"The Night Shift" --- Not A Good Time To Get Sick
On Thursday, November 2, 2000, 15-year-old Lewis Blackman of Columbia, South Carolina underwent surgery to correct a relatively common birth defect called “pectus excavatum”, or “sunken chest,” at the Medical University of South Carolina Children's Hospital in Charleston. The condition is not life-threatening but can sometimes lead to respiratory difficulties, so Lewis and his parents decided to go for a minimally invasive surgical correction: inserting a metal strut to support the breastbone. The surgery was supposed to last only 45 minutes. Dr. Edward Tagge, who performed the surgery, promised that within 3 days, Lewis should be feeling better. But something went wrong … terribly wrong.
The boy grew weaker, unable to keep food and liquids down. 3 days after the operation, he suddenly developed excruciating abdominal pain. Despite doses of a powerful painkiller called Toradol, Lewis was racked with agonizing pain. Oddly, the pain seemed centered in his abdomen, not his chest.
Helen Haskell, Lewis’ mother, was at her son’s bedside almost the entire time. Lewis grew weaker during that night. His heart rate climbed to 142 beats per minute (normal is 60 to 100), and his temperature dropped to 95 degrees. His eyes were hollow, his skin was pale and he was sweating cold buckets. Helen was terrified, but because it was the night shift, there was not much she could do. Dr. Edward Tagge, who performed the surgery, was not available. Nor, it seemed, was any other veteran doctor. All night long, Helen Haskell could not get adequate treatment for Lewis. As morning breaks, Lewis went into cardiopulmonary arrest. Now, as doctors and other hospital personnel begin the day, the hospital responded with its full resources. 11 physicians frantically were trying to save Lewis. "I had no idea he was near death," says Helen. "We brought in a perfectly healthy child." An autopsy revealed that Lewis had bled to death internally from a perforated ulcer, which was likely caused by the painkiller Toradol. Much of his blood had drained into his peritoneal cavity. A more experienced doctor -- especially one familiar with the dangerous side effects of Toradol -- might have recognized the symptoms early enough during the night to save him. The Medical University settled for $950,000 without a lawsuit. A portion of the money was plowed into Mothers Against Medical Error, an activist group founded by Helen, who now works full-time as a patient advocate. Her efforts led to the passage, in 2005, of the Lewis Blackman Hospital Patient Safety Act, which requires all physicians in South Carolina to wear identification describing their rank.
More later about night time mistakes at hospitals.