St. Agnes suit drags on

The first medical malpractice case filed against St. Agnes Medical Center following last year’s fatal lab error is making progress, albeit too slowly, according to the plaintiff’s attorney.

On Monday, attorney Aaron J. Freiwald will take depositions from hospital president Sister Marge Sullivan and Catholic Health East’s chief medical officer, Dr. Richard Afable.

Freiwald represents Catherine Hines, one of more than 900 patients warned that a lab mix-up could have affected their dosages of the blood thinner Coumadin. Three St. Agnes patients died because of hemorrhaging in the brain related to excessive doses of the drug, the Philadelphia Medical Examiner’s Office determined last year.

Hines, now 77, was rushed to Thomas Jefferson University Hospital in July 2001 after her husband discovered she was bleeding from her pores. The symptoms were caused by an extremely high dose of Coumadin — three times more than is typically prescribed — administered in error at St. Agnes, Broad and McKean streets.

Since the incident, Freiwald said, Hines has been incapacitated, splitting her time between Jefferson and a nursing home in North Philly. She also has accumulated more than $1 million in medical bills, he said.

Hines filed a lawsuit in August 2001 alleging negligence against St. Agnes laboratory staff and corporate negligence against the hospital. Freiwald said last week that his client will be adding charges of recklessness to the suit.

The lawsuit does not specify the damages sought, but Freiwald said he intends to provide evidence showing the accident has caused economic loss, physical pain and suffering "well in excess of several million dollars."

Last month, Freiwald accused the hospital of delaying the legal progress by failing to turn over documents and hospital officials for deposition, specifically Sister Sullivan and Afable. The attorney threatened to file a motion for sanctions with the court stating that St. Agnes had failed to comply with court orders.

He agreed to refrain from that action, however, when the hospital’s lawyers promised the Monday meeting.

"The extent of non-cooperation is unusual," Freiwald said. "It is even more unusual and difficult to understand with regard to the public posture the hospital has taken with regard to this tragedy."

St. Agnes spokesperson Teresa Heavens countered that many of the hospital’s witnesses had met with Freiwald, and those who have not will soon.

"If you are hearing otherwise, that is not the case," she said.

Heavens said she was unaware of Sister Sullivan and Afable missing a scheduled meeting with Hines’ attorney. And she suggested any problem could be attributed to "just a matter of matching people’s schedules."

Heavens also passed along the following statement from Sister Sullivan: "We are cooperating fully with the discovery process of this investigation. St. Agnes Medical Center has met all of the requirements that were outlined for us to take for patient safety. We have gone above and beyond that."

In March, the Pennsylvania Department of Health returned the $447,500 in fines it had collected from St. Agnes so the facility could pay for an automated prescription-management system.

Usually, money collected from fines goes into the state’s general fund, but St. Agnes was able to negotiate a settlement to spend the money on the prescription system because the hospital reported its mistake and cooperated with the investigation.

St. Agnes has agreed to a five-year contract with San Diego-based Pyxis Corp. to set up what it calls an "automated physician-order management system." The new computer-based prescription-tracking system will eliminate lost orders and decrease paperwork and the chance for human error.

As another provision of the settlement, St. Agnes will conduct 12 health and wellness lectures for South Philly residents on topics such as diabetes, healthy eating, arthritis, colorectal cancer and proper use of medications.

Publicly, St. Agnes has seemed to want to take care of the situation, then put it in the past, Freiwald said. Even when he first filed the suit, he expected it would be settled quickly, but now Freiwald believes it will end up in court.

"I don’t know whether it is the lawyers, or whether it is the hospital or whether it is the insurance company behind the scenes," he said.

Hines was prescribed Coumadin following heart-valve-replacement surgery in 1999.

She was admitted to St. Agnes twice during the spring of 2001 complaining of lightheadedness and dehydration. During the second stay, which began June 4, her dosage of Coumadin was increased every day for a week until she was taking three times the necessary amount of the drug.

On July 18, Hines began bleeding internally and was admitted to Jefferson Hospital.

St. Agnes notified 932 patients by letter in August 2001 explaining the mix-up. The state investigation later showed those affected received the drug between June 4 and July 25 last year.