way/
steve d
March 31, 2009 10:09 PM
Ive been an anesthesiologist for 10 years and I must say that we need to add other assistants in the OR. We need to train more physician assistants to deliver anesthetic care and more anesthesiologist assistants in the OR to assist our board certified anesthesiologists. Unfortunately, more complications will arise if we continue to dumb down medicine and allow nurses who dont require basic chemistry classes with labs taking care of patients and thinking they have the educational backround to make independent decisions. I know there is legislation in the works in many states to allow PAs and AAs to assist our bd certified anesthesiolgists in the OR>
From the perspective of a hospital administration, presiding over multimillions of dollars in assets and operating expenses, etc. and hundreds of personnel, etc., and depending for its business on its reputation in the community and by licensing boards, etc., the idea that they were doing the smart thing by FORGING a document rather than seeking to minimize or deny that their employees acted improperly (and attacking the credibility of anyone who contradicted this, including Dr. Amy, who was retained on hospital staff for the interim few years between the alleged death and the lawsuit) does not conform to what we would expect to see in the least.
If the hospital was so intent on blocking a wrongful-death suit that they were willing to carry out criminal activities that risked devastating exposure possibly endangering their viability as a hospital, you would think they would have terminated Dr. Amy BEFORE the lawsuit got underway and done what they could to neutralize her credibility in anticipation of that suit.
What hospital wouldn't have expected a wrongful death lawsuit eventually? Why would they keep Dr. Amy, who had made no secret of her opinion that the hospital killed her patient, on in the meantime?
I recommend that those who are still taken in by Dr. Amy that they examine what she does and says more carefully. The woman is a fraud, perhaps not in her degrees (for all I know she may very well have the degrees she claims), but most certainly in the stories that I have seen her tell. Were she not spinning false tales then her attitude of utter and implacable hostility to even mild questions being put to her would not be present. Witness her reaction to Gregor Mendel.
I'm not saying there aren't legitimate reasons to do this, but there are also legitimate reasons to be curious.
And Alex, are you the son who told your mother that she sometimes comes off as an a-hole?
This is just sad.
They all end the same way, too. "Are you as angry about this as I am, or is there something wrong with you."
And yet, I can't stop reading these.
1) The story is a great read and Amy should consider writing fiction.
2) The very large, large majority of physicians I've met and interacted with will never in their lives encounter the sheer enormity of ethical situations that Amy has written about in her blog. That alone is a red flag waving in my mind as to whether or not any of this is even true (I really don't care if it is or not though....). We'll all encounter some, but from what I'm told, Amy writes almost exclusively on these accounts. They just seem to be really rare in my experience.
3) The physicians that advertise their MD to draw readers in based on their degree are being deceptive, and that deception increases 1000 fold when said physician doesn't even practice any longer. Waving credentials wreaks of egoism and I've found people who do so to be completely unoriginal and insecure. I can't differentiate Amy from Dr. Rey (fake plastic surgeon on TV), the advertising dermatologists I see on TV, the ER dude on that show 'Doctors', and the DO vouching for the weight loss supplement I see on TV. It's America, so these people can do whatever they want, but they give the public more reason not to trust physicians.
4) The large majority of us are very hard working people who've been hard working for a very long time, who just want to make a living providing care for people.
5) I won't read another post from Amy.
Why my mother decided to start blogging is anyone's guess, but she stopped practicing medicine after my little sister was born in 1994. As far as I know, at that point she decided she'd rather be a mother than a physician.
And no, I'm not the son you're referring to.
"Ever thought about writing a book?"
I have written a book. It's called How Your Baby Is Born and it was published in 1994. You can find it on Amazon.com. The English version is out of print, but it sold 25,000 copies and many of them are being resold on other websites. It has been translated into several other languages, and to my knowledge, most of them are still being sold (I don't own the foreign rights). You can find it in Portugese, Italian, and Mandarin Chinese.
Since it's out of print, I posted it, in its entirety on my AskDrAmy.com website. Be sure to check out the back cover:
http://www.askdramy.com/imgback.html
Pretty clever, don't you think? I planned ahead 15 years, wrote an entire book, put my picture and credentials on the cover, all so I could convince people I am a doctor.
Oh, and don't forget the hundreds of articles I have written for various medical encylopedias. They are scattered across the web, too. Not to mention my affiliation with the website iEmily.com.
Since it's pretty clear that all the people who are convinced that I'm not a doctor can't even manage the most basic research, it's hard to take them seriously when they are convinced that this incident didn't happen.
If what the lawyer AND paralegal says is true about depositions, that they are a matter of public record, then why not direct us to said deposition?
And, why not describe more details of the case?
Are you insinuating that they are not telling the truth or that there is some patient confidentiality thing we're all unaware of? If so, could you tell us what this stipulation might be?
WHY WON'T YOU ANSWER!
Perhaps those people were lazy and didn't know how to do their research, but have you ever tried to find out where someone who stopped practicing medicine in 1994 earned their medical degree?
So kudos for providing some small bit of evidence to silence your critics: you are/were a doctor who went to Radcliffe and BU. But that's not the only criticism that has been leveled against you or this story. I never doubted your credentials, and I have no reason to believe that anything you write is false, EXCEPT for the fact that you treat medical and legal professionals who comment on your blog with hostility. That raises some red flags.
I'd like to see you, as a doctor, raise yourself above the pettiness and treat others with professionalism and respect. That's not expecting too much, is it?
"have you ever tried to find out where someone who stopped practicing medicine in 1994 earned their medical degree?"
Yes, but you won't be able to find it on the Internet. People have become so dependent on online research that they don't realize that simply because something is not online does not mean that it does not exist.
The challenge to my identity and credentials is integral to the challenge to the veracity of the story. Some people, for their own reasons, don't want to believe the story or they want to criticize me personally. My existence and my credentials are easy to confirm, but it requires finding out the facts. People are not interested in the facts or are too lazy to search for them.
It is really laughable how many people are "sure" that I'm not a doctor. The same people are "sure" that the story isn't true. Those claims have the exact same credibility as the claims that the story isn't true: which is to say, none.
I'm still trying to figure out what reason there could be for doubting the story (or my credentials) beyond a desire to criticize me personally. I can't think of anything else.
If what the lawyer AND paralegal says is true about depositions, that they are a matter of public record, then why not direct us to said deposition?
And, why not describe more details of the case?
Are you insinuating that they are not telling the truth or that there is some patient confidentiality thing we're all unaware of? If so, could you tell us what this stipulation might be?
"Are you insinuating that they are not telling the truth"
No, they simply have no idea what they are talking about.
Ok, if I'm reading this correctly, you are saying they are uninformed as to how depositions occur and the legalities surrounding them.
Okay, that's fine. To be honest, I truly don't know.
What I would like to know is....what are the legalities surrounding deposition? Your last comment makes it clear that you feel you are somewhat informed on this matter.
Is this deposition not a matter of public record? Are most depositions that way? I really have no idea.
Amy writes: "I'm still trying to figure out what reason there could be for doubting the story (or my credentials) beyond a desire to criticize me personally. I can't think of anything else."
Either she hasn't actually read all of the comments on her blog herein where people, myself included, have raised VERY specific reasons why we doubt the veracity of her hospital killed the mother story, or she is abnormally unable to think beyond the narrowest of parameters to wit:
Rule #1 AMY IS ALWAYS RIGHT, NO EXCEPTIONS;
Rule #2, if anyone doubts Rule #1 THEY ARE OUT TO GET AMY;
Rule #3, any doubters or questioners SHALL BE GREETED WITH HOSTILITY;
Rule #4, AMY DOESN'T HAVE TO ABIDE BY THE RULES OF NORMAL CIVIL AND HONEST DISCOURSE AND SHE'S NOT OBLIGATED TO ANSWER ANYONE'S QUESTIONS;
Rule #5, ANYONE WHO EXPECTS CIVIL AND HONEST DISCOURSE FROM AMY IS OUT TO GET AMY.
Weren't you one of the people who doubted that I was a doctor simply because you couldn't find my credentials on line? I'd say you pretty much blew your credibility with your willingnews, no eagerness, to impugn me personally without so much as bothering to check the facts. As I said before, you should be ashamed of yourself.
Dennis Loo,
Weren't you one of the people who doubted that I was a doctor simply because you couldn't find my credentials on line? I'd say you pretty much blew your credibility with your willingness, no eagerness, to impugn me personally without so much as bothering to check the facts. As I said before, you should be ashamed of yourself.
@ Amy,
Ok, if I'm reading this correctly, you are saying they are uninformed as to how depositions occur and the legalities surrounding them.
Okay, that's fine. To be honest, I truly don't know.
What I would like to know is....what are the legalities surrounding deposition? Your last comment makes it clear that you feel you are somewhat informed on this matter.
Is this deposition not a matter of public record? Are most depositions that way? I really have no idea.
However, could you just tell me more about depositions and this deposition in particular?
I also said that you were nonetheless a fraud in your writing specifically (not your degrees necessarily) because of the obvious holes in your hospital story and your transparent efforts to stonewall lawyers' insistence that your cover story that you cannot divulge the details is inconsistent with the law.
You refuse to divulge details because you know in fact that it would destroy your story, either in whole or in part.
"Is this deposition not a matter of public record?"
I know it is not available on line or on Lexis.
I'm not even sure that if you knew the docket number and went to the courthouse and asked for the case record that it would be there.
I don't know, but I surmise that a confidentiality agreement was part of the settlement. Most large med-mal settlements are reported in the local newspaper, and this one never was.
When a suit is filed the identity of the parties becomes a matter of public record. (And remains so absent a protective order or sealing by the court - which is exceedingly rare.) Depositions are considered part of the court file but they are often maintained by the attorneys and not actually filed with the court until the time of trial.
So I am puzzled about why the blogger believes that stating the name of the case would impinge on the confidentiality of her (deceased) patient.
Indeed, even if she does not want to name the patient, she certainly has no confidentiality obligations to protect the identity of the medical center personnel who engaged in fraud and perjury. If anything, I would think that an honest person would have an obligation to name them. Were it me, I would be shouting those f*ckers names from the rooftops and I would have personally filed complaints with the medical licensing board and do everything in my power that they never treat a patient again.
Until there is some verification, this will have to be filed under "interesting if true."
People pay to have you answer questions on "askDrAmy.com" right?
Sincere question, offense not intended.
"Were it me, I would be shouting those f*ckers names from the rooftops and I would have personally filed complaints with the medical licensing board and do everything in my power that they never treat a patient again."
I find that difficult to believe. You won't even use your real name when offering your "legal advice."
"isn't it illegal to offer medical advice"
I don't offer advice. You may have missed the disclaimer:
"Disclaimer: Keep in mind that this is not medical advice and is not a substitute for medical advice. Only a doctor who has examined you and is familiar with your medical records can give you medical advice."
Second, it is exceedingly odd to me that you possess iron-clad proof (in the form of your original and forged statement) that would would conclusively extablish that various doctors, hospital personnel, and lawyers attempted to mislead the court and committed perjury yet you decline to say who they were.
Even more odd is that you base this on some "confidentiality" concerns when you obviously have no legal or moral obligation to protect the identity of people who engaged in this crime.
I have been involved in cases where defendants altered documents and this fact was proven at trial. I know it happens.
I was directed to your site by another blog maintained by another plaintiff's lawyer so your post has created some interest among members of the bar who work to hold hospitals and doctors accountable for their actions.
It's a shame that you seem to be proving to be a flake.
"yet you decline to say who they were."
Why do you think you are entitled to "proof?" You don't have to believe the story if you don't want to believe it. Feel free to pretend that it isn't true, if that makes you happy.
"I was directed to your site by another blog maintained by another plaintiff's lawyer so your post has created some interest among members of the bar who work to hold hospitals and doctors accountable for their actions."
I am aware of that. Clearly quite a few med-mal plaintiff's lawyers find the story completely believable.
"Disclaimer: Keep in mind that this is not -legal- advice and is not a substitute for -legal- advice. Only a -lawyer-who has examined you and is familiar with your -legal-records can give you -legal-advice."
All clear now?
Doesn't your refusal to name the hospital and doctors involved, allow them to continue to practice and remain free to make similar mistakes?
"Why do you think you are entitled to "proof?" You don't have to believe the story if you don't want to believe it. Feel free to pretend that it isn't true, if that makes you happy."
Oh, I am not "entitled" to proof from you any more than I am entitled to proof from people who claim to have been abducted by aliens or perfected cold fusion or to have received gold tablets from the angel Moroni. Not entitled at all.
However, since you are making a fairly extraordinary claim if you had any concerns for your credibility one would think that you would happy supply any confirming evidence you have (such as the original statement or any confirming details about the doctors/hospital involved.) I mean it's one thing for someone to claim they were abducted by aliens. Its something else for them to say, "Oh, and I snatched away a piece of equipment from their starship and I have that in my basement, but why should I have to "prove" it to you by showing you that?
I mean there are some sainted souls in this world who have nothing to prove and aren't interested in argument or proving their points. A quick perusal of this blog and other postings of yours show that ain't you. You seem to delight in quibble and conflict.
Given that it is just so odd that here you are in possession of this rock solid proof that would confirm your story yet you decline to give it. And even more odd that your asserted reason (patient confidentiality) is so obviously facile and misplaced given that you have no confidentiality obligations to the people who attempted to defraud the court, further victimize the family of the woman you claim was your patient, and make you complicit in perjury.
So I guess the options are that you have a fantastic explanation for this - and you just not choose to share it - or that your credibility has the consistency of something I scrape off my shoes after walking through the pasture.
Will you tell us the name of the hospital...so we can avoid it? I don't think that jeopardizes patient confidentiality. Does it?
"So I guess the options are that you have a fantastic explanation for this - and you just not choose to share it - or that your credibility has the consistency of something I scrape off my shoes after walking through the pasture."
You seem to have difficulty with a very basic point:
The truth of my story is entirely independent of whether or not you believe it.
It's analogous to the fact that the truth of my identity and credentials is entirely independent of whether of not people believed that. They were utterly wrong, and pretty lazy and irresponsible to boot.
The fact that you don't believe tells us nothing about the truth of the story and nothing about me. It tells us a lot about you, though, and your apparent belief that you are the arbiter of "truth."
"Will you tell us the name of the hospital...so we can avoid it?"
No. Haven't I made that clear?
Could you tell us the reason that you won't tell us the name of the hospital? I'd really like to know.
"as telling us what hospital was involved tells us nothing about the patient"
As I said in the original post, maternal deaths are exceedingly rare. Identifying the hospital could allow someone to identify the patient. You might not know how to use that information to access the patient's identity, but other people will know how to find out.
Yeah...
"It's analogous to the fact that the truth of my identity and credentials is entirely independent of whether of not people believed that. They were utterly wrong, and pretty lazy and irresponsible to boot."
Hey, nice try at deflection - I didn't say any of those things.
"The fact that you don't believe tells us nothing about the truth of the story and nothing about me. It tells us a lot about you, though, and your apparent belief that you are the arbiter of "truth.""
Oh, I don't think I am the arbiter of "truth" at all.
It is just a bit odd, a bit flaky, that you won't provide any confirming details.
Your purported concern about patient confidentiality is patent b.s..
As many commenters have pointed out, when the suit was filed in court, the "patient" was identified.
You have allegedly been witness to a fraud perpetrated on the courts and the further victimization of the family of the deceased by the hospitals/doctors/lawyers fabricating evidence - yet you will not identify them.
You are complicit in allowing this stuff to happen because (and this assumes that you aren't batty and making all of this up which may be an unwarranted assumption) you refuse to call out people who killed your patient and then attempted to cover it up.
Are they still practicing? Are the hospital administrators still there? Are the people who witnessed your statement still practicing medicine? Hmmm? Didn't you say something about the people continuing "to practice at the same hospital, free to make similar mistakes."
Did this happen at the end of your career as a physician? And by that I mean, was this the incident where you finally said, "I've had enough!" ....and quit?
What about the woman who died on the floor of King's County hospital while two security guards rolled by on chairs, a nurse kicked her on her side to see if she was awake, and then finally someone realized that she needed attention. Unfortunately, the woman was already dead because they left her to die on the floor. The nurses, doctors, and administrators all tried to cover their asses by falsifying the chart. But the camera never lies and they were all caught.
And then there was the horrific incident of the woman who was left to bleed to death on the floor of Martin Luther King hospital in LA. She was on the floor bleeding, her family was begging someone to come to help her, the husband had to call 911 because he could not get help in the hospital. When the cops came, she was handcuffed. She too died. And, like the other incidents, the administration and the staff circled the gurneys to cover their criminal behavior. Again, it was memorialized on tape.
What Dr. Amy said is not at all uncommon or fantastic. Doctors and nurses can keep their jobs regardless of gross incompetence, racism (a nurse at my mom's place told a sickle cell patient not to "bring her black ass back.), drug stealing, among other things. It is nice that for once, a doctor did not blindly follow the omerta.
Haven't you made enough of a fool of yourself already? Why do you keep coming back to confirm it?
"was this the incident where you finally said, "I've had enough!" ....and quit?"
There was no specific incident that made me quit.
The proximate cause of my leaving medicine was that for many years I had worked only at night, so I could stay home with my children during the day. The HMO where I worked refused to allow me to continue at night only and I could not find a similar job. I didn't go back, though, because of my overall frustration with trying to provide quality care in a profession that was being run to maximize profits.
"What about the woman who died on the floor of King's County hospital while two security guards rolled by on chairs, a nurse kicked her on her side to see if she was awake, and then finally someone realized that she needed attention. Unfortunately, the woman was already dead because they left her to die on the floor. The nurses, doctors, and administrators all tried to cover their asses by falsifying the chart. But the camera never lies and they were all caught."
I never witnessed anything as egregious as that, but there are incompetent physicians that cannot be dislodged no matter how desperately everyone tries to do so. However, heartlessness is far more common than incompetence.
The good doctor has stated repeatedly that she wants to avoid any legal headaches. She asked if the readers were willing to indemnify her. After seeing all of this back and forth, the issues related to patient confidentiality seem insignificant versus the risk of libel asserted by one or most of the protagonists in the drama if the facts as described don't line up with the facts as they were. Just a hypothesis. But, a testable one.
"I had been told to plan for a deposition that was several hours in length, but it didn’t take nearly that long."
If, as you have now admitted, you told your attorney upon your FIRST meeting with him, that you HAD the "smoking gun" signed statement which reflected your original recollections of this incident, why were you told (by him, presumably) to expect a deposition of several hours? As your story is told by you, the deposition comes to a sudden, short, and climactic end when you reveal the original statement to the astonishment of all in the room.
Also, why were you not named in the suit? You describe yourself in your story as "a participant at a critical juncture in this woman’s care." It would be common practice for the plaintiff's attorney(s) to name you as one of the defendants if you were in the role you describe. Were you NOT named because you told the family that the anesthesiologists "killed" her? Is that why you were left out? Did you speak to her family at all? What did you tell them? And if you were left out because you fingered the anesthesiologists, then why did it take the family a few years to file suit?
I had intended to not post more on your blog Amy, but it isn't I who is proving to be the fool here. I guess I feel compelled, as do others here, to find out what the truth really is.
"I had intended to not post more on your blog Amy"
Hallelujah!
"I guess I feel compelled, as do others here, to find out what the truth really is."
That's BS. You couldn't care less what the truth really is. You started commenting for the express purpose of criticizing me. You made yourself look very irresponsible and foolish and now you keep posting in an effort to make yourself look better. Don't lie and pretend that you care about what actually happened. You already know what actually happened.
But I am very disappointed that you didn't disclose that you have allowed your medical license to lapse and that you haven't been practicing medicine since 1994. That would make the 12 year old on birth control at least 27 now if not older. So much has changed in the intervening years in technology and even social mores.
Your patient killed by the anesthisiogist has been dead for at least 14 years, she died long before HIPAA laws came into effect.
I understand this column to be a sort of unpaid apprenticeship for your future career as a medical expert of some sort-- I think your writing is compelling and your subject matter interesting. But in the interests of full disclosure, you should have been more upfront with your readers about where you are professionally.
I don't really have a problem that you take artistic license with your memoirs-- and by example, I mean, your assertion in your comments that in reality, you told your lawyer about the signed deposition right away, but in your essay, you slowed down that exchange and added more dialogue for dramatic effect or a "punchline" (which I would usually associate with a joke not a story about a death and a criminal coverup but that is beside the point).
But ultimately, I think you have to decide whether you are writing your blog as a medical expert or as a dramatic memoirist. There is some expectation that portions of memoirs will be fictionalized for dramatic intent-- even more so when you are talking about memories that are at least 15 years old if not older.
Having gotten that off my chest-- I will reveal this much about myself-- I am a full-time attorney, with two children under the age of 3, and one more on the way. I would love to know more about your experiences as a professional working mother in the late 80s and early 90s and how/why you eventually chose the "Mommy Track" opt-out. Do you have any intention of renewing your license, of maybe practicing medicine on your own terms as a solo practitioner? Have you kept current with continuing education seminars?
If you posit yourself a medical expert, you should maintain your professional license. I hope that now that your children are older you will consider doing so.
If I already know what the truth of the matter is, as you claim, please tell me what that truth - the whole truth, not the imagined truth - is. We're all anxious to know.
I do want to say something briefly to those who feel that your story is authentic because it resonates with them about other incidents of poor or outrageously bad care by the medical administration: yes, there are many horror stories. But those stories are real. Amy's story has too many holes in it to be real. It is either entirely or partially false as it stands. She refuses to divulge any real details even when informed repeatedly that her stated rationale for refusing to do so is not applicable. Why is that?
"Your patient killed by the anesthisiogist has been dead for at least 14 years, she died long before HIPAA laws came into effect."
That's false. HIPAA specifies:
"Protected Health Information. The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information "protected health information (PHI)."
“Individually identifiable health information” is information, including demographic data, that relates to:
* the individual’s past, present or future physical or mental health or condition,
* the provision of health care to the individual, or
* the past, present, or future payment for the provision of health care to the individual,
and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual."
"why you weren't named in the lawsuit."
The anesthesiologists were sued, not the obstetricians.
"HIPAA was not written to be retroactive."
It is not retroactive in the sense that it cannot be used to punish people who violated the rules before they existed. It does apply to all medical information regardless of when it occurred. Moreover, legal rules protecting patient confidentiality were in place in my state long before HIPAA was passed.
You're full of crap.
Massachusetts laws are notoriously vigilant when it comes to protecting the privacy of patients. Dr. Amy is bound by the legal standard of the Privacy Rule which often comes into conflict with the Privacy Rules in many states. It is still a huge legal controversy, but I will try to explain Dr. Amy's position on why she cannot give away more details.
Even though the department of Health and Human Services (HHS) is a federal agency, it still controls who is covered under the privacy rules in all of the states. I will not waste time by listing everyone whose privacy rights are protected and against whom. There are instances in which health care providers do not need consent from patients to disclose medical information. In some instances, health care providers are permitted to, indeed, obligated to report anything that impacts public health, inter alia, sexually transmitted diseases, domestic violence, cooperating with the police, child abuse or neglect of a child, and some other things.
As Dr. Amy pointed out, death during child birth is pretty rare except when antepartum conditions exist. That this woman died during childbirth as a result of gross negligence on the part of the anesthesiologist made her case extraordinary and therefore made her easily identifiable. Dr. Amy would have broken the law had she given any further details about the circumstances of this woman's death.
Depositions in medical malpractice suits are equally private unless the plaintiff-patient forfeits that right, in writing, to specific individuals. HIPAA and Privacy Rights laws before it were meant to preempt defense tactics and that is why the patient holds so much power. I do not know that the patient in question gave Dr. Amy permission to disclose her medical information.
It is routine that anyone involved in a deposition like this one to have legal counsel present. Though Dr. Amy was not the target of the suit, her lawyer would be present to halt her from answering any questions he deemed inappropriate, potentially damaging to her, and irrelevant. Dr. Amy was not the only one with something to lose there: the insurance company could have been assessed damages if Dr. Amy said anything implicating herself, which would have cost them money because then she would be a target of the litigation.
Dr. Amy and her lawyer were obligated under the rules of perjury and subornation of perjury, respectively, had she knowingly withheld evidence and her lawyer let her do it.
I am neither surprised nor disappointed that the patient's survivors settled. A hospital has virtually bottomless resources to defend itself against a lawsuit and can just extend the suit out until the plaintiff can no longer afford to continue with the case. It is commonplace and it allows the family to move on without having to combat unscrupulous people for years to come.
By the way, Dr. Amy, I did not relate the story at King's County simply to badmouth doctors and nurses. I told it because of the tendency of hospital administration or lower level employees to alter patient records. In the story I told about the scrub nurse with whom my mom works, a woman who worked in the building with the mainframe of the hospital computer reported that a person from middle management tried to get her to further alter the records. That woman declined.
Lastly, Dr. Amy is absolutely right when she says it is hard to get rid of a doctor or nurse no matter how bad s/he is. One doctor my mother knows used a nurse to obtain drugs from the pixis (it is a machine that holds drugs and requires a code to get in) because doctors are not permitted to handle or administrate drugs. He falsified the charts to make it appear as if he had ordered the meds, but he was actually taking them himself. The nurse got fired because it was her recorded code in the pixis requisitioning narcotics. The doctor, who practiced while high, diverted narcotics, falsified records, and fooled a nurse got to come back.
You state that immediately after the incident you knew that "they had killed your patient" and that is what you told the people who investigated for the hospital.
You don't say whether or not you immediatly told the family that your patient (and someone's wife/daughter/mother) had been killed. People have asked you about this and you have declined to respond. Obviously, you did not. Because if you had you would have been the very first person that the plaintiff's lawyer would have contacted. You would have been the star witness.
Instead, you just kept silent to protect your colleagues - the ones you called killers.
Then "several years later" a suit is filed and your deposition is taken just as one of many.
So here's the question for you, where was all of this righteous indignation back when it could have made a difference? Hmmm? Did you not feel any obligation to the family and loved ones of you killed patient?
Instead, hear you are 15 or 20 years later offering up your sad little fantasy of you being the crusader for truth and accountability.
Wow that is a lot of information. Unfortunately for you it's all irrelevant.
Dr.Amy has and had no obligation whatsoever to protect the identity of the doctors/hospitals/administrators who falsified her statement and attempted to commit perjury.
None.
You see they were not here patients.
So all of you very thoughtful comments about HIPAA are pointless.
Dr.Amy claims that if she were to reveal the identity of the doctors/hospital etc. that someone could then find out the identity of her patient. So what? The only way they could find that out is to go back and search through public records that would connect the drs/hospital, etc. to the patient. Public records. Get it?
So what else you got?
You defend yourself quite well. Kudos!
For a laugh:
http://www.gaspasser.com/animal%20farm.html
I do not recall the hospital's attorneys trying to force her to perjure herself. They presented her with a false document and said that she would be crucified with it because it deviated from her account story she told them. As I recall, no one threatened her job, home, or reputation if she did not tell the story they concocted, so there was no crime there. If the attorneys for the hospital knew of the forgery and helped concoct it, then he breached any number of ethical violations and would have been disbarred. He did have a right to cross examine her if he felt she was lying at the time of the depo and would have likely gotten away with it by contending she was lying.
As for Dr. Amy protecting the privacy of the decedent, she has every duty to do so because she is an employee at that hospital. The Right to Patient Privacy is nearly sacrosanct.It does not matter that she was not the attending physician. Nurses, orderlies, lab techs, unit clerks are all bound by that code.
It is interesting that this incident took place in Massachusetts because it has the strictest laws concerning patient privacy. Individual patient records can never be made public. In fact, they can only be subpoenaed by specific government bodies and they are never public record under Mass. law. and even then the names are redacted.
You sarcastically, asked if people have a right to know about the hospital or doctor who is about to treat s/him. If a patient, or later his/her lawyer, wants access to a doctor's records, they can find them online. But, the information is not specific enough to tell if the doctor was found blameless, acted below the standard of care,works in a specialty with a mortality rate, etc. It is true that a potential plaintiff can find out the reason behind a malpractice suit, but a civil court would not subvert one patient's right to privacy to another who is availing himself/herself to the civil term. Those records are not discoverable in a civil trial. So, no, confidential files even in the interest of rooting out corrupt administrators never trumps an individual's constitutional right to privacy.
You do raise an interesting point about Dr. Amy's obligation to report what happened. However, the proper channel would have been the Board of Registration in Medicine of Massachusetts. Even then, the proceedings are confidential until the BMM has completed its investigation. Those records are available for about 8 years.
Do you see now how this system works? If a doctor reports another then patients who feel they were victims of malpractice can come forward, not embarrassed by doctors and hospitals trying to save their asses.
Dr. Amy never said if she went this route. Perhaps she could have made a dent in corrupt hospital administrations. I, for one, make them put my business card (I am an attorney) on my chart so as to put everyone on notice. It is shameful that I have to do that.
"I would like to point out that a more excellent course when one is having a baby would be to avoid the hospital altogether, and give birth at home."
Only if you don't care whether your baby lives of dies. All the existing scientific evidence (including papers that claim that homebirth is safe) actually shows that homebirth triples the risk of perinatal death. The only people who don't know this are homebirth advocates.
My father's a physician and I can't imagine him talking like this. He is an iconoclast so he HAS on many occasions railed against other medical practitioners for handling matters improperly. And he has spoken of instances when patients died unnecessarily because they didn't get the proper care, but to say: "they killed my patient" or "they killed the patient" is, to say the least, exceptionally unusual language to use, most especially for a physician.
To kill has a number of different possible meanings, of course. It's not as strong a term as "murder," which has a much more particular meaning indicating malice and intent. (One of my areas of specialty, by the way, is criminology, another reason why this particular story of Dr. Tuteur's concerns me.)
In the instant story, Tuteur asserts that the anesthesiologist(s) "killed" the patient. Allowing her some latitude in choice of words designed in her case no doubt to sensationalize the story for headline attention, it is still problematic. Killing someone, even though she isn't using the term murder here, implies that at a minimum the anesthesiologists behaved egregiously and not merely negligently. Many people are hurt or die through medical practitioners' oversights, errors, incompetence, etc., we're talking here about human beings, after all, who can and do make mistakes.
From the standpoint of the hospital, their most reasonable defense - and most reasonable inference independent of the matter of defending itself against a wrongful death lawsuit - is that the anesthesiologists acted competently and not negligently. Mistakes can and may certainly have been made in this case, anesthesiology is tricky and overdoses happen, but unless the anesthesiologists in question here had a history of incompetence, or were impaired on that day (drunk, etc.), the hospital would, we could expect, assert that there wasn't gross negligence, let alone anything more extreme than that. They could claim, with validity, that anesthesiology is difficult to always get exactly right. (The matter of the medical response being incompetent to the patient's difficulties is another matter, but Amy's remained silent on that). The need, therefore, for the hospital to criminally forge the document (and do so incompetently, forgetting to forge the necessary signatures) is peculiar especially in the face of a witness (Amy) who was and is to all who have had any contact with her and by her own account in this case, unwilling to budge from her conclusions no matter what. It's rather like trying to get rid of a mosquito by getting out a baseball bat and hammering yourself with it.
Dr. Tuteur starts her story by saying that maternal deaths are extremely rare. She has only been involved in one unavoidable maternal death in her entire practice. If this is so - maternal deaths are extremely rare and she's only seen one non-avoidable one - then why is so terribly angry about this extremely rare event? No deaths are welcome, but if it's so rare and she's only seen it once in her lifetime, then why the fury? I can understand her being angry about it if she thought it was avoidable, but if it's only once, again, why the implacable fury?
She also says that this was "my patient" and that she was "a participant at a critical juncture" in this patient' s care. Because of this unspecified participation by Amy, she is:
"interviewed extensively by a senior member of the obstetrics department and a member of the hospital administration.
"I was very angry at the care the patient received from the anesthesiologists, because I believed that her death had been entirely avoidable. I did not hide my anger during the interview, going to so far as to say that I felt that the anesthesiologists had essentially killed the patient."
I am wondering, as I have previously asked Amy, what her exact role in this patient's care was. She has refused to answer this question, for what reason I don' t know. Her description of the patient as her patient indicates a stronger relationship to the deceased than her statement early in the second paragraph of her story that "I’ve been involved with several maternal deaths, though never as the primary physician."
According to her own words, then, she wasn't the patient's primary physician, but the woman was nonetheless her patient.
Her statement that this death was "entirely avoidable" is not the same as saying that the care she received "killed" her. At most "entirely avoidable" might indicate that there was gross negligence, but that isn't the same thing as killing someone. The result is the same - the patient died - but the intent and performance by the caregivers are quite different.
If there was gross negligence, did Amy, who continued to work at this hospital for at least a few years after this incident, refuse to work with the anesthesiologist(s) in question?
Since Amy's presumably still got her original statement about the incident, she could go a ways towards silencing her critics here if she provided a redacted scanned copy of that document for readers along with a redacted version of the forged document.
I'm not an advocate - I'm a very busy homebirth midwife. I do NO advertising - women find me because they want to avoid bad hospital outcomes, like your fine article describes. There are more bad outcomes at hospitals than at home, but the hospital does a better job of covering it up, as you pointed out.
Thank you for adding more motivation to my patients!
"There are more studies pointing to the safety of homebirth than there are studies against it."
There are NO studies demonstrating that homebirth is as safe as hospital birth for comparable risk women. The studies that claim to show that homebirth is safe (like the widely quoted Johnson and Davis 2005 study) ACTUALLY show that homebirth nearly triples the rate of neonatal death. The US now collects statistics on homebirth. Their statistics also show that homebirth triples the risk of neonatal death.
As I said above, the only people who appear to be unaware of the dangers of homebirth are its proponents.
If you knew that one of the women under your care were "killed" by other medical providers, would you promptly tell the family and loved ones of the deceased woman?
In my last posting where I said the following:
"She has only been involved in one unavoidable maternal death in her entire practice. If this is so - maternal deaths are extremely rare and she's only seen one non-avoidable one - then why is so terribly angry about this extremely rare event?"
I meant to say "avoidable" where I said "non-avoidable" above.
However,
It does not in anyway suprise me that a patient died as a result of negligence at the hans of an anaethnatist in these circumstances, or that notes were falsified to cover it up.
On July 14th 2000, at Musgrove park hospital, Taunton, Somerset, UK, I was nearly injected with an epidural into a vein instead of spine by an anaethnatist, my husband alerted staff to the problem as having observed the procedure with my older child he thought that the ammount of blood in the catheter was unusual. The midwife attending confirmed verbally that the epidural had been placed badly. But for the vigilance of my husband medication could have been administered that was potential fatal to me and my child. My notes record only "bloody catheter" to mark the event. I am unable to make a complaint against the hospital as time has now passed, and the only independent witness, my husband is now deceased. I had personal reasons for not complaining at the time.
disclaimer:I am in no way associated, related, or otherwise in contact with Dr Amy, I don't even live on the same continent!)
I can believe, though, from things I have heard from PAs and doctors-in-training and some patients, that a lot of this malpractice goes on. Maybe this will seem like an unrelated example, but a man I knew who was studying to be a PA told me how he saw a resident--at a University hospital near where I live--make a huge mistake on a patient brought into the ER. The patient had a bullet wound, and the resident couldn't tell exactly where. She removed a "perfectly good" lung, because she thought the lung was damaged, when the bullet had caused damage elsewhere. The PA told me that I should pray that if I ever had a wreck, they would not dump me at that hospital. It does seem that if you deal with residents often, you would see a lot of mistakes (I don't know where Dr. Amy was when this story unfolded...perhaps these were all seasoned professionals). Residents never sleep. They don't always get the supervision they need. I have heard that some schools are trying to give residents a break, but that established doctors don't want this (my uncle, a nurse, said this). It seems to me it could only benefit the patient if these people, new to the profession, could actually THINK through a problem. Here is an article on NPR about residents' hours:
http://www.npr.org/templates/story/story.php?storyId=4512366
Anyway, since I am in no way a medical or legal professional, of course my two cents isn't worth as much as some who have posted. But I do have an (ever-growing) fear it seems of hospitals, though I know if you watch many news specials, they are, of course, going to give you worst-case scenarios.
You got that right. I don't think it's about your credentials. And Lord knows that bad things happen in hospitals. It's your attitude sweetie. Your rude, dismissive of everyone attitude.