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Sarah Witter fractured two bones in her lower left leg while skiing in Vermont last February. She had two operations to repair the damage. The second surgery was needed to replace a metal plate that broke after it was implanted.
Matt Baldelli for KHN
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Matt Baldelli for KHN
Sarah Witter couldn’t catch a break even though her leg had gotten several.
As she lay on a ski trail in Vermont last February, Witter, now 63, knew she hadn’t suffered a regular fall because she couldn’t get up. An X-ray showed she had fractured two bones in her lower left leg.
A surgeon at Rutland Regional Medical Center screwed two gleaming metal plates onto the bones to stabilize them. “I was very pleased with how things came together,” the doctor wrote in his operation notes.
But as spring ended, the wound started to hurt more. In June, Witter returned to the doctor. “He X-rayed it and said it broke,” she said. “And I was thinking, what broke? And he said, the plate. He said they do sometimes.”
The doctor performed another operation, removing the cracked plate and replacing it with a larger one.
Witter said she had been dutifully following all the instructions for her recovery, including going to physical therapy and keeping weight off her leg.
“I was, of course, thinking, ‘What did I do?’ ” Witter said. “The doctor said right off the bat it was nothing I did.”
Then the bill came.
Patient: Sarah Witter, a retired teacher and ski buff who had moved from Pennsylvania to Vermont for the outdoorsy lifestyle.
Total bill: $99,159 for emergency services, therapy and hospital care, including $52,587 for the first surgery and $43,208 for the second surgery. Altogether, Witter’s insurer, Aetna, paid $76,783. Witter paid $18,442 — including $7,808 for the second surgery. About half of Witter’s total expenses were copayments; an additional $7,410 was the portion of hospital charges that Aetna considered unreasonably high and refused to pay.
Service provider: Rutland Regional Medical Center, the largest community hospital in Vermont, performed the surgeries. Emergency services, anesthesia and physical therapy were done by other providers.
Medical service: In February, two metal plates called bone fixation devices and manufactured by Johnson & Johnson’s DePuy Synthes division were surgically attached to two lower leg bones Witter had fractured in a skiing accident. These plates are long, narrow pieces of metal with holes drilled in them at regular intervals for screws to attach them to the bones. A crack had developed in one of the plates running from the side of one of those holes to the edge of the plate. A second surgery was required to remove the plate and replace it.
What gives: When devices or treatments fail and need to be replaced or redone, patients and their insurers are typically expected to foot the bill. That may be understandable if a first course of antibiotics doesn’t clear bronchitis, requiring a second drug. But it is more problematic — and far more expensive — when a piece of surgical hardware fails, whether it’s a pacemaker, a hip that dislocates in the days after surgery or a fractured metal plate.
Warranties, standard features at an electronic store or a car dealership, are uncommon for surgeries and medical devices used in them.
Dr. James Rickert, an orthopedic surgeon in Indiana and president of the Society for Patient Centered Orthopedics, said a plate like the one implanted in Witter’s leg can fail if the surgeon doesn’t line it up correctly with the bone, although usually that causes the screws to break or back out. A plate also can fail if the patient puts too much weight on it or doesn’t follow other recovery instructions. There can also be a flaw in the implant.
If implanted medical devices fail, as one of Witter’s metal plates did, patients and their insurers usually have to pay for repairs. “I hate to pay for it again, and the doctor clearly said it wasn’t anything I did,” she said.
Matt Baldelli for KHN
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Matt Baldelli for KHN
“When the plate breaks, it’s usually from overworking it, or a defect in the plate itself,” Rickert said. “The vast majority of people follow their instructions and are honest about it. If a person comes in and tells you they’ve been following their instructions and the surgery’s done properly, to me that’s a hardware failure.”
Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said sometimes hospitals won’t charge for a second surgery “if they were aware that it was something they did that caused the patient to need follow-up care.”
Rutland Regional, Witter’s hospital, wouldn’t discuss Witter’s care or bills, even though she gave it permission to do so. “The organization is not comfortable in getting into the specifics of an individual patient’s case,” a spokeswoman wrote. The hospital also declined to discuss under what circumstances, if any, it would discount a second surgery’s cost because of the first’s failure.
Hospitals don’t consider it their responsibility if a medical device failure is the problem, Foster said. But manufacturers are reluctant to take the blame for an unsuccessful surgery.
AdvaMed, a trade group for medical device manufacturers, said some companies will provide replacement devices if theirs failed, but others don’t, especially if the failure of a procedure cannot “easily be attributed” to the device, the group said in a written statement.
“There are numerous factors outside of a manufacturer’s control — and unrelated to the safety of the device as designed — that could result in a device not performing as intended,” AdvaMed said.
These devices aren’t cheap: Witter’s hospital billed $9,706 for the first set of plates. It billed $12,860 for the replacement and an extra piece of equipment to attach it.
DePuy Synthes, which manufactured Witter’s plates, said in a written response that “in rare circumstances” metal plates “may fracture under normal weight-bearing or load-bearing in the absence of complete bone healing.” Even then, the company said, that is a chance patients have to take.
AdvaMed said it doesn’t keep statistics on device performance, and DePuy didn’t respond to questions about how often its plates fail.
Resolution: The second surgery delayed Witter’s recovery by four months and prevented her from gardening, golfing, hiking, biking and motorcycling through the summer and fall, as she usually does. “I was pretty much chairbound for 20 weeks,” she said.
In November, she wasn’t able to join her husband and son on a trip to Iceland. Instead of volunteering at a nearby ski resort, as she had done for six years — and which carries the benefit of a free season pass — Witter said she tried selling hand warmers and lip balm out of a small kiosk and watching the skiers through a window. She said she had to quit after six days because of the pain in her feet.
“The biggest annoyance with this whole thing, even though it took eight months out of my life, is I hate to pay for it again, and the doctor clearly said it wasn’t anything I did,” she said.
Aetna said in a statement that while it doesn’t allow providers to charge for indisputably inept medical mistakes such as leaving a surgical sponge in a patient or operating on the wrong limb, a broken plate doesn’t qualify for such protection. (Medicare follows a similar approach.)
After reviewing Witter’s records, Aetna said it concluded the hospital had billed Witter for the portion of charges Aetna had considered excessive — a practice known as “balance billing.” While Aetna cannot reject those charges because the hospital doesn’t have a contract with it, the spokesman said Aetna would try to negotiate with the hospital on Witter’s behalf to reduce the bill.
Rutland Regional, however, indicated in its statement that the only reason it would discount a bill was for people who had inadequate insurance or were suffering financial hardship from the size of the bills. Witter said she doesn’t meet the hospital’s criteria.
The hospital invited her to meet with her surgeon and its chief financial officer.
The takeaway: Witter brought up the seeming unfairness of the double charges to the hospital’s billing department as well as to her doctor, who, she said, was “charming,” but told her “he had no wiggle room to do anything.” Patients are usually out of luck when a second surgery is needed because of the failure of a medical device or a surgeon’s mistake. A few places, most prominently the Geisinger health system in Pennsylvania, offer warranties for hip and knee, spine and coronary artery bypass surgeries, among other procedures.
AdvaMed says that if a company provides a replacement, the hospital or surgeon isn’t supposed to bill Medicare or the patient for the equipment — even if the operation incurs charges.
Patients should scrutinize their bills and question their doctor and hospital or surgical center about charges for replacement devices.
If the doctor or hospital is partially at fault for the failure of the first procedure, request that part or all of the costs of the second surgery be waived. Get it in writing so you can make sure the billing department follows through. Also, in a medical market where insurers want to pay only for value-based care, let your insurer or employer’s human resources department know that you are being charged twice for the same surgery. Let them fight the battle for you.
NPR produced and edited the interview with Kaiser Health News’ Elisabeth Rosenthal for broadcast. Nina Keck, a reporter with member station WVPR in Vermont, provided audio reporting.
Do you have an exorbitant or baffling medical bill that you’d like KHN and NPR to look into? You can tell us about it and submit a copy of the bill here.
KHN is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that isn’t affiliated with Kaiser Permanente.
The “Medicaid Drug Decisions Transparency Act” would require pharmaceutical companies to disclose their payments to pharmacists and others who serve on state Medicaid drug boards — the advisory groups that decide which drugs Medicaid will and won’t cover.
Gary Waters/Ikon Images/Getty Images
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Gary Waters/Ikon Images/Getty Images
Sen. Cory Booker, D-N.J., says he will introduce federal legislation this week that would require more transparency surrounding states’ Medicaid drug decisions. The bill comes in response to a recent investigation by the Center for Public Integrity and NPR.
The measure, known as the “Medicaid Drug Decisions Transparency Act,” would require pharmaceutical companies to disclose their payments to pharmacists and others who serve on state Medicaid drug boards. These boards help decide which drugs Medicaid patients will be able to access easily. Currently drugmakers must only disclose perks given to doctors, such as free dinners, speaking fees and consulting gigs. In addition, the bill would increase penalties for companies that fail to comply with reporting requirements.
“These are really nefarious tactics that drug companies use, and they use them to influence state Medicaid programs’ drug coverage decisions,” says Booker. “My bill’s going to address this problem by increasing transparency — shining a light onto these payments.”
The proposed federal legislation was prompted by the recent Medicaid, Under the Influence investigation from the Center for Public Integrity and NPR, which revealed how drugmakers influence states’ choices regarding drugs for Medicaid patients.
The investigation, published in July, found that drug companies swarm state Medicaid board meetings when their drugs are under consideration, and have given payments and perks to three out of five doctors recently serving on those boards. The companies’ efforts to undermine state drug cost controls have helped push up Medicaid expenses nationwide.
The Senate bill would also require states to publish and update the lists of members on their Medicaid drug boards. The Center for Public Integrity had to scour meeting minutes, call agencies and formally request public records to compile a list of board members across the U.S. Even so, reporters still could not obtain information on two committees in Illinois and South Carolina.
Booker’s bill would require the U.S. Secretary of Health and Human Services to provide states with summaries of drug company payments made to members of their Medicaid drug committees.
With only weeks remaining in the current session of Congress, the bill is unlikely to pass. But Booker says he hopes it will help set the upcoming agenda for Democrats; he intends to reintroduce it in 2019.
The Center/NPR investigation previously prompted Arizona Gov. Doug Ducey, a Republican, to issue an executive order tightening his state’s ethics rules and to boot a doctor from the Medicaid committee who had received more than $700,000 in payments and perks from drugmakers. Officials in Colorado, New York and Texas also took action in response to the Medicaid investigation.
The Center for Public Integrity is a nonpartisan, nonprofit investigative news organization in Washington, D.C. You can follow Liz Essley Whyte on Twitter at @l_e_whyte.
The “Medicaid Drug Decisions Transparency Act” would require pharmaceutical companies to disclose their payments to pharmacists and others who serve on state Medicaid drug boards — the advisory groups that decide which drugs Medicaid will and won’t cover.
Gary Waters/Ikon Images/Getty Images
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Gary Waters/Ikon Images/Getty Images
Sen. Cory Booker, D-N.J., says he will introduce federal legislation this week that would require more transparency surrounding states’ Medicaid drug decisions. The bill comes in response to a recent investigation by the Center for Public Integrity and NPR.
The measure, known as the “Medicaid Drug Decisions Transparency Act,” would require pharmaceutical companies to disclose their payments to pharmacists and others who serve on state Medicaid drug boards. These boards help decide which drugs Medicaid patients will be able to access easily. Currently drugmakers must only disclose perks given to doctors, such as free dinners, speaking fees and consulting gigs. In addition, the bill would increase penalties for companies that fail to comply with reporting requirements.
“These are really nefarious tactics that drug companies use, and they use them to influence state Medicaid programs’ drug coverage decisions,” says Booker. “My bill’s going to address this problem by increasing transparency — shining a light onto these payments.”
The proposed federal legislation was prompted by the recent Medicaid, Under the Influence investigation from the Center for Public Integrity and NPR, which revealed how drugmakers influence states’ choices regarding drugs for Medicaid patients.
The investigation, published in July, found that drug companies swarm state Medicaid board meetings when their drugs are under consideration, and have given payments and perks to three out of five doctors recently serving on those boards. The companies’ efforts to undermine state drug cost controls have helped push up Medicaid expenses nationwide.
The Senate bill would also require states to publish and update the lists of members on their Medicaid drug boards. The Center for Public Integrity had to scour meeting minutes, call agencies and formally request public records to compile a list of board members across the U.S. Even so, reporters still could not obtain information on two committees in Illinois and South Carolina.
Booker’s bill would require the U.S. Secretary of Health and Human Services to provide states with summaries of drug company payments made to members of their Medicaid drug committees.
With only weeks remaining in the current session of Congress, the bill is unlikely to pass. But Booker says he hopes it will help set the upcoming agenda for Democrats; he intends to reintroduce it in 2019.
The Center/NPR investigation previously prompted Arizona Gov. Doug Ducey, a Republican, to issue an executive order tightening his state’s ethics rules and to boot a doctor from the Medicaid committee who had received more than $700,000 in payments and perks from drugmakers. Officials in Colorado, New York and Texas also took action in response to the Medicaid investigation.
The Center for Public Integrity is a nonpartisan, nonprofit investigative news organization in Washington, D.C. You can follow Liz Essley Whyte on Twitter at @l_e_whyte.
Doug Kiker (left) and Dan Schmalen are founders of Retrofit Careers, a job portal for those in successful drug and alcohol recovery.
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Emma Lee/WHYY
For most of his life when he was in between jobs, Tim Tulvey would toss his resume up on a hiring site like Indeed.com. He had decades of management experience working for landscaping companies, and even owned his own pest control business for a while.
“I was getting hits left and right,” Tulvey said, recalling previous times he’d posted. “I mean, there was companies reaching out to me a lot.”
But this time was different. This time, he had been through rehab, and picked up an assault charge. He didn’t get any bites.
For many with a history of addiction, finding a job can be tough. Of the 22 million adults in recovery in the United States, nine percent are unemployed — that’s more than double the overall rate. There are lots of reasons for this – addiction can cause people to go long stints without working, and that doesn’t look great on a resume. For others, like Tulvey, addiction goes hand-in-hand with jail time and a criminal record.
But that doesn’t necessarily make them less qualified for a job — or at least, that’s the logic behind a new hiring website called Retrofit Careers, designed specifically for people in recovery.
Tulvey was 50 years old when he decided he had to stop drinking. It had gotten bad — each day when he woke up, he knew he’d be drinking by lunchtime until he went to bed at night. He had no illusions that quitting would be easy — he checked himself into rehab and after, moved into a recovery house to get back on his feet. But he was homesick, and wanted to move back into his own place. As soon as he did, he started drinking again. One day, he blacked out and threw a glass at the wall, hitting his wife. He was arrested for assault and spent almost a month in jail.
Tulvey had been working as a warehouse manager for a construction company, and through rehab and the assault charge, his boss agreed to keep him on. But maintaining regular hours on probation can be tricky — as a condition of his release, Tulvey had to carry a breathalyzer that he was required to blow into at random times to give his bail officer a blood alcohol level. But, Tulvey says, often the machine didn’t work right. So, to prove he wasn’t drinking, he would have to take a train from his job in the northern suburbs of Philadelphia, into the city, and hop on another train to head South to the courthouse where he would blow a negative breathalyzer test in person for his bail officer.
Pretty soon, Tulvey’s boss said all the trips to see his bail officer were eating up too much of the workday, and he let him go.
Tulvey put his resume on Indeed, like usual, but he didn’t get any responses. He figured potential employers must be doing background checks. So, he stopped even applying for lots of the jobs he thought he’d be qualified for.
“Right now, I’m steering away from anything that I think might be iffy as far as, you know, having an assault on your record,” Tulvey said. “I mean, I’m not that person, but the word assault says it all.”
Eventually, Tulvey got a job with the recovery house where he lives — they knew about his past, but also trusted that he was a good guy.
That idea — that with a little context, employers will give someone a chance — is the foundation for Retrofit Careers. Doug Kiker, who has been sober for 13 years, is one if its founders. He always made an effort to hire people in recovery for his construction business, and he knew there were other employers out there like him. So he figured there should be a formal way to connect people in recovery with workplaces that will understand their situation.
“So that even if the question’s asked, the answer is, well, this is when I was rehabbing, this is when I was on the street, this is why I got fired from my last job,” Kiker explained.
It may seem like a tough sell to ask employers to pay to post jobs that draw from a pool of applicants in recovery. So far, Retrofit has just a handful of employers advertising for jobs. But more and more, job places are actually looking for people with a history of addiction. While private job boards are less common, some states are aggregating “recovery friendly workplace” lists.
Delta lighting runs a bustling call center just north of Philadelphia. Its 50 or so sales reps sell lighting and cleaning supplies to companies across the country. Joe Arndt is Vice President there. He’s been recruiting workers with a history of addiction for years and says he’s found they make great employees.
“They’re tremendously loyal to us, and they just work harder because they realize that they don’t necessarily have a lot of other options which is kind of sad,” he said.
When Arndt heard about Retrofit, he called to see how he could advertise for open positions at Delta.
“I’m not gonna sit here and say like we’re saints and we really want to help the community, which we do, but at the same time, we see it is an opportunity to get more employees like the ones we had gotten,” he admitted.
Arndt says he knows there are risks involved with hiring people in recovery – commission jobs aren’t for everyone, and the potential for relapse is real.
But, he says, a lot of those are risks you’d come up against with anyone. At least this way it’s out in the open.
For four decades the Oakland ensemble Kitka has sung intricate harmonies from Eastern Europe. Members Shira Cion and Kelly Atkins talk about the group’s new album, “Harmonies of Heaven and Earth.”
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Tomas Pacha/Courtesy of the artist
LULU GARCIA-NAVARRO, HOST:
The daylight is dwindling away. The solstice arrives on Friday. So let’s listen to some warming songs from Eastern Europe that celebrate the season upon us.
(SOUNDBITE OF SONG, “MOMCI KOLEDARCI”)
KITKA WOMEN’S VOCAL ENSEMBLE: (Singing in Bulgarian).
GARCIA-NAVARRO: The album “Evening Star” features harmonies unique to Balkan, Slavic and Caucasian lands. But here’s the twist – they’re served up by Kitka, a vocal ensemble of many years standing based in the San Francisco Bay Area. Shira Cion is the group’s artistic director. She joins us from the studios of KQED. Welcome.
SHIRA CION: So great to be here, Lulu. Thank you.
GARCIA-NAVARRO: Also with us is Kelly Atkins. She’s another Kitkat – I think that’s what you call yourselves, right?
KELLY ATKINS: It is, yes. Hi.
GARCIA-NAVARRO: Hi. Shira, I’m going to start with you. You’re quoted in the press notes saying this music springs from a, quote, “instinct to come together and sing in the deep, dark heart of wintertime.” I love that, by the way. Does this music help bring up the body temperature?
CION: They actually think it probably does. And it’s been interesting. You know, so many studies are now coming out about sort of the physical and cognitive and social benefits of harmony singing and choral singing. And I think all the science is just proving something that Eastern European villagers have known for centuries, which is that when times are tough, when weather conditions are cold, where merely surviving through a difficult season really calls upon communities to come together, it’s a time to sing. And I think singing does lift spirits. It does sort of synchronize our organisms together. I really do believe it helps us survive through trying times.
GARCIA-NAVARRO: Kelly, that image of the deep, dark heart of wintertime is also a metaphor, I guess, of the kind of music that this is. Tell me what – how you see it.
ATKINS: Well, we also use the metaphor of the cycles of life. Some of the songs, as you probably noticed, from the album are literally about winter. And some of them are about the winter of life. So we kind of see a lot of the songs that we sing not only about the holidays themselves but about the cycles that we go through in our own lives.
GARCIA-NAVARRO: Let’s listen to a bit of the title track. It’s a Bulgarian song – “Evening Star.”
(SOUNDBITE OF SONG, “ZVEZDA VECERNICA”)
KITKA WOMEN’S VOCAL ENSEMBLE: (Singing in Bulgarian).
GARCIA-NAVARRO: I got to tell you, it feels like something deeply thrumming and ancient. You know, it comes – it really comes from this sort of essential place. It really does. It’s amazing. Kelly, I understand you have a background as an indie rocker. What got you interested in Eastern European vocal music?
ATKINS: Well, the first time I saw the Bulgarian Women’s Choir, I was at Grace Cathedral. And I sat in the pews and just wept. And I couldn’t figure out what was happening to me. And it just rocked me on a very, very deep level. So I think that was my gateway drug, as we call it in the group. Most of us have our gateway drug of Bulgarian choir music.
GARCIA-NAVARRO: (Laughter) Shira, people also may be surprised to learn that there’s actually many vocal groups here in the states specializing in Eastern European music. There’s Kitka. There’s Planina based in Denver. There’s the Yale Slavic Chorus, which has been around almost 50 years. What do you think makes…
CION: Yes.
GARCIA-NAVARRO: …The music so irresistible to female vocalists?
CION: Well, I think for those of us who I would say identify as liberal American feminists, there’s something about the quality of powerful women’s voices joined together in this very physical, very close harmony, sometimes dissonant harmony configurations that really appeals to a contemporary American female sensibility.
(SOUNDBITE OF UNIDENTIFIED KITKA SONG)
KITKA WOMEN’S VOCAL ENSEMBLE: (Singing in foreign language).
CION: And these are cultures where labor was traditionally divided by gender. And women were accustomed to creating in community and creating music together in community. We were actually just talking about this in the greenroom earlier today – how all of us who sing in Kitka are much more oriented towards kind of collective and harmony singing than individualistic, soloistic singing. And I think it sort of counters the sort of strongly individualistic trend that America values so much. It’s, like…
GARCIA-NAVARRO: Exactly.
CION: …Everyone to…
GARCIA-NAVARRO: The solo artist.
CION: …Themself (ph).
GARCIA-NAVARRO: Yeah.
CION: The solo artist. And this is really a communal form that can really only take flight when there’s a community of people participating in it.
GARCIA-NAVARRO: Let’s listen now to a Ukrainian carol from your album.
(SOUNDBITE OF SONG, “V HOSPODARON’KA”)
KITKA WOMEN’S VOCAL ENSEMBLE: (Singing in Ukrainian).
GARCIA-NAVARRO: So this is actually a Ukrainian carol for New Year’s. And you actually traveled there a while back and met up with a Ukrainian group. What about your other travels to perform in Eastern Europe? What’s been the reaction from audiences?
ATKINS: We were in Serbia about – was it five years ago?
CION: Yeah, 2013.
ATKINS: And it was my first time with Kitka traveling abroad and singing Serbian music to Serbians. And I honestly was nervous going. I was thinking, who am I as an American to go and sing these songs in front of these people where, you know, they have these deep roots with these songs? But in fact, we were received very warmly. And it was really a cathartic experience for both the audience and for us.
GARCIA-NAVARRO: So, Kelly and Shira, this is to both of you. What’s your favorite song on the album?
CION: Oh, that’s a tough one.
ATKINS: It is.
CION: What do you think about maybe “Blazentsv”?
ATKINS: Maybe “Blazentsv.”
CION: Yeah. This isn’t technically a winter song. But it’s a song that we feel articulates qualities that we all try to summon in ourselves during the holiday season. It’s a musical setting of “The Beatitudes” by the Russian composer Vladimir Martynov. And, you know, these are calling the listener to embody qualities of generosity and compassion and kindness, living simply so that others might simply live and seeing that true contentment really comes from kind of going against the grain of greed and egoism and materialism and violence and living gently, living kindly so that others can feel the kingdom of heaven here on Earth.
GARCIA-NAVARRO: That is a good holiday message. Shira Cion and Kelly Atkins from the Kitka Woman’s Vocal Ensemble. Their new album is called “Evening Star.” Thank you both very much.
CION: Thank you so much for having us.
ATKINS: Thank you.
(SOUNDBITE OF SONG, “ZAPOVEDI BLAZENSTV/ THE BEATITUDES”)
KITKA WOMEN’S VOCAL ENSEMBLE: (Singing in Russian).
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In Bleed Out, filmmaker and comedian Steve Burrows documents the 10-year odyssey of trying to figure out what went wrong when his mom went in for a hip replacement surgery and came out with brain damage and mobility issues after a weeks-long coma.
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In 2009, Steve Burrows’ mom, Judie, went in for hip replacement surgery. She came out with brain damage and mobility issues after a weeks-long coma that would change her and her family’s life.
In the new HBO documentary Bleed Out — Burrows, a filmmaker and comedian, tracks his 10-year odyssey to find out what happened to his mother and who is to blame. It’s a deep dark dive into the heart of America’s health care system.
What happened to Judie is complicated, but it essentially began with massive blood loss.
“In the end, that’s really how this whole thing started,” Burrows says in an interview with NPR’s Lulu Garcia-Navarro. “She lost over half the blood in her body.”
After her surgery, she was put into recovery and left alone with that’s called an electronic intensive care unit, or eICU.
With a series of monitoring tools that usually include microphones, video cameras and alarms, eICUs are meant to provide the 24-hour monitoring that many patients require after a major medical emergency.
“This [eICU] didn’t notice my mom was in a coma for at least a day and a half and I wanted to talk to the ICU doctor who was there that night,” Burrows says. “We were told there was no doctor there. I said ‘Well that’s insane, what do you mean?’ “
He says there were doctors monitoring the cameras out by the airport in Milwaukee and they were supposed to be the safety net for his mother.
Burrows says that when he asked whether the camera was on, the head of the ICU told him it wasn’t because of patient privacy issues.
As Burrows dug into his mother’s case and the failure of the eICU to recognize her coma, he came across a staggering statistic. According to a study by researchers at Johns Hopkins University, the third leading cause of death in the United States is medical errors.
YouTube
And those errors, Burrows says, can leave patients one step away from financial ruin.
“That’s the hard lesson we learned,” Burrows says. “My mom, certainly. She was a single mom, she raised my sister and I. She did everything right. She was set. And this happened and two and half years later, she’s broke. She’s on Medicaid … and now we, all the American taxpayers, are paying for her.”
Burrows says that before her surgery, Judie was a vibrant, independent and adventurous woman. These days, her health care has become increasingly more complicated, and in the past two months, she has started long-term hospice care.
“She is very compromised,” Burrows says. “She lost her speech several years ago and that was really the thing that really hurt her the most because she was so articulate and so full of life. I know that the loss of her speech is really the thing that is really killing her the most.”
Throughout the 10 years that Burrows documented his mother’s struggles, he recorded many conversations — both openly and secretly. One of those conversations was with the doctor who conducted his mom’s hip replacement surgery. At the time, the doctor didn’t know he was being recorded.
Steve: If you were in my shoes, right now, what would be …
Doctor: I’d like an accounting, just like you, for why in the hell no doctor was there. Their intensive care unit, where this problem occurred, we still don’t know what happened. We don’t have accountability.
Steve: I mean, do you think they’ll ever tell the truth?
Doctor: No. I don’t.
Up until this point, Burrows had been asking basic questions to the doctors and caregivers involved in his mom’s situation and their stories were always changing, he says. When he finally heard what he thought was the truth by the doctor, Burrows says it was shocking.
He started filming his mother’s pain and suffering after consulting with attorneys about trying to pursue justice for her. She was at her most vulnerable. It was painful and uncomfortable, but he knew he had to do it.
At the time, he didn’t want to make a documentary, but he eventually decided others needed to know what happened.
“When I started to find out about this universal thing, about the third leading cause of death, and then the eICUs, I thought I really have to tell people about what I just found out,” Burrows says. “Because I’m a pretty informed guy and I didn’t know about any of this stuff.”
Although he’s done his best to make sure his mother is comfortable, Burrows says he hasn’t been able to give her what she really wanted, which was to get her life back.
“I had a great mom and I really tried hard to give her everything she wanted and I couldn’t give her any of that,” he says. “She wanted to go home. She wanted to drive. She wanted her life back.”
Burrows says he hopes that as people watch the film, they realize they need to ask thoughtful questions when it comes to their health care, and he stressed the importance of having a patient advocate in case things like this happen.
“You need to shop for doctors and hospitals like you’d shop for a car,” he says. “You know, shop like your life depends on it because we found out that it does.”
NPR’s Sarah Handel and Cindy Johnston produced and edited the audio for the story. Wynne Davis adapted it for Web.
A federal judge in Texas struck down the entire ACA on Friday, but the law will stay in place pending appeals. NPR’s Michel Martin talks with Julie Rovner of Kaiser Health News about the implications.
The network is under fire — again — for its workplace culture and its treatment of female employees. A potential merger could bring more upheaval for the company.
SCOTT SIMON, HOST:
The board at CBS has a lot to fret about these days, with multiple sexual misconduct allegations and settlements involving top executives and stars. With all of this turmoil, even the future of CBS seems unsettled. There’s talk of merger with another company. NPR’s David Folkenflik has been covering the story for us and joins us now. David, thanks for being with us.
DAVID FOLKENFLIK, BYLINE: Of course.
SIMON: Tell us about some of these latest developments at CBS, where, I should say up front, I’m a special contributor to “CBS Sunday Morning.”
FOLKENFLIK: Where to start, Scott? I think first you’ve got to acknowledge The New York Times story, just this week, about a secret settlement between CBS network and the actress Eliza Dushku, who was – she had a part that was on several episodes of the hit series “Bull” on CBS, a primetime show. And she said that she complained about repeated remarks made by the star of the show, Michael Weatherly, that she felt, in a sense, violated. She brought it up, felt dismissed, and they phased her character out, even though they had planned a several-season arc for her. She received a $9.5 million payout that apparently would have been roughly equivalent to what she would have received had she stayed on the show for those years.
Most recently, the executive producer of the CBS News show, “CBS This Morning,” Ryan Kadro, is out. He’s going to leave the network as of next month. He had been executive producer when Charlie Rose was there, at least, for a stretch of when Charlie Rose was there as its star. There’s just been a couple of settlements of suits that CBS has made of women who said they were harassed by Charlie Rose, the star of that show and “60 Minutes.” And Kadro is on his way out. It may well be that his departure has something to do with those settlements, as well.
SIMON: And of course, this comes after the so many stories of misconduct by Les Moonves, former head of CBS, and moreover, his effort to hide those action with what amounts to bribes. What’s CBS done about that?
FOLKENFLIK: Well, the question on its plate at the moment is whether or not it’s supposed to pay the $120 million that it might appear that Les Moonves is due, as extraordinary as that figure is, for his service and for what his contract stipulates in departing from CBS as its chairman. He was forced out earlier this year. In fact, the very actions to – as investigators claim, the law firms doing this claim – to mislead, to deceive, to lie to the investigators and, in fact, to erase evidence may well be caused for the board to step in and to void or to diminish that payment. It would be quite an insult added to the injury that a number of women have said that Les Moonves did if he were to be paid off such a huge amount for being fired, effectively, as a result of the public awareness of what he had done to them.
SIMON: And, David, in your reporting, have you come across people who believe there’s a climate at CBS – entertainment division and parts of the news division – that foster sexual harassment and maybe even sexual assault?
FOLKENFLIK: Well, you know, the most glaring example of this in many ways is Fox News under Roger Ailes. But this was very disturbing coming from the top. Les Moonves had been essentially running CBS for two decades. And if you look at what happened in the news division, as well – the fact that Jeff Fager, a former executive producer of “60 Minutes” and former chairman of CBS News, has been accused of sexual harassment and tolerating a culture at “60 Minutes” of that, the fact that it turned out his predecessor, Don Hewitt, according to revelations, had essentially sexually assaulted former subordinate and colleague female subordinate so severely that CBS ended up paying her what totaled up to $5 million over the years in payments that apparently have still been going on as recently as this year, it’s hard not to think that there’s a climate that is not only hostile to women, but hostile to the idea of accountability for this kind of behavior, at least until these revelations now.
SIMON: And there’s a merger on the table?
FOLKENFLIK: It certainly looks likely. Shari Redstone is the controlling owner of both CBS and Viacom. She has wanted to merge these sister companies once more, reunify them. And the main obstacle in her way was Les Moonves and the corporate board at CBS that had been supporting him. That board has changed. The sympathies toward Moonves’ position’s changed, and Moonves is gone. So it would seem as though the stars are aligning for her to be able to get control of both companies and to ultimately bring them under the same umbrella.
SIMON: NPR’s David Folkenflik. Thanks so much.
FOLKENFLIK: You bet.
Copyright © 2018 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
NPR’s Scott Simon discusses the week in sports with ESPN’s Howard Bryant, including impressive wins by the NBA’s Toronto Raptors and the NFL’s Los Angeles Chargers.
SCOTT SIMON, HOST:
This is WEEKEND EDITION from NPR News – I’m Scott Simon – where BJ Leiderman writes our theme music. Here it comes. Time for sports.
(SOUNDBITE OF MUSIC)
SIMON: Basketball, football and litigation – America’s favorite sports. Howard Bryant from espn.com and ESPN The Magazine joins us. Howard, thanks so much for being with us.
HOWARD BRYANT, BYLINE: Hey, Scott. How are you?
SIMON: I’m fine, thanks. Let’s begin – but not as good as the Toronto Raptors. Let’s begin with the NBA. They’re not just lucky, are they? They completed their season sweep of the Warriors, the Golden State Warriors, this week – beat them by 20 points. What’s going on in Toronto?
BRYANT: Yeah, and they won that game on the road, as well. And that is – it’s a great one.
I know people talk about the 82-game season, and none of the games matter until the playoffs or whatever. But if you are the Toronto Raptors, and you were struggling for respect, you’ve never been to the NBA Finals, you were the best team in the league in your conference last year – or so you thought you were – and you won more games than you’d ever won before, and then LeBron James came in and blew your doors off…
SIMON: Yeah.
BRYANT: …And then you fired your coach, you need these victories. And it’s important to measure yourself against the greatest team of this era, the Golden State Warriors. And so to beat them twice in a season, I agree with what Steph Curry said. We’re after the game. He said, hey, if we meet them in the playoffs, it’s 0-0. Nothing matters from here.
That’s OK when you’ve won three championships – quite a different story when you’re the Raptors, and you’ve got Kawhi Leonard, and it’s a very, very different team. I always say – we’ve talked about this so many times on this show – that the NBA is a best-player-wins league, and Kawhi Leonard is the best player, I think, in the Eastern Conference. He didn’t even play…
SIMON: Yeah.
BRYANT: …In that game, and they still won. So it shows you how much confidence this team has now.
SIMON: And now to the NFL and the AFC, where the Los Angeles Chargers – still a little uncomfortable to say that.
BRYANT: San Diego…
SIMON: Yeah. I…
BRYANT: Yeah.
SIMON: Well, Stephen Smith said San Diego again this week – didn’t he? – several times.
The Los Angeles Chargers are also for real. They beat the Kansas City Chiefs with a 2-point conversion in the last few seconds Thursday night, even though there were some questions raised about it. How are they doing it?
BRYANT: Well, I think they’re a very good team. And I think that one of the interesting things about the Chargers, especially – we talked about the Raptors earlier. The Chargers are in a very similar boat. If you go back and think about this history of this team, they haven’t been to the Super Bowl – they’ve never won the Super Bowl. They haven’t been to the Super Bowl since ’95, when they lost to the 49ers.
And you think about this team having all these players – when they had LaDainian Tomlinson and Shawne Merriman and Antonio Gates. And now they’ve got Philip Rivers, who’s the old man of the conference now. And this might be their best team.
And I think that what’s funny about it is that, on the one hand, the NFL is – it’s a mediocre league. You know, they – the game is set up for every team to pretty much have a chance at winning because of the rules. But they’re 11-3, and they’re right up there. They’re tied with the Chiefs. They’re a game and a half ahead of the Patriots.
And so maybe this is how it works the same way it worked with the Philadelphia Eagles last year – that the best team that you’ve had in your history isn’t the team that wins, but maybe this is the one that gets there.
SIMON: I want to close this week, Howard, by talking about – asking about Russell Beckman, a Green Bay Packers fan. He lost a court case this week. He – you know, he’s one of these Packer fans that puts the cheese stuff on. He wants to stand along the sidelines at the game tomorrow and wear his Packers gear at a pregame event. The Bears won’t let him do it. Firstly, I am appalled that this winds up in court.
BRYANT: Yeah. I think, on the one hand, it looks like one of these quirky stories where you say, well, wow, this is sort of kind of funny news of the weird. But on the other hand, you look at it, and you say, why is this in court in the first place? On the one hand, I understand it. It sounds…
SIMON: And the Bears are being small-minded – no doubt about it. Yeah.
BRYANT: But it also sounds like classic trolling. You have these events, and you do them for your fans. And why would you have a Packers fan on the Bears sideline? Now, the guy paid his money, obviously. He’s a season ticket holder.
On the other hand, you also recognize that this is – once again, there’s no reason to do this. There’s no reason, if you are a real, true Packer fan, why are you on the sideline of the Chicago Bears other than simply being a nuisance? I understand that.
And I think, on the other hand, you also look at it, and you say – you also say, well, this isn’t something that belongs in a courtroom. This is something that should be fun. But if it does end up in a courtroom, then I suppose that maybe the republic is not collapsing after all. There’s room for this.
SIMON: Howard Bryant, thanks so much.
BRYANT: Thanks, Scott.
Copyright © 2018 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
