Imagine waiting anxiously near a hospital OR to hear word on how your mother’s surgery is going. You suspect problems because the procedure is taking longer than expected.
The surgeon finally appears, but he reports that the surgery didn’t go well. He begins to relate details, then suddenly falls to his knees, covers his face with his hands, and says “This isn’t your fault, it’s my fault,” she’s in the hands of a higher power.”
That’s the recollection of the daughter of Bertie Lang, a patient who died two days after surgery, and whose family is now suing Meadowview Regional Medical Center in Maysview, Kentucky, and Dr. John Christian Gunn.
The case, which is currently being heard in Kentucky, is noteworthy for a couple of reasons. For one, the issue of potential negligent credentialing is under consideration. The accusation relates directly to the decision by leadership of Meadowview Regional Medical Center to grant temporary clinical privileges to Dr. Gunn.
If you’re not familiar with temporary privileges, they are often granted after a streamlined review of a physician’s credentials and background in order to allow him/her to begin practicing in the hospital quickly. A full credentials and background review takes time. There are occasions when temporary privileges are quite appropriate, but at times they are granted without a thorough understanding of the risks to both patients and the organization.
The second matter this trial brings to the forefront, is disclosure. Physicians and other caregivers make mistakes, systems break down, and when that happens disclosure needs to be made to the patient and/or family. However, reading the way the disclosure was apparently handled in this case gives me reason to feel sympathy, not just for the family of Bertie Lang, but also for Dr. Gunn. His guilt and anguish are obvious, and his attempt to appropriately disclose painful, both for the family and for himself. Add to that, the hospital’s additional exposure to legal liability and potential loss based on the words uttered at that stressful time.
This case strongly reinforces the need for caregivers to be taught how to appropriately disclose unanticipated outcomes. That education also takes time, and with privileges quickly granted there is less opportunity for Risk Management to offer that education.
There are two important take-aways from this case, regardless of the court’s final judgment. Hospital leadership must be extremely judicious in granting temporary privileges, and risk management must work proactively to educate and assist caregivers regarding appropriate disclosure of unanticipated or undesirable outcomes.
Malpractice Case Focuses on Doctor With Temporary Privileges – CRC Blog
8/16/09 Update – Out of Court Settlement Reached
8/18/09 - Physician now serving a prison sentence for 2008 armed robbery.