The Legacy of An Unnecessary Death

In 2012 a 43 year-old woman named Carmen Alexander came to the Emergency Room at Santa Barbara Cottage Hospital with a large bruise on her chest, a high white blood cell count—which indicates unchecked infection—difficulty breathing, and nausea. The doctors sent her home later that day.  She died two days later.

Carmen Alexander was a victim of necrotizing fasciitis, a rare but potentially deadly infection caused by bacteria that rapidly destroy tissue as they multiply. By the time she was discharged from the Emergency Room, her lungs were filling up with blood. When she returned to the ER the following day in severe distress, she was admitted directly to the Intensive Care Unit, where a surgical team couldn’t save her, despite having the correct diagnosis.

Ms. Alexander’s family recognized that the Emergency Room physicians made a critical error when they decided to send her home after her initial visit, and her three teenaged children sued the hospital.  “The evidence was right in front of them,” said Vadim Hsu, the children’s guardian. “It should have made the physician jump out of her skin.”

It took almost exactly 5 years after Alexander’s death for the plaintiffs to settle the case.  The total fees and costs were about $200,000, and each child will receive a total of slightly over $132,000.  For them, though, it’s not about the money.  “What the upshot of this lawsuit was, was to put in place measures to idiot-proof policy and procedure,” said Hsu. “There needed to be a system in place so that a doctor who ordered the test in the first place actually reads the test and does something about it.”

Cottage Hospital has changed its Emergency Room policies to require physicians to respond immediately to white blood cell counts as high as Ms. Alexander’s.  Dr. Edmund Wroblewski, the hospital’s vice president of Medical Affairs, wrote a letter to her children stating “Had this change in policy been made prior to your mother’s death, she would not have been discharged from our hospital on February 19, 2012.”

While the circumstances surrounding Ms. Alexander’s death were tragic, patients who appear at the Emergency Room with the same symptoms are now protected against her fate. The lawsuit and the policy changes that resulted, said Hsu, ensure that she “didn’t die in vain.”