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In Memoriam: Christina Zisa

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On January 23rd we lost Christina Zisa, aged 27, of New Jersey. She will be remembered by family, church and her caregivers, and her passing will be documented in a brief obituary in a local newspaper.

So who is Christina Zisa? She is a young woman with a story that is worth telling, particularly in light of our President's speech last night in which he noted that he is "willing to look at other ideas to bring down (healthcare) costs, including ...medical malpractice reform to rein in frivolous lawsuits." (For more on this issue, please see my earlier post, TORT Reform: An Elephant In The Room). The resounding cheers from Republicans and Democrats alike at the President's mention of Tort Reform signaled that this issue's time has come. This morning on GMA, Senator John McCain said to George Stephanopolous that Tort Reform would be addressed this year, he thought, among other issues.

Christina Zisa died after spending years as a "consumer" of the "world's best health care system." Her medical woes started 27 years ago, on the occasion of her birth in a New Jersey hospital. The doctor did not want to deliver infant Christina at night -- an inconvenience -- and so the mother-to-be was administered Secobarbital to delay the happy event. The doctor then appeared 9 1/2 hours later to check on his patient. Secobarbital also happens to be a drug used to euthanize animals, and is of a family of drugs like Pentobarbital used in the deadly cocktail on death row to execute inmates, most recently in Oklahoma on January 7th.

Both Secobarbital and Pentobarbital are barbiturates with a comparable liquid solubility, and as a result of this doctor's decision, an infant in distress was born with mental limitations that would leave her totally dependent on the care of her parents for life. There would be no attending school with friends, no dating, no marriage, no children or family of her own. Despite this, she was loved and protected by her family. She went swimming at the local YMCA -- which she loved -- with her doting father, Rosario, who called her his "Bambola" and his angel. Rosario came as a young immigrant from a small Italian village to make his fortune in America, the land of opportunity where he could fulfill his dreams. He worked hard, married and began a family. Christina was to be the culmination of that American dream -- a job, a wife and a second child. What more could a young immigrant want?

Three weeks ago, this already tragic story took a drastic turn for the worse. Christina had been putting on considerable weight, her glucose was rising and seizures were becoming more frequent, her clothes drenched in sweat. She was supposed to be admitted to a hospital for a stay of several days while doctors performed tests, including an Electroencephalogram (EEG.) She was on Medicaid, and no bed was available for her. The medications she took to treat her epilepsy included the anti-epileptic drug Carbamazepine at 400mg 3 times per day, and Vimpat, which had been increased from 50mg to 250mg 2 times a day. There are no accurate tests available for the effectiveness of Vimpat, and thus none are performed, unlike the testing available for other drugs like Carbamazepine. Therefore, the effectiveness of Vimpat has never been established. This is an all-too-familiar tale from the FDA -- questionable drugs used for illnesses that have not been fully evaluated.

Throughout those 27 painful -- and yes, joyful -- years, there was never justice served in the case of Christina Zisa. No frivolous lawsuit or lottery-laden windfall. And then, before this young woman could enter the hospital, one final seizure ended her life.

So, what has all of this to do with anything? It has to do with the lack of safety addressed in the new Health Reform Bill. The delivery of healthcare remains the same. In 1999 an IOM report noted up to 98,000 people died yearly due to "doctors' errors" and hospital-acquired infections. Today, that number has grown to 250,000 deaths per year, a rise of 150% in just over ten years. Our healthcare system has become an oxymoron that is actually a danger to our health. How will you address this Mr. President? It will be far from enough to merely cap settlements if a med mal case is settled, which relatively few are. A serious review of how healthcare is delivered would be among the appropriate steps to take.

The State of New Jersey and its health officials ping-ponged Mr. Zisa's letters on behalf of his daughter from one official and agency to another for over 20 years as he sought a response to and accounting of what happened during the birth of his child 27 years ago. He will now have to update his correspondence to those officials to include her death, the questionable medication she was prescribed, and that she was unable to be admitted to a hospital when her need was so great.

If any other industry ran this way -- with 250,000 deaths reported yearly -- you can bet there would be hearings and legislation passed. It is right that this issue get the same response, as nothing else so affects us all.