Readers of this blog know that I’ve written previously about the problem of hospital alarm fatigue. It’s a new type of medical malpractice claim, and it’s not necessarily an easy problem to solve – at least not overnight.
Very recently, a case of this type that was previously filed against Massachusetts General Hospital, settled prior to trial, for $850,000. Actually, the hospital and the patient’s family had reached an agreement on settlement back in May, but the settlement was not filed in court and made public until very recently. The case was brought by the family of a man who died at MGH when nurses failed to respond to alarms on his cardiac monitor . The incident brought national media attention to the dangers of “hospital alarm fatigue” among nurses and other hospital staff – and raised the question of what, exactly, can be done to combat the problem. This case was noteworthy not only for the subject matter of hospital alarm fatigue, but for the way in which it was settled. Usually, the liability insurance companies that insure doctors and hospitals fight medical malpractice and medical negligence cases to the end. They do that in large measure because they know that their chances before a jury are very good: Statistically, juries are reluctant to find against doctors and hospitals.
As a Boston Massachusetts medical malpractice lawyer, I can assure you that this is due in large measure to the public brainwashing that has been accomplished on the subject of “tort reform” by the liability insurance industry. Anyone reading this post should, without delay, view the HBO award-winning documentary “Hot Coffee“. This stunning expose will show you exactly what “tort reform” means when it comes to medical malpractice and medical negligence cases – and of just how unjust it is.
Back to this case: In a rare display of cooperation, the malpractice insurance company that insures MGH and its affiliates was quite forthcoming, reaching a settlement on behalf of MGH and the doctors and nurses who were responsible for the victim’s care (the deceased’s name was not released due to privacy considerations.) The victim, 89 years old, was recovering from heart surgery and awaiting the implantation of cardiac pacemaker when he died in January 2010. According to both state and federal investigators, 10 nurses who were on duty at the time could not recall hearing the alarm (a series of beeps,) at the nurses’ station. The nurses and staff also did not see ticker tape-style messages on three separate hallway signs that were warning them that the patient’s heart rate was falling over a 20-minute time period. Investigators concluded that the nurses and staff had experienced “alarm fatigue” due to being constantly exposed to beeping monitors. However, and importantly, it was also discovered that the volume for a separate crisis alarm on the patient’s bedside monitor had been turned off.
Patient monitors can save lives when they alert nurses to dangerous changes in a patient’s condition, but the problem is that statistically, most alarms are false, triggered by patients usually shifting in bed, or minor events. Not only have I blogged previously on this subject, but The Boston Globe published an investigation published earlier this year, exposing this danger and how it has been linked to hundreds of patient deaths at a variety of hospitals.
I will say that according to all reports of which I am aware, MGH conducted itself admirably at least in this one case. In April 2010, two months after the patient’s death, MGH’s senior vice president for quality and safety wrote the family a letter of apology, acknowledging that “we know that we let him (the patient) and you down in our care.” In the letter, the official wrote that the hospital had conducted an internal investigation that led to system improvements, including disabling the off switches on 1,100 cardiac monitors, providing increased education to nurses and doctors about responding to monitor alarms quickly, and installing increased speakers so that alarms can be better heard.
More cases of this type remain to be resolved. It would be a blessing, and an admirable change of attitude amongst hospitals, doctors, and the professional liability insurers that defend these cases, if a lot more of these cases could be handled the way this case at MGH was. It does neither the victims of medical malpractice, doctors, nurses, or liability insurers, much good at all to drag these cases out, with heels dug deeply in denial. If acknowledgements of mistakes could be made more by doctors and medical staff when a mistake occurs, apologies offered, and reasonable compensation extended as was here, the wars that so often result in these cases, could be averted.
Is that asking too much?