Story of medical failure inspires next generation of health professionals

On Thursday evening, patient safety activist Helen Haskell spoke with students from UNC-Chapel Hill’s Health Affairs schools about medical error. Approximately 1 in 300 people die from health care errors in the United States every year, and Haskell’s son, Lewis Blackman, was a victim of preventable errors. She shared her son’s story in the hope that students will become strong advocates for patient safety throughout their careers.

“If you lose a child, you have to do something for that child,” said Haskell. “You have to give that child a life. You have to create a legacy for them because they can’t.”

The program began with a film that outlined the details of Lewis’ case. Born with pectus excavatum, a genetic condition that leads to a sunken chest, Lewis and his parents decided to try a new minimally invasive surgery that would adjust the position of his sternum. During recovery, Lewis began to complain about severe pain in his abdomen. The health professionals caring for him believed the pain was caused by constipation. Four days after the surgery, Lewis died. An autopsy revealed that nearly three liters of blood and fluid had leaked into Lewis’ abdomen through an ulcer caused by his pain medication.

Lewis Blackman

Lewis Blackman

As the credits rolled, many students were in tears. When the lights came up, they had an opportunity to share their reactions and ask Haskell questions.

Some asked questions about the aftermath. Haskell described her quest for answers. Like many family members who lose a loved one due to medical error, she had to pursue legal action and ultimately came to a settlement with the hospital. Getting answers to her questions helped, she said, and it also made a difference to know that the surgeon who operated on her son was grieving for him. “It helped to know that he cared,” she said.

Others wanted to know what they could do to help keep patients safe. “What I ask is that you invite patients and families to help with care,” said Haskell. “When you have someone who is post-operative you could tell [their family] what symptoms to look out for in the patient. If there is a problem, let them know who to call. That basic navigational information needs to be available.”

The discussion was moderated by Beerstecher-Blackwell Term Professor and Dean Emeritus Linda Cronenwett. A national expert on patient safety and former leader of the Quality and Safety Education for Nurses initiative, Cronenwett had her own words of wisdom to convey to the students.

“I challenge each of you who are students here to observe the extent to which we health professionals get our tasks done and don’t think about the big picture,” she said. “We have made this culture and only we can change it.”

Students left the auditorium with a new perspective on the professions they are about to enter. First-year medical student Thai Truong said that Haskell’s experience was a powerful reminder that even though students are receiving excellent training at UNC, they can still make critical mistakes. “I’ll definitely invest time in methods that help keep patients better accounted for,” he said.

By Meagen Voss.

Published March 28, 2014.