Medical Malpractice

A Death in the Hospital /Medical Malpractice

A Death in the Hospital

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 in 9,000,000.

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 Order Book.

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 actions.

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.