Gracie Smith was a toddler who needed just a routine tonsillectomy. She got that – and more – at Huntsville Hospital. The “routine” 15 minute surgery left the vibrant young child in a coma and suffering up to 50 seizures each day. Could stories like this explain why Huntsville Hospital was ranked as one of the “least safe in Alabama” by Consumer Reports?
Gracie's family cared for her at home for years after her hospitalization, with the family forced to rely on Medicaid:
They would serve breakfast through a tube which connected to a plastic button poking out of the little girl's stomach. Then they would put her in her chair and give her the morning meds through 10 syringes. To prevent seizure, to prevent drooling, to stop her muscles from firing randomly. She would get 10 more each night. In their home outside Athens, the Smiths had dedicated a cabinet above the dishwasher to Gracie's medicine.
For medicine and doctor's visits and therapy, the Smiths were left to depend on Medicaid, the national safety net for those below the federal poverty line. Alabama's Medicaid program last year received $3.9 billion from the federal government, but the state also put up $1.4 billion.
She died last week leaving a twin sister, a loving family – and a take-it-or-leave-it offer of $100,000 in compensation from the hospital.
How did this happen? Gracie wasn't properly monitored during recovery from surgery:
Dan Aldridge, attorney for the Smiths, said Gracie “was not connected to the customary monitoring equipment that sounds an alarm if vital signs reach a dangerous zone.” He said the nurses, three of them, were in the recovery room. At one point, her mother voiced concern. “I was told, 'Mom, now don't wake her up, if we get her up, we will never calm her down,” said Dee Dee Smith. “My response was she was not breathing.”
Dee Dee said one of the nurses touched the girl's foot. It was cold. Aldridge said “code” was called. Medical staff poured into the room. Gracie would spend the next 18 hours in a coma. When Dee Dee finally got to hold her girl again, the girl's eyes were open but unmoving. She had no muscle control. “She was just jello,” said Dee Dee of the moment she got her baby back.
According to the family, Huntsville Hospital hasn't apologized, accepted responsibility for any error, or done anything to help care for Gracie. Their offer was $100k in “compensation.” Take it or leave it. That reaction was in line with the Consumer Reports finding:
Both Huntsville Hospital and Crestwood Medical Center received low marks for poor communication with patients and for high rates of infection. Both received mediocre marks for high rates of re-admission and unnecessary scans.
Many of us who live in North Alabama have long marveled at Huntsville Hospital's ability to suck up real estate, open fitness centers, and lobby to stop competition – even as it poormouths about how much it spends on “indigent care.” Those families dunned endlessly by the hospital's “business office” and debt collectors are probably not that sympathetic.
Challen Stephens really nails it in his article:
Huntsville Hospital officials note they receive no public money and provide indigent care. By law, health care authorities are exempted from state open meetings requirements and their board members are exempt from the state ethics law. No other “government entity” enjoys such privacy. Hospital officials, including CEO David Spillers and board chair Phil Bentley, say such secrecy is necessary to allow for effective competition with private for-profit medical providers. They say otherwise Crestwood could know every move they made.
And Huntsville Hospital has been quite successful at business, winning the rights to operate in Madison, forming relationships with medical providers in surrounding counties, and recently opposing Crestwood Hospital's expansion of angioplasty. The state Health Care Authorities Act does not bind such a hospital to a county or even to the state, creating a local government entity that could buy and run a hospital in Hawaii or Idaho.
In short, Huntsville Hospital is able to function as a private entity when it comes to business competition or public scrutiny. But Huntsville Hospital functions as a public entity when not paying property taxes and when limiting liability to $100,000.
Gracie was buried yesterday. Our sympathies to the family she left behind.