Here’s a clickbait idea for U.S. business publications: The annual Corporate Cowardice Awards. Although its only March, this year’s recipient is a no brainer – The American Hospital Association. Wright L. Lassiter III, the trade group’s 2022 chair and CEO of Detroit’s Henry Ford Health System, is most deserving of accepting the award on behalf of his industry’s executive colleagues.
The AHA has been shamefully silent on the criminal prosecution and conviction of RaDonda Vaught, the former Vanderbilt University Medical Center nurse who mistakenly administered a paralyzing drug prosecutors argued was responsible for killing a 75-year-old patient named Charlene Murphey. A jury on Friday convicted Vaught of gross neglect and negligent homicide; she faces up to six years in prison.
The American Nurses Association and the Tennessee Nurses Association issued a joint statement saying they were “deeply distressed” by the verdict and “the harmful ramifications of criminalizing the honest reporting of mistakes.”
Vaught fessed up to her error, which resulted from her overriding an electronic drug dispensing cabinet reportedly prone to error messages. An industry source explained to me electronic medicine cabinets are intended to ensure hospitals capture all possible billings, not as a safety measure.
Getting off scot free is the Vanderbilt University Medical Center, which according to the Tennessee Department of Health “carried a heavy burden of responsibility” for Murphey’s death. Unfortunately, the Nashville DA’s office only chose to prosecute Vaught, despite Vanderbilt’s attempts to cover up the crime.
If making medical errors is deemed a crime, America is in urgent need of more prisons. A 2016 Johns Hopkins study estimated that more than 250,000 patients die every year because of medical errors, making it the third leading cause of death in the U.S. The study’s researchers cautioned that most medical errors “aren’t due to inherently bad doctors” but rather “represent systemic problems, including poorly coordinated care, fragmented insurance networks, the absence or underuse of safety nets, and other protocols, in addition to unwarranted variation in physician practice patterns that lack accountability.”
Hospital safety runs a wide gamut in America. According to the latest rankings from Leapfrog, a nonprofit that assigns safety ratings to U.S. hospitals, only 43 percent qualify for an “A” rating, while 23 percent garner a “B” rating, 31 percent a “C” rating, and three percent a “D” rating.
One might expect that running a hospital system with stellar safety ratings would be a requisite for being named chair of the American Hospital Association, but unfortunately the trade group’s bigger priorities are increasing profitability, combating price transparency regulations, and derailing the success of nurse staffing agencies, which is forcing hospitals to pay nurses higher wages. AHA members prefer spending tens of millions on union busters rather than pay their nurses higher wages, despite evidence that when nurses unionize, hospital patient safety improves.
Henry Ford’s flagship hospital in Detroit, which AHA chair Lassiter oversees, once earned an “A” Leapfrog rating, but safety apparently has been slipping under his watch. After earning an “A” rating in the spring of 2019, Henry Ford’s rating slipped to a “B” the following fall, then slipped to a “C” in the spring of 2020, where it has remained.
Sliding safety standards aren’t Henry Ford’s only dubious distinction. The hospital has the worst ranking in the country for errors resulting in air and gas bubbles in the blood. Leapfrog said this “serious mistake” can happen during surgery or other procedures, like getting an injection. If blood flow is blocked, a patient can suffer a stroke or die.
When I asked Henry Ford for comment about its Leapfrog ratings for a story I wrote for Deadline Detroit, a hospital spokesman noted that Leapfrog’s ratings are based on dated billing data and that “it has long been our counsel that patients not rely solely on quality surveys when making informed decisions about their healthcare.”
In 2019, when Henry Ford hospitals achieved “A” and “B” Leapfrog ratings, its news release touting the achievement made no mention of concerns about Leapfrog’s dated data. Moreover, patient safety at U.S. hospitals is known to have declined in 2020 because of “significant increases” in healthcare associated infections. Leapfrog’s latest ratings are mostly based on 2017-2019 data.
Henry Ford’s entire statement responding to its latest Leapfrog ratings can be found here.
The American Hospital Association should be leading the charge warning about the dangers of criminalizing medical errors, particularly given the hospital industry’s poor and declining safety record. As researchers for John Hopkins noted, medical errors typically are the result of systemic problems, which are the responsibility of hospital managements to correct, not individual nurses or doctors.
Therein is the issue: The AHA, which represents 5,000 hospitals, health care systems, and other providers of care, promotes management interests, not the interests of the medical providers who do the work. My guess is if Vanderbilt hospital CEO Jeffrey Balser was criminally charged, the AHA would have used its formidable federal and state lobbying might to have the charges dropped. In a peculiar twist, Balser has a PhD in pharmacology as well as an MD degree in anesthesiology.
The AHA clearly isn’t willing to put the necks of its dues-paying executive members on the line to defend a nurse whose error Dana Kellis, a physician and retired medical director of Florida’s BayCare Hospital system, bravely said was indeed the “cumulation of a series of systemic errors within Vanderbilt University.”
As another example of hospital associations representing the interests of management, when Beaumont Health CEO John Fox stepped down from the Detroit-area hospital system whose reputation he destroyed boosting profitability, the Michigan Health & Hospital Association praised his leadership.
“On behalf of the MHA, we’d like to express our sincere gratitude to John Fox for the many contributions and outstanding leadership he provided to our association during his tenure at Beaumont Health, particularly during his time as MHA Board Chair, and wish him the very best into the future,” MHA CEO Brian Peters said in a statement.
The American Hospital Association doesn’t have a monopoly on shame for silence on Vaught’s conviction. The American Medical Association also is tongue tied, which serves yet as another reminder why few doctors belong to the trade group. The AMA makes oodles of money licensing medical billing codes and it’s not about to pick a fight with government prosecutors defending a nurse.
Nashville’s District Attorney Office, which prosecuted Vaught, is also deserving of a badge of shame. A day after winning their case, the agency put out a statement reaffirming her wrongdoing. Vaught already has suffered enough but the DA clearly wants every pound of flesh it can secure. Law enforcement officials should only argue their cases in court, not the media.
What’s tragically comical is that the American Health Association lists suicide prevention as one of its 2022 behavioral health strategic priorities. Multiple studies have shown that nurses are at much higher risk of suicide than the general population. It’s likely the risk will increase significantly in the wake of Vaught’s conviction.
As far as I’m concerned, all U.S. medical providers are in urgent need of psychiatric evaluations. Anyone choosing to work in American healthcare given current industry conditions truly needs their head examined.