All language subtitles for Diagnosis Murder s05e21 First Do No Harm

What do you got, Will?

9 -1 -1. Female, maybe four years old.

Severe respiratory distress.

Asthmatic? Oh, no. She's got a hell of a
fever. 105 .6. Well, let's get her on

exam one. Anyone with her? Her mother
should be right behind us. Hey, get an

ambu bag and start the O2.

One, two, three.

Where's she? Where's Wendy? Where'd they
take her? Are you her mother?

What are you doing with her?

Where's Wendy? Listen, my name is Dr.

Travis, and your daughter is right in
there. She's receiving emergency

care, okay?

I want to be with her. I know, I know.
Who's your attending physician?

What? Your regular doctor.

I don't know. They changed it.

I think it was Grossman. Grossman?

No, it was something like that. Did you
call him before you came in?

No, I just called 911.

There's not going to be any trouble, is
there?

I mean, I have my insurance.

See, here's the card.

Triax MultiCare Incorporated.

It's through my job. I know I'm covered.
Okay.

Dr. Travis? Be right with you. Could I
have a word with you now?

Ms. Pearson, you can bother me about
administrative paperwork later. Right

I have a patient in respiratory
distress. You can't just go on.

What? It's a 911 call. No attending
physician on record.

What does that have to do with anything?

She signed with an HMO.

We need pre -authorization from them
before we can treat the child. We can't

even go beyond emergency breathing care
without their approval.

I'm the physician in charge of the ER,
right? I know, I know, but you have to

make the call.

I have to call them?

Stop wasting time and make the call now.

I tell you what, you get them on the
phone and I'll talk. Right now, a little

girl needs my help.

So your gunshot victim hasn't told you
anything yet?

The doctors in ICU say you'll probably
never regain consciousness, but I've got

to stick around just in case. In that
case, I'll buy you a cup of coffee. So I

paged you. It has been more than two
hours since I called. Now, I've got a

patient here. I'm sorry, sir. I've
already left a message on the voicemail.

if you'll just be patient.

No, no. I'm not going to wait. Now, you
put on one of your damn managed doctors

now, or I will be calling every ten
minutes until I speak to one.

What's wrong, Debbie?

I've got a patient in there.

A four -year -old girl. But Betty here
says that I cannot... Central

administrative problem. It's been two
hours. The procedure is very clear. The

patient is no longer in a life or death
situation.

Let me be the judge of that.

I'll have to owe you that coffee. Put it
in my ledger. What do you got? When she

arrived, she was febrile and cyanotic.
We put her on O2 and bronchodilators.

She was brought in at 11 .10? Yeah.

What the hell with it?

Bring her in, admit her from ER, and
start her on definitive treatment right

away. Blood cultures, antibiotics, chest
x -ray. Dr. Sloan, I'm sorry. We can't

do that. The patient is signed with
Triax Multi -Health, Inc. We have to

permission to treat.

Let's have a look at her.

Well, her temperature's still over 103.

Maybe she has a secondary infection.

Could be another septic focus is going
into bronchospasm.

Excuse me.

She's my little girl.

I'm her mother.

Please, doctor, do something.

Do something.

I've got Dr. Holbein, the M .D. from
Triax Multihelf Inc.

Let's see if we can clear this up.

Yes, Dr. Holbein, this is Mark Sloan,
the community general.

Dr. Sloan, M .D.? Yes.

Why didn't the subscriber call her
primary care physician first?

I don't know. Probably because her
little girl was turning blue and she was

scared to do anything but dial 911.

Well, in any case, the patient should be
at the Triax Multi -Health Contracted

Facility. That would be Greenlawn
Hospital.

Well, Doctor, she's not at Greenlawn.
She's in my ER.

And we're going to admit her into
pediatrics and start a course of

I'm afraid not.

Hello?

Ah, Mr. Turner.

I'm afraid this little confusion is your
mistake.

You know, you should have called your
primary care physician, Dr. Grossman.

And he would have arranged for the
patient's admission to the proper

But I didn't know.

I was scared. I called 911.

What I think you should do now is
correct your mistake.

I don't understand.

Do you have your car there at Community
General?

Yes. Then I suggest you simply bring the
patient over to Greenlawn now.

That way, everything will be back in the
proper order with the least trouble to

everyone. What did you say?

I beg your pardon? It's 20 miles across
town to Greenlawn. Now, the child was

suffering acute respiratory distress two
hours ago.

You want us to throw her in the backseat
of a car before we even know why?

Frankly, I'm reluctant to authorize the
expense of an ambulance when the error

is obviously that of the subscribers.

Are you out of your mind? The
regulations are clear.

A patient must be treated in the HMO
contracted facility unless there are

legally binding, obvious, immediately
life -threatening circumstances.

Doctor, I just told you. Simple
breathing difficulties that respond to

treatment do not qualify.

over from Greenlawn. It should take,
ooh, perhaps an hour.

An hour? My God, man.

I'm terribly sorry. I have another call.
If you wouldn't mind waiting, I'll get

right back to you.

Wait a minute. Thank you for calling
Triax Multi -Health Incorporated. Your

is very important to us.

Please stay on the line.

Admit her.

Dr. Snow. I'm not holding off treatment
any longer. I'll get back to Relia for

pediatrics. The hospital directives are
very clear.

With HMO patients, we must get
permission before undertaking any

treatment. What do you want to do,
Betty? Wait an hour for their ambulance?

She's having a seizure.

Get into ICU.

I'll get Vaccarelli.

Let's roll her on her side. Take her
airway. Get that oxygen mask back on.

an IV valium. Now. Vaccarelli, please
call ER immediately. Dr. Sloan, line

Dr. Sloan, line two. Sloan.

This is Dr.

Arthur Holbein here again.

I'm afraid the ambulance will be
slightly delayed.

There is a backup at Greenlaw. Don't
worry. It'll arrive. The patient will be

appropriately cared for at the proper
facility.

Dr. Baccarelli. Dr. Baccarelli, call ER
immediately.

Dr. Baccarelli.

I don't know.

I find that hard to believe. What
exactly don't you know?

Those phone calls.

Betty, when I was a young intern, if you
were sick, you were taken care of. If

you had money, you paid. And if you
didn't, you were a charity case.

I remember I served three, four years in
a free clinic for the poor.

Now with the docs, it was a very poor
neighborhood.

Mostly condos now.

Do you remember how long someone had to
wait to be seen in a clinic like that?

I do.

I grew up in a very poor family.

My father was a pants presser when he
could get to work.

Health insurance.

He couldn't afford an aspirin.

I think, Dr. Sloan, your memories of
those days are a bit skewed.

In those days, if you were poor, you
might not be treated at all.

I remember my Aunt Sophie dying of
pneumonia all alone in her room.

There's something to be said for today.

Medicare, Medicaid, HMOs, managed care.

They are a lot better than nothing.

About 25 minutes after we got the little
girl into the ICU, she went into

cardiac arrest.

Stan Vagarelli did all he could, but,
uh... She died within 15 minutes.

Anybody tell the mother?

I did.

Four hours since she came in here and
the ambulance from Greenlawn just

Mark, there's no way of knowing if we
had admitted the child any sooner, if we

could have saved her.

We did the right thing. We had no
choice. We had to follow the protocol.

Yeah.

And our call was obviously very
important to them.

We did everything we were authorized to
do.

You won't have any real answers until
they do the post -mortem.

I know we'll be vindicated.

I think it was murder.

Dr. Sloan?

Here. Melvin Pinter, attorney at law.

I got your name from Mrs. Andrea Turner.

What are you doing in my house?

I'm representing Mrs. Turner in a suit
for damage involving the death of her

daughter, Wendy.

I haven't heard about anything like
that.

Nobody has.

What I mean to say is the case hasn't
actually been filed yet, which is why I

wanted to talk with you.

I understand that you were present when
the child was brought into Community

General Emergency Room. Not what you
brought in later.

Close enough. The point is you took part
in telephone negotiations with Tri -X

Multi -Health, the HMO.

I spoke to someone over there, yes. An
Arthur Holbein, M .D.? That sounds

Good. Well, what I'd like to do
informally is go over with you exactly

happened before actually deposing you in
the case. Just exactly who are you

suing? Oh, everybody.

But not you, personally.

Who?

Tri -X Multi -Health Incorporated, of
course.

The Turner's primary care physician
under the HMO, Dr.

Arthur Holbein, and Community General
Hospital. I'm particularly interested in

those in charge of the ER. Goodbye, Mr.
Fender.

Dr. Sloan.

A four -year -old child is dead.

You know she died because of negligence,
malpractice, and greed.

Which side are you on?

Was he killed with an 8 -inch Phillips
screwdriver or not?

You know, he could have been killed by a
long -range X -ray beam from a flying

saucer, but I won't know until I can
complete my autopsy, which I can't do

you hovering and pestering me. Come on,
Amanda, it was sticking out of his

chest. I've got a witness and I've got
the weapon. What's the mystery?

Amanda?

I'm sorry, were you in the middle of
something?

No, this gentleman was just looking for
a spot for his screwdriver.

Don't ask.

Oh.

Listen, do you remember doing an autopsy
on a four -year -old girl about three

weeks ago?

Yeah, that was Wendy Turner.

Right. Do you remember the post -mortem
findings?

I believe that she died from
cardiopulmonary arrest due to

and that was complicated by bacterial
pneumonia.

I was thinking more of the time
question.

Do you think further treatment, say,
two, three hours earlier would have

her? What I mean is, was delay the cause
of death.

In a general way, earlier treatment is
always best. I'd need to pull the file.

It's tough to say what brought on the
cardiac arrest. There are always

variables. Okay.

All right, thanks.

Dr. Cohn, report to administration.

Dr. Cohn, please report to
administration.

What was that all about?

He keeps thinking about that kid's
death.

I'd take him out to dinner Tuesday
night.

You took him out to dinner? That was a
special occasion.

Yeah, but he didn't eat a thing.

Just kept asking himself if he could
have done more to save her.

I wasn't much help.

Neither was I.

Look, I can pull that file and take
another look, but that's about it.

So, what can I do for you, Harold?

Hal. Just Hal.

Uh, I think you said for me, Hal.

Yes. Well, as a matter of fact, I was
just wondering.

There's a bit of a rumor, you know, just
a wispy sort of thing.

Somebody was looking for you, a certain
Melvin Pinter.

Is Pinter suing Community General, I
mean, directly?

You didn't actually say anything to
Pinter, did you?

Not yet.

Because, as a matter of fact, legal says
there's very little chance he can sue.

And as a matter of fact, it wouldn't
even be a suit per se. Well, you know, a

lot of these HMOs have a contractual bar
in their contract against court action.

So most of the time, an arbitration is
the first and sometimes the only

recourse. But Pinter couldn't actually
win. I mean, there's so many, you know.

intangibles, variables, and I can't...
After all, we didn't do anything,

right? Oh, that's right. We didn't do
anything. We just let that child lie

in the ark.

Mark, you provided emergency care and
you stabilized her. After that, any

delay is the HMO's fault.

Nearly. Four hours went by before
anything happened beyond initial

therapy. Well, that's inexcusable. It's
inexcusable.

If anybody asks me about this in court
or anyplace else, I've got to tell the

truth. Of course.

Just be careful.

That's all.

You know, we have certain interests of
our own in this, right?

I don't understand.

The HMO doesn't own us. Why do we have
to do what they say?

The HMO may not own us, Mark.

But HMO -approved doctors send us
patients.

They send us money that we badly need.

I mean, look, if they continue to like
us and send us cases, we can pay

for what? Research projects? We can pay
for experimental services, teaching, my

salary, your salary. It can't be so bad
that we let them tell us what to do.

The old days of Norman Rockwell -type
family doctors with charity

clinics and even federal payments like
Medicare and Medicaid. It just wasn't

working. Something had to happen to
control costs.

What about the patient, Al?

Mark, Mark.

been looking into this Pinter. I don't
like the way he does things.

Please, don't... don't talk to him
anymore.

Okay?

Dr.

Sloan. Hi, auntie. Something wrong?

I need a minute.

In private.

She's in her 40s, Lena Rizzoli, in room
114.

She was admitted this morning for a
routine removal of lipoma on her back.

She was admitted for a fatty tumor
removal?

I thought that was all outpatient these
days.

Well, it would be, but this one's too
deep for drive -through surgery, and it

interferes with her arm movement, a lot
of pain. She was admitted for two days.

I wish you'd speak to her.

Why? Well, the routine admissions blood
test came up from the lab. Now, it could

be severe anemia, but when I was getting
her settled, she was feeling very

faint. It was abdominal pain.

The admitting doctor came in. Well,
naturally, I asked him about it. He told

to forget it.

You know him? No. His name is Gould.

Leonard Gould.

He really snapped at me. He told me that
the patient was fine and everything was

under control.

Implied that I should know my place.

I see.

Mark, you know, I put in a lot of time
and the...

Outpatient cancer service.

I had that lumpectomy myself five years
ago.

I remember.

Is Gould still here?

No.

You didn't tell him you were going to
talk to me or anyone else, did you? No,

no. You know you could get fired.

It doesn't matter.

The woman needs our help.

You know, I wouldn't ask anybody else.

I wouldn't say yes to anybody else
either.

Well, let's see.

It must have been almost a year ago.

I just felt, I don't know, completely
blah.

Did you call a doctor then? My insurance
company signed up with LifeSuits

Incorporated five years ago.

That's the HMO.

And you were complaining of?

I'd feel weak.

Then I'd feel faint.

I actually passed out a few times.

I lost a lot of weight and...

I had this pain in my stomach.

Did you report that to the doctor?

I couldn't get an appointment with Dr.
Gold for almost six weeks.

The people at the LifeSys Inc. walking
clinic gave me pills.

They said I had psychosomatic arthritis
brought on by tension and depression

over my recent divorce.

They prescribed an antidepressant and
iron supplements.

Standard procedure.

And Dr. Gould agreed.

He said my anemia was improved.

But I just didn't feel well.

So I called people at the HMO about a
specialist.

But they kept sending me back to my
primary care physician.

The gatekeeper.

Yes.

That's how they called Dr. Gould. The
gatekeeper.

So these problems continued, huh? I
asked him if I shouldn't have some other

test. I don't know what they called
them.

MRIs, CAT scans.

But he said they were unnecessary.

So for six months, I was on iron
supplements and Prozac.

And now this thing.

This thing on my back, the lipoma, grew.

And really hurt.

And that's what I'm here for.

I see.

Mr. Zoli, have you ever had a mammogram?

As a matter of fact, I asked about that
as well.

But Dr. Gould said it was HMO policy
that it was unnecessary for a woman

the age of 45.

With all those presenting symptoms, it's
hard to understand how a doctor could

treat someone for that long and not
order any further tests.

Capitation.

You're talking about Rizzoli, Nancy's
patient?

It's okay. I told her.

What does capitation have to do with
Lena Rizzoli?

LifeSys, Inc. is like other HMOs.

They pay doctors so much per month, per
patient, $15, $20 per head.

Capitation.

If the doctor orders tests, medication,
anything over the $20 that comes out of

his own pocket.

To stop doctors from doing unnecessary
procedures.

That's the theory.

It sounds like rationing a medical care
to me.

Point is, anyone who stays well is a
profit.

Anyone who requires treatment is a loss.

And further tests on Lena Rizzoli would
definitely be a loss.

How could a doctor deny care simply
because of a few dollars profit or loss?

I love you, Dr. Sloan. You are a sweet
breath of innocence in a bottom -line

world.

Some HMOs offer big bonuses to doctors
who have a reputation of keeping the

down.

You've heard of the gag rules.

A doctor is prohibited from even
mentioning to a patient any treatment

HMOs won't authorize.

I thought the state and federal
regulations pretty well took care of

Technically. Is there any chance that
Gould can still order those tests? I

she is his patient.

I don't think so. When I suggested it,
he blew up. He pointed out that an RN is

not in a position to lecture an MD.

Threatened me with strong disciplinary
action.

But she needs those tests.

The protocol is clear.

Permission for any procedure has to come
from the primary care physician.

And that means LifeSys, Inc.

What are we going to do?

We'll do exactly what we did in the case
of Wendy Turner.

And if Lena Rizzoli dies, that'll be
murder, too.

Not this time.

I want to know who's responsible for
this.

I am.

Do you realize what you've done?

There is no excuse for this kind of
unauthorized activity.

You're going to get community general in
deep, deep trouble. We've already heard

from the legal department of LifeSys,
Inc. You have opened us to all kinds of

charges of financial irresponsibility.
Why did you do this?

Because I'm a doctor, Hal.

I swear by Apollo and Aesculapius, first
do no harm to Hippocratic Oath. You

remember that?

Don't patronize me, Mark.

If you were anybody else, I would have
you fired.

I demand you get Sloan in here right
now. Already done, Doctor.

You may be Chief of Internal Medicine,
Sloan, but you've overstepped your

authority.

Ordering tests on my patient? Tests you
should have ordered yourself.

I don't have to admit my patients here,
you know. I can always take them to...

To another HMO facility.

Well, you are the gatekeeper after all.

Oh, so that's what this is all about,
huh? You think this is about HMO

procedure, do you? Well, you're wrong.

This is bottom line doctor -to -doctor
medical ethics.

Mrs. Rizzoli is admitted for routine
minor surgery, a lipoma excision, and

you and Community General Hospital move
in with the obvious motivation of

running up enormous bills by a lot of
unnecessary procedures.

is the grossest kind of ethical lapse,
Dr. Gould. I am sure that we can settle

this without any kind of... What, you're
going to let him get away with this?

Because I'm not.

We'll just see what the county medical
society and the state licensing board

will do.

Got anything to say, Sloan?

You tell me, what excuse can you make?
What possible justification can you

Microcytic anemia.

Positive occult blood in the stool.

Mark, TEA elevation 65 .8.

Excuse me, what the hell is going on
here?

The results of the test on Lena are so
late. The endoscopic report shows her

without question advanced colon cancer.

The pathology report in the biopsy makes
it very clear that cancer has been

developing for at least eight months,
widespread beyond the colon.

Had the symptoms, the continuous anemia,
the weakness, the unexplained weight

loss, pain in the abdomen, been
interpreted to call for tests, when she

it, the early stages could have been
spotted, and the prognosis would have

a lot different at this point. As it is,
Cascan shows widespread metastases to

the liver.

We'll have to call in an oncologist.

You know Malcolm McAuliffe?

Good man.

Probably call for cryotherapy or a
possible removal of the lesions.

Neither one is very successful very
often. Of course, chemotherapy.

I, um... Excuse me, please. I think I
should go downstairs and see my...

Mrs. Rizzoli.

You think this started eight months
back?

Well, the natural history of colon
cancer suggests it's been at least that

Eight months.

How long has she got?

Well, I have no specialist help. Six
months a year.

Well, talk to McAuliffe.

See what you can do for her.

Six months to a year of chemotherapy.
You think Life Cis Inc. is going to pay

for that one?

It's all right.

You'll be okay now.

It's the chemo. There's always some
nausea.

Three days.

She's under pretty heavy sedation.

Dr. Slott. Yes.

How are you feeling? Any better?

I thought it was Dr. Gould.

He came to see me.

I actually sort of laughed.

I was thinking, where were you eight
months ago?

It might have done some good.

Dr. McCullough did everything that
should be done.

I know.

Dr. Gould said he was sorry.

He apologized.

I didn't have the strength to feel
anything particular.

I told him I... I forgave him.

Isn't that silly?

Forgave him?

What difference does it make?

Hi. We've got some company.

Dr. Leonard Gould.

I didn't see a car out there. He came up
from the beach about an hour ago.

I think he's a little bombed.

He said he wouldn't leave until you got
here, so I left him in the house with

his bottle.

Well,

you better make some coffee.

High octane. All right.

You're back from the hospital.

Mm -hmm.

How's the patient doing?

Oh, you know, standard reaction to
chemo, nausea, that kind of thing.

I haven't been there for ten days. I
transferred the case over to Malcolm

McAuliffe. Yes, I know.

Did you know that a suit has been filed
by Melvin Pinter, counselor -at -law

against Life, CIS, Inc., HMO, and
Leonard David Gould, M .D.?

For five million dollars damages.

I will drink to life, sis. Ink.

Of course they won't get five mil.

Judges tend to throw out huge jury
awards.

Have to settle for maybe 700 thou.

On the other hand, my own malpractice
insurance has been cancelled.

What I can do next in...

Medicine is an interesting question.

Doctor, I'm not sure you should be
talking to me. Oh, I think I should talk

you. I think I have to.

There's nothing I can do. I mean, the
malpractice action is out of my control.

It's out of my control, for God's sake.

But you can at least listen.

All right, all right.

The implication, The accusation is to
pile up nickels and dimes out of my per

capita HMO payment. You know about that.
I know about capitation.

All right. To make an extra buck here
and there, they say I purposely withheld

treatment to the sick.

That isn't true.

I think... I mean, take...

Take managed care.

And I did.

You have to look at the social gains,
the economic necessity.

See, the point is, without it, there's
waste, terrible waste.

Now, in the old days, unnecessary
treatment was the way a lot of doctors

their money, right?

Right. Well, probably.

In some cases, a few of those. Oh,
you're romantic, Dr. Sloan. You know

true. We have to control costs, make
sure...

Nobody is misusing our resources.
Otherwise, the world's best health care

will destroy itself.

Doctor, past abuses are no justification
for inexcusable actions in the present.

Don't you think this is enough for now?
No, no, no. You've got to understand.

I cannot. I will not believe that a
payment system geared to keeping

down would have influenced my medical
judgment.

I refuse to believe that I would let
myself be used to increase some...

Corporate profit margin.

Doctor, I don't pretend to understand
your motivations, financially or

psychologically or any other way. All I
know is the treatment was denied.

Lena Rizzoli has six months to a year.

I must not admit that even unconsciously
my concern for my income would make me

responsible for Lena Rizzoli's death.
You see that, don't you?

I see advanced colon cancer. I see
metastases to the liver.

You're not listening. You do understand.

I mean, you've got to believe me. You've
got to believe me.

I'm not guilty of that. I'll take them
all. Come on.

You've got to believe me.

Oh, please, please.

My God, you're a doctor, too.

Okay, continue the four tasks.

One gram.

Q8H. Mark.

I didn't know you were working today.

Actually, I came by to say goodbye.

I've been fired.

Nancy, you knew you were risking your
job when you questioned Gould's

and came to me. That's only part of it.

I think they also found out I'm the one
that tipped off Melvin Pinter.

It's a good thing they can only fire me
once.

Let me talk to Mr. Lomax. No, please.
There's no point.

In fact, they're offering me a reference
and six months' severance pay.

They're buying you off. Oh, I'll let
them.

I don't regret what I did, but they
might.

I got an offer to teach in a nursing
school.

I like the idea of unleashing a few
Nancy Rushes on the Lomaxes of this

Oh, we're going to miss you.

I'll miss you.

I'm sorry, Mr. Lomax. I tried to stop
him.

Why are you firing Nancy Rush?

She broke protocol.

Come on, Hal.

On top of which, Lex's Inc. became aware
that she was instrumental in Melvin

Pinter's malpractice suit against them.

They made it clear she had to go. Why?
Because they wouldn't like us anymore?

You know, you are not sitting in this
chair, Mark. There are some very large

issues involved here.

For one thing...

Payment on six months to one year of
chemotherapy and other treatments in the

Rizzoli case?

Probably in the neighborhood of $250
,000 or more.

And I'm not even sure that Lycis will
pay.

Well, they won't like it even if they
do.

You know what the HMOs say, a quick
death is a cheap death.

There are legitimate financial issues
here, Mark.

20 % of our patients are admitted here
and paid for by LifeSys, Inc. and other

HMOs like them.

This is a fair executive decision
because, on balance, Community General

their... their goodwill.

Against that, one RN... One RN who has
the integrity to put the patients first.

It seems to me the Community General
needs her, too.

Lorraine, would you do me a favor?

Call... Melvin, Pinter, please.

Yes, tell him I'd like to discuss with
him a malpractice suit he has.

Wendy Turner.

You know, they sent out to the farmer's
market for the locks.

No, thanks.

Very fancy offer.

What, this isn't yours?

They won't even let me into the men's
room here.

Even the janitor has a degree from
Harvard Law.

Now, they just lend out their boardrooms
for fancy arbitrations.

Like today.

That's right. For stage and non -binding
arbitration.

You mean there's no judge?

An arbitrator.

Well, actually, he's a retired judge.
Teaches legal ethics at UCLA Law.

Don't think I'll find too friendly an
ear there.

Why not?

This case he sat on, he threw out five
out of six charges.

Then cut the amount of damages down from
one million to a piddling 100 ,000.

Point is, for a major insurance company
or HMO to get out from under for a lousy

100 ,000, it's like finding a bargain at
a yard sale.

How much are you asking?

An excess of three and a half million
dollars.

Stay away from the onions.

Morning, Harold.

It's Harold.

And I really don't understand your
aiding and abetting this hijacking

Pinter, right?

So far, I haven't noticed he's been
responsible for anybody's death. Now,

actually, in a way, it's not too late.

For what?

Well, I know you will want to consider
your ongoing relationship with

Community General. That is, when you
testify.

A little discretion, one way or the
other, would make a big difference to

Community General and to you.

Now, Dr. Travis, I just want to get this
clear.

During the time you had the patient in
the emergency room, Wendy Turner, she

receiving only standard inhalation
therapy, which means this was not

a life -threatening emergency situation?

Well, yes, but then she started
seizures.

But that was after the telephone
conversation with Triax MultiHealth HMO?

Yeah, I guess so, yes.

I see.

That's all the questions.

Any further cross -examination for this
witness?

Nay, Your Honor.

Mr. Pinter, you're next, if you please.

Thank you, Your Honor. Dr.

Mark Sloan.

Dr. Mark Sloan.

Your call is very important to us.
Please stay on the line for the next

available operator.

Dr. Sloan, do you recall Dr. Holbein's
suggestion on behalf of Triax Multi

-Health Incorporated that Mrs. Andrea
Turner should take her child in her car

miles across town to the Greenlawn
Hospital?

The only place that child should have
been taken was our pediatrics unit.

But as soon as the seizures were noted,
Dr. Sloan, full emergency care was

immediately instituted.

Yes, but that might not have been
necessary if we hadn't been kept waiting

hours for the HMO to give us permission
to treat her. But isn't it a fact that

the post -mortem shows no definitive
indication that delay was involved in

cause of death?

Common medical practice in the handling
of emergency situations calls for the

quickest possible treatment.

Not pointless delays.

Any further cross -examination for Dr.
Sloan?

No, Your Honor. No.

Dr. Sloan, you're excused.

Your Honor, I wonder if I might say just
a few words.

I object, Your Honor. Your Honor, Your
Honor, please.

Please, Your Honor, this is not a forum
for personal opinion.

No, it's not.

It's an arbitration.

My arbitration.

And I'll decide who talks and who
doesn't.

Now, Dr. Sloan, you've been sitting in
that chair for the past hour, and it

seems like you've been a little bit
uneasy.

And I, for one, would like to know why.

Thank you.

I'm aware that the post -mortem is
indeterminate as to the precise

time in this child's death.

Speaking from the point of view of the
doctor, I only remember one thing.

The clock on the ER wall.

It jumped convulsively every second.

Jump. Jump.

Jump.

I can remember the weight of the
wristwatch every time I looked at it.

It was four hours before that ambulance
would arrive from Greenlawn.

For that, my profession has no excuse.

The key to...

The proper delivery of medical services
has only to do with the patient's needs.

The patient's needs.

The profits of a corporation, the rise
and fall of its stock in the market, all

of the vast economic problems which have
erupted out of the mountain of demands

and expectations, they're all secondary
to the actions of the doctor,

the nurse.

The clinic.

The hospital.

And most important to those in danger.

In pain.

At risk.

No hospital is the equivalent of a
factory.

Or a bank.

Or a supermarket.

I'm no expert on who's legally
responsible here. You're lawyers. It's

ballgame.

The minutes that Dr.

Travis and I spent on the telephone
arguing with a computer playing elevator

music, arguing business regulations as
to who had claimed that the patient's

billing and control.

All that was a violation of my oath.

Those minutes belonged to that little
girl.

Then tell me, Dr. Sloan.

Who is responsible for Wendy Turner's
death?

The HMO.

Triax Multi -Health, Inc.

The doctor in their office.

The administrative regulations enforced
at Community General Hospital.

And me.

Well, I have some news.

The ruling came down this morning.

How'd it go?

Told you I was afraid of Judge Kesey.

First off, the claims against the
hospital have been thrown out. That

make you happy, Dr. Sloan. Not very.

Second, the judge is proposing a
settlement.

What kind?

The companies, the insurance, and the
HMOs have agreed to pay, but they don't

have to accept any blame for any
wrongdoing.

They're guilty of nothing.

Exactly how much is this settlement?

$200 ,000.

How does Mrs. Turner feel about it?

She's not very happy.

Not because of the money. I mean, that
doesn't really matter to her.

But Triax Multi -Health Incorporated
gets off without acknowledging their

in Wendy's death.

So you think they won? Is that it?

In a way.

Remember what I told you. To a billion
-dollar corporation, a few hundred grand

is a cheap insurance premium to let them
go on just the way they did before.

How about you, Dr. Sloan? Have you got
any backlash from the hospital because

your testimony?

Oh, no, not yet.

It's much easier to get rid of a
registered nurse who doesn't have a term

contract.

Although Lomax has stopped asking me to
call him Hal.

You all right, Dad?

Yeah, I'm fine.

At least it's over.

This case.

But there'll be others.

Lena Rizzoli.

Now, that one should be easy.

Of course, I'll...

Probably have to subpoena you, Dr.
Sloan.

But at least the hospital's in the
clear.

That's great for the lawyers and the
hospitals, but what about the people who

practice medicine?

I mean, what's the point of becoming a
doctor if I can't be a doctor? Some

corporation is going to tell me who I
can treat and how to treat them.

Jesse, there's only one rule that
applies to what we do, and it hasn't

in the last 2 ,000 years, no matter how
much the practice of medicine has.

First, do no harm.

Even though they're not making it easy
for us.