Nora Bostrom had pulmonary hypertension that required her to use oxygen and take intravenous medications. But in spite of these challenges she had a high quality of life. She was a bright, funny, and happy three-year-old full of promise and optimism. But after a visit to the hospital, she became a victim of several preventable medical errors that lead to her death.
One day, Nora awakened with a high heart rate, unable to eat or drink, and was complaining of heart pain. She was taken to the emergency room of a prominent Bay Area hospital where she had been treated many times before. Her parents informed Nora’s treating cardiologist of her symptoms and that they were in the ER. For three hours, no one evaluated Nora. When they finally came to see her, they did not do an examination and did not order any treatment. The family waited nearly six hours more before they gave Nora IV fluids. By that time, it was too late. Nora had already gone into acute heart failure as a result of dehydration. Nora’s heart was prematurely damaged as a result of the lack of medical care. She required additional medications and many additional hospital stays.
During one of those subsequent hospital stays, Nora contracted a central line infection within 48 hours of being admitted. She went into septic shock and nearly died. A few days later, while she was still recovering from septic shock, Nora contracted a hospital-borne respiratory virus. While she was fighting that virus, a nurse administered a double dose of a potent medication. The nurse relied upon an outdated doctor’s order. Within thirty minutes of receiving the double dose, Nora suffered heart failure and respiratory distress that required intervention.
Her parents later discovered that at the same time Nora received the double dose, she had not been receiving any nutrition. Nora was too sick to eat as a result of the sepsis and respiratory virus and received all her nutrition intravenously. The doctors mistakenly discontinued her intravenous nutrition and no medical staff noticed for several days. It was not until doctors noticed she wasn’t eating that the doctors discovered the error. It was too late. A few days later, Nora was dead.
Each of these errors related to basic care and were easily preventable. If hospital staff had done their jobs properly, Nora would still be alive. Thanks to MICRA’s arbitrary cap on noneconomic damages for patients harmed by medical negligence, the hospital had little incentive to reform its practices in the wake of Nora’s death.