James Williams is running a little late on this overcast October morning, but as he sweeps into his wife Sharon's hospital room he takes a moment to greet her nurses before bending to kiss her. She is sitting up in a chair. Her eyes are open, moving about the room, and from time to time she turns her head.
The routine is a familiar one. Williams has been by his wife's side nearly every day since April 11, 2000, when she lapsed into a coma after undergoing routine surgery at Fairview-University Medical Center's Riverside campus. A subsequent state investigation found that her nurse left her alone in the recovery room after administering the pain medication morphine, neglecting to activate the alarms on the device that monitored the patient's vital signs. At some time after that, Sharon Williams stopped breathing. By the time the staff began resuscitation, her brain had been deprived of oxygen for several minutes, leaving her with profound brain damage.
For the past year and a half, the 46-year-old Williams has continued his vigil, sitting with Sharon, talking with her, praying with her. There have been only a few occasions when he couldn't come to this Golden Valley care center. Some days he was traveling, meeting with medical experts in the hope of finding a way to help his wife. Other days he sat in a courtroom, or in depositions, or in mediation sessions, hoping his lawsuit against Fairview Health Services would finally shed light on the events that brought Sharon, who turned 44 this summer, where she is today. (The Sharon Williams case was the subject of "The Silent Treatment," City Pages' January 31 cover story.)
That part, at least, is over. Earlier this month Williams reached a settlement with Fairview, ending his medical malpractice lawsuit. Financial terms were not disclosed, although Fairview-University Medical Center issued a statement that expressed sympathy for the Williams family and said that "this resolution will provide for Sharon Williams' medical care for the rest of her life."
This morning, less than a week after the settlement was finalized, the exhaustion--physical, mental, emotional--is apparent on James Williams's face. The financial worries no longer gnaw at him. "Now I can focus solely on her condition and her medical treatment and having the resources to pay for what we need," he says. But, he adds, "Another side of me says this matter will never be over."
Though the legal claim has been resolved, Williams is clearly still angry with Fairview for its treatment of his wife and for its repeated failure to explain what happened.
Much of the information gathered about the events in the recovery room was part of the hospital's internal investigation. Under state law, such investigations, known as "peer reviews," are confidential. That way, the thinking goes, hospital staff can candidly discuss incidents without fear of liability, creating an open dialogue that will in turn improve patient care.
Williams and his attorney William Tilton dispute that notion. Open disclosure of mistakes, they argue, is the way to improve patient safety; confidential peer reviews have the opposite effect. "It's used to hide documents, hide dirty laundry, and its justification as a self-policing policy is false," Tilton asserts.
Williams hopes his family's tragedy might make lawmakers reconsider those policies, and make hospitals focus more attention on patient care. "This is particularly egregious. I would like that the public would have some real insight about what happened to us, so hopefully there would be enough concern and attention that something like this will never happen again," he says. "There were so many mistakes made. How many of these types of things go on? Is this an aberration, a one-in-a-million type thing? Or is it more like one in ten?"
The confidentiality of the peer review created an obstacle that for months kept Williams from learning precisely what transpired when his wife emerged from the operating room after undergoing a hysterectomy. The turning point, he says, came just a few months ago, when his attorney discovered that a witness had been present in the recovery room while Sharon Williams was there. Tilton had to get a court order to compel Fairview to release her identity. "Once we subpoenaed this person and took her deposition, it was appalling," Williams recalls.
Documents filed in Hennepin County District Court cite the testimony of the witness, the mother of a 13-year-old patient who had just undergone a surgical procedure. The woman, whose name was redacted from the documents, testified that for four to six minutes, during which she was at her daughter's bedside, no nurses were present in the recovery room.
"I thought, Where did everybody go? I was holding my daughter's hand. I thought in my head, Geez, where is everybody? Where is the nurse?" the witness testified. "I sat there and I kept thinking to myself, Where is the nurses, why isn't anybody coming in here, why aren't they attending to my daughter?"
Meanwhile, the woman noticed, Sharon Williams's condition was worsening: "[She started] breathing real funny....Just like, well, she needed help. Like she was choking and gasping for air. And it was a real awful sound," she testified.