In 2004, Danielle Bellerose gave birth to two premature babies during an emergency caesarean section at Beth Israel Deaconess Medical Center. The newborn twins, Katherine and Alexis, only weighed about three pounds each, and eight days after birth, Katherine was declared dead due to necrotizing enterocolitis. The family filed a negligence lawsuit, and they won the largest malpractice award in the state that year. According to Darshak Sanghavi, the chief of pediatric cardiology at the University of Massachusetts Medical School in Worcester, a doctor apology system can help resolve lawsuits and allow patients to be heard.
When Danielle visited her babies at the end of the first week, Katherine appeared mottled and pale, and it was only after she alerted nurses that the baby was diagnosed with necrotizing enterocolitis, a devastating intestinal complication that affects premature babies. After surgery and multiple rounds of CPR, Katherine was declared dead.
Searching for an explanation as to why Katherine’s condition hadn’t been diagnosed sooner, Danielle contacted the hospital multiple times and made three requests to meet with the caregivers from the hospital. She was never seen, and when she called to request Katherine’s medical records, the clerk said no such patient had ever been treated.
After hiring at attorney, a doctor and professional expert witness reviewed the medical records and determined that Katherine suffered a “premature and preventable death” from necrotizing enterocolitis that occurred as a “direct result” of “deviations from the accepted standards of care.” Danielle was sickened by the years of silence from the doctors and nurses, and during the 2011 trial, she often had to leave court to “throw up.”
A change in how doctors communicate with patients, however, might be able to settle lawsuits and allow patients to share their side of the story with the doctors. Richard Boothman, the executive director for clinical safety at the University of Michigan Health System, reworked the hospital network’s medical liability program. As an attorney, Boothman saw numerous cases in which patients just wanted to be heard by the doctor and receive an apology for a mistake.
Boothman proposed impartial medical providers should first review claims, and if the review found a real mistake causing harm, providers were encouraged to apologize face to face, and then the hospital would quickly offer reasonable cash settlements. His “disclosure with early offer” is often more humane than a prolonged malpractice trial, and it is also much cheaper for the insurer and hospital network. In 2006, data revealed that the average time to claim resolution dropped from 21 months to ten for lawsuits against the University of Michigan.
Recently, lawmakers in Rhode Island have reintroduced a doctor’s apology bill into legislation that would allow health care providers to apologize to a patient or relative about a negative outcome without fear that they could be sued. Although the bill failed last year, Rep. Joseph McNamara brought it back before the Rhode Island General Assembly on February 21.
Boothman’s new system proved successful in a case where Jennifer Wagner’s doctor made a mistake by failing to test a suspicious lump in her breast that was later identified as advanced breast cancer. Five impartial doctor’s reviewed the case files, concluded the doctor had made a mistake, and three months later, Wagner and doctors sat down for a two-hour meeting. Afterwards, Wagner noted how euphoric she felt after the meeting knowing that she had finally been heard. She received $400,000 to start college funds for her son.
Danielle Bellerose, however, wasn’t given the opportunity to be heard or receive closure. As a result, she suffered years of depression and therapy. Her statements reveal that if the doctors and nurses in the case had better responded to her questions, they might have avoided a major malpractice suit: “In the beginning, all I wanted were answers. If someone had just talked to me, none of this never would have happened.”