I’m at the opening session of Health Journalism 2008, which is being kicked off by Dennis Quaid telling the story about his twins daughters receiving 1,000 times the recommended dose of Heparin.
Quaid and his wife have started a foundation to help combat medical errors. One of the measures they advocate is bedside bar-coding.
The breach of patient privacy in their case was another concern. The overdose incident happened (twice) on a Sunday, and was discovered late Monday night. When the Quaids came to the hospital early Monday they were met by risk management, and during the process of the Heparin working its way out of the system (a 41-hour process), he said blood was squirting on the walls. On Tuesday they got a call that the news was all over the gossip site TMZ, even though the Quaids hadn’t told even their close family members.
While they were in the hospital they worked for about a week and a half to get their children’s medical records, and the pages related to the time when they were being overdosed were missing from the 600 pages (300 pages for each of the twins.)
Quaid says that if he had been met with an apology instead of a risk management team, he likely would have responded much differently. One of the overdoses had happened on Sunday while the Quaids were with their twins. When he had called Sunday night to check on them, the nurse told Dennis they were “fine.”
A few months before this incident, three children in Indianapolis died of an overdose when adult Heparin was given in place of the pediatric dose. The Quaids are suing Baxter, not Cedars Sinai, though, because the product wasn’t recalled when the Indianapolis incident happened. He said he’s not interested in any settlement that involves non-disclosure; he wants to raise awareness about the problem of patient safety.
I will have some video highlights from Quaid’s presentation a bit later. It’s good that he is giving public attention to this issue. As he says, patient safety doesn’t typically make headlines because incidents happen one at a time, and not to celebrities. He is making a lot of the same points I’ve heard patient safety leaders make at Mayo Clinic. He has a megaphone that enables him to get the issue noticed, and today he spoke to a bunch of journalists who I’m sure will help with the effort.
I wonder whether bloggers will take up this patient safety issue in a big way.
I think his suit is misplaced. If anything, the suit belongs against the hospital, however, though it was an egregious error, can any long term effects be established?
Instead of tossing out more litigation that will roll on for many years –even a decade, the Quaids should work with the hospital, nursing staffs and also the manufacturers to address the miscalculation of dosages.
Mr. Quaid said that he will sue Cedars hospital in Los Angeles if they do not institute an automated system like a barcode to match patient with dosage. He said he is waiting to hear that Cedars is doing this before he begins the lawsuit. The hospital, alledgedly, is “mulling” over some ideas.
Many lesser hospitals in this country employ barcode systems for administering medicine. Mr. Quaid’s “threat” to Cedars does not sem so out of line.
Why hasn’t Cedars, which is one of the most “reputable” hospitals in the nation, supposedly, had some type of automatic dispensing of medicine before this? To save money. Their “three- tiered-safety system” and hospital protocol “failed” as their CEO admitted on Sixty Minutes.
What is more astonishing is theat the hospital has still not disclosed the extent of their error to the Quaids. Some pages having to do directly with their children’s overdoses are “missing” from their 300 page report on each Quaid child.