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Friends of Michael Hurewitz knew him as a man who would go out of his way to help others. So when his younger brother, Adam, needed a liver transplant due to a rare disease called sclerosing cholangitis, no one was surprised that Mike stepped forward."He had worried about Adam's illness for years," says Mike's wife, Victoria. "This was a completely emotional decision." A 57-year-old reporter for the Times Union in Albany, N.Y., Hurewitz seldom spoke to his wife about the surgical risks he faced, and masked his own anxiety with humor.
In early 2002, both brothers entered Mount Sinai Medical Center in New York City, a world leader in living-donor liver transplants. Unknown to them, however, nurses on that unit had been filing "protest of assignment" forms for months with the hospital administration and the New York State Nurses Association. Too few nurses, they claimed, were on duty to care for the patients.
Surgery for both brothers took place on Thursday, January 10, and went smoothly. Adam's healing progressed without a hitch, and today his new liver is functioning perfectly. But his brother's fate was far different.
At no time after his operation did Mike's surgeon pay him a visit. Instead, he was assigned to a first-year resident, who seldom appeared.
So Mike's nursing care was especially critical. It proved woefully inadequate. When Mike was moved into his regular hospital room 12 hours after surgery, his wife noticed that there seemed to be very few nurses on his floor. "When Mike needed his bandages changed, I'd have to chase a nurse down," she says.
A fit jogger and mountain climber, Mike appeared at first to be recovering uneventfully. But two days after surgery, monitors showed that he had an abnormally rapid heartbeat, and that his blood pressure had dropped. After giving him a shot for his symptoms, the harried nurses paid scant attention. He also became chilled, so Victoria tracked down a nurse who told her they had no blankets. Victoria walked to her hotel room to get one.
By Sunday afternoon, Mike had begun coughing up blood and Victoria became more and more alarmed.
When a nurse appeared briefly in his room, Victoria's sister-in-law, a physician, asked her a question about Mike's blood test. "I don't know," the nurse replied curtly. "I've got three things going on right now." Another nurse said she'd call a doctor, but the resident on call didn't stop by until 25 minutes later. Mike vomited up blood for two more hours until, to Victoria's horror, he choked to death right in front of her. An autopsy revealed that Mike had been suffering from a serious and untreated bacterial infection.
Not long after Mike Hurewitz's death, Mount Sinai voluntarily suspended its living-donor liver transplant program for nearly a year. That wasn't enough for the New York State Health Department, which in August cited "serious quality care violations" not only regarding Mike Hurewitz, but in ten other cases. Mount Sinai was fined a total of $66,000.
The health department's report bluntly stated that Mount Sinai did not provide adequate nursing staff. Moreover, health officials found "no evidence," in some cases, that nurses on the liver transplant unit provided follow-up care "to patients experiencing significant changes in their health condition."
Victoria Hurewitz expresses her anger in plainer English: "Mike had space-age surgery and Third World care." She filed a wrongful-death lawsuit that is now pending.
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