When a patient is seriously injured—or dies unexpectedly—during or after hospital care, the patient and family may feel shocked, frightened, or overwhelmed. It may be difficult to know what to do first.
The following steps can help protect the patient, preserve important information, and prepare the family to seek answers. Take them one at a time.
If the patient is still in the hospital and may be in danger, tell the bedside nurse what has changed and ask for an immediate assessment. If your concern is not addressed, ask to speak with the charge nurse or attending physician. Clearly explain what you are seeing.
You may also ask for:
If the patient’s condition is rapidly worsening, tell staff the patient needs immediate help and ask how to summon the hospital’s rapid-response team. Some hospitals allow patients and families to call the team directly.
If the patient is at home and has serious or worsening symptoms, call 911 or seek emergency care. Do not delay urgent treatment while trying to determine whether an error occurred.
If the patient has died unexpectedly, ask about an autopsy promptly, before burial or cremation. See Step 2.
An autopsy may provide information that cannot be obtained later. Ask promptly whether the medical examiner or coroner has been notified and whether that office will investigate the death. The rules vary by state and by the circumstances of the death.
If the medical examiner or coroner will not conduct an autopsy, ask about a hospital autopsy or seek advice about arranging a private one. Private autopsies may be costly. Act before burial or cremation, because delay can limit the available options.
Request copies of the death certificate, autopsy report, and medical examiner’s findings when they become available.
Record what you personally saw or heard, and separate facts from suspicions. Memories can fade quickly, especially during a crisis.
Keep the original versions. Do not write on, alter, or discard them. Store copies in a safe place.
Send a detailed written request to the hospital’s medical-records department. List the records you want, including physician and nursing notes, medication orders and administration records, test results, imaging reports and the actual imaging files, consultation reports, consent forms, discharge records, and emergency-department records. Ask where to send a separate request for itemized billing records.
If the patient has died, the person requesting the complete record generally must have legal authority to act for the deceased patient or the patient’s estate. Ask the hospital what documentation it requires to establish that authority.
The first set you receive may not include everything. Compare it with your written request and ask specifically for anything missing. Keep copies of your requests and a log of when records arrived and what was missing.
Ask the attending physician or the clinician responsible for the patient’s care to explain:
Bring someone who can listen and take notes. Ask whether the hospital will provide a written explanation. After the conversation, send a written account of what you understood and ask the hospital to correct anything you have misunderstood.
Avoid signing releases, settlement agreements, or other documents you do not fully understand.
You do not need to wait for the complete medical record or the hospital’s investigation before seeking advice. Legal deadlines vary by state, and special notice requirements or earlier deadlines may apply to claims involving government-operated hospitals.
Hospital risk-management staff represent the hospital’s interests that take precedence over your interests. For an independent assessment of your options, consider speaking with a qualified medical professional or attorney. An attorney can explain applicable deadlines and whether a medical expert should review the circumstances.
Seeking advice does not mean you are filing a lawsuit. It can help you understand your options while important decisions still need to be made.
