Read Online The Good Nurse: A True Story of Medicine, Madness, and Murder by Charles Graeber - Free Book Online Page B
Authors: Charles Graeber
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Nancy.”
“Yeah?”
“You did nothing wrong.”
“Yeah.”
“And that’s why him and I sat down and discussed it.”
Nancy sounded like she was trying hard to keep it together. “Okay…”
“Because if, God forbid, Nancy, if they try to do anything to you, professionally?”
“Yeah?”
“We will one hundred and fifty percent back you up.”
“Okay.”
“I put it together,” Bruce said. “You? You just called for information.”
“Yeah.”
“On how to increase dig levels, or whatever.”
“Okay,” Nancy said. She sounded grateful at Ruck helping her, getting the story straight.
“You should not take the brunt.”
“I really appreciate that,” Nancy said. “I do.”
“You know,” Bruce said.
“Yeah,” Nancy sighed. She sounded on the edge of tears. “You don’t know how much that means to hear you say that right now.” 3
T here would be only one more conference call between Dr. Marcus at Poison Control and the Somerset Medical Center administration. Again,Marcus told the Somerset administrators in no uncertain terms that they were obligated to report these incidents to the state within twenty-four hours of their occurrence, and they were already out of compliance with their obligations. And again, Marcus was told by Somerset that until they’d mounted a thorough investigation, they were not planning on reporting them to anyone: not the New Jersey Department of Health and Senior Services (commonly known as the DOH), and not the police. 4
But this second conversation differed from the first in two crucial aspects. The first was raw volume, most of it from Dr. Marcus. He was, in his own words, “extremely concerned” and “frustrated”; “rude, confrontational, and adversarial in his dealings with Somerset Medical Center employees,” was how Dr. Cors would later characterize Marcus’s phone manner. The poison control director was furious and unmuzzled. He loudly protested that this was a police matter, a matter of patient safety. He gave them twenty-four hours; if Somerset refused to act, Marcus had an obligation to report their problem to the DOH, personally, and he added that it would “look a lot worse if I do it.”
In fact, Marcus had already reported the issues at Somerset. 5 Earlier that afternoon he’d called Eddy Bresnitz, MD, the state epidemiologist and assistant commissioner of the DOH, pulling him out of a meeting. Marcus would recall 6 telling Dr. Bresnitz of “a cluster of illnesses in the hospital in the state which may be based on a criminal act.” He then dashed off an e-mail to Amie Thornton, the assistant commissioner of health, summarizing both “what appears to be a cluster of four untoward clinical events” at the hospital, 7 and Somerset’s unwillingness to report them until after they mounted a thorough investigation themselves. 8
The second crucial difference came twenty minutes into the call, when Marcus informed the Somerset Medical Hospital administration that all their conversations had been recorded.
A few hours later, 9 Mary Lund contacted the Department of Health and reported their four patient incidents, Gall and Han by digoxin and the others by insulin. 10 The report, by fax and e-mail, explained the steps thus far taken to account for these incidents. They’d checked for manufacturer’s recalls and adverse drug interactions. They’d ensured that IVs and bedsidemonitors were serviceable and accurate. It couldn’t have been a lab error—they’d already rerun all the lab tests. They were running out of alternate theories, and as a caution, Somerset tightened pharmacy controls on digoxin, as they had on insulin, making their nurses now accountable for these commonly used medicines; if the drugs were being used to harm their patients, the least they could do was make them more difficult to get.
The most likely scenario to account for the incidents was human error of some sort—medication errors were always possible in a
“Yeah?”
“You did nothing wrong.”
“Yeah.”
“And that’s why him and I sat down and discussed it.”
Nancy sounded like she was trying hard to keep it together. “Okay…”
“Because if, God forbid, Nancy, if they try to do anything to you, professionally?”
“Yeah?”
“We will one hundred and fifty percent back you up.”
“Okay.”
“I put it together,” Bruce said. “You? You just called for information.”
“Yeah.”
“On how to increase dig levels, or whatever.”
“Okay,” Nancy said. She sounded grateful at Ruck helping her, getting the story straight.
“You should not take the brunt.”
“I really appreciate that,” Nancy said. “I do.”
“You know,” Bruce said.
“Yeah,” Nancy sighed. She sounded on the edge of tears. “You don’t know how much that means to hear you say that right now.” 3
T here would be only one more conference call between Dr. Marcus at Poison Control and the Somerset Medical Center administration. Again,Marcus told the Somerset administrators in no uncertain terms that they were obligated to report these incidents to the state within twenty-four hours of their occurrence, and they were already out of compliance with their obligations. And again, Marcus was told by Somerset that until they’d mounted a thorough investigation, they were not planning on reporting them to anyone: not the New Jersey Department of Health and Senior Services (commonly known as the DOH), and not the police. 4
But this second conversation differed from the first in two crucial aspects. The first was raw volume, most of it from Dr. Marcus. He was, in his own words, “extremely concerned” and “frustrated”; “rude, confrontational, and adversarial in his dealings with Somerset Medical Center employees,” was how Dr. Cors would later characterize Marcus’s phone manner. The poison control director was furious and unmuzzled. He loudly protested that this was a police matter, a matter of patient safety. He gave them twenty-four hours; if Somerset refused to act, Marcus had an obligation to report their problem to the DOH, personally, and he added that it would “look a lot worse if I do it.”
In fact, Marcus had already reported the issues at Somerset. 5 Earlier that afternoon he’d called Eddy Bresnitz, MD, the state epidemiologist and assistant commissioner of the DOH, pulling him out of a meeting. Marcus would recall 6 telling Dr. Bresnitz of “a cluster of illnesses in the hospital in the state which may be based on a criminal act.” He then dashed off an e-mail to Amie Thornton, the assistant commissioner of health, summarizing both “what appears to be a cluster of four untoward clinical events” at the hospital, 7 and Somerset’s unwillingness to report them until after they mounted a thorough investigation themselves. 8
The second crucial difference came twenty minutes into the call, when Marcus informed the Somerset Medical Hospital administration that all their conversations had been recorded.
A few hours later, 9 Mary Lund contacted the Department of Health and reported their four patient incidents, Gall and Han by digoxin and the others by insulin. 10 The report, by fax and e-mail, explained the steps thus far taken to account for these incidents. They’d checked for manufacturer’s recalls and adverse drug interactions. They’d ensured that IVs and bedsidemonitors were serviceable and accurate. It couldn’t have been a lab error—they’d already rerun all the lab tests. They were running out of alternate theories, and as a caution, Somerset tightened pharmacy controls on digoxin, as they had on insulin, making their nurses now accountable for these commonly used medicines; if the drugs were being used to harm their patients, the least they could do was make them more difficult to get.
The most likely scenario to account for the incidents was human error of some sort—medication errors were always possible in a
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