Suit settled over patient’s death after heart monitor detached

Mercy Health Saint Mary's to pay $750,000 to family of Peter Winkle

Peter Winkle
An undated courtesy photo of Peter Winkle.

GRAND RAPIDS, Mich. (WOOD) — A Grand Rapids hospital that disconnected a patient's heart monitor before he flatlined will pay the man’s family $750,000.

The judgment against Mercy Health Saint Mary’s comes nearly three years after the heart attack that killed Peter Winkle, 72.

"(It was) just unbelievable," his wife Renee Winkle said of the night her husband's heart stopped beating. "It went from a bladder infection to cardiac arrest within hours."

BLADDER INFECTION PROMPTED TRIP TO CLINIC

Peter Winkle, an ordained minister who worked as a hospice chaplain, stopped into Saint Mary’s southwest campus in Byron Center the evening of May 10, 2014. He felt a bladder infection coming on and wanted to take care of it before a planned trip to Arizona.

But when a nurse checked Winkle’s vital signs at the clinic on 64th Street, she found a fast heart rate, rapid breathing rate and elevated blood pressure. In a deposition for the lawsuit, a nurse at the southwest campus reported that Winkle also complained about his chest.

"His words were, 'My chest feels heavy. It feels tight,'" registered nurse Gabriella Mascari recalled in response to questioning by Renee Winkle's attorney.

After additional testing, Dr. Ann Knapp, who was on duty at Saint Mary’s southwest campus that night, diagnosed Winkle with sepsis, a potentially dangerous condition that develops when the body is fighting infection.

The doctor ordered Winkle taken by ambulance with continuous heart monitoring to Saint Mary’s downtown campus.

RECEIVING NURSE DETACHED HEART MONITOR

But once downtown, an admitting nurse disconnected Winkle’s heart monitor.

"The failure in this case is the nurse is not supposed to detach a patient from continuous heart monitoring without a physician or a physician assistant order," said Rob Buchanan, the medical malpractice attorney from Buchanan & Buchanan PLC who represented Winkle’s estate. "And she did it, and didn’t tell them. And they didn't put it back on him."

ALONE AND UNMONITORED, PATIENT FLATLINES

It's not clear how long Peter Winkle lay alone in his room after his heart stopped beating.

Saint Mary's said it was no longer than five minutes, but the family's attorney thinks it was more like 30.

Peter Winkle
Peter Winkle.

"He's in his room, unobserved, (the nurse) comes back after probably a half hour and finds him in cardiac arrest," Buchanan said.

Hospital staff were able to resuscitate Winkle, though it took at least five shocks to do so. But Winkle never regained consciousness, and he died 10 days later.

FAMILY'S ATTORNEY: HEART MONITOR COULD HAVE SAVED LIFE

"Had he been on continuous heart monitoring, they would have seen it from a (monitoring) station," Buchanan said. "Alarms would be going off, and they'd run in and they'd have been able to resuscitate him. Or, actually, they'd see an abnormal rhythm before he went into cardiac arrest so they would have prevented any cardiac arrest at all if he had been on the monitor he was supposed to be."

The internal medicine physician who was on duty at the downtown campus, Dr. Bilal Ali, did not order continued heart monitoring for Winkle once he arrived. In the lawsuit, Saint Mary's argued that Winkle's symptoms, even though he had a history of cardiac problems, did not justify continuous cardiac monitoring.

"In this case, the physician at the emergency facility (in Byron Center) had not identified chest tightness," the hospital's expert, Dr. Lawrence Warbasse, wrote in an affidavit. "Additionally, no such tightness, nor any other signs of an ongoing cardiac event, were present upon arrival at Saint Mary's."

But the Winkle family's attorney said Ali had a conversation with the southwest campus doctor prior to Winkle's transport and agreed to admit him downtown to a bed with continual heart monitoring.

"The plan was to keep him in a bed that was monitored at all times, and (Ali) just didn’t follow through with what he was supposed to do," Buchanan said.

Ali, in his deposition, said he didn't know that Winkle was ever on a monitor.

HOSPITAL: DOCTOR AND NURSE MET 'STANDARD OF CARE'

In its response to the lawsuit, Saint Mary's said all of its providers met the standard of care in Winkle's case.

In a statement to Target 8, Trinity Health, which owns Mercy Health Saint Mary's, did not address the allegation that mistakes were made in Winkle's care.

"We settled this matter prior to a trial to avoid high litigation and time costs, and to ensure our resources and energies remained focused on fulfilling our Mission in the community. With this settlement, the situation comes to an end only in the court system. As the loss will continue to be felt by the Winkle family, our thoughts and prayers remain with them," the statement reads.

Trinity Health did not respond to Target 8's questions regarding the employment status of Ali or the nurse who disconnected the heart monitor when Winkle arrived downtown. Target 8 determined, however, that Ali relocated to Memphis, Tennessee, and is practicing there.

IMPORTANT TO ADVOCATE FOR YOUR OWN CARE

Buchanan said that the care Winkle received is evidence of a systemic problem facing hospitals.

"This is an example of care that was provided over the weekend," he said. "This happened on a Saturday, and I think you see a lot of medical malpractice occur on weekends and holidays… You have the second-string people in there taking care of patients, so that’s when you see errors occur."

He urged patients to be advocates for their own care.

"Make sure you’re speaking up," he advised. "If you have questions, speak up. Don’t just take for granted that they’re going to do the right thing or look out for your best interest. They get busy. They get distracted. They make errors. So as a patient, it's important to be your own advocate."

Peter Winkle, Renee Winkle
Peter and Renee Winkle.

Renee Winkle said she sometimes asks herself, "Why didn’t I go with him that night?"

"I remembering thinking, 'It's just a bladder infection and he's in good hands,'" she said. "'He's at the hospital. What better hands could he be in?'"

'YOU RAISE GRACE FROM HEAVEN'

Winkle ministered to all kinds of people throughout his life, including the homeless community in downtown Grand Rapids' Heartside neighborhood.

"I think the community is a much better place because of Peter," said Renee Winkle, his wife of 10 years. "He touched so many lives and especially those lives that needed to be touched."

But the 72-year-old's most cherished role was that of husband to Renee Winkle, 28 years his junior, and father to their daughter, Grace, who was 9 when her dad died.

Peter Winkle
An undated courtesy photo of Peter and Renee Winkle and their daughter, Grace.

"Peter had so many strengths, but one of them was just being a great father," Renee Winkle said. "Watching him be a parent just taught me how to be patient and kind and loving and he was just so gentle with her."

As the end neared, she held her husband in her arms.

"I said to him, 'You know, Peter, you raise Grace from Heaven and I'll raise her from Earth. But we'll continue to raise Grace together.'"

RESOURCES

PDF: Is there a 'weekend' effect in major trauma?

PDF: Preventable morbidity at a mature trauma center

PDF: Quality of care and mortality: Do hospitals provide lower quality care on weekends?

PDF: Survival from in-hospital cardiac arrest during nights and weekends

PDF: Incidents of "never events" among weekend admissions versus weekday admissions to US hospitals: national analysis

Online: Why being hospitalized on a weekend costs more lives, health care dollars

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