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Sunday, February 3, 2013

Hospital's mistake leaves single Brooklyn mom with 6 months to live

EXCLUSIVE: When Laverne Wilkinson first felt chest pains, the Kings County Hospital doctor told her to take Motrin. But the doctor failed to tell her that her chest X-ray, in fact, showed a suspicious, 2-centimeter nodule in Wilkinson’s right lung.

Laverne Wilkinson went to the hospital in 2010, believing she was having heart attack. Despite X-ray showing suspicous nodule in her lung, she was told to go home and take pain medication. Now, she has has lung cancer that has spread to  brain and spine. Photos by Debbie Egan-Chin/Daily News

Debbie Egan-Chin/New York Daily News

Laverne Wilkinson went to the hospital in 2010, believing she was having heart attack. Despite X-ray showing suspicous nodule in her lung, she was told to go home and take pain medication. Now, she has has lung cancer that has spread to brain and spine.

On the morning of Feb. 2, 2010, Laverne Wilkinson was suddenly seized with chest pain while cleaning her apartment.

The single mom made her way by bus to Kings County Hospital, stricken with the fear she was having a heart attack. Doctors in the busy emergency department ordered an EKG and chest X-ray — and gave her a clean bill of health.

First-year resident Dr. James Willis assured Wilkinson that her tests were normal.

“You should take Motrin for pain, and follow up with your doctor,” Willis wrote on her chart.

He was dead wrong.

The chest X-ray, in fact, showed a suspicious, 2-centimeter nodule in Wilkinson’s right lung. The radiologist had recommended in his written report that Wilkinson have a followup X-ray in three months, and if “clinical concern warrants, a CT scan is suggested.”

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Debbie Egan-Chin/New York Daily News

Laverne Wilkinson

But Wilkinson was never given this information. Not that winter day in 2010. Not during two years of followup clinic appointments, during which she complained of a chronic cough. Not from her primary care clinic doctors at Kings County.

When Wilkinson returned to the ER in spring 2012 — wheezing and short of breath — a new chest X-ray was taken. It showed the nodule was cancerous, had more than doubled in size and spread to her left lung.

Now the diagnosis was Stage 4 lung cancer — and it had metastasized to her liver, spine and brain.

As Wilkinson’s lung cancer galloped unchecked for more than two years, Kings County doctors botched her care, offering her cough medicines, inhalers and steroids in the blind belief that her ailments were caused by her longstanding asthma.

“I was shocked. I was told I had six months to a year to live,” the former home health aide told the Daily News in an emotional interview in her public housing apartment in Brooklyn.

Breaking down in tears as she spoke about her only child, a severely retarded and autistic 15-year-old daughter, Wilkinson sobbed, “She is going to be left without a mother. What is going to happen to my little girl?”

As if a diagnosis of terminal metastatic cancer wasn’t horrible enough, there was one more bombshell to be dropped on Wilkinson — she probably could have been cured.

Dr. Gary Briefel, the attending physician on call when Wilkinson was in the hospital in May 2012, broke the stunning news to her about the findings on the February 2010 chest X-ray, and that she had a chance to live.

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Jeff Bachner/for New York Daily News

Laverne Wilkinson (seated center), at church with (left to right) Valerie Thompson, Angie Hansen, Linsey Morris, Kim Call and Mara Kofoed.

His shockingly candid chart note of May 18, 2012, written after a bedside visit, said it all:

“I spoke to the patient about the fact that she had a chest X-ray in Feb 2010 while she was in the ED that showed a nodule that probably represented an earlier stage of what we now know is Squamous Cell Cancer,” Briefel wrote.

“I told her that apparently nobody saw the report, which suggested either repeating the X-ray or getting a CT scan. I told her that it was not clear whether earlier diagnosis would have led to a cure, since many lung cancers by the time they are seen on a CXR (chest X-ray) have already spread, but that it was possible that a surgical cure could have been achieved.”

Wilkinson recalled the doctor giving her a hug and apologizing.

Reached at home by The News, Briefel said he remembered Wilkinson vividly, but he was not at liberty to talk without the hospital’s permission.

“Everyone felt terrible about what has happened,” said Briefel, who did the honorable thing of documenting the error in her chart.

A spokeswoman for the city’s Health and Hospitals Corporation — which oversees Kings County Hospital — declined comment, citing possible litigation.

“It’s mortifying,” said Judith Donnel, Wilkinson’s attorney. “No one looked at the radiology report for more than two years. And over those same two years, her primary care doctors at Kings County clinics ordered all these drugs that were breathing-related but never ordered another chest X-ray or pulmonary-function test. Her life could have been saved.”

Donnel has filed a Notice of Claim, the first step in a potential lawsuit against the city. A hearing is scheduled for Jan. 25. The claim seeks monetary damages for severe injuries, pain and suffering inflicted upon Wilkinson “as a result of the carelessness, recklessness, negligence and medical malpractice” at Kings County Hospital.

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Emergency Room doctors tell Brooklyn mom her chest x-ray was normal and sent her home.

Indeed, lung cancer experts say patients such as Wilkinson — nonsmokers with a 2-centimeter “squamous, nonsmall cell cancer” — have a good chance of being cured with surgery.

“If you find a lung cancer early, before it has invaded lymph nodes, the cure rate is 75%,” said Dr. Roy Herbst, chief of medical oncology at the Yale School of Medicine. “Once it spreads, a cure doesn’t exist.”

Wilkinson, now 41, is growing weaker. She told The News her head and back often hurt, and she is not able to do as much as she did before the cancer spread. Just last week, she was hospitalized for five days for a blood clot that developed in her lung.

With very little family in the city, she is sustained by one aunt and members of her church, who have taken her and her daughter, Micalia, under their wing.

It was a church member, a tax professor at Brooklyn Law School, who suggested she speak with a medical malpractice lawyer when he learned of Wilkinson’s plight.

“I am just going to say there is no amount of money in the world,” Wilkinson said, her voice cracking with emotion. “If someone was to give me a choice between having money or having my life back and my health back, I would choose my health and having my life back for the sake of this beautiful, little girl.

“Doctors need to be more careful and realize they have the lives of their patients in their hands,” she added. “They are human and do make mistakes. If it were a mistake where I was going to lose a lung and still live, then I could deal with that.”

But Wilkinson wasn’t given that chance.

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“We trust our doctors,” she said. “I think that’s where a lot of us go wrong, because we put this trust in them that if there is something going on with me, I will get the information and I will be sent for followup care.”

Now, as she measures her days, Wilkinson thinks only of the girl she has devoted her entire life to. Micalia doesn’t speak, and is a physical handful as she gets older and stronger. She is dependent on her mother for every aspect of her life. Wilkinson said she has appointed a guardian for Micalia, but church friends say she worries her daughter may end up in an institution without her round-the-clock devotion and singular love.

Wilkinson’s great source of comfort has been the congregation at The Church of Jesus Christ of Latter-Day Saints in Park Slope. One member, Mara Kofoed, has known her for 10 years. Along with other congregants, she has accompanied Wilkinson to her chemotherapy treatments in hopes of slowing the disease, and has brought the family dinner as Wilkinson struggles with her health.

“Laverne is just one of the most loving people I ever met,” said Kofoed, 35, as the two shared a warm moment at a recent Christmas church service. “She is incredibly patient, just loves her daughter to no end. That woman is full of wisdom, and strength and peace.

“What has happened to her is heart-wrenching. It’s heartbreaking to think of her having to let go of Micalia.”

Wilkinson said she decided to go public with her tragedy to “help prevent this from ever happening to anyone else.” Looking sullen and resigned, she added, “This may be my last Christmas with my daughter.”

Reviewing Wilkinson’s medical records, it is unclear how many doctors failed her and how such a lethal lapse could have happened. What is clear is that the ER’s first-year resident Willis — and the attending Dr. Antonia Quinn — told Wilkinson she was fine and discharged her around noon on Feb. 2, 2010. Radiologist resident Dr. Driss Raissi and attending Dr. Russell Areman’s final report documenting the nodule in her right lung was written at 2 p.m. — two hours after Wilkinson went home.

In his May 18, 2012, chart note, written after his bedside visit with Wilkinson, Dr. Briefel promised a shattered Wilkinson that a thorough review of her case would be undertaken “with the goal of finding ways to improve how we provide care and that the hospital would let her know the results of the investigation.”

It has been nearly eight months. Wilkinson has never heard a word from administrators or doctors at Kings County Hospital.
hevans@nydailynews.com


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Debbie Egan-Chin/New York Daily News

Dr. Gary Briefel, an attending doctor at King's County Hospital, discovered medical mistakes and tells Wilkinson the tragic truth that her X-ray report from 2010 was never seen. Briefel documents the error in Wilkinson's chart.

 





Comments (237)
Carol Davis6 days ago
Reality #1. Doctors make mistakes. We put them in a position of high accountability, as we should. But this was a 1st year Intern, keep that in mind. Responsibility was in the hands of the attending veteren physicians and medical director.
Reality #2. Always, always get a second opinion. If you're not comfortable with the diagnosis, you have the right for 2nd, 3rd opinion. Follow your intuition
Reality #3. Research the medical facility you go to. What is their hospital ranking? Malpractice history, find out how low or high they score. There's the difference in quality when shopping for hospitals, they are not all equally competent.

Quality Assurance/Quality Control...what systems if any were implemented? Facilities with manual systems vs. digital patient medical records systems are much more prone for break down in their quality assurance systems. Obvisiously there was no "Abnormal results" logging system. Take for example a system which is completely manual. Lets say for example the person responsible to generate manual logs of abnormal pap smears, is unfamilair with the process, has poor training, or the printer experiences mechanical failure. While the reports were printing, the printer jams up. The resulting lab doesn't resend auto prints once they are generated. The abnormal paps for Jane Doe is generated but "electronically lost" in the printer, or slips behind the printer, or gets lost in the deep piles of paperwork that medical offices experience. The paper result is never printed and never filed in the patient's file=missed follow up for the patient, left untreated terminal cervical cancer.. Had this been an electronic Medical Patient system, the report is automatically sent to the patient's electronic medical record. The medical provider has instant access to it, and is one of the first reports they will review. There's an electronic paper trail for QA/QC. Patient abnormals are addressed with early intervention. I stay away from medical offices with paper medical charts, not worth the unending scenarios of simple human error and the breakdown of processes.

Part of the Healthcare Reform bill by Obama (which is strictly optional to medical facilities) is the HITECH Act of 2009

On February 17, 2009, President Barack Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the stimulus package referred to as the American Recovery and Reinvestment Act. With provisions to promote meaningful use of health IT in an effort to improve the quality of American health care, this electronic medical records stimulus legislation designates $19.2 billion to fund the adoption of health IT.

My heart goes out to this brave mother and I can only hope for the best, that she beats all the odds, and does survive.
Carol Davis6 days ago
Reality #1. Doctors make mistakes. We put them in a position of high accountability, as we should. But this was a 1st year Intern, keep that in mind. Responsibility was in the hands of the attending veteren physicians and medical director.
Reality #2. Always, always get a second opinion. If you're not comfortable with the diagnosis, you have the right for 2nd, 3rd opinion. Follow your intuition
Reality #3. Research the medical facility you go to. What is their hospital ranking? Malpractice history, find out how low or high they score. There's the difference in quality when shopping for hospitals, they are not all equally competent.

Quality Assurance/Quality Control...what systems if any were implemented? Facilities with manual systems vs. digital patient medical records systems are much more prone for break down in their quality assurance systems. Obvisiously there was no "Abnormal results" logging system. Take for example a system which is completely manual. Lets say for example the person responsible to generate manual logs of abnormal pap smears, is unfamilair with the process, has poor training, or the printer experiences mechanical failure. While the reports were printing, the printer jams up. The resulting lab doesn't resend auto prints once they are generated. The abnormal paps for Jane Doe is generated but "electronically lost" in the printer, or slips behind the printer, or gets lost in the deep piles of paperwork that medical offices experience. The paper result is never printed and never filed in the patient's file=missed follow up for the patient, left untreated terminal cervical cancer.. Had this been an electronic Medical Patient system, the report is automatically sent to the patient's electronic medical record. The medical provider has instant access to it, and is one of the first reports they will review. There's an electronic paper trail for QA/QC. Patient abnormals are addressed with early intervention. I stay away from medical offices with paper medical charts, not worth the unending scenarios of simple human error and the breakdown of processes.

Part of the Healthcare Reform bill by Obama (which is strictly optional to medical facilities) is the HITECH Act of 2009

On February 17, 2009, President Barack Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the stimulus package referred to as the American Recovery and Reinvestment Act. With provisions to promote meaningful use of health IT in an effort to improve the quality of American health care, this electronic medical records stimulus legislation designates $19.2 billion to fund the adoption of health IT.

My heart goes out to this brave mother and I can only hope for the best, that she beats all the odds, and does survive.

Carol Davis6 days ago
Reality #1. Doctors make mistakes. We put them in a position of high accountability, as we should. But this was a 1st year Intern, keep that in mind. Responsibility was in the hands of the attending veteren physicians and medical director.
Reality #2. Always, always get a second opinion. If you're not comfortable with the diagnosis, you have the right for 2nd, 3rd opinion. Follow your intuition
Reality #3. Research the medical facility you go to. What is their hospital ranking? Malpractice history, find out how low or high they score. There's the difference in quality when shopping for hospitals, they are not all equally competent.

Quality Assurance/Quality Control...what systems if any were implemented? Facilities with manual systems vs. digital patient medical records systems are much more prone for break down in their quality assurance systems. Obvisiously there was no "Abnormal results" logging system. Take for example a system which is completely manual. Lets say for example the person responsible to generate manual logs of abnormal pap smears, is unfamilair with the process, has poor training, or the printer experiences mechanical failure. While the reports were printing, the printer jams up. The resulting lab doesn't resend auto prints once they are generated. The abnormal paps for Jane Doe is generated but "electronically lost" in the printer, or slips behind the printer, or gets lost in the deep piles of paperwork that medical offices experience. The paper result is never printed and never filed in the patient's file=missed follow up for the patient, left untreated terminal cervical cancer.. Had this been an electronic Medical Patient system, the report is automatically sent to the patient's electronic medical record. The medical provider has instant access to it, and is one of the first reports they will review. There's an electronic paper trail for QA/QC. Patient abnormals are addressed with early intervention. I stay away from medical offices with paper medical charts, not worth the unending scenarios of simple human error and the breakdown of processes.

Part of the Healthcare Reform bill by Obama (which is strictly optional to medical facilities) is the HITECH Act of 2009

On February 17, 2009, President Barack Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the stimulus package referred to as the American Recovery and Reinvestment Act. With provisions to promote meaningful use of health IT in an effort to improve the quality of American health care, this electronic medical records stimulus legislation designates $19.2 billion to fund the adoption of health IT.

My heart goes out to this brave mother and I can only hope for the best, that she beats all the odds, and does survive.
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