Pain and Suffering

 A third excerpt from the book:

Justice for Lisa

The extraordinary story of one avoidable 

hospital death and the people who

 helped those responsible avoid accountability

David Baker

   Five months after Lisa’s death, another patient also with diabetes died in the same hospital in shockingly similar circumstances.  Once again, a nurse failed to monitor the patient’s glucose level after an episode of hypoglycemia.

    Members of Samaritan Hospital’s management had learned nothing from what they had done to Lisa.

   Or maybe they just didn’t care.

    But Samaritan Hospital’s response to the two cases was very different:  The lawsuit filed by the family over the second patient’s death was settled just over a year later with minimal litigation for $125,000. (Which was five times the amount — $25,000 —  that at one point Samaritan Hospital offered me to settle:  I turned it down.) 

   In Lisa’s case, the hospital’s management was desperate to avoid acknowledging the mistake that took Lisa’s life.

   Its lawyers repeatedly claimed that Lisa and I were not married at the time the lawsuit was filed - meaning I would not have been eligible to sue the hospital  Then, faced with my motion for summary judgment, they paid Matthew C. Leinung, a doctor at nearby Albany Medical Center Hospital, to provide an affidavit stating it was his opinion that a nurse who failed to follow specific written instructions on treating low blood glucose did not deviate from the standard of care.  It was all the impatient judge needed to dismiss my claim. 

   So what was the difference between the two cases? 

   In four words: Conscious pain and suffering.

   In the medical records of the second death, there is no indication the patient was aware of the drop in his blood glucose level; he became unconscious and died.

  In Lisa’s case, it’s clear she knew that without a source of glucose she was going to die.

   She always was aware when her blood-glucose level was dropping.  The shear terror she would have experienced that evening before being found in her hospital bed near death can hardly be overstated.

  Here’s how I described visiting Lisa the day she collapsed:

   “When I arrived in Samaritan Hospital’s ICU a few hours after Lisa had been found near death, she was sitting up in the bed.  But she was far from normal.  She didn’t speak.  Instead, her eyes were rolled up in her head.  She was making a strange groaning sound while sticking out her tongue, holding her arms out in front of her as if reaching out to hug someone and turning her body from side to side from the waist.  Lisa’s brother had come in while I was there and he was so disturbed by what he saw that he had to quickly leave.”

   It’s an image that will be with me until the day I die.

   The lack of glucose had caused catastrophic damage.  Her brain cells were slowly dying. She was later placed on life support, where she remained until she died.

   But for a week or so she was minimally conscious. She would respond the doctors’ and nurses’ requests, such as “lie still, or “sit up’. She understood spoken words and so would have been acutely aware of her dire situation.

***

   In many claims for wrongful death there are two elements of a jury award or a pre-trial settlement   One is for economic damages: the amount the victim would have earned over his or her expected lifetime,  as well medical and other expenses. 

  The second - and often the far larger amount — is for conscious pain and suffering and fear of imminent death.

  In the second case in Samaritan Hospital there was no indication of the patient’s conscious awareness of his impending death.

   In Lisa’s case, the evidence is overwhelming.

    And that is why the management of Samaritan Hospital was desperate to defeat my claim for Lisa’s wrongful death.

  They got my claim dismissed.  But they are left with the outrageous claims made by that doctor at Albany Medical Center Hospital on their behalf, permanently available in a  public record.

   And now, this book.  Lisa, and how Samaritan Hospital’s management dodged responsibility for taking her life, will not be forgotten. 

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A doctor's outrageous claim

 Here’s another extract from the book:

Answers for Lisa

The extraordinary story of one avoidable hospital death and the people who helped those responsible avoid accountability

David Baker

********

   In October 2008, Saratoga County Supreme Court Justice Stephen A. Ferradino dismissed my wrongful death claim against Samaritan Hospital and four nurses after the hospital paid Dr. Matthew Leinung at Albany Medical Hospital to provide an affidavit stating that the hospital was not responsible for Lisa’s catastrophic brain injury and subsequent death.

    But one of the claims Leinung made in his affidavit goes to the heart of the wrongful death claim, and is truly astounding. That he would make this statement in a sworn affidavit should question his fitness to ever have practiced medicine.

   The allegation in the lawsuit was that the hospital staff had failed to properly treat an episode of hypoglycemia - low blood  - glucose by neglecting to follow up a quick acting carbohydrate with a longer lasting protein, such as bread or cheese and crackers. Without that, blood glucose will rise immediately from the danger level but then rapidly fall.

   Entries made in the medical chart by the nurse treating Lisa that evening, show that she did not give her patient the required protein.  

   Four hours later Lisa was found unresponsive with a blood-glucose level recorded in her chart at an almost non-existent  level of 2 mg/dL (2 milligrams of glucose per deciliter of blood).

   Explaining away this fact, Leinung, without presenting any evidence, then made the following extraordinary claim:

  “Although defendants’ standard hyperglycemia protocol recommended that 1 protein should follow the administration of  juice, I can state with a reasonable degree of medical certainty that the administration of protein is no longer the standard of care for for the treatment of of hypoglycemia. Therefore, defendants’ failure to follow the administration of carbohydrates with 1 protein according to its protocol is not a deviation from the standard of care.”

   The hypoglycemic protocol was a printed document. The issue  current at the time of Lisa’s November 2003 admission to Samaritan Hospital was created on Dec. 10, 1997 and revised on Sept. 17, 2002 — 14 months before Lisa was found in her bed at 2 a.m., “unresponsive” and near death.

   On page 2 of the three-page protocol is the following instruction for treating moderate hypoglycemia (emphasis added).

“Give 15 grams simple carbohydrate i/e, 4 oz juice, skim milk or three tabs. Retest in 20 minutes. Repeat above treatment if symptoms persist and/or glucose is (less than) 60 mg/dL

  “If more than 1 hour remains before next meal [it did],  follow up above treatment with 15 grams complex carbohydrates and one protein serving: 6 oz milk with 3 graham crackers or 1 oz cheese with 6 saltines.”

   That’s what’s Lisa’s nurse should have done. But according to her own entries in the chart, she didn’t do it. 

  This nurse also was failing to comply with a doctor’s specific order; a telephoned instruction from Dr. Rajinder K. Jain, written into Lisa’s chart the previous afternoon that said:  “Follow hypoglycemia protocol if patient comes hypoglycemic.” 

   Apparently Dr. Jain, the consultant for Lisa’s diabetes, was unaware that the standard treatment for hypoglycemia specifying that a protein be given had been abandoned.

   But after acknowledging Dr. Jain’s order in his affidavit, Leinung then states that the nurse who ignored the protocol and Dr. Jain’s order to apply it was not negligent because “…the protocol itself did not set forth the standard of care.” 

  So Leinung blames the hospital’s management partly responible for the death, suggesting that only having detailed hypoglycemia treatment instructions in the protocol was not sufficient for the nurse to know how to treat her vulnerable patient.  

   

   The only conclusion to come from all of this is simple: Samaritan Hospital killed Lisa Baker, then went to extraordinary lengths to escape responsibility for her totally preventable and excruciatingly painful death, steps that included paying an unethical doctor at Albany Medical Center Hospital to state under oath whatever Samaritan Hospital’s management wanted the judge to see.

***