Code 15

Table of Contents

 

 

 

 

FATHER OF THE DEAD

Morgan tried to calm the man. “I understand how upset you must be, but I promise you, your sons received expert medical care.”

“My sons are dead, Dr. Connolly.” Kaine’s stony glare never shifted from Morgan’s eyes. She didn’t feel physically threatened, but his intimidating demeanor made her uneasy. It was obvious her words were falling on deaf ears.

Kaine dropped his hands to his sides. His voice never became louder but its added intensity left no possibility of misinterpretation. “I don’t believe you did everything possible. Absent your excuses, the obvious conclusion is that you failed to save the lives of two healthy boys.”

Without waiting for a response, Kaine walked past Morgan. When he got to the doorway he stopped. “If you think this is over, you’re sadly mistaken. You have no idea who you’re dealing with, and if I have anything to say about things, you and this hospital are going down.”

PRAISE FOR

Gary Birken, M.D., and
Plague

“Fans of Robin Cook, Patricia Cornwell, and Kathy Reichs are going to want to put
Plague
on his or her must-read list. The heroine is spunky, intelligent, and intuitive, a combination that makes her an excellent medical detective.”

—
Midwest Book Review

ERROR IN JUDGEMENT

 

FINAL DIAGNOSIS

 

PLAGUE

 

 

EMBOLUS

 

CODE 15

THE BERKLEY PUBLISHING GROUP
Published by the Penguin Group
Penguin Group (USA) Inc.
375 Hudson Street, New York, New York 10014, USA
Penguin Group (Canada), 90 Eglinton Avenue East, Suite 700, Toronto, Ontario M4P 2Y3, Canada
(a division of Pearson Penguin Canada Inc.)
Penguin Books Ltd., 80 Strand, London WC2R 0RL, England
Penguin Group Ireland, 25 St. Stephen’s Green, Dublin 2, Ireland (a division of Penguin Books Ltd.)
Penguin Group (Australia), 250 Camberwell Road, Camberwell, Victoria 3124, Australia
(a division of Pearson Australia Group Pty. Ltd.)
Penguin Books India Pvt. Ltd., 11 Community Centre, Panchsheel Park, New Delhi—110 017, India
Penguin Group (NZ), 67 Apollo Drive, Rosedale, North Shore 0632, New Zealand
(a division of Pearson New Zealand Ltd.)
Penguin Books (South Africa) (Pty.) Ltd., 24 Sturdee Avenue, Rosebank, Johannesburg 2196,
South Africa

 

Penguin Books Ltd., Registered Offices: 80 Strand, London WC2R 0RL, England

 

This is a work of fiction. Names, characters, places, and incidents either are the product of the author’s imagination or are used fictitiously, and any resemblance to actual persons, living or dead, business establishments, events, or locales is entirely coincidental. The publisher does not have any control over and does not assume any responsibility for author or third-party websites or their content.

 

CODE 15

 

A Jove Book / published by arrangement with the author

 

PRINTING HISTORY
Jove mass-market edition / December 2009

Copyright © 2009 by Gary Birken, M.D.

 

All rights reserved.

No part of this book may be reproduced, scanned, or distributed in any printed or electronic form without permission. Please do not participate in or encourage piracy of copyrighted materials in violation of the author’s rights. Purchase only authorized editions.

For information, address: The Berkley Publishing Group,
a division of Penguin Group (USA) Inc.,
375 Hudson Street, New York, New York 10014.

 

eISBN : 978-1-101-15156-3

 

JOVE
^®
Jove Books are published by The Berkley Publishing Group,
a division of Penguin Group (USA) Inc.,
375 Hudson Street, New York, New York 10014.
JOVE
^®
is a registered trademark of Penguin Group (USA) Inc.
The “J” design is a trademark of Penguin Group (USA) Inc.

 

 

 

To err is human, to cover up is unforgivable, and to fail to learn is inexcusable.

SIR LIAM DONALDSON,
SPEAKING AT THE LAUNCH OF THE
WORLD ALLIANCE FOR PATIENT SAFETY IN
WASHINGTON, DC,
ON OCTOBER 27, 2004

TO:
All Officers, Department Chiefs, Chief Nursing Officer.

FROM:
Robert Allenby, C.E.O.

SUBJECT:
CODE 15s

 

 

Listed below is a partial list of the types of medical errors and adverse patient outcomes, termed CODE 15s, which must be reported to the state of Florida’s Agency for Health Care Administration (AHCA) within fifteen days of their occurrence. Please be advised that
all
medical mistakes that result in patient injury must be reported to this office.

DADE PRESBYTERIAN HOSPITAL
NORTH MIAMI, FLORIDA
MARCH 3, 2007

 

 

The port wine-colored rash that shrouded Andy Kaine’s body was an undeniable omen of his impending death. Clad in a sterile green gown and wearing a protective plastic face mask, Dr. Morgan Connolly, chief of Emergency Medicine, moved to the head of the stretcher. She motioned to the paramedic who had just transported the critically ill young man to the hospital.

“What’s the story on this kid?” she asked above the cacophony of numerous high-pitched alarms.

“He’s a freshman at Florida International University. His girlfriend found him in his dorm room about forty-five minutes ago. He was completely unresponsive.”

“What were his vital signs coming in?” Morgan asked.

“We had a lot of trouble getting a blood pressure. Maybe it was forty.”

“What about a pulse?”

He shook his head. “We never felt one.”

“When did you start CPR?”

“In his room. We also intubated him,” he said, pointing to the plastic tube that they had placed through Andy’s mouth and down into his windpipe.

Taking particular note of his ashen color and vaporous eyes, Morgan turned to Pam Devlin, the charge nurse. “His blood pressure’s not registering on the monitor. See if you can get one manually.”

“I just did,” Pam answered. “It’s thirty over zero.”

From her new vantage point, Morgan studied the amorphous, punched-out lesions on Andy’s torso. They each wept a blood-tinged straw-colored fluid and, as a group, seemed to be multiplying in front of her eyes. Morgan was quite familiar with the highly contagious strain of meningitis. It was one of the few diseases that instantly filled her with an all-encompassing feeling of doom and helplessness. Morgan took a step back.

Even though she knew a full-blown code blue was almost certainly an exercise in futility, she felt she had no choice.

“We’re going to give this a shot. Continue the chest compressions.” She then pointed to a plastic IV bag suspended from a metal pole. “Open up that saline all the way. Somebody get me a full loading dose of penicillin.”

“He’s crashing,” Pam said, pointing at the flashing red display on the blood oxygen monitor that was in a freefall. “I can’t get a blood pressure.”

The respiratory therapist, who was standing next to Morgan, continued to squeeze the breathing bag. “I’m not getting much air in. His lungs must be filled with fluid.”

Morgan eyes bolted to the cardiac monitor. It showed flatline. “Keep up the chest compressions and give him an amp of epinephrine.”

“Giving it now,” one of the other nurses answered as she injected the medication into Andy’s IV.

“He’s not responding,” Morgan yelled. “Give him another amp.”

“Going in now,” the same nurse answered.

For the next half hour Morgan and the code blue team did everything possible to bring Andy back to life. But his face remained the color of chalk, and his eyes fell deeper into his skull, leaving his pupils widely dilated and hollow.

Finally, Morgan stepped back from the stretcher. The words of her mentor and professor of emergency medicine echoed in her mind with the same sobering effect as they had fourteen years ago when she was an intern: Any physician worth their salt will learn to recognize the difference between a resuscitation and a resurrection.