Univ. of Washington Medicine Sued for Allegedly Botched Care....Where is the Collaborative?
Happy New Year to all of our readers and friends! Let's get the New Year started with a bang!
The Collaborative for Accountability and Improvement (aka "The Collaborative"), a leading organization in the disclosure & apology movement, is housed at University of Washington Medicine. The group's website banner proudly proclaims "UW Medicine," and the email addresses for their staff are "uw.edu."
The UW/Collaborative arrangement has always raised eyebrows in the disclosure movement, chiefly because UW Medicine itself is not known for having a leading disclosure program, if any formal disclosure program at all. Moreover, the Collaborative was originally billed as a think-tank for the disclosure movement -- which is fine -- but they now heavily advertise their high-priced consulting services for hospitals. Money on the barrel leads to Collaborative experts telling you how to do disclosure. How is it, people in the disclosure movement wonder, can the Collaborative tell other hospitals and healthcare organizations how to create and sustain disclosure programs when their home institution -- UW Medicine -- is not considered a leader in the disclosure movement and may not even have a formal disclosure program? The whole thing looks a little strange. Yes, the Collaborative's Executive Director, Dr. Tom Gallagher, is heavily published in the disclosure literature. Moreover, the Collaborative does many other good things including educational outreach in the medical and legal communities. However, academic publishing and educational advocacy are much different beasts than actually starting and sustaining a disclosure program.
Maybe those chickens are coming home to roost....meet Jeremy Morton-Maxon and George Piano.
Jeremy, who is 39 years old and has a history of bladder cancer in his family, recently sought treatment at UW Medicine. UW doctors thought they detected a tumor in Jeremy's blader, so they scheduled for the tumor to be removed and biopsied. Then, weeks allegedly passed with no communication regarding the results of the biopsy, despite repeated phone calls to UW Medicine from Jeremy. Finally, his surgeon called and apologetically stated the tumor had been lost but was likely cancerous, yet, Jeremy claims he was given no treatment plan. Furthermore, Jeremy states that he heard nothing from hospital leadership regarding the never event. Jeremy filed a lawsuit and UW Medicine admitted to losing the tumor sample, but UW denied negligence and all other claims made by Jeremy and his attorney. If true, how could this behavior happen at the Collaborative's home institution?
George Piano was admitted to UW Medicine in December 2022 to remove his appendix, yet according to his attorney and multiple news reports, UW surgeons could not find the appendix and, instead, UW surgeons removed portions of Mr. Piano's bowel --- a never event. What followed was a horrific year of multiple surgeries, extended hospitalizations, excruciating pain, depression, etc as Mr. Piano fought for his life. According to Mr. Piano's attorney, the hospital told Mr. Piano early on about not finding his appendix during the first surgery, but has done little else for Paino and his family. UW apparently promised to get back to Piano and his attorney after a written notice of a claim was filed, but, according to Mr. Piano, it's been crickets chirping. That doesn't sound like the behavior that should be exhibited by a robust disclosure program.
When asked by the media about Piano's case, UW Medicine gave the deer in the headlights look by stating they care deeply for their patients but could not comment any further on pending litigation. So, UW Medicine, home to the Collaborative, could not think to say they were "sorry" to Mr. Piano and his family for the outcome, please keep Mr. Piano and his family and their staff in the prayers of the community, and they look forward to working with Mr. Piano and his attorney to understand what happened and resolve the situation quickly? Have they received no training? Is there no formal disclosure program at UW Medicine, home of the Collaborative that will tell your hospital how to do disclosure for a hefty fee?
Sure, even the best hospital or nursing home with the most robust disclosure program can have disgruntled patients, but these two never events that resulted in litigation should throw up red flags and gives credence to skeptics who wonder why the Collaborative is in the business of disclosure consulting. It's not a good look. Indeed, if UW Medicine won't eat the Collaborative's cooking, why should your healthcare organization? Should the Collaborative just follow its originally stated purpose of being a think tank for disclosure and patient safety? Regardless, UW Medicine needs to eat cooking from someone when it comes to disclosure and apology -- and start eating that cooking quickly!
Some may think this column is a pot shot, which is their prerogative. However, I believe any reform movement only reaches excellence and sustains change when criticisms can be aired. Indeed, many people have wondered why the Collaborative is in the business of consulting and telling others how to do disclosure, or CRP as they like to call it. These lawsuits will surely add to that discussion in the disclosure movement. Hopefully, this e-newsletter will also lead to discussions within the Collaborative and, most importantly, UW Medicine. Something needs to be done in Seattle....
Let's a have a great 2024 in patient safety!
Sincerely,
Doug Wojcieszak, MA, MS
Founder & President
Sorry Works, a 501c3 non-profit
618-559-8168 (direct dial)
doug@sorryworks.net