Deadly Errors
Page 1
Praise for Allen Wyler’s Thrillers
“DEAD END DEAL is a medical thriller of the highest order, reviving the genre with a splendid mixture of innovation and cutting-edge timeliness. Neurosurgeon Allen Wyler knows of what he writes, and the result is a thriller that equals and updates the best of Robin Cook and Michael Crichton. His latest is terrifying, riveting, and a masterpiece of science and suspense.”
—Jon Land, best-selling author of STRONG AT THE BREAK
“DEAD END DEAL by Allen Wyler is a masterful medical thriller, intelligent, ferociously paced, scary as hell, ripping with suspense, and filled with fascinating (and horrific) details that only a neurosurgeon-turned-writer like Wyler could provide. If you like the medical thrillers of Robin Cook or Michael Crichton, you will absolutely love DEAD END DEAL.”
—Douglas Preston, author of THE MONSTER OF FLORENCE and co-creator of the PENDERGAST NOVELS
“The gritty, graphic details of cutting-edge surgical procedures, capped with an exciting conclusion, should keep fans of the genre riveted.”
—Publishers Weekly
“With its lightning-paced excitement and fascinating science, DEAD HEAD has everything you could hope for in a medical thriller!”
—Tess Gerritsen, author of THE MEPHISTO CLUB
“In the tradition of Robin Cook, Wyler takes us behind the scenes to show us things the medical establishment doesn’t want us to see. DEAD RINGER builds a high-speed plot on a startling but all-too-plausible premise. This is the stuff nightmares are made of.”
—Joseph Finder, New York Times Bestselling Author of PARANOIA and BURIED SECRETS
“The suspense builds and builds in this riveting page-turner. It’s a skillful merging of the medical thriller and political thriller … Tom Clancy meets Tess Gerritsen!”
—Kevin O’Brien, New York Times Bestselling Author of THE LAST VICTIM and KILLING SPREE
“You’ll be asking the nurse to swab your forehead when you’re admitted into this tense medical thriller exposing DEADLY ERRORS. Wyler does for hospitals what Benchley did for the ocean.”
—Joe Moore, co-author of the international best seller THE GRAIL CONSPIRACY
“Wyler writes a fast-paced thriller, which reawakens your scariest misgivings about the Medical-Industrial Complex and the profit motive corrupting the art of healing.”
—Darryl Ponicsan, author of THE LAST DETAIL
“DEADLY ERRORS has a fascinating and frightening premise that gives it the potential to be a best seller in the Robin Cook mold.”
—William Dietrich, author of HADRIAN’S WALL
“This is an ‘up all night’ pass into troubled places that only hardworking doctors know about; a turbulent world of trusting patients and imperfect humans struggling with the required image of perfection. Only a gifted surgeon like Allen Wyler could craft such a wild and wonderful best-of-the-breed medical thriller!”
—John J. Nance, author of PANDORA’S CLOCK and FIRE FLIGHT
“Wyler’s debut novel is both an engrossing thriller and a cautionary tale of the all-too-frequent intersection of high technology and higher greed. It’s a message all of us better pay attention to, or face the consequences.”
—Mark Olshaker, author of EINSTEIN’S BRAIN, UNNATURAL CAUSES, and THE EDGE; co-author of MINDHUNTER, JOURNEY INTO DARKNESS
This is a work of fiction. All characters and events portrayed in this novel are either fictitious or are used fictitiously.
DEAD ERRORS
Astor + Blue Editions LLC
Copyright © 2012 by Allen Wyler
All rights reserved, including the right to reproduce this book or portions thereof, in any form under the International and Pan-American Copyright Conventions. Published in the United States by:
Astor + Blue Editions, LLC
New York, NY 10003
www.astorblue.com
Originally Published by Tor/Forge Books 2001
Publisher’s Cataloging-In-Publication Data
Wyler, Allen. DEADLY ERRORS—ebook edition.
ISBN: 978-1-938231-20-9 (paperback)
ISBN: 978-1-938231-18-6 (epub)
ISBN: 978-1-938231-19-3 (epdf)
1. Neurosurgeon Doctor—Thriller—Fiction 2. Electronic Medical Errors—Fiction 3. Corporate Greed and Corruption—Fiction 4. Fraudulent use of Medical Records—Fiction 5. Dangerous Medical Operations—Fiction 6. Seattle (Wash)—Fiction 7. American Thriller story I. Title
Book Design: Bookmasters
Jacket Cover Design: Ervin Serrano
CONTENTS
Prologue
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
Chapter 26
Chapter 27
Chapter 28
Chapter 29
Chapter 30
Chapter 31
Chapter 32
Chapter 33
Chapter 34
Chapter 35
Chapter 36
Chapter 37
Chapter 38
Chapter 39
Chapter 40
Chapter 41
PROLOG
Maynard Medical Center Reduces Medical Errors
By WILLIAM BARR
Seattle Times staff reporter
Seattle—In a statement issued today, Maynard Medical Center CEO Arthur Benson reported a twenty-fold decrease in medical errors since becoming a beta test site for the highly-touted Med-InDx electronic medical record (EMR). This makes it by far the safest West Coast hospital according to Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the accrediting organization for hospitals. “This is a remarkable improvement in patient safety,” said Sergio Vericelli, chairman of the JCAHO committee charged with selecting a benchmark EMR within the next year.
Vericelli added, “In November 1999, the Institute of Medicine concluded a study entitled ‘To Err Is Human: Building A Safer Health System.’ It focused attention on the issue of medical errors and patient safety by reporting that as many as 44,000 to 98,000 people die in hospitals each year from preventable medical errors. This makes preventable medical errors this country’s eighth leading cause of death—higher than motor vehicle accidents, breast cancer, or AIDS. About 7,000 people per year are estimated to die from medication errors alone.”
In support of its mission to improve the quality of health care provided to the public, JCAHO reviews a hospital’s response to sentinel events in its accreditation process. A “sentinel event” is an unexpected occurrence involving death or serious physical or psychological injury. Such events are called “sentinel” because they signal the need for immediate investigation and response.
AUGUST
“… THE NEEDLE, SPONGE and cottonoid counts were correct. The estimated blood loss was 350 ccs with no blood or blood product replacement. This has been dictated by Tyler Mathews.”
Neurosurgeon Tyler Mathews finished dictating his operative report, returned the beige dictation telephone to its cradle and leaned his weary body against the acoustical tile wall of the small dictation booth. The sweat-dampened scrub shirt chilled his back but he was too exhausted to move to a more comfortable position. For an uncharacteristic mo
ment he savored the professional satisfaction and pride his work gave him. The benign brain tumor, a meningioma, had been a particularly nasty one involving a fifty–year-old woman’s nerves for sight and eye movement. He’d spent the past six hours peering through a surgical microscope, picking bit by bit at the knobby, cream colored, grape-sized hunk of tough fibrous tissue until every visible nubbin was removed. A total removal was one thing. But the real trick—and the thing that made this case so satisfying—was getting out of there with the surrounding nerves functioning perfectly.
It was meticulous, demanding work. He loved the challenge.
With a deep breath he palm-wiped his face.
Ignoring the familiar fatigue created by six hours of continuous mental exertion, he pushed off the bar-height stool and headed for the recovery room to once again check his patient’s progress recovering from anesthesia.
“DOCTOR MATHEWS, THERE’S a man wants to see you.” Matilda, the ever-smiling unit clerk nodded toward the automatic doors leading to the rest of the hospital. The man appeared to be close to Tyler’s 38 years and perhaps two inches shorter, maybe 5’9”. He wore a summer weight dark gray suit, white shirt and abstract black and white tie.
Tyler thought, FBI, without knowing exactly why.
“What does he want?” By now the man was approaching with a self-assured strut Tyler recognized as characteristic of law enforcement or military types.
“Doctor Mathews?”
“Yes?” The questioning stares of nurses and anesthesiologists tingled Tyler’s back, their interest already sharpened by a stranger in street clothes in a restricted area.
The stranger glanced around. “Not here. Let’s move this out into the hall.” His tone carried an irritating edge of authority.
Tyler didn’t move. “Not until you tell me what this is about. I’m wrapping up a case. Who are you?”
The man pointedly surveyed the room again. “I think it’s better we continue this discussion in the hall.”
Tyler told the clerk, “I’ll be back in a minute,” as his gut tightened into a square knot.
Out in the hall the automatic doors slid shut at their backs. The man studied Tyler a moment before his hand appeared holding a wallet. “Agent Dillon, DEA.” The wallet dropped open exposing official looking identification.
The square knot in Tyler’s gut began to send sharp stabbing pains up through his diaphragm. “Yes?” He’d wondered about reprisals from his chairman and how they might come. Was this the beginning?
“Mind if I have a look-see in your locker?”
Tyler’s heart started galloping. “Why would you want to look in my locker?”
Legs spread in military at ease, Agent Dillon hooked both thumbs over his belt, throwing open his suit coat just enough to flash a shoulder holstered firearm. “And why would this be a problem, Doctor?”
Tyler spread his legs too, folded both arms across his chest. “The problem’s your attitude. It sucks. I want to know what you’re looking for and why.”
Dillon laughed. “Hey, not my problem. And I will look in your locker… . One way or another.”
Tyler shook his head. “There’s nothing in my locker that would interest the DEA. Period.”
“Hey, have it your way. But, we can do this one or two ways. Either you open it for me, or I’ll have security do it.” As he spoke, his right hand replaced the ID wallet with a folded paper from his inside breast pocket. “This is a signed order to search your locker.” A shrug. “Your call, Doc.”
Seeing no other option, Tyler marched toward the dressing room, anger constricting his chest. “What’s the deal, you guys don’t have enough to do in The War on Drugs? You have to get your jollies now by bullying doctors?”
As they rounded the corner to the narrow passageway between rows of identical gray metal lockers Tyler came face to face with two security guards, one leaning against his locker, the other one blocking the aisle, telling a joke. Their conversation stopped abruptly when Tyler appeared.
Tyler turned to Agent Dillon. “What are they here for?”
Dillon flashed irritation. “Just open the fucking locker.”
Tyler glanced at the guard leaning against his door. “Mind?” The guard moved away with an embarrassed grin.
Tyler’s mind started racing as he reached for the combination lock. What if someone placed something in there? How long ago had he opened the locker to change into scrub clothes? He checked his watch. Six hours. A long time. Long enough for anything to have happened.
“Well? You going to open it?”
Tyler spun the dial and missed the third number. He started over and missed again. By the third time his fingers, trembling from anger, hit the combination and the lock dropped open. He stood aside. “Go ahead, knock yourself out,” and drilled the closest security guard a questioning look. The guard glanced away.
Agent Dillon snapped on a latex glove, stepped up, opened the door and stood there a moment before reaching up to the single shelf above Tyler’s hanging clothes. “My oh my, what have we here?”
“What the hell—” Tyler reached out but the DEA agent slapped his hand away.
“Don’t touch a thing.” Dillon pulled down a vial from the shelf. The label read Morphine Sulfate. He turned to one of the security guards. “Open one of those plastic bags for me, will you? And neither one of you to is touch anything before I drop it in a bag. Understood?”
OCTOBER
ATTORNEY, MARY MCGUIRE’S richly appointed office occupied the southwest corner of the fifteenth floor, and commanded a magnificent view of San Francisco’s industrial district. The morning sky was so dark with late October fog and drizzle that cars snaking along the streets below had headlights on at nine o’clock in the morning. It would rain soon. Tyler was sure of this.
“You have a choice. You can accept their offer, which by the way, I think is extremely generous under the circumstances, or you can take your chances in court. I shouldn’t have to reiterate the consequences should you lose the case, but just for the record, I will. In this state, as is the case in most states, a felony conviction would mean loss of your professional license. Bottom line, you lose the case and you will never practice medicine again. Ever.”
“Goddamit,” Tyler said, his frustration and fury building. He continued to stare out the window, fists shoved deeply into his pockets, shoulders hunched as if protecting his body from the chilly, foggy, autumn gusts outside. “Say we got to trial, what do you estimate my chances of winning?”
His lawyer sighed. They’d been over this how many times this morning? “If you hadn’t come up with a positive urine test, well, I would’ve said pretty good. But, considering that particular bit of ammunition …”
“Goddamnit, just give me the odds.”
“They haven’t changed from the last time we went over this,” she said testily. “My guess, you have about a ninety percent chance of losing.”
Typical. He’d asked for his chances of winning. She’d given his risk of losing. He grunted sarcastically and continued staring at the street below.
“Just so I understand this completely … so I have an informed consent …” His jaw muscles were aching again, producing tight throbbing across his forehead. He paused to work out the tension. “Tell me again exactly what the deal is.” He glanced over his shoulder at her.
Peering back at him over the tops of her half-height reading glasses, sending him her stern-faced lawyer expression, she said, “First, you must complete a drug rehab program here in San Francisco. One that is certified by the California Medical Society’s impaired physician program. Only after being fully discharged from such a program can you practice again. Second, when you do practice again, it must be outside the State of California.”
“This is the part that baffles me. Can they really do that? Dictate which state I practice in?”
“Under the circumstances of this particular deal they can, yes.”
“Final question. How long do I hav
e to consider this?” He turned to fully face her.
She reached up, took off her reading glasses, her face deadly serious now. “What’s to consider? It’s a no brainer, so far as I see. But, to answer your question, no time at all. They expect an answer from you today.”
He knew what he had to do. He thought of Nancy, how he still had her in spite of losing everything else that mattered in his life. He drew in a deep breath, and gave his answer.
LATER THAT DAY
THE MOMENT TYLER opened the front door to their one-bedroom apartment, a bolt of intuition warned of something wrong. He hesitated, hand still on the doorknob, then shrugged it off as residual paranoia from a very bad day.
He turned into the living room and saw Nancy push up from the couch, fists clenched, cheeks streaked black from mascara. Confused, Tyler stopped. Two pieces of luggage stood neatly aligned to each other a few feet from the couch. She moved to them.
His heart stumbled, a knot of fear encasing it. “Something happen to your mother?”
Fresh tears trickled down her cheeks. “No, Tyler, she’s fine but I’m not. I’m moving out. I’ve contacted a lawyer. I’m filing for divorce.”
He placed a hand on the wall for support as his legs weakened. “I—”
She shook her head. “It’s not debatable, Tyler. I’ve made up my mind.”
“Not debatable? Who said anything about a debate?” He found himself unable to think clearly.
“I know how you are, that’s all. I just don’t want to discuss this.”
“Jesus, I come home from a very bad day and you tell me we can’t even discuss this … that you’re leaving me? Why?” He pointed at the suitcases. “Christ, we’ve always been able to talk things out … that’s been one of the really special things about our relationship … being able to communicate.”
“Well, not this time, Tyler. I just don’t want to be pressured out of my decision.”
He straightened his legs back up. “As I remember, the vows went something like, ‘for better or worse.’ Were we both on the same page that day?”