She walks nicely: Staph infection and payment for hospital errors

Virginia Harvey, age 47, broke two bones in her left ankle while stepping off a curb in Boston in 1996. She required two operations at Brigham and Women's Hospital. After the second surgery, her ankle became infected, in the hospital, she believes.

The staphylococcus infection ate away parts of her ankle and crept up her shin, requiring 26 additional surgeries, 15 of them at the Brigham. Eventually she switched to Beth Israel Deaconess Medical Center in Boston, where surgeons amputated her leg below the knee. The infection has caused other problems, for which she now takes medication.

Virginia testified last week on a bill now being considered by the Massachusetts Legislature (H.2226/S.1277), the Healthcare Transparency bill. She walks nicely, and you wouldn't guess that she wears a prosthetic leg and foot. That belies the suffering she has experienced over the years. In addition to her suffering are the bills: she has paid $18,000 so far out of her own pocket for the prostheses – which she will need to replace as she ages.

Insurance covered most of the cost of her care; the Brigham has not waived any of her bills. Insurers, of course, set their premiums so as to cover their payouts, so all Massachusetts residents are paying for the Brigham’s errors.

The vice president for clinical affairs for the Brigham's parent organization, Partners HealthCare, said he and his colleagues are now developing a policy on when to waive charges. Until then, he added, Partners' executives make decisions on a case-by-case basis.

Nationally, Medicare has recently formed a policy aimed at preventing hospitals from receiving payment for their errors, beginning in October 2008.

Advice to victims of medical error: Ask your state legislators if you can testify on bills to reduce medical errors. Tell your story there, and here.

Read about another patient's experience with a leg staph infection, or read more from Liz Kowalczyk's article in today's Boston Globe.