Reporter offers advice on avoiding embarrassing incident Date: 08/03/11
By David Wahlberg
A call from the medical examiner to my editor the morning of Friday, July 22, started the worst day of my 22-year journalism career.
A patient featured in my front-page story about a new treatment for brain aneurysms, whose photo appeared above a quote saying she felt "fantastic" after having the procedure at a local hospital, died six days before the article was published.
How did this happen? I hope my explanation allows this unfortunate episode to yield lessons for other journalists who cover health care.
I called the patient the previous Friday, after she got home from the hospital where I had interviewed her two days earlier following her procedure. She was doing well. I told her the piece would likely run early the next week, as was the plan. I turned in the article and was off until Tuesday.
The editors held the piece for several days to run stories that were more timely. I moved on to other work. There was no obituary announcing the death.
The preventive treatment the patient received, in which doctors thread a catheter through the groin to the brain and deploy a stent, was not exceptionally risky. She had not been unusually ill. Her aneurysm, discovered in April, had not ruptured. Nobody thought it likely that she would die.
Obviously, in hindsight, I should have checked on her again. I accept that the blame starts with me.
But this reporting nightmare also shined a light on doctors who apparently were so focused on their mastery of technology that they neglected the human and public aspects of what they do. The doctors would later say the death was not related to the procedure, but skeptics might wonder if the doctors simply didn't want to reveal a negative outcome.
The patient, 63-year-old Susan Baker Kiconas, died July 16 at University of Wisconsin Hospital. An ambulance took her there after her daughter found her unresponsive at home. Kiconas had received the newly approved stent at the hospital four days earlier.
She died from a hemorrhage in a different part of her brain from her aneurysm, her primary doctor said. She had a rare disorder (pseudoxanthoma elasticum, or PXE) that increases the risk of hemorrhages and was on blood thinners after the procedure, which can make hemorrhages worse, he said.
I had interviewed that doctor by phone and another who treated her by phone and in person, so they knew I was working on the story. At least one of them knew I had interviewed Kiconas and another patient, two of eight patients who got the device at the hospital the first week. (I checked just before submitting this to AHCJ, and the other patients were fine.) Both doctors knew Kiconas died. But they didn't tell me or the hospital's public relations representative, whom they had asked to generate publicity for their work.
The lack of information didn't stop with the doctors. On Wednesday, four days after the death and two days before my article ran, I emailed a nurse who is the clinical coordinator for the hospital's brain aneurysm program. She had been with me and the PR person in the hospital room when I interviewed Kiconas.
In the email, I asked the nurse if Kiconas had been the first patient at the hospital to get the procedure. The photo editor had just given me copies of the photos we were going to use with the story and asked me to write cutlines. If Kiconas had been the first, I would have mentioned that.
The nurse, who had been very helpful before, said Kiconas was not the first patient. But she said nothing about Kiconas having died.
On Friday, after the medical examiner informed us of our problem, I talked to both doctors again.
The primary doctor, David Niemann, M.D., said he was so busy doing procedures that he barely knew I had been at the hospital and didn't know I had interviewed patients. Beverly Aagard Kienitz, M.D., said Kiconas told her I had interviewed her. But Kienitz said she couldn't release information about Kiconas' death because Kiconas was Niemann's patient.
Both doctors said they thought my story would focus on them and the new technology, not on patients who received the device. They said they didn't realize the importance of disclosing the death.
The nurse, Sheri Chambers, R.N., hasn't responded to my requests to explain why she didn't tell me in the email about the death.
Kiconas' 21-year-old daughter, Jennifer Robinson, whom I had met when I interviewed her mother, graciously accepted my apology for publishing the story as if her mother were still alive.
My editors were understanding. They felt, and I agreed, that more than a typical correction was needed. I wrote a story explaining what happened, which we posted online late Friday and published Saturday.
The hospital PR person, Susan Lampert Smith, and her supervisor were as shocked and disturbed by this episode as I was. They vowed, as I did, to do a better job of checking on patients, especially when stories are held.
But the lessons here may not be as clear cut as they seem.
What if my story had run Monday or Tuesday as planned? The outcome would have been the same – though with a less embarrassing time interval after the death – unless I had checked on Kiconas over the weekend or asked a weekend staffer to do so. How many news outlets do that? Remember, this patient wasn't clinging to life in an ICU. She was at home, doing well, with no warning signs. How often should we check on patients when they seem fine?
I think we have to rely to some extent on medical providers to give us updates on patients, especially if their desire for publicity is what leads us to do the story in the first place. As this episode illustrates, however, at least some doctors think differently. I suppose I'll be more direct with doctors now when I interview their patients, asking the doctors to notify me or a PR person if anything goes awry.
If other journalists see additional lessons, I'd like to hear from them. I accepted AHCJ's offer to explain what happened so we can all try to prevent this from happening again – and so July 22 can hopefully remain the worst day of my career.