Right now, I am driving to my attorney's office and then to the courthouse for the first day of trial.

And you know, I don't feel so good.

Basically they have to lay out their case about why I am a substandard physician and how, you know, I breach the standard of care and then led to this horrible outcome.

It's so hard to listen to.

(suspenseful music) So here we are.

A patient feels maybe true, maybe not true.

A patient feels that they were harmed by a medical professional who did not act in a competent matter.

That's how this whole thing starts.

And they feel like someone, somehow, in this mix is responsible.

(somber music) - This is a collection of photos my sister gave to me when we were in college, or just after college age.

And she made this with the intent that someday when we were old and gray, we would have a photo to put here together.

Megan was my younger sister, we were super close.

She was, at the time, living with her boyfriend.

They were fixing up her house, plans to get married.

And you know, she was really in the prime of her life when she had the stroke.

I was very concerned when I heard she was going to the ER because that was very different than any other migraine she'd ever had.

We were always able to take care of them on our own.

And I had never seen my sister in so much pain.

Megan had a CT scan that was read as normal.

And when I saw that she'd been discharged, I had some relief because I trusted them and I thought, okay, well they know what they're doing.

So the next morning, I had another text from Megan saying, this migraine never left.

I think I need to go back to the ER.

Megan was in the ER room for many hours before another CT was even talked about.

It was about midnight and the neurology resident came in and started asking Megan some questions and asked her, can you tell me your name?

And Megan said, ten nine eight seven six five four three two one.

And I knew something awful had happened.

(clicks tongue) Sorry.

(somber music) - [Chad] Chad Englehart appearing on behalf of the estate of Megan Barrett.

Also present is Amanda Grieshop, the personal representative of the estate.

Doctor, would you please state your full legal name for the record?

- All of our cases start with a bad outcome in a clinical setting.

Then our job is to look at at the specific facts of the case and identify whether that bad outcome was simply an uncertainty of medicine or a physician-caused injury because of delay or inaction that could have been and should have been prevented with exercise of reasonable care by the physician.

Is this the Megan that you remember?

- [Physician] I can't recall.

- [Chad] You don't remember her as a person, just the events?

- I remember the events, yes.

- Okay.

- The medical malpractice system, the point of it is to try to provide compensation for patients or family members who are hurt because of negligence or bad things that happen in medicine.

And in an ideal world, that it also dissuades or serves as a disincentive for errors happening in the first place.

Unfortunately, it doesn't really work that way here in the U.S. - After Megan had the surgeries and was in the coma, I felt I had developed a closeness with one of the nurses in the neurology area, and I asked her, you know, where can I find a public record of the triage policy for the hospital?

And she said, I can't answer that question.

And because you've asked me that question, I have to notify our Risk Management Team.

- From the time that there is an adverse event, as soon as, you know, risk management services or the hospital lawyers or whoever is involved, from that time, there is no communicating directly with the patient.

The wagons are circled, everybody's marked off their sides, and every communication thereafter will be through attorneys.

- [Chad] You understand that the severe headache that she was experiencing in the emergency room was caused by a clot in her brain?

- [Physician] I don't understand the question that I'm being asked, I'm sorry.

- Sure.

- Do I understand that she had a clot in her head?

- Yes.

- At this point now, yes, two years later.

- [Chad] And you depended upon the radiologist to find that clot and report it to you, correct?

- [Physician] I depend on.

- Research has shown very clearly that the top three reasons patients sue are first just a simple search for answers, factual information about what happened.

Secondly, a very powerful sense that what happened to them not happened to somebody else.

And there's a sense of responsibility that they are actually thinking about others.

And thirdly, there is a yearning for some sense of accountability, validation for their injury.

And a sense that there is someone who is paying attention to that and is accountable.

- This is a terrible, traumatic thing that has happened to them or to the person they love and they wanna know what happened and they can't find out.

From the patient perspective, what that feels like is you do not care.

(somber music) - After she died, we took flowers and put them all around her, in her hands and around her hair.

And then we brought the kids in to spend some time with her before they took her body away.

So this is, in there, you can see my oldest son, my middle son, and my youngest son are all here.

It was a lot for them, but I think it was an important part of the process.

Initially when I called the lawyers, I called because I wanted validation that something had gone wrong.

Was I just crazy?

Was I angry that she had died and I was reading into this?

Or was there really something that had gone wrong?

- When I first received the call from the radiologist who did the blind read, I recall what he said, which is, oh my God, tell me he didn't miss this.

- [Chad] In radiology, I've heard the term clear miss.

Is that something you've heard?

- Yeah.

- And you'd agree with me this was a clear miss, correct?

- [Physician] Yep.

- [Chad] Do you take full responsibility for having missed?

- [Physician] I missed it.

Hundred percent I missed it.

- [Chad] And it was your job to see it?

- [Physician] And it was my job to see it.

It's caused me tremendous pain.

I lost a lot of sleep over it.

- Rather than coming in and making excuses for his care, making excuses for anything that happened, the radiologist came in and offered a sincere and profound apology.

- When he admitted to missing the clot, it felt good to hear it that, you know, we were right and what we suspected.

But it was angering.

This lawsuit was exceptionally emotionally draining.

I was not as available to my family.

It was a full-time job for me for three years.

And I was on multiple antidepressants for multiple years during the process.

It was by far the most stressful thing I've ever gone through in my life.

I didn't want it to go on.

And at that point I realized it doesn't matter what we do.

If we go to trial, none of these doctors are gonna stop practicing.

In the end, their insurance company paid out and it didn't change anything.

- It is incredibly difficult for patients to prove medical malpractice, which requires this series of very specific legal steps, can be really expensive, and can be really emotionally exhausting.

- The court system is clogged up.

So it takes sometimes years before you get your trial and if it's appealed it might be more years.

So it just isn't very efficient.

And because it's so costly and so risky for the plaintiff to bring the case, the smaller cases are turned down routinely by lawyers who do medical malpractice.

So if you have a relatively modest case, with maybe a few hundred thousand dollars in damages, most lawyers can't afford to take that case.

- The other major problem is, is it's just really a horrible experience for all who are involved.

For patients, they lose probably 80% of the time.

For doctors who are involved in malpractice claims, it really feels like they're being dragged through the mud in a highly adversarial process that goes on for years.

So the medical malpractice system really doesn't serve any of the parties involved particularly well.

(audience applauding) - Thank you all.

I'm here to talk about how we need to fix a broken medical liability system.

(audience applauding) - Doctors feel like they're constantly looking over their shoulders for fear of lawsuits.

I recognize that.

(audience applauding) Don't get too excited yet.

Thank you.

I understand some doctors may feel the need to order more tests and treatments to avoid being legally vulnerable.

That's a real issue.

- Instead of trying to heal the patients, doctors try not to get sued.

Defensive medicine drives a wedge between the doctors and the patients.

And defensive medicine is incredibly costly for our society.

- As a physician, you spend literally decades of your life.

You sacrifice a lot to become a doctor, right?

For a lot of us, we sacrificed our twenties or our thirties, and then, you know, there's the costs involved.

Medical school, residency, fellowship, and then all those years spent, really dedicated to your patients, right?

People go into this because they want to help people.

They have a certain skillet, and they are willing to make those sacrifices in order to help their patients, right?

So that's this very central ethos for people that go into medicine.

But of course, you know, if you're a good physician, what people don't understand is that you second guess yourself a million times a day.

Like every decision that you make, you think should I order this or should I order that?

Should I let this person go home now or should I keep them?

- You spend a lot of time studying and trying to stay up and current.

But the patient volume is such that you really do not have time to spend a lot of time thinking.

You have to act, you've gotta move.

You've got a waiting room that has a six hour wait.

You're just moving from crisis to crisis.

Maybe an intubation, approaching intubation, a cardioversion or shocking someone.

We're all human, we make mistakes.

And it's just impossible not to make mistakes.

- Unfortunately, everything we do in medicine, like everything we do in life comes with risks.

So if I prescribe you a medicine or even if I order blood work, none of those actions are without the risk of something bad happening on the other side.

- This is the videotaped deposition of Dr. Matthew Seaman on March 26th, 2019.

- [Person] Raise your right hand please.

Do you swear or affirm the testimony you shall give in these proceedings will be the truth, the whole truth, and nothing but the truth?

- I do.

- Thank you.

(somber music) - My dad wasn't a super social person, but he loved what he did and he took it really seriously.

And I think that was his way of really connecting with people and serving people.

- He was extremely calm and patient and he was the one that I hoped that he'd be working if my family came in, especially if they're critically ill or a critical trauma, which really two of his areas of expertise.

- I heard about my dad being sued in 2018.

There started having to be these meetings with lawyers, meetings with medical board, phone calls, insurance agency with the malpractice insurance, and stuff like that.

It exacerbated the depression that my dad was already dealing with.

- He'd had two prior depressions and I could tell that he was getting depressed again.

The case went on with all these appeals and disclose, I don't even know all the, the processes that went on.

Matt always kept me at bay 'cause he knew I would get distressed.

So he always said, don't worry about it, it's okay.

You know, things are going along just as they should.

- There was not chest pain, there was not cervical spine pain.

There was no evidence of a head injury.

- [Attorney] And did you chart all that?

- No.

- Why?

- I suppose it would be great to document everything, but it's just not possible sometimes.

- [Attorney] Why wasn't it possible on April 9th, 2015?

- Divorce is very common at this time.

Substance abuse is very common at this time.

We don't know how to cope.

We do not know how to- - So my interest in this is completely born out of my own experience within the medical malpractice system.

It was a very, very, very long, and protracted, and painful experience.

And I also did not know anything about what to do, who to call, who would support me.

No one had ever talked to me about it in my training.

And the first thing they did when you show up was say, do not talk about this.

I was really emotionally devastated.

I didn't wanna be a doctor anymore.

- [Attorney] They hired a emergency room doctor to serve as their expert witness.

- Number two.

- Thank you very much.

This is called his analysis and opinion.

Dr.

Seaman fell below the standard of care in his historical evaluation and documentation of his initial modified trauma evaluation.

Do you understand what he's saying there?

- I believe so, yes.

- The standard of care, the definition of it varies a little bit from state to state, but the most common way to think about it is it's sort of what a prudent and reasonable physician would have done under that circumstance.

- You have to have expert witnesses, obviously.

You need experts whenever a subject is one that the jury can't decide on its own because a lay person doesn't have the ability to make that decision.

So if you have to prove that a doctor violated the standard of care, you have to have another doctor who's gonna get on the witness stand and define what the standard of care is and explain to the jury why it was violated in this case.

- Almost every doc I've talked to was completely unprepared for the emotional impact of reading expert witness, adverse expert witness testimony, meaning expert witness for the plaintiff's side.

'Cause you get to read that stuff.

It's hard to describe the emotional impact of another doctor just, you know, smearing you and your care.

(somber music) - As an emergency physician, I have very few colleagues who have not been sued.

I've also served as a expert on both the plaintiff and the defendant's side.

And so I've seen the effect of the malpractice system on patients and their families who have suffered wrongs.

And because of the way the system works, actually can't get compensated appropriately.

And physicians, nurses, physician assistants who've been sued for things that weren't at all their fault, who go through years of anguish.

It creates a sense of fear.

And in some cases leads people to leave medicine altogether.

- He has never answered it.

- He's answered it.

- [Attorney] I have said, where do you find hypoxic encephalopathy?

- You don't like the answer, but I answered it.

- [Attorney] No Peter, let me go on the record.

I have asked him about hypoxic encephalopathy and he has never answered it.

He has only talked about an anoxic event.

- [Peter] That's because you don't like his answer.

- [Attorney] No, it has nothing to do with that.

- The worrisome thing for me was that Matt's story had changed.

He no longer felt like he was a good doctor and he said, so.

I think I am bad.

Maybe I've just been a terrible doctor all these years.

You know, he no longer was defending himself.

He felt rejected, ashamed, humiliated, and you name it.

But he didn't know how else to feel better.

So it's like he just gave up.

So the day of the deposition, he came home about four that afternoon and he said, I felt totally worthless by the end of that deposition.

[Attorney] Nothing further.

- [Person] This is the end of tape number three.

And this concludes the deposition of Dr.

Seaman on March 26th, 2019.

- And the next morning, I went downstairs to tell Matt goodbye.

I was gonna go to the medical school to give a talk.

And then I found him.

He had hung himself.

(somber music) How can you take an accomplished person who worked on the front lines of medicine so diligently, days and nights, doing exemplar work?

How can you take someone like that and treat them so poorly, and humiliate and demoralize them to the point they don't wanna live?

I just think there's a better way.

And I think Matt's a good example of what should not happen.

(sighing) (somber music) (somber music continues) - We have to carry all sorts of really heavy emotional burdens all the time.

And that's part of being a good doctor, is you just pick that rock up and you carry it and you don't complain about it.

It's just that you move on and see the next patient.

That's what you do.

And so admitting that you need help, in some ways, sort of culturally frowned upon.

And that's just something within the house of medicine that really ought to change.

- It's a very difficult thing to go through, no question about it.

But you have to understand that the person who's bringing that lawsuit has also been very seriously injured before they bring that lawsuit.

So they're also going through a very difficult time.

- Early in my career, I tried a case and as we were impaneling a jury, it occurred to me that the patient who was suing my surgeon had not talked, they had not talked to each other for six years.

Six years.

After we won the case, after the jury was filing out, the lady who sued my client leaned around the podium and said, if I had known everything I heard in this courtroom, I would never have sued you in the first place.

And I realized that there had to be a better way.

That this was not working.

(uplifting music) - There are models of systems that compensate patients without necessarily laying blame.

In an ideal world, you both provide compensation for that person for whom something didn't go right.

And you have a blame-free system to look at what were the underlying root causes of why that happened.

- It was a fundamental shift from a century of relying on the legal and insurance professions, and moving it to a clinical response.

This approach resonated with every caregiver I talked to.

In fact, it was rather startling to have a lawyer of my experience and prominence, I suppose, say that it's okay, we can tell the truth and the sky is not gonna fall in.

(somber music) - We found out we were pregnant with Selah, was it a week after I found out I got into law school?

- I think so.

- They took us in and they told us that she had DiGeorge syndrome, a chromosomal disorder.

Over two years, they said she probably wouldn't, she'd be delayed walking.

She was walking, she was signing, she had an a lazy eye.

And so they said, you know what, let's go ahead and fix that muscle in her eye.

She went into surgery and she was back in her room.

She was resting comfortably.

During that night, her alarms kept going off.

Her SATs, her oxygen levels were doing something funny.

Her heart rate didn't look right to me because, you know, two years with a heart baby, you know, you know all the monitors, you know the pulse ox.

I mean, you know everything in the room.

And I said to a nurse, I said, something doesn't look right.

And she said, you know what, let me get the doctor.

It was a resident.

And he came in, it was dark in the room.

He didn't turn the lights on, he didn't examine her.

- He brushed it off.

- And he walked out.

- I decided to be closer to her.

I wanted to hold her.

The nurses helped me get in the bed and have Selah on top of me.

And while she was in my arms, that's when she had her last seizure and slipped into a coma.

- Her heart was still pumping, but her brain was gone.

After Selah passed away, we found out she had meningitis from the autopsy.

We didn't want a big, huge back and forth with the hospital, about pointing fingers and all that stuff, but to have a real open, honest conversation and be able to say, you know, as a family in the midst of losing somebody that we loved, you know, these are some of the things that were really, really harmful and painful that made the experience worse than it had to be.

- Yeah, I was afraid that it would be more like an us versus them conversation, but it wasn't.

- They felt that some of the things that we highlighted in the meeting that we have with them, that they agreed and they wanted to change and they wanted to get better.

They wanted to make it better.

That was like, whoa, they heard us.

- When you hear from patients that have gone through this system, what they say is, hearing first from the hospital, someone reaching out to them saying, what happened to you was unexpected or wrong or whatever.

And we want to talk to you and find ways to help.

We wanna work with you.

We wanna be open, but you can actually talk together in a way that restores humanity.

- It has proven to be very true over the last 20 years that I was involved in that.

I can count on the fingers of one hand the times when people tried to take advantage of us.

I think that restoring and rekindling the trust that occurs between caregiver and patient is really an important factor to this.

- I just could not shake the resident who came in the room.

And so I asked the hospital if I could talk to him, if I could see him before we left the hospital.

And so when that resident walked in, I went over to him and I said, I just need for you to know that it's okay.

It's okay.

And I need you to move forward and be able to learn from this experience and use it, you know, for the people that you treat in the future.

And then I hugged him.

- And he started crying.

- Reggie hugged him too.

(chuckles) We both.

- I did, - We both embraced him and we both held him and he laid his head on my shoulder and he just started sobbing.

- Yeah, I have to be honest, I hugged him for a different reason.

She hugged him because she wanted to show that love and concern.

I had to hug him because that was the only way for me not to hit him.

But there's something in me that let me know that this was bigger than me and I needed to kind of check my emotions and make sure I was being as supportive as possible.

And I'm glad, I'm glad I did.

- CRP programs, Communication Resolution Programs are not programs that they have in every state.

But while we wait for the world to change, you can't let it eat you alive.

It's not necessary.

If I could go back and talk to myself, I would try to tell her that this is common.

It doesn't mean that you're a bad doctor.

This happens to almost everyone at some point during their career.

It's happened to your role models.

You just don't know because they're not talking about it.

But it's happened to people that you really respect and admire and have learned from.

So talk to people about how you're feeling and it's gonna be all right.

(somber music) (somber music continues) (somber music continues) (somber music continues) (somber music continues)