Hospital's Calm in a StormThe extraordinary nursery...


March 12, 1995

Hospital's Calm in a Storm

The extraordinary nursery incident at Anne Arundel Medical Center calls for some critical thinking about our hometown hospital. As an outside observer with an abiding concern in the county's health care delivery system, I believe AAMC's performance in response to this disturbing episode has been commendable.

News that three babies at AAMC suffered respiratory distress after receiving an unknown opiate provoked interest throughout the region and concern by the community. Daily reports continued as the investigation unfolded and ultimately led to the now well-publicized conclusion: a gravely serious human and system error. A hospital pharmacist, operating under an expired license, mistakenly prepared an intravenous solution of morphine rather than heparin as intended.

Fortunately, the babies, who were quickly stabilized, survived. But how will such an error be prevented in the future?

The hospital has made several system changes as a result. Internal changes to pharmacy management, purchasing and medication processing have been instituted to further reduce the possibility of error. . . .

But aside from professional issues, what about the community concern? The circumstances -- adverse, and for a while quite mysterious -- presented AAMC with a true institutional crisis. The hospital's response to that challenge is very instructive. It gives us an unusual glimpse into the heart of the institution, an institutional core inevitably formed by the character and values which individuals throughout the hospital bring to their jobs.

The nursery staff was attentive in quickly recognizing problems and stabilizing the newborns. When a third baby was affected, the hospital immediately and voluntarily closed the nursery. AAMC undertook its own exhaustive review of the incident, involving the state's attorney, outside experts, licensing authorities and an independent laboratory. A regulator involved in the investigation told me the hospital's cooperation and commitment to the review was unprecedented.

Equally unprecedented was AAMC's openness in providing updated information throughout the in vestigation. The result has been accurate media reports and an informed public. . . . Local residents are key stakeholders in the affairs of a community hospital. To be responsible for the lives of family members, including our fragile newborns, is to be accountable far beyond "minimum standards."

It appears AAMC has demonstrated that higher level of accountability. Truly there is no greater trust that a community can invest in an institution. By its responsiveness, the hospital has shown itself to be part of the fabric of this community. AAMC is obligated to us and recognizes that obligation. . . .

Frances B. Phillips


The writer is an Anne Arundel County health officer.

Gary's Tough Calls

OK, enough is enough. Away with you modern Romans, who love to crucify those you do not understand. In this case, it's our newly elected county executive, John Gary.

Who has pulled your strings? Who has rattled your cage? Perhaps, it's the Sanhedrin of the North County, seeking to regain political power. Always remember this: "Puppets dance when someone else pulls their strings" and "Lions roar, but to the hunter's advantage."

. . . Has it ever dawned upon you that Mr. Gary is doing what has to be done?

Leadership requires making the "tough calls." . . . I wonder how long you "armchair quarterbacks, back seat drivers and self-proclaimed critics" would survive in the political arena, trying to make Anne Arundel County the best that it can be. . . .

Dr. Frank Phelps


Why These Three Murals

In order to set the record straight with respect to the Annapolis council chamber murals (editorial, "Back to the Drawing Board," Feb. 3), it was I who, as a historian, chose the 20 or so episodes in Annapolis' 300-year history that were suitable subjects for murals. I selected them from my short 1988 history of the city, "Annapolis on the Chesapeake."

Had it been feasible, the whole series should have been executed for the Annapolis 300 Celebration this year.

But the mayoral committee, of which I was a member, recognized the improbability of immediately raising the necessary money to fund the whole project and the impracticability of having so many murals painted in so short a time.

We had, therefore, no choice but to settle on the first three, in chronological order, and hope that they would inspire the municipal authorities and the public to carry the project to its conclusion in the years to come.

One of the three murals commissioned depicts women as well as men, and two of the three include blacks. As a former member of the Maryland Commission on Afro-American History and Culture, saw to that.

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