After 6 days being unwillingly made a
human model for training purposes, our
son Seth Speken died on August 27, 1993.
His death was at the premier Ivy League
teaching hospital, Columbia Presbyterian
Hospital in the City of New York.
This Web Site is dedicated to Seth. It
is also dedicated to the other 133 people
who died that week directly as a result of
medical negligence in hospitals in New
York State. The Harvard Medical
Practice Study, documented in The New
England Journal of Medicine, (February
7, 1991), found strong evidence of
6895 deaths during the year 1984 in New
York hospitals due to negligent medical
care alone. One can only imagine what the
statistics are now.
On a national basis the Harvard
numbers work out to approximately
100,000 people dying each year from
medical negligence. To make this figure
understandable, it is roughly equivalent
to one 747 jetliner, filled with passengers,
crashing every day of the week.
Yet, as frightening as these numbers
are, they may be vastly understated. As
reported in Lancet (1997:349:309-313),
the actual rate of medical negligence in
hospitals could be at least 17.7% and
probably higher. People in hospitals run
an almost 1 in 5 risk of suffering medical
negligence. In many case, as happened to
Seth, this will result in death.
To put this figure in perspective, your
risk of dying in a plane crash is around 1
The Harvard Medical Practice Study
identifies "Physician inexperience" as
being probably the largest single cause of
medical negligence. In The Girl Who Died
Twice (Delcort Press, 1995), Natalie
Robbins describes a common practice
in teaching hospitals called the Closed
It is the blatant permission
to leave health care decisions involving
human life in the hands of green students
who receive minimal supervision and
monitoring if they receive any at all.
In the Law, a Fiduciary is the person
you place your trust in to handle
important issues you are incapable of
handling yourself. A physician is a
Fiduciary whom you entrust with your life.
Not knowing of the Closed Order Book,
we entrusted the care of our son's life to
inexperienced trainees. The system of
medical education typified by the Closed
Order Book meant that Seth's body was
in the Allen Pavilion principally to serve
the training needs of the students. These
trainees were to learn by their mistakes.
This was vastly different from the
medical education I had received a
generation earlier when experienced
physicians closely monitored all my
As pointed out by Robbins, medical
educators and State Medical Board
regulatory agencies are well aware of this
practice of giving patient care
responsibilities to untrained students.
This is called the 'dirty little secret' of
Medicine. In the case of Seth Speken the
Closed Order Book, that is, the turning
over life and death decisions to the
youngest and least experienced, led to
its ugliest but predictable conclusion.
The American health care delivery
system may be the world's finest but there
is a monstrous level of 'acceptable'
death. This is a national shame.
Ralph H. Speken, M.D.
Stephanie Z. Speken, M.S.
Click for Preface