Ch. 10 – The story behind the story


Wow, there are so many things about this case to discuss. Was a ‘cluster’ from moment one – a patient with something real, who was not welcome in the ED. We have all seen them and had the same feelings – but here is one thing no one would disagree with; everyone dies. No matter how many tattoos, how few teeth, how addicted to narcotics, or how fat… everyone dies. For all of us, it is hard to get past our biases.

Reading Crystal’s testimony, around 100 pages long, was difficult. Many of the questions had to be asked repeatedly, and the court reporter had trouble understanding her answers, due to her difficulty with speaking. Was her ultimate outcome preventable? Probably not, but the lawsuit was. If she had been admitted, we wouldn’t be discussing this case…

We were fortunate to be able to speak with the plaintiff expert who shed light on the case as well as his experiences with other legal actions. Speaking with Jerry Hoffman was an inspiration. The conversation occurred in December 2010, with my 3 year old watching Caillou on the couch, I recorded the call then transcribed it later. Whereas the medical aspect and discussion of the case and controversy around TPA was enlightening, the philosophy of practicing medicine was inspirational.

The case was the focus of a Risk Management Monthly program in April 2011 with Rick Bukata, Greg Henry, Jennifer L’Hommedieu Stankus, MD, JD, and John Rockwood, PA-C. Check it out at: (subscription required)

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