I lived, but that was the problem.
I nearly died after my twins were born. The “nearly” here is important because when I contacted five lawyers afterward to try to sue for medical negligence, the fact that I was alive and well was a problem. If I hadn’t been, they would have taken the suit in a heartbeat (or…lack thereof). After my fifth rejection from a medical malpractice law firm, I didn’t try any further.
One lawyer asked me, “And there’s nothing wrong with you now?”
“Other than extreme emotional distress to both me and my husband, no,” I said.
“Well, that’s not enough,” he said.
I didn’t hold it against him. He knew how the system worked. If I had to be alive (God forbid), I needed to be damaged in a way that would make jury members cry. It didn’t matter that what had happened to me could happen to someone else, and the hospital should be forced to make changes to prevent that. All need for that was considered irrelevant because I was “fine.”
But I didn’t feel fine. I had nearly died. I had nearly left my then husband alone with two itty bitty infants. A doctor even suspected I might wake up brain-damaged (then we could have sued), but medical malpractice lawsuits for the big bucks need devastating clinchers and I, gratefully, was not.
***
A medical malpractice suit in the United States can only be filed if certain parameters are met: “The injured patient must show that the physician acted negligently in rendering care, and that such negligence resulted in injury.”
The emphasis is on long-term physical effects or injury. Emotional pain and suffering are add-on complaints; they’re rarely the primary. What matters is if you’d forever lose the ability to form words or perform simple tasks with your writing hand. It wouldn’t matter if you had a terribly harrowing experience if it hadn’t left some devastating physical reminder on you. Emotional distress or pain and suffering can’t well be quantified if they exist alone.
Only 1% of medical incidents may result in a lawsuit. Negligent care that doesn’t lead to long-term harm or injury isn’t grounds for a lawsuit. This means a negligent hospital or staff member can potentially keep on being negligent since no one is held legally accountable. When I reached out to the hospital with complaints over my care, I was told an “independent” audit had been conducted that agreed with every choice that was made.
“How could that nurse have done NOTHING wrong when I was unconscious for twelve hours and only regained consciousness after THREE shots of Narcan?” I asked. Narcan is a medication designed to reverse opioid overdose rapidly, and multiple doses (as I received) are only required when the opioids are stronger.
“She followed procedure,” I was told.
When I later reviewed my medical records, I found that the nurse had incorrectly noted my self-reported pain scale and administered the highest dose of pain medication to me. This nurse, whom I’d entrusted with my care, had overdosed me with opioids.
***
Because I had a c-section to deliver my twins (both were breech), I was prescribed pain medication. A c-section requires that the stomach and uterus be cut into, so pain medication afterwards is necessary. I was prescribed dilaudid and oxycodone. While the pain medication worked well most of the time, whenever I coughed, laughed, got up, or sat down, the pain was considerable.
Each time my nurse, who was with me from immediately after my c-section at 1pm to midnight, asked me my level of pain on a scale of one to ten, I told her, “It’s about a three, but if I laugh or cough, it’s about a nine.”
On my medical records, she wrote down a “nine” every time and administered pain medication to me based on that number. Soon after the nurse shift change at midnight, I started nodding off while trying to hold the hospital-grade pump. My husband told our new nurse this.
“Honey, she just had two babies. She’s going to be tired,” she told him.
“But she can’t even hold the pump. She’s nodding off like she’s had too many drugs,” he told her.
“You’ll just need to help her hold it then, and try to get some rest when your babies are resting.”
Around one in the morning, my husband alerted the nurse that I was unconscious and unresponsive. Our babies were sent to the nursery, where they were bottle-fed formula by the nurses, and my then husband stayed by my side. MRI and CAT scans and bloodwork were done. Nothing was conclusive.
I regained consciousness sporadically. Every time I resurfaced, my doctor asked me, “Who are you? Why are you here? What year is it? What’s your birthday? Who’s the president? Who’s that man over there [pointing at my husband]? Who am I?”
I was only ever able to answer two questions correctly: who the man was in the room (my then husband), and who the president was (Obama at the time). When they asked me who I was, my husband said I looked blank and puzzled. When they asked me why I was in the hospital, I believed I was there because I’d had a car accident. When they told me I was in the hospital because I’d just had my children, I said, “Yeah, okay,” like I didn’t believe them. When they asked me what year it was, I was convinced it was 2012 (it was 2016).
I didn’t entirely regain consciousness until twelve hours later, after my third dose of Narcan. Doses one and two had effected no change in me. When the opioids are stronger, it can take multiple doses to reverse their effects, and it took three for me.
Twenty minutes after I received the third dose of Narcan, I was conscious, and physically…fine. My then husband cried and stroked my hair and told me about the harrowing twelve hours only my body had been present for. When the doctors asked me their questions (“Who are you? Why are you here? What year is it? What’s your birthday? Who’s the president? Who’s that man over there [pointing at my then husband]? Who am I?”), I could answer each one correctly. Our babies were brought to us, and I fed them. It was like I was Lazarus risen from the dead, only I had no idea I’d died or for how long.
When a doctor came to see me several hours later, she said, “I’m so surprised you’re talking so well.”
“Why?” I asked.
“It looked like you’d have extreme brain damage after being unconscious for so long.”
“Like how?”
“Like you wouldn’t even be able to speak.”
I was so stunned by her answer that I didn’t say anything else. It wouldn’t be until months later that I would finally understand how amazingly lucky I was and am. I shouldn’t have woken up, and if I had, I should have had extreme brain damage. What had happened to me wasn’t okay. It was actually terrifying.
The nurse who effectively overdosed me still has her nursing license and is still, to my knowledge, in employment at the hospital where I delivered. I was told that what had happened to me was simply a “fluke.”
***
Medical malpractice ranks as the third leading cause of death in the U.S. Further, less than 2% of medical personnel account for the majority of all of medical malpractice lawsuit payments. Meaning, a small fraction of medical personnel are responsible for the majority of medical malpractice lawsuits. Those who are likely to be medically negligent in their duties are also likely to be repeat offenders.
The current status of medical malpractice lawsuits are a problem. Even with multiple malpractice cases lodged against the same medical personnel, it may not trigger a suspension or license revocation. Doctors and nurses are licensed and disciplined by state medical boards. These state medical boards have the right to decide who does and doesn’t lose their practicing privileges. Members of these boards may be appointed by the state governor, which means they may have a conflict of interest in not pursuing the removal of other physicians.
I don’t know if the nurse who overdosed me has been negligent in her care of other patients. I hope not. But, as it stands, it doesn’t sound like she faced any repercussions or consequences and may not see that she did anything wrong in my case, especially when her supervisors and what I was told was an “independent” audit showed she’d “followed procedure.”
Jim Axelrod and Andrew Bast reported that, “Medical boards do a good job weeding out doctors who have broken the law — say, for overprescribing opioids — but when it comes to doctors who commit malpractice and hurt their patients, medical boards often look the other way.”
When I selected that hospital to deliver my babies, I did it because I trusted them. I trusted that hospital and all of its medical staff to care for the lives of me and my children. That trust was broken, and the consequences could have been devastating. My story shows a gap in our medical malpractice system, where its emphasis on physical and long-term harm supercedes any emotional or psychological trauma a patient may face. Further, it’s a problem when negligence that doesn’t lead to long-term injury doesn’t also lead to an obvious change in procedures.
Since a small fraction of medical professionals are responsible for the majority of medical malpractice claims, this is also a systemic issue. Repeat offenders are allowed to continue to practice without facing significant consequences. The role of state medical boards needs to be reevaluated.
Patients deserve better. I deserved better. We deserve a system that holds medical professionals accountable for anynegligence, including whether it causes physical harm or emotional distress. Stricter regulations should be put in place, as well as a system that truly prioritizes patient care. I shouldn’t have been a “fluke,” and we shouldn’t have to wait until a “fluke” turns into actual harm to make change.