More Fear

In the early 2000s I was told many stories by family members of people taken care of by Advanced Medical Transport. The majority of these people are afraid to talk to the media. They are fearful of losing friends and business acquaintances even when a loved one has died. They are afraid of OSF. And they don't have the economic means to take OSF’s powerful legal team, which is a national law firm Hinshaw-Culbertson.

One friend of mine lost her husband. The primary fire department unit that arrived at their home could only give Basic Life Support and they needed to wait for AMT to arrive. The waiting time for AMT was very long–approximately 20 minutes. Her husband was in congestive heart failure and was transported initially without lights and sirens to OSF. She was in the ambulance with her husband and she was screaming for them to go faster. As her husband would attempt to sit up to breathe better during the ride, he would be eased back into a lying position which made it more difficult for him to breathe. He died several hours later at OSF. 

Not long after her husband died, OSF's Dr. Hevesy met with her in her home for hours, explaining things to her. She did not know at the time that Dr. Hevesy, who was in charge of all ambulances in the Peoria area, was on AMT's payroll. She was invited to give lectures to the ED residents at OSF regarding Emergency Medical Services and did not litigate against OSF or AMT for her husband's medical care. 

Another friend’s mother waited 18 minutes for AMT to arrive. Her mother died also. The PFD was at the scene but could only provide Basic Life Support. My friend told Andrew Rand, Executive Director of AMT, that she would write a letter to the PJS regarding her mother. He responded that if she did, he would respond in kind. The PJS published her letter and then a letter from another writer defending AMT. Her mother had no say so in the discussions.

In 2000, I had a Haitian Hearts patient with a severe congenital heart defect called tetralogy of Fallot. He was six years old and awaiting heart surgery and living with a host family in Peoria. One afternoon he became unresponsive at the host family home. They called 911. The PFD arrived within a few minutes and administered Basic Life support. Approximately 16 minutes after 911 was called, AMT arrived and spent quite a bit of time with him at the scene. One of the transporting AMT paramedics told me in the OSF--SFMC ED that they did not check his oxygen level at his fingertip because the boss is trying to save money. What he meant was that AMT did not carry a pulse oximeter on the ambulance to check the boy's oxygen level. Pulse oximetry is considered standard care everywhere in the developed world and oxygen saturation is considered one of the "vital signs". When I checked the child's oxygen level in the ER at OSF, it was very low, which is not uncommon with his heart defect. The paramedics did an EKG on the Haitian boy (which he didn’t need), and by mistake, they put the leads on the wrong arms. When AMT’s response was questioned in a Journal Star forum article by another physician, the acting Project Medical Director, Dr. Jim Hubler, stated that the leads were correct and that AMT had done a wonderful job. (Jim would resign his position the following year. Jim had become too friendly with the PFD and was supportive of the PFD getting rigs for transport. This thoroughly frightened Rand, Hevesy, and Miller, so Hubler left and was replaced with Rick Miller.)

People are afraid in Peoria. People fear for their jobs, scholarships for their kids, etc. They fear being marginalized. They even fear being denied medical care…I know because they have told me.

Things need to change.

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April 30, 2006

Terry Bibo wrote an article today regarding a surgical mishap at OSF. Basic mistakes happen in hospitals all around the world every day. The interesting part is the fact that OSF sent "officials" to the patient's home and apparently offered the patient and his wife a settlement. (This is very similar to Dr. Hevesy visiting my friend's home after her husband had died.)

Bibo's column ended with a "statement" from hospital spoksman Chris Lofgren who talked about "patient safety is a strategic goal for OSF St. Francis". Lofgren should have focused more on the patient and his chronic iatrogenic medical problems than the strategic goals of the hospital.

Below is the column:

Terry Bibo

April 30, 2006

Jim Scott weighs 116 pounds. He sleeps in a hospital bed instead of with his wife, Kim. That is, when he sleeps. Jim says he's in constant pain, takes a cocktail of medications and has trouble eating regular food. At 51, the one-time over-the-road trucker who loved to water ski rarely leaves his house, or even the couch.

If asked, Jim will lift his worn flannel shirt and flip out the little plastic feeding tube that has provided most of his nourishment for the last 15 months. He had to postpone our interview for a couple of days so he could have his throat dilated - a procedure

to stretch his flesh so he might be able to live more normally at some point. He's had this done a couple dozen times in the last year. It takes a day or so for him to rest up afterwards.

"It's like a balloon, they say," he rasps.

At one point, Jim's wife, Kim, blamed herself for this mess. That's because when Jim Scott was told he had an ulcer last fall, she begged him to seek a second opinion. Cancer runs in Jim's family. Kim Scott just wanted to be sure there was no mistake.

As it turns out, that second opinion was itself a mistake, the first of many. It would lead to decisions and surgery that changed the Canton couple's lives forever and plunged them into a multi-million dollar lawsuit. They've still got a lot of questions about how this happened. The "cure" did take care of his ulcer. But now Kim blames OSF Saint Francis Medical Center for the lingering effects.

"I pushed for him to go over there," she says.

In November 2004, the once-robust Jim was down to 147 pounds and continuing to lose weight. His family doctor diagnosed the cause as an ulcer, but Jim went for a number of additional tests. Then he was told he had cancer - adenocarcinoma of the esophagus. He was advised to have a radical surgery which would remove most of his esophagus and stretch his stomach so it would attach almost directly to his throat.

The Scotts were devastated. They had been married more than 25 years, with eight children between them. Jim was only 49 years old. But surgery seemed the best option. In early January 2005, Jim celebrated his 50th birthday - and the surgeon's assurance that he'd removed the cancer - at St. Francis.

Despite the feeding tube and the pain, it seemed like a fair trade. Then the Scotts went back for a doctor's appointment on March 4. Kim wanted to know when her husband would start chemotherapy and radiation. Instead, she got the classic good news/bad news of all time: Jim did not have cancer. He never had cancer. A mistake had been made. Jim's biopsy had been mixed up with another person's test. But he would live. And he would live with its effects for whatever remained of his life.

Again, the Scotts were stunned. They already were having trouble making the bills. Although Kim is the Canton ESDA director with a pager on her hip 24/7, that isn't really a full-time position, and Jim hadn't worked for months. The Scotts were scraping by with help from family and neighbors, particularly after a story in the Canton Daily Ledger by Kim's best friend.

"People were starting to send us money, gifts, gift cards," Kim says. "They would just sign these things 'A friend.' We were going through some tough times."

As a result, she says she "lost it" on the OSF officials who had come to apologize.

"I've got a $3,000 light bill at home I can't pay," she says she told them. "My husband could have been working and supporting us."

Kim says they were sent a $10,000 no-strings-attached check for their expenses from a source which asked to remain anonymous. And they were offered $1 million in settlement. But they were also getting sent to collections for related medical bills. Lawyers were calling all the time. She settled on a Chicago attorney named Joseph Powers who has advised them to seek more than 20 times that offer. In the meantime, they are preparing for trial. She doesn't know when it will end . . . or if Jim will be here when it does.

"I wish we could put this part behind us," she says. "We'll never put it all behind us. But he wouldn't have to worry."

OSF spokesman Chris Lofgren said the hospital has issued the following statement:

"We can confirm that an incident involving Mr. Scott did take place at OSF Saint Francis in January of 2005. We notified him and his wife as soon as we were aware of the situation. It is our policy to notify patients and families of any incident that could affect their health or safety.

"Patient safety is a strategic goal for OSF Saint Francis and we are part of the national '100,000 Lives' campaign to reduce medical errors.

"We make every effort to ensure a safe environment for our patients and respond quickly when a problem is discovered. We are extremely sorry for the error made in Mr. Scott's case."

Or errors. Sitting around the house pondering their own future, Jim and Kim Scott wonder about somebody else: What happened to the guy who really did have cancer? They may never know.

TERRY BIBO is a columnist for the Journal Star.