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Huntsville Hospital Hides Behind State Government Liability Limit. Families Left With The Bills

by: countrycat

Thu Dec 06, 2012 at 08:33:09 AM CST

Gracie Smith was a toddler who needed just a routine tonsillectomy.  She got that - and more - at Huntsville Hospital.  The "routine" 15 minute surgery left the vibrant young child in a coma and suffering up to 50 seizures each day.  Could stories like this explain why Huntsville Hospital was ranked as one of the "least safe in Alabama" by Consumer Reports?

Gracie's family cared for her at home for years after her hospitalization, with the family forced to rely on Medicaid:

They would serve breakfast through a tube which connected to a plastic button poking out of the little girl's stomach. Then they would put her in her chair and give her the morning meds through 10 syringes. To prevent seizure, to prevent drooling, to stop her muscles from firing randomly. She would get 10 more each night. In their home outside Athens, the Smiths had dedicated a cabinet above the dishwasher to Gracie's medicine.

For medicine and doctor's visits and therapy, the Smiths were left to depend on Medicaid, the national safety net for those below the federal poverty line. Alabama's Medicaid program last year received $3.9 billion from the federal government, but the state also put up $1.4 billion.

She died last week leaving a twin sister, a loving family - and a take-it-or-leave-it offer of $100,000 in compensation from the hospital.

How did this happen?  Gracie wasn't properly monitored during recovery from surgery:

Dan Aldridge, attorney for the Smiths, said Gracie "was not connected to the customary monitoring equipment that sounds an alarm if vital signs reach a dangerous zone." He said the nurses, three of them, were in the recovery room. At one point, her mother voiced concern. "I was told, 'Mom, now don't wake her up, if we get her up, we will never calm her down," said Dee Dee Smith. "My response was she was not breathing."

Dee Dee said one of the nurses touched the girl's foot. It was cold. Aldridge said "code" was called. Medical staff poured into the room. Gracie would spend the next 18 hours in a coma. When Dee Dee finally got to hold her girl again, the girl's eyes were open but unmoving. She had no muscle control. "She was just jello," said Dee Dee of the moment she got her baby back.

According to the family, Huntsville Hospital hasn't apologized, accepted responsibility for any error, or done anything to help care for Gracie.  Their offer was $100k in "compensation."  Take it or leave it. That reaction was in line with the Consumer Reports finding:

Both Huntsville Hospital and Crestwood Medical Center received low marks for poor communication with patients and for high rates of infection. Both received mediocre marks for high rates of re-admission and unnecessary scans. 

Many of us who live in North Alabama have long marveled at Huntsville Hospital's ability to suck up real estate, open fitness centers, and lobby to stop competition - even as it poormouths about how much it spends on "indigent care."  Those families dunned endlessly by the hospital's "business office" and debt collectors are probably not that sympathetic.

Challen Stephens really nails it in his article:

Huntsville Hospital officials note they receive no public money and provide indigent care. By law, health care authorities are exempted from state open meetings requirements and their board members are exempt from the state ethics law. No other "government entity" enjoys such privacy. Hospital officials, including CEO David Spillers and board chair Phil Bentley, say such secrecy is necessary to allow for effective competition with private for-profit medical providers. They say otherwise Crestwood could know every move they made.

And Huntsville Hospital has been quite successful at business, winning the rights to operate in Madison, forming relationships with medical providers in surrounding counties, and recently opposing Crestwood Hospital's expansion of angioplasty. The state Health Care Authorities Act does not bind such a hospital to a county or even to the state, creating a local government entity that could buy and run a hospital in Hawaii or Idaho.

In short, Huntsville Hospital is able to function as a private entity when it comes to business competition or public scrutiny. But Huntsville Hospital functions as a public entity when not paying property taxes and when limiting liability to $100,000.

Gracie was buried yesterday.  Our sympathies to the family she left behind.


countrycat :: Huntsville Hospital Hides Behind State Government Liability Limit. Families Left With The Bills
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Those oxygen monitors are very simple and noninvasive (4.00 / 2)

It's a little spring-loaded gizmo that clips onto your finger.  I believe their use has been standard for any medical procedure involving anesthesia for a couple of decades.  I'd love to know the hospital's excuse for why this poor child did not have one clipped to her finger -- assuming they ever felt the need to offer any explanation at all.

I guess the lesson from this is to have your surgical procedures at Crestwood (or other private hospitals) so that, even if the hospital kills you, your heirs will at least be able to sue for damages.  It pains me to say that because I've always felt that hospitals should not be in business for the profits, but it seems that Huntsville Hospital has figured out how to profit at public expense, not to mention patient expense.

Work harder and work smarter!

Sure (4.00 / 2)

the little O2 Sat. monitor checks oxygen levels. post-op patients are supposed to be monitored very closely with a check every 5 minutes minimum. It's not that uncommon for people to have reactions to anesthesia.

my only question is why she needed a trach in the first place. There might be a back story there which would show why the hospital knew it had a high risk patient.

A lie gets halfway around the world before the truth has a chance to get its pants on. -Churchill

[ Parent ]
in general (0.00 / 0)

and I am not commenting on specific hospitals in this instance, the overwhelming data is that public hospitals have significantly lower complication rates and better outcomes than their private for-profit counterparts.  So I would hate to see people on this page start recommending private hospitals just so they could sue.

The best outcomes in safety/ quality result from non-punitive approaches using sentinal events and transparency.  A liability prone atmosphere encourages coverups and poor communication (again, I'm not commenting on this case because I don't know the real details).  All medical people are human and WILL make errors-- the best approach is to treat any observed error as a "sentinal event" and respond by collaborative effort to change the institutional practices, such as with checklists. Obviously healthcare workers who are determined to be impaired or not competent should have that remediated if possible or their licenses terminated if not.

If we had real healthcare reform-- single payer-- we would not have to see families struggle to fund healthcare or be stuck with only providers who take Medicaid.  That's a separate issue of course. And in other countries, there are also non-punitive funds for coverage of non-medical costs to individuals/ families who suffer medical injuries, similar to our Vaccine Injury Compensation fund.  Punishment is not the most effective approach to change behaviors.  There are so many other thoughtful and effective things we could do.


[ Parent ]
Clanton AL has lost its only hospital (4.00 / 2)

There was a small facility here which has now closed doors for good. It was being leased by the Carraway Medical Systems, LLC which is based in MO.

The brothers who were in charge have been sentenced to five years, but for a scam they were running in Texas, not Alabama.

The county is poor, so there's a lot of indigent care and that was cited as the reason for the hospital's financial failure. It wasn't paying bills - to the point where medical suppliers refused to deliver any more goods. Payroll wasn't met. 

The cash was going into someone's pocket, and the bills were piling up. The end result is that Clanton won't have a hospital at all for the foreseeable future. The building has aged, so now it doesn't meet "code". That means no one wants to lease the hospital and take on the huge cost of upgrading the building. A few guys got richer and the county got a lot poorer. 

Health care for profit is a very, very bad idea.


Former hospital operators sentenced to five years in federal prison

 Theft seems to run in the family...Suspect in hospital property theft extradited to Hope

 Commission to give closed hospital nearly $1 M



A lie gets halfway around the world before the truth has a chance to get its pants on. -Churchill

This is going on all over Alabama (4.00 / 1)

Probably all over the South if not the entire country.  Smaller hospitals are closing their doors and bigger, regional hospitals are getting bigger.  A woman in labor shouldn't have to drive 3 counties over to get to a hospital that can deliver a baby.

I've never liked for-profit medical care, but I also don't like the idea of shielding not for profit hospitals from the consequences of bad care they've provided.  Not sure what the answer is, but we have a problem.

Work harder and work smarter!

[ Parent ]



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