'Bleed Out' Shows How Medical Errors Can Have Life-Changing Consequences

Dec 16, 2018
Originally published on December 16, 2018 8:25 am

In 2009, Steve Burrows' mom, Judie, went in for hip replacement surgery. She came out with brain damage and mobility issues after a weeks-long coma that would change her and her family's life.

In the new HBO documentary Bleed Out — Burrows, a filmmaker and comedian, tracks his 10-year odyssey to find out what happened to his mother and who is to blame. It's a deep dark dive into the heart of America's health care system.

What happened to Judie is complicated, but it essentially began with massive blood loss.

"In the end, that's really how this whole thing started," Burrows says in an interview with NPR's Lulu Garcia-Navarro. "She lost over half the blood in her body."

After her surgery, she was put into recovery and left alone with that's called an electronic intensive care unit, or eICU.

With a series of monitoring tools that usually include microphones, video cameras and alarms, eICUs are meant to provide the 24-hour monitoring that many patients require after a major medical emergency.

"This [eICU] didn't notice my mom was in a coma for at least a day and a half and I wanted to talk to the ICU doctor who was there that night," Burrows says. "We were told there was no doctor there. I said 'Well that's insane, what do you mean?' "

He says there were doctors monitoring the cameras out by the airport in Milwaukee and they were supposed to be the safety net for his mother.

Burrows says that when he asked whether the camera was on, the head of the ICU told him it wasn't because of patient privacy issues.

As Burrows dug into his mother's case and the failure of the eICU to recognize her coma, he came across a staggering statistic. According to a study by researchers at Johns Hopkins University, the third leading cause of death in the United States is medical errors.

And those errors, Burrows says, can leave patients one step away from financial ruin.

"That's the hard lesson we learned," Burrows says. "My mom, certainly. She was a single mom, she raised my sister and I. She did everything right. She was set. And this happened and two and half years later, she's broke. She's on Medicaid ... and now we, all the American taxpayers, are paying for her."

Burrows says that before her surgery, Judie was a vibrant, independent and adventurous woman. These days, her health care has become increasingly more complicated, and in the past two months, she has started long-term hospice care.

"She is very compromised," Burrows says. "She lost her speech several years ago and that was really the thing that really hurt her the most because she was so articulate and so full of life. I know that the loss of her speech is really the thing that is really killing her the most."

Throughout the 10 years that Burrows documented his mother's struggles, he recorded many conversations — both openly and secretly. One of those conversations was with the doctor who conducted his mom's hip replacement surgery. At the time, the doctor didn't know he was being recorded.

Steve: If you were in my shoes, right now, what would be ...

Doctor: I'd like an accounting, just like you, for why in the hell no doctor was there. Their intensive care unit, where this problem occurred, we still don't know what happened. We don't have accountability.

Steve: I mean, do you think they'll ever tell the truth?

Doctor: No. I don't.

Up until this point, Burrows had been asking basic questions to the doctors and caregivers involved in his mom's situation and their stories were always changing, he says. When he finally heard what he thought was the truth by the doctor, Burrows says it was shocking.

He started filming his mother's pain and suffering after consulting with attorneys about trying to pursue justice for her. She was at her most vulnerable. It was painful and uncomfortable, but he knew he had to do it.

At the time, he didn't want to make a documentary, but he eventually decided others needed to know what happened.

"When I started to find out about this universal thing, about the third leading cause of death, and then the eICUs, I thought I really have to tell people about what I just found out," Burrows says. "Because I'm a pretty informed guy and I didn't know about any of this stuff."

Although he's done his best to make sure his mother is comfortable, Burrows says he hasn't been able to give her what she really wanted, which was to get her life back.

"I had a great mom and I really tried hard to give her everything she wanted and I couldn't give her any of that," he says. "She wanted to go home. She wanted to drive. She wanted her life back."

Burrows says he hopes that as people watch the film, they realize they need to ask thoughtful questions when it comes to their health care, and he stressed the importance of having a patient advocate in case things like this happen.

"You need to shop for doctors and hospitals like you'd shop for a car," he says. "You know, shop like your life depends on it because we found out that it does."

NPR's Sarah Handel and Cindy Johnston produced and edited the audio for the story. Wynne Davis adapted it for Web.

Copyright 2018 NPR. To see more, visit https://www.npr.org.

LULU GARCIA-NAVARRO, HOST:

In 2009, Steve Burrows' mom, Judie, went in for hip replacement surgery. She came out with brain damage and mobility issues after a weekslong coma that would change her and her family's life. In the new HBO documentary "Bleed Out," Steve Burrows tracks the 10-year odyssey to find out what happened to her and who's to blame. It's a deep, dark dive into the heart of America's broken health care system. Steve Burrows joins us now from New York. Welcome to the program.

STEVE BURROWS: Thank you very much. Appreciate being here.

GARCIA-NAVARRO: The third-leading cause of death in this country, according to a recent study, which you cite in this documentary, is actually medical errors. And that's a shocking statistic. Like all medical cases, what happened to your mom is complicated. But essentially, in her surgery, she had massive blood loss, right?

BURROWS: That's correct. That - in the end, that's really how this whole thing started - was just this - she lost, well, actually over half the blood in her body.

GARCIA-NAVARRO: And after that, she was put into recovery after what was not a run-of-the-mill hip replacement surgery. And she was left alone in what is called an eICU. Can you explain to us about eICUs?

BURROWS: Well, I will try.

GARCIA-NAVARRO: Yeah.

BURROWS: This ICU didn't notice my mom was in a coma for at least a day and a half. And I wanted to talk to the ICU doctor who was there that night. And we were told there was no doctor there. And I said, well, that's insane. What do you mean? Well, we had this thing called electronic ICU. And there was a camera doctor out by the airport in Milwaukee. And they were the ones who are, you know, the safety net, apparently, for my mother. And I asked if the camera was on. And they could not - in fact, the head of the ICU at that time told me the camera was not on. And I'm like, well, I don't get it. Why? And he said, due to patient privacy issues. And I'm like, this is nuts. I don't understand any of this.

GARCIA-NAVARRO: I mean, I think what the film shows so graphically is how even with the best planning - I mean, your mom worked all her life. She had savings. In this country, you can be just one step away from ruin because of health care.

BURROWS: That's the hard lesson we learned. You know, my mom certainly - she was a single mom. She raised my sister and I. She did everything right. She was set. And this happened. And, you know, 2 1/2 years later, she's broke. She's on Medicaid, Title XIX. And now we all - you know, all the American taxpayers are paying for her.

GARCIA-NAVARRO: During this, you record many conversations, both openly and secretly. And I want to have us listen to one conversation that you ended up having with your mom's doctor who conducted the hip replacement surgery on that fateful day. Let's listen to what he had to say when he didn't know that he was being recorded.

(SOUNDBITE OF ARCHIVED RECORDING)

BURROWS: If you were in my shoes right now, what would be...

UNIDENTIFIED PERSON: I'd like an accountant just like you for why in the hell no doctor was there. Their intensive care unit when this problem occurred - we still don't know what happened. We don't have accountability.

BURROWS: I mean, do you think they'll ever tell the truth?

UNIDENTIFIED PERSON: No, I don't.

GARCIA-NAVARRO: What was that like to finally hear what you thought to be the truth told to you by this doctor?

BURROWS: Boy, that's a good question. You know, as I kept asking all the doctors and all the - you know, all the caregivers and all the nurses affiliated with this particular situation, I kept asking all just basic questions. I just wanted to know what happened. And, you know, the stories kept changing. And I thought if I could record it, I would at least have that version of it. And, you know, what he told me was pretty shocking.

GARCIA-NAVARRO: We should say here that you worked in Hollywood as a comedian and director. And you've mentioned that you didn't want to start making this movie. So what finally pushed you to sort of make this public?

BURROWS: When I first consulted attorneys in trying to find out how I would even pursue any type of justice or anything, they told me immediately I needed to start filming my mom's pain and suffering for - eventually for a jury and for a trial if that ever made it that far. And this was a very difficult thing for me to do. You know, my mom is literally at her most vulnerable. And I'm even kind of uncomfortable thinking about it right now. But that - I had to do it. And especially when she came out of the coma, you know, she woke up. And, you know, I've got a camera in her face. And I tried to explain her why I'm doing it. And she trusted me completely. And it was really, really for the attorneys in the early years. But then when I started to find out about this universal thing, about a third-leading cause of death and the eICUs, I thought, I really have to tell people what I just found out because I'm a pretty informed guy. And I didn't know about any of this stuff.

GARCIA-NAVARRO: You've described your mom before her surgery as sort of a vibrant, adventurous and independent woman. How is she doing now?

BURROWS: We've just started a long-term hospice just in the past month and a half. She is very compromised. She still knows what's going on. You know, she lost her speech several years ago. And that was really the thing that really hurt her the most because she was so articulate and so full of life. And I know that she - that's - the loss of her speech is really the thing that is really killing her the most. She's very comfortable. She's in a great facility. And she's getting great care. But it's just - she's declining.

GARCIA-NAVARRO: I have to say, watching this, you were so dedicated to her cause to finding out what happened to her and to managing her life and trying to make it as comfortable as possible. I mean, you're a great son.

BURROWS: Oh, well, thank you. I had a great mom. And she - I - you know, I really tried hard to give her everything that she, you know, wanted. And I couldn't give her any of that. You know, she wanted to go home. She wanted to drive. She wanted her life back. And I couldn't give it to her, so I tried to at least make her comfortable.

GARCIA-NAVARRO: What do you want people to learn from this film?

BURROWS: One thing that I really learned was when things like this happen, you need an advocate. You need someone to come in with you when you're sick. Because if you're sick or in an emergency room, you - you're not in any position to, like, ask thoughtful questions about your care. And if you have a question about something with the care or you want a second opinion, go get one because that's going to guarantee you get even better care. And that first doctor is going to respect you and maybe even learn something. You need an advocate. You need to ask questions. You need to shop for doctors and hospitals like you'd shop for a car. You know, shop like your life depends on it because we found out that, you know, it does.

GARCIA-NAVARRO: Steve Burrows is the director of "Bleed Out," which airs on HBO this Monday. Thank you so much.

BURROWS: Thank you, Lulu. Transcript provided by NPR, Copyright NPR.