[HN Gopher] US hospital told family their daughter had checked o...
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       US hospital told family their daughter had checked out when in fact
       she'd died
        
       Author : howard941
       Score  : 129 points
       Date   : 2024-08-21 20:07 UTC (2 hours ago)
        
 (HTM) web link (www.theguardian.com)
 (TXT) w3m dump (www.theguardian.com)
        
       | JumpCrisscross wrote:
       | > _an autopsy that could have indicated whether there had been
       | medical malpractice associated with her death was "rendered
       | impossible", according to the lawsuit_
       | 
       | This crosses into criminal liability.
        
         | blackeyeblitzar wrote:
         | This is just horrible but I'm not surprised since I have read
         | so many stories of malpractice recently, from the skull flap
         | thing to the Texas hospital triple booking surgeons to other
         | stuff
        
           | CatWChainsaw wrote:
           | Triple booking surgeons? Do they think patients in need of
           | surgeries are just going to up and cancel, and hospitals are
           | behaving like airlines?
        
             | toomuchtodo wrote:
             | Lack of accountability leads to outcomes. As a patient, you
             | don't know your trust is being violated (in this specific
             | scenario).
             | 
             | https://www.seattletimes.com/nation-world/texas-heart-
             | surgeo...
             | 
             | https://www.justice.gov/usao-sdtx/pr/texas-medical-center-
             | in...
        
               | malfist wrote:
               | Texas also has "tort reform", limiting you to a maximum
               | of $250k in damages. Good luck suing a big hospital for
               | malpractice, you gotta pay the lawyer too out of that
               | $250k.
        
               | mandmandam wrote:
               | > you gotta pay the lawyer too out of that $250k
               | 
               | On average, a medical malpractice case might require
               | anywhere from 500 to 1,000 hours of legal work, with more
               | complex cases potentially requiring over 2,000 hours.
               | 
               | Average lawyer cost in 2022 was $313/hr.
               | 
               | So we're basically looking at, generously, 750 hrs x
               | $300, or $225k to the lawyer.
               | 
               | And that's just one side - the hospital presumably pays
               | near the same.
               | 
               | ... Huh.
               | 
               | Once again, I am stunned at the American legal system
               | being so obviously and cartoonishly evil.
        
               | 0xcde4c3db wrote:
               | I hope that limit only applies to punitive damages. For
               | medical malpractice in the US, actual damages could
               | easily exceed $250k.
        
               | phonon wrote:
               | https://crosleylaw.com/blog/texas-personal-injury-law-
               | change....
        
               | voxic11 wrote:
               | It applies to actual damages, specifically non-economic
               | actual damages such as pain and suffering, mental
               | anguish, and loss of companionship. It does not apply to
               | economic actual damages such as lost wages and medical
               | costs.
               | 
               | Before tort reform punitive damages were already capped
               | in Texas at a value twice the amount of economic damages
               | plus the amount of non-economic damages, so tort reform
               | does also have a effect of sometimes reducing punitive
               | damages.
        
             | blackeyeblitzar wrote:
             | https://www.usatoday.com/story/news/health/2024/06/25/baylo
             | r...
             | 
             | In Texas, three hospitals (Baylor St. Luke's Medical Center
             | (BSLMC), Baylor College of Medicine (BCM) and Surgical
             | Associates of Texas P.A. (SAT)) agreed to pay $15m as part
             | of a settlement with the DOJ. These doctors/surgeons were
             | booked for multiple simultaneous procedures that they could
             | not have possibly conducted, even though they recorded
             | things to make it look like they conducted all the
             | surgeries. In reality many procedures were performed by
             | unqualified residents and other caretakers and not who the
             | patient was told would be performing the procedure.
             | 
             | > To make it seem as if the teaching physicians were
             | present during the "entire" operation, they would lie on
             | medical records, the court filings say. The medical staff
             | also would not tell patients that the surgeon planned on
             | leaving the room to perform another operation, the
             | documents continued.
             | 
             | This only came out because of a whistleblower, and because
             | the DOJ pursued it. It is nearly impossible for a patient
             | to know if they are wronged or harmed this way because they
             | are put under for these procedures, and because
             | friends/family are typically not allowed to observe or
             | record anything (likely to prevent accountability). And
             | then there's the cost of lawsuits, the stress, and
             | limitations under law (like tort reform in Texas) - it's
             | just lucky that this was pursued by a government agency
             | (DOJ).
             | 
             | > Under the False Claims Act, the private whistleblower who
             | reported the allegations will receive over $3 million from
             | the settlement, the Justice Department said.
             | 
             | We need more incentives like this, but we also need greater
             | penalties and jail time for the practitioners and literally
             | everyone who knew. They should be investigating who was in
             | the room, what was recorded in logs, and who accessed
             | records, and go after all of them. Right now, this
             | settlement achieves nothing. Some articles claimed that
             | these hospitals made more than $150 million off these
             | procedures for which they are settling the lawsuit for just
             | $15 million.
        
             | SkyPuncher wrote:
             | More common than you think.
             | 
             | A lot of hospital care is done by residents with surgeons
             | overseeing and stepping in for the most difficult parts.
             | 
             | Our healthcare system would literally collapse without
             | residents doing the heavy lifting. It won't change until we
             | stop artificially limiting the supply of doctors or give
             | mid level practitioners more power.
        
               | CatWChainsaw wrote:
               | Or both, both would be nice.
               | 
               | Until then I guess we all just have to make sure we never
               | need to use the healthcare system we all pay so much for.
        
           | spondylosaurus wrote:
           | Dare I ask about "the skull flap thing"?
        
             | blackeyeblitzar wrote:
             | https://lawandcrime.com/lawsuit/lawsuit-claims-emory-lost-
             | pa...
             | 
             | Basically they had to cut into someone's skull as part of a
             | surgery. They did not label and catalog skull parts
             | properly. Because they lost the skull part they had to use
             | a synthetic skull flap, and they charged the patient for
             | it. The synthetic flap caused an infection. The patient was
             | on the hook for something like $150K for all of this (the
             | synthetic part, the procedure of placing it, the infection)
             | which was due to the hospital's own criminal negligence. An
             | investigated showed that the hospital was not properly
             | labeling and cataloging parts for many patients and
             | basically had a mess of random skull parts that would not
             | make their way back to all those patients, so it is a
             | systemic issue and not just an unfortunate one off mistake.
             | All of this is alleged and there is a lawsuit pending, but
             | it seems to me like the part about a systemic issue of
             | mishandled parts is confirmed.
        
               | sva_ wrote:
               | Sounds like material for the next Dr. Death season. The
               | first two seasons were both pretty great.
        
       | jklinger410 wrote:
       | I'm glad we pay for the most expensive medical care in the world
       | in the US. That's what keeps the quality so high.
        
         | realo wrote:
         | Sorry but I think you pay for the most expensive _doctors_ in
         | the world...
         | 
         | It would seem that the actual care you receive is only remotely
         | related to that.
        
       | bourbonjuggler wrote:
       | _" Dignity Health, which operates Mercy San Juan..."_
       | 
       | It appears they need a name change after this lawsuit
        
         | LiquidSky wrote:
         | As usual when entities have these noble names, they don't mean
         | your or my dignity.
        
           | evantbyrne wrote:
           | Low quality places have the most absurd names in this
           | country. For example, there is a trailer park nearby with a
           | "Manor Lane". At least they put it by "Shady Lane" to balance
           | expectations.
        
             | Aloha wrote:
             | any apartment complex that advertises 'luxury' is by
             | definition not.
        
             | The_Blade wrote:
             | Blind date with the chancer
             | 
             | We had oysters and dry lancers
             | 
             | And the check when it arrived we went dutch, dutch, dutch,
             | dutch
             | 
             | A redder shade of neck on a whiter shade of trash
             | 
             | And this emory board is giving me a rash
             | 
             | I'm flat out
             | 
             | You're so beautiful to look at when you cry
             | 
             | Freeze, don't move
             | 
             | You've been chosen as an extra in the movie adaptation of
             | the sequel to your life
        
             | ljm wrote:
             | Sanatoriums, asylums, mental institutes, and retirement
             | homes... all called Mount Pleasant.
        
         | Nuzzerino wrote:
         | Dignity health is god awful. I've never had a good experience
         | with them.
        
       | HorizonXP wrote:
       | I read the headline expecting that it was a simple
       | misunderstanding or clerical error, with limited impact to within
       | 24 hours.
       | 
       | The article is so much worse and the headline buries the lede. I
       | would be horrified. My condolences to the family.
        
         | bluSCALE4 wrote:
         | Completely agree. I can't imagine being lead on a wild goose
         | chase looking for a loved one only to be told by police that
         | said party lied to me. I guess there's a lesson here: talk with
         | nurses. I'm sure some would toe the line but if something
         | smells fishy, I'm sure someone will crack. Then again, maybe
         | only one nurse would know the truth so it's may not be easy.
        
           | smcin wrote:
           | It's worse than that, it's like burying a double or even
           | triple lede:
           | 
           | - it's not just that the hospital told her family totally the
           | wrong thing for a day or a year...
           | 
           | - or even negligently cremated or buried her in a pauper's
           | grave...
           | 
           | - but they also mishandled the corpse, which IIUC is a
           | misdemeanor (corpse desecration, which is a felony, might not
           | apply), by shipping her decomposing body to an off-site
           | warehouse morgue.
           | 
           | - and failing to timely issue a death certificate or do an
           | autopsy prevents determining whether there had been medical
           | malpractice associated with her death.
        
             | ghostly_s wrote:
             | and _they_ didn 't even know she was dead - the death
             | certificate was not completed until her body had been
             | rotting in their facility for a year.
        
       | bluSCALE4 wrote:
       | I wonder if it's possible that she checked herself out but
       | immediately died outside the hospital which would explain why the
       | paper work was in order. I would not explain why after being
       | ID'd, why family wasn't informed or how she was placed into
       | offsite storage facility. Gross incompetence and criminal
       | negligence. I hope the family gets the 5x the jury award as
       | requested. Didn't know you could even do that.
        
         | cogman10 wrote:
         | > I wonder if it's possible that she checked herself out but
         | immediately died outside the hospital
         | 
         | I find that really unlikely.
         | 
         | I mean, for starters, they had her body and knew it was her
         | body in storage. That doesn't happen if they don't have IDs
         | attached to the corpse. I find it unlikely that the hospital
         | wouldn't be ringing the family like crazy because of a body
         | they want to unload. Especially if they have the paperwork
         | showing that she'd checked out. There'd be no reason not to
         | almost immediately say "Hey, actually, we found her right
         | outside the hospital dead, sorry for your loss".
         | 
         | I'm guessing an obvious fuck up killed her like 10xing her
         | insulin dosage by mistake. Or administering something other
         | than insulin.
         | 
         | And it wouldn't surprise me if, conveniently, 17 or 24 months
         | just happens to be the retention policy for medical records.
        
           | Terr_ wrote:
           | > And it wouldn't surprise me if, conveniently, 17 or 24
           | months just happens to be the retention policy for medical
           | records.
           | 
           | This was in California, where the law [0] is 7 years minimum,
           | potentially more if the patient was a minor.
           | 
           | AFAICT every state wants at least ~5 years of retention.
           | 
           | [0] https://www.law.cornell.edu/regulations/california/22-CCR
           | -72...
        
       | 015a wrote:
       | Hospital management: "What new system or form can we add so our
       | liability is limited in this happening again? Just one more
       | e-signature bro, it'll work this time I swear, this is the one,
       | just one more."
        
       | khaki54 wrote:
       | Crazy. I wonder if they made a mistake, somehow killing her, but
       | thought she was indigent or mentally ill, and that's why they did
       | all this. Then again, it sounds like she was treated many times
       | by this hospital. I cannot fathom the circumstances where the
       | actions after her death could have been a simple mistake, but
       | they've had 16 months to come up with a story and destroy all the
       | evidence, so we may never know the truth.
        
       | jofer wrote:
       | You'd be amazed how bad hospitals can be at keeping track of
       | fairly critical things.
       | 
       | I had a cousin who voluntarily checked himself into the hospital
       | related to severe withdrawal symptoms (and had bouts of psychosis
       | related to said with withdrawal - meth addictions are nasty). His
       | mother stayed for awhile but had to leave for work. She was
       | repeatedly guaranteed by multiple doctors and nurses that he
       | could not check himself out and would be there for several days
       | at least. They told her to come back the next morning.
       | 
       | Late that night, he was discharged. Not even "he checked himself
       | out". The hospital discharged him (and that's over an hour ride
       | away from home, btw - no hospitals in rural areas these days).
       | 
       | He had no phone and no wallet. According to staff, he tried to
       | call his mother to pick him up, but couldn't remember her cell
       | phone number (it had changed recently). He called his sister and
       | left a message, but she was traveling and didn't get it until
       | much later. According to the hospital, he tried to call several
       | different numbers trying to get a ride home and they made him
       | stop and made him leave. In a quite rough downtown area he was
       | not familiar with. While clearly not in his right mind. At 2am.
       | With no wallet, no phone, no nothing.
       | 
       | The hospital had his mother's contact info. They did not give it
       | to him even when he requested it. They did not attempt to contact
       | her in any way.
       | 
       | We still don't know what happened afterwards. His body was found
       | four days later in the river and it had been there for awhile.
       | 
       | Forcibly discharging someone under those circumstances and
       | refusing to even contact their emergency contacts is beyond
       | belief. I'm furious about it. Apparently it's common and not even
       | something there's any recourse for.
        
         | mrinfinitiesx wrote:
         | Reading that makes me incredibly outraged. I'm sorry that
         | happened and your family had to go through that.
        
         | JohnMakin wrote:
         | When I was a teenageer a school counselor incorrectly perceived
         | me to be in a crisis and had me sent to 72 hour hold (which
         | stays on certain records for quite a while and can be
         | incredibly disruptive, but that's besides the point) - for some
         | reason I was sent almost 40 miles away in another county in a
         | city I'd never been. The hospital doctors took one look at me
         | and realized I didn't belong there, but to do a discharge
         | apparently is a pretty lengthy process once this process is
         | initiated - almost 20 hours later (again, being held completely
         | against my will for no reason) they released me. I asked them
         | where I was supposed to go and if I could call my dad. They
         | said no, but they gave me two (2) bus tokens, which wasn't
         | enough to get back where my car was parked at the school, plus
         | I had no idea how to use the bus system in that county, and
         | didn't have my glasses, phone, or wallet.
         | 
         | I really don't know how long it took or how I made it, but many
         | many hours later I made it back to my car. I had to beg for
         | money and walk the last several miles once I recognized finally
         | where I was. It really sucked, and ever since then I've had a
         | great deal of sympathy for people that are churned through this
         | terrible system and spit right back out with no dignity
         | whatsoever, let alone empathy. This incident disrupted my life
         | irreversibly (ended up missing tests and having to do a medical
         | withdrawal from school, lost scholarships, etc) and derailed a
         | lot of things I had wanted to do for many, many years. The
         | hospital/medical care industrial complex doesn't optimize for
         | empathy. They're just trying to get the bodies through as
         | quickly as possible.
        
         | SkyPuncher wrote:
         | I'm sorry for your loss.
         | 
         | Unfortunately, the staff "guaranteeing" he would not be
         | discharged had no basis for their statement. Your brother was
         | an adult. In most (all?) states, he cannot be forcibly kept at
         | the hospital unless he has a court order for a involuntary
         | treatment plan.
         | 
         | This involves convincing a judge that the patient is at harm
         | for leaving the facility. Generally, if the patient is
         | cognizant it's extremely hard to force them into an involuntary
         | hold. Sometimes patients will agree to a voluntary, involuntary
         | hold to force themselves to commit to a treatment plan, but if
         | they're fighting it from the start, it's hard to get it
         | approved.
         | 
         | Further, "he checked himself out" isn't necessarily a thing. He
         | could leave against medical advice or he could have simply told
         | the staff that he decided against treatment. They'd discharge
         | him just like any other patient who no longer needs treatment.
         | 
         | In general, a hospital cannot simply keep a patient if there's
         | not medically necessary treatment. Occasionally, you'll see
         | patients get discharged walk out the door then immediately walk
         | right back into the ED. That being said, most patients are able
         | to wait in the hospital premises (for a reasonable amount of
         | time), until transportation can be arranged.
         | 
         | A patient discharged in the middle of the night is not going to
         | be literally kicked to the curb in the middle of the night.
        
           | lazyasciiart wrote:
           | > A patient discharged in the middle of the night is not
           | going to be literally kicked to the curb in the middle of the
           | night.
           | 
           | This does, very literally, happen. It _should not_ happen,
           | and may even be directly against hospital rules, but it does
           | happen.
           | 
           | https://www.huffpost.com/entry/woman-filmed-on-street-in-
           | hos...
        
           | kayodelycaon wrote:
           | > A patient discharged in the middle of the night is not
           | going to be literally kicked to the curb in the middle of the
           | night.
           | 
           | Oh, yes they are. They would have had on-site police drag me
           | out if I didn't walk out myself.
        
           | ghostly_s wrote:
           | Are you a hospital admin? Kindly fuck off with your universal
           | "facts" which contradict the lived experience of the people
           | you are talking to here.
           | 
           | There are many, many facets to how medical is "supposed" to
           | work; what happens in reality is often much different.
        
           | egypturnash wrote:
           | you: A patient discharged in the middle of the night is not
           | going to be literally kicked to the curb in the middle of the
           | night.
           | 
           | the post you were responding to: [the hospital] made him
           | leave. In a quite rough downtown area he was not familiar
           | with. While clearly not in his right mind. At 2am. With no
           | wallet, no phone, no nothing.
        
           | nradov wrote:
           | Los Angeles area hospitals routinely dumped patients until a
           | lawsuit settlement a few years ago. I wouldn't be surprised
           | if other hospitals are still kicking patients out today.
           | 
           | https://abc7.com/good-samaritan-hospital-patient-dumping-
           | hom...
        
         | colechristensen wrote:
         | Are they suing the hospital and care team for many millions of
         | dollars? That's the level of neglect of responsibility that
         | should get you enough money to own the hospital that did that
         | kind of thing.
         | 
         | I regularly have to aggressively bully medical care teams for
         | myself and others to get them to do the right, obvious things.
         | 
         | I do not trust doctors, they do not care to figure out
         | problems, ignore so many people's problems, and make wildly
         | stupid mistakes all of the time.
        
           | ghostly_s wrote:
           | > Are they suing the hospital and care team for many millions
           | of dollars?
           | 
           | Did you try clicking the link? They are. 5 million dollars. I
           | expect they will win, and that still won't make them whole.
        
             | tailspin2019 wrote:
             | You're replying to someone who in turn was asking the GP a
             | question about their comment, not about the article.
        
         | nostrademons wrote:
         | I wonder how much this correlates with socioeconomic status.
         | 
         | When my kids were born, the hospital had this incredibly
         | elaborate, incredibly detailed checklists of things that needed
         | to be in order before they would let you leave. Did you have a
         | carseat? Did you have a ride home? Did the doctor come by and
         | give you discharge instructions? Do you have all the belongings
         | you came with? Did you fill out the birth certificate
         | application? Have all your discharge papers been signed?
         | 
         | They actually wouldn't let my wife walk herself down - they had
         | to call Transport, and she had to be wheeled down in a
         | wheelchair with the baby's carseat on her lap, and I had to be
         | waiting at the designated curbside to pick her up. She was
         | perfectly capable of walking herself down, and we were both
         | capable of putting the carseat into the car in a normal parking
         | spot, but everything had to be done in the presence of an
         | orderly.
         | 
         | This is the same health care company mentioned in the article,
         | but at a pretty affluent suburb of Silicon Valley.
        
           | ghostly_s wrote:
           | None of those checklist things are done out of an interest in
           | care - it is about avoiding liability.
        
       | croes wrote:
       | >Mercy San Juan hospital failed in its most fundamental duty to
       | notify Jessie's family of her death
       | 
       | Despite the misconduct, I think saving people's lives is the most
       | fundamental duty of a hospital.
        
         | dgfitz wrote:
         | Yeah: "we failed at our one job" should have been IMMEDIATELY
         | expressed to the family.
        
       | EE84M3i wrote:
       | This might sound silly, but technically speaking how does this
       | kind of notification work in relation to HIPAA? Is there some
       | kind of a carve out that allows hospitals to tell your family
       | you've "been discharged against medical advice"? How does next of
       | kin notification work for death?
       | 
       | To put it another way, clearly the outcome in this story was
       | unacceptable, but what was the correct outcome?
        
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       (page generated 2024-08-21 23:00 UTC)