Articles - Medical Malpractice
Wesley settles patient lawsuit ::
(11 18, 2005)
Friday, July 7, 2000
By Ron Sylvester
The Wichita Eagle
The Wichita hospital will pay $2.7 million to avoid a trial on allegations a nurse shortage nearly cost a woman her life.
The family of a Wichita woman who claimed she had suffered a paralyzing stroke because of nursing shortages at Wesley Medical Center agreed to a $2.7 million settlement with the hospital Thursday.
Shirley Keck, now 63, entered the hospital in February 1998 for lung problems. In their lawsuit filed last year, Keck and her family said there weren't enough nurses to check her regularly.
That led to a gradual deterioration of her condition until she almost stopped breathing, went into a coma and suffered brain damage that left the mother of five daughters who once enjoyed making crafts unable to care for herself, Keck's family said.
Wesley's top administrator maintained Thursday that the hospital was hit by a staff shortage that spans the entire health care industry and that the medical center looks out for the safety of its patients. Wesley is one of more than 200 hospitals under the corporate ownership of HCA -- The Healthcare Co., based Nashville, Tenn.
"There are times that because of patient population our staff may fall below our desired levels in an attempt to serve the community," said Wesley president and chief executive Carl Fitch. "But I am confident that our staffing levels are safe and appropriate to the industry."
Keck's lawyer, Brad Prochaska, said Wesley was using talk of a nationwide nursing drought to wash away its own shortcomings.
Wesley's settlement with the Kecks does not include a confidentiality clause. That allows Keck and her lawyer to release documents and talk about circumstances they say left her unable to walk, talk, feed herself or perform other simple tasks.
And they want to talk about what happened to Shirley Keck.
"To me, you can't hide something like this," said Becky Hartman, Keck's daughter who quit her job as a telephone operator to care for her mother. "People need to know about this, so it won't happen to them."
Prochaska said Wesley did not live up to its own staffing guidelines, dipped below safe levels and did not use methods practiced at other Wichita hospitals to shore up staffing during patient crunches.
"This is not about someone sitting on a bedpan for hours or not getting their sheets changed," Prochaska said. "People are getting harmed by this."
Prochaska was prepared to take the case to trial next week in Sedgwick County District Court.
Among his court filings:
An incident report by Keck's physician, John Hart, criticizing nurses for not keeping him informed about her condition.
The sworn testimony of Wesley nurses and former nurses that the incidents of low staffing in 1998 weren't isolated. The nurses said understaffing, especially on the medical-surgical unit in the Seventh Tower, where Keck was a patient, was well known within the hospital for years.
Wesley documents showing the staffing on the second shift of the Seventh Tower failed to meet the hospital's own staffing guidelines for 51 of 59 days from January through February 1998.
Testimony from expert witnesses saying Wesley did not use some of the same methods as other Wichita hospitals to relieve staffing problems.
Alison Goodman worked as a Wesley nurse in the float pool, a staff within the hospital not permanently assigned and available to floors that don't have enough nurses.
"Seventh Tower chronically sends messages for help, seemingly daily, despite float pool assistance," Goodman said in court papers. She added that she saw "chronic, long-term, unsafe levels of staffing, which translates to well- documented unsafe care."
Linda Dick, a former Wesley nurse, said she quit the hospital because of routinely long shifts, mandatory overtime and tireless demands created by staff shortages.
"Many had complained of the staff problems prior to this in (the) fall of '97 and still no staff was found," Dick wrote. "I felt that patient safety was in jeopardy...."
Fitch maintained that Wesley always put patient safety first.
But he said when nurses feel overworked and quit, it exacerbates the shortage.
"I think there's a vicious cycle that goes on," Fitch said. "The staff feels understaffed, so they leave, then that leaves you further understaffed. Then they go across town and find they're understaffed, too. I'm not pointing fingers at any hospital. This is just a problem all hospitals are facing."
But a nursing administrator at Via Christi Regional Medical Center, testifying as an independent expert, stated that her hospital takes steps that she saw no evidence of in reviewing staffing documents at Wesley.
Margaret Short, program director for nursing systems at Via Christi, said she saw no evidence Wesley used outside agencies, bonuses or other alternatives that she seeks on a regular basis to bolster her own staff of nurses.
"I spend time each week talking with local and national agencies to obtain supplemental staffing for our needs," Short wrote in papers filed with the court.
Short said in reviewing Wesley's records, she found no evidence the medical center took the seriousness of patient conditions into account in its staffing.
That's known in hospitals as patient acuity, and Fitch said that's not as important in today's managed care environment as in decades past.
"Twenty years ago, you might have really sick patients and unsick patients on the same floor," Fitch said.
Then, patient conditions determined levels of care and staffing needs, he said.
"Today, because of the way insurance pays and government pays, you can be pretty sure patients in the hospital are all pretty sick," Fitch said. "You can predict the needs based on volumes of patients and not acuity because everyone in there is sick."
Hartman said she complained about lack of attention by hospital staff to her mother's condition.
While Hartman was out of the room, she remembers, nurses said her mother needed resuscitation.
"They said, 'We were able to save her.' I said, 'Save her? You did this to her,' " Hartman said.
The daughter-in-law of the patient who shared Keck's room, Martha Skaggs, said in court documents that nurses didn't respond to call lights seeking help for the two women.
The settlement money, scheduled to change hands in Sedgwick County District Court by July 17, should ensure Keck the help and treatment she needs for the rest of her life, her family and lawyer said.
But Prochaska said he turned down the same amount of money last week because Wesley wanted to bar the parties from further comment.
At trial, scheduled to start Tuesday, Keck planned to ask for $10 million.
Prochaska said his clients balked at the confidentiality clause.
"You can take the money, but if you can't talk about it, then the problem doesn't get fixed," Prochaska said.
Wesley then dropped its demand for confidentiality.
Fitch said the suit hasn't changed the way Wesley staffs its units.
"We've been making changes constantly in our recruitment and retention of nurses," Fitch said. "This incident didn't cause us to do anything different than we have for the last 15-20 years."
Reach Ron Sylvester, who covers courts, at 268-6514 or rsylvester@wichitaeagle.com.
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