Critique of Boston Hospital's Apology to Widower
Some of you have heard about the tragic story of widower Peter DeMarco and his late wife Laura Levis. A brief summary of the story so we are all on the same page: Laura, age 34, died of an asthma attack after literally being locked out of the ER at Boston's Somerville Hospital at 4am on September 16, 2016. She was married to Peter DeMarco, who, at the time, was a reporter for the Boston Globe. Laura had also written for the Globe (it's where the couple met), and, at the time of her death, was working for Harvard University's media services.
Laura was on her own that evening...she and Peter were going through a rough patch in their marriage and were separated, but they were scheduled to attend couples counseling the next morning. A long-time asthma sufferer, Laura felt an attack coming on and walked a few blocks to the nearby Somerville Hospital at 4am, only to find the emergency room doors locked and no one responding. She probably panicked, which likely worsened the asthma attack, and called 911 asking for help. Laura sat down on a bench outside the hospital (because she probably couldn't walk any further), and passed out. A nurse from the hospital was notified by 911 and gave a cursory look, but claimed she could not see Laura who was sitting just 29 feet from the ER entrance. Laura was found 10 minutes later by firefighters and cops who were furious at the hospital's lackadaisical response. CPR re-established a heart beat, but Laura succumbed to hypoxic brain injury a week later surrounded by her husband, family, and friends.
According to Peter, while Laura laid in the ICU for seven (7) days, Cambridge Health Alliance (CHA) -- owner of the Somerville Hospital -- never said anything about Laura being locked out of the hospital's ER at 4am. Nor did the hospital system mention anything after Peter wrote a heart-wrenching letter to the editor to the New York Times (New York City was Laura's hometown) publicly thanking the CHA medical staff who cared for Laura. The story of Laura's death made national news, but not a word from CHA about what went horribly wrong.
Peter's Uncle Bob thought something was amiss, he called the police for records and reports, and those records told quite a story. Laura's father -- a physician himself -- read the reports and then told Peter that the hospital "killed Laura." Peter was thunderstruck by what happened to his wife and that no one from hospital leadership bothered to share the information --- it took his uncle digging around. Shortly thereafter, Peter visited a law firm to pursue a lawsuit and he also filed complaints with regulatory authorities.
Regulators found multiple problems and laid the blame for Laura's death squarely on the hospital and their staff. They painted a picture of a hospital (and hospital system) that too often missed the mark on patient safety. CHA paid a $90K fine but the hospital's attorney made a point to say their organization was not admitting liability by paying the fine. Moreover, Peter's civil lawsuit went nowhere. Due to a $100K cap for "public hospitals" in Massachusetts, the lawsuit was not economically feasible. Peter's dreams of using settlement dollars to do good works in wife's memory went down the drain; no funds for the foundation Peter established in Laura's memory. Moreover, Peter's wish that a huge settlement would cause this hospital and other hospitals to make safety changes would not happen.
Then, Peter spilled all the beans over three weeks ago in a November 3, 2018 article entitled "Losing Laura" in The Boston's Globe Magazine. My printer spit out 51 pages -- 51 pages! - of excruciating details about Laura's death and how Cambridge Health failed not only Laura, but also failed her husband and entire family with their lack of communication and accountability. The story is sickening and heart-wrenching, and is a must read for all -- including medical and nursing students -- on how errors and lack of accountability can literally destroy lives.
A few days following publication of November 3rd, 2018 article, a face-to-face meeting between Cambridge Hospital Alliance executives and Peter was held at the headquarters of the Boston Globe. The hospital executives apologized, accepted responsibility, discussed the mistakes and how those mistakes were being fixed (or had already been fixed), and hugs were exchanged. Peter DeMarco said he was disappointed in some aspects of the meeting, but was grateful to hear from hospital executives.
Where to begin?
- This hospital had to be publicly bludgeoned -- 51 pages of bludgeoning! -- before doing anything remotely close to the right thing. Moreover, had Peter NOT been a gifted writer with connections at the Boston Globe there never would have been an apology. It's not every day that a family member is allowed to write a short book about their tragedy and have it scattered to the winds by a prominent publication. The lengthy story surely forced the hospital's hand two years after the fact when they should have been talking to Peter and his family while Laura was dying in their ICU. Indeed, to the casual observer, the apology looks like, "Sorry we got caught." This speaks to the need for disclosure programs where hospitals/nursing homes are on top of these situations from Day One and leadership/staff are always empowered to do the right thing in the moment.
- The apology appears incomplete. Sure they said 'sorry," explained how they made mistakes and remedies that will prevent re-occurrence, and even gave hugs --- which is all great and important stuff. But what about economic compensation? What about repaying Peter for the funeral expenses, including travel expenses for family and friends, counseling expenses for Peter and other family, missed time from work, and other economic damage -- including Peter leaving his job at the Globe due to grief issues? What about reasonable pain and suffering? Peter appears to be still dealing with serious grief and guilt issues, and may do so for a long time (perhaps forever). Also, CHA could make a sizable donation to the foundation Peter established in Laura's memory, and even offer to partner with Peter and the foundation on safety projects. Now, sure, some attorney or claims guy will scream, "But the cap is only $100K...we don't owe a penny more!" This is not about what's legal, it's about what is right. However, if we are so concerned about expenses, what about the expenses associated with all the horrible PR associated with this event? The reputational damage to CHA is absolutely enormous, and costly. CHA was publicly gutted. Which brings me to my next point...
- Lawyers and claims guy are often blind -- literally blind -- to the larger picture. They "win" cases which make losers out of hospitals and nursing homes. The money they "saved" you by not quickly and fairly paying a claim often ends up costing you more, especially in lost reputation, with not only the public but also doctors and nurses. Disclosure and apology is becoming state of the art for many doctors and nurses, and in Boston there are many prominent healthcare organizations that are trying really hard to do disclosure. Then, you have the crowd at CHA which just got eviscerated by the Boston Globe. CHA will be hard pressed to claim they are an "employer of choice" for Boston-area docs and nurses.
- Hospitals and nursing homes that do the right thing will look at the entire picture, including the compensation piece, and fairly compensate people regardless of some out-of-date tort reform statute. Don't look at the law for advice...search your heart instead.
- If you have lawyers, claims guys, or medical staff that resist disclosure, require them to read Peter's article entitled "Losing Laura," and then task them with writing a reflective essay (yep, just like in school) describing how they would want to be treated if Laura had been their wife, daughter, or sister. Fire them if they can't or won't write the essay. I am serious. Those people are more trouble then they are worth.
Now, what I am going to write will anger some people, perhaps many people: In spite of all my criticisms, this apology does represents some progress. Had this story happened 10 to 15 years ago, there would have been no apology, no explanations, no answers. Nothing but stony silence. The hospital, at the direction of an iron-fisted attorney, would have endured the public thrashing and no one would have talked about the tragedy much less learned from it. At some point, a similar error/accident would have happened (because no one learned the first time) with the cycle repeating itself. Despite the numerous flaws in the apology, there is some closure for Peter DeMarco and this hospital and other hospitals will learn from this story; medicine will be safer because of Laura Levis' death. This represents incremental progress, and we should give thanks. Perhaps CHA felt pressure to eventually apologize because of all the good work happening with disclosure in Massachusetts -- a dividend of progress on a state/regional level. Nevertheless, Laura and Peter's story also reminds us that we need more progress, more reform, and more change, and I will continue to fight for full implementation of disclosure and apology programs (including fair, upfront compensation) in hospitals and nursing homes across the United States and around the world.
Doug Wojcieszak, Founder and President
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