Second Thought: Wednesday, May 22, 2003
RX: Call Austin

The value of patients’ rights hits home.


I’ve been an advocate of patients’ rights since I entered nursing in the 1970s, when the idea of people talking back to their doctors was practically revolutionary. This spring, however, the true importance of patients’ rights was brought home to me in a very personal way. I hope this story will convince medical consumers to rise up against legislation in Austin that would limit those rights.

Last month, my 30-year-old daughter received antibiotics for a minor ailment. When that didn’t solve the problem, her doctor prescribed an anti-inflammatory drug. The problem: The drug contains sulfa, to which my daughter is highly allergic, a fact thoroughly documented in her medical records. My daughter took the drug — and got sicker. By the sixth day she had developed flu-like symptoms, plus a rash over her face and upper body. In response, the doctor prescribed a stronger antibiotic. When a day’s worth of the new antibiotics didn’t help, she stopped taking all the drugs except Benedryl, for the itching from the rash.

The next day, my worried son-in-law called me to come over. When I saw my daughter, I knew that she almost certainly had had a serious reaction to medication. Essentially, she appeared to be chemically burned over 90 percent of her body. I rushed her to the hospital with my blinkers flashing. At this stage, the drug reaction could have damaged her internal organs.

At Harris Hospital Fort Worth, the emergency room nurse spotted the problem — the sulfa drug — right away. Emergency personnel immediately began administering powerful steroids to combat the allergic reaction. But by then she truly looked like a burn victim. Large, raised welts covered her face, neck, arms, and legs.

My daughter’s doctor couldn’t come to the emergency room, but his associate did. When the associate arrived at my daughter’s bedside, I was proud that she looked him in the eye and told him she didn’t know whether he should be allowed to treat her, since it was his partner who had caused her problems in the first place. The associate doctor was compassionate, straightforward, and thorough. But I told him I still expected his partner to come to the hospital to explain and apologize.

He did. The primary doctor took full responsibility for the error and agreed to reimburse her for lost wages and for current and future medical costs and to do all he could do to return her to full health.

My daughter is making a good recovery. However, her skin still shows a splotchy rash, and she remains on powerful steroids, which make her joints ache and leave her dizzy. There is no way to know if she will suffer long-term ill effects.

But what would have happened if my son-in-law hadn’t called me, or my daughter hadn’t been able to get to the hospital? We could have lost her. And how would we have been treated if I had not known where to look in the medical records to find out what had happened, or if her doctor had not been an honorable man who admitted a mistake?

Under House Bill 4, being considered by the Texas Legislature, voters would be asked to change the Texas Constitution to cap punitive damages on medical negligence at $250,000. To satisfy business interests, this bill would take away your constitutional right to have a jury decide those damages.

When I began my nursing career in Chicago, doctors would pat pregnant women on the shoulder and tell them not to worry about the details of childbirth. When I moved to Atlanta a few years later, I introduced the first Lamaze classes there. When I arrived in Texas in 1979, husbands were rarely allowed in the labor room with their wives, much less in the delivery room. I spent years telling women to challenge their doctors and to demand a larger role in making childbirth decisions. I was considered a maverick; I always considered myself a pioneer.

I have been saddened, therefore, at the lack of response I have seen to the so-called tort reform proposals that are now threatening the rights of medical consumers. Such “reforms” supposedly will hold down malpractice insurance rates and medical costs and discourage “frivolous” lawsuits.

I agree that all sides need to try harder to resolve cases of possible medical negligence without going to court. I also believe that hospitals and doctors should deal with negligence claims in good faith, acknowledging errors and negotiating claims when appropriate.

Families, in turn, need to be better advocates for loved ones injured by doctors’ mistakes. They need to insist on accountability for errors and complain to administrators when doctors don’t provide information. They must be ready to ask tough questions, to be persistent, to insist on the right to read medical charts. They should never leave a family member in the hands of medical personnel until they are satisfied that good care is being given.

But when your doctor is acting more like a businessman than a physician, to whom do you turn for medical care? Where is the Hippocratic oath these days? And when will medical consumers speak out for their rights?

Linda LaBeau is a civil and family court mediator.

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