“I’m sorry.”

People don’t sue people they like, and most patients don’t want to sue you. They want to like you, and when you show how deeply you care and how badly you feel, they want to forgive you.

As the director of patient relations at a local hospital for the past 15 years, I’ve listened to thousands of patient complaints and managed hundreds of lawsuits. The physicians who are on the receiving ends of these complaints and lawsuits are not the physicians with the worst complication rates or the most deaths, or any other statistic for that matter. The physicians who get sued, time and time again, are the ones who appear not to care about what has happened.

Case Study

“Carrie” was a 24-year-old female who came in for outpatient gynecologic surgery. An artery was nicked during the procedure, but the injury wasn’t identified during the case. In the recovery room, Carrie began to show signs of hypotension. The nurse and the anesthesiologist managed her with medications and Trendelenburg. Carrie’s blood pressure came up nicely and she was discharged home. Four hours later, Carrie was back in the emergency room with a massive retroperitoneal hematoma, requiring emergent surgery, blood transfusions, and two weeks of hospitalization, with resulting permanent nerve damage.

Carrie’s surgeon rushed to her bedside when called by the emergency department physician. “Carrie, I am so sorry! Your surgery went so well. There were no complications, and I looked so carefully for bleeders before closing you up. I feel awful about this. I’m going to be waiting for you when you get out of surgery. I’ll be with you every step of the way.”

Carrie recovered … and sued. She sued the hospital, the nurse, and the anesthesiologist. She didn’t sue the surgeon! When asked why she didn’t sue the one who caused the problem, she answered, “Because he owned it. He made no excuses for what happened, and he apologized for an honest mistake. I understand mistakes. We’re all human. I’m not suing my surgeon!”

So, how much is an apology worth? In Carrie’s case about $400,000. While Carrie’s story illustrates an extreme example of how effective an honest apology can be, it does not speak to the 98 percent of cases that never make it to litigation.

Any time there is an unexpected or untoward outcome in a patient’s care, California law mandates that we disclose the outcome to the patient and/or designated decision-maker and that we document the disclosure. How we convey this information becomes pivotal for the patient’s emotional well-being, the relationship between the patient and the caregivers, as well as often being the determining factor in whether a patient will seek legal counsel at all. As we are painfully aware, attorneys do not sue the individual care provider who committed the “error,” but, rather, they will name every single practitioner whose signature appears in the medical record. Thus, a kind, caring practitioner can save multiple care providers from litigation by a single act of caring.

In all its irony, I have had numerous patients who express great gratitude to us after an untoward event! Why? Certainly not because the untoward event occurred. Their gratitude is extended due to our willingness to express sympathy and to care for them emotionally and physically after the event has occurred.

Can my expression of sympathy be held against me in court?

The short answer is “No.” California law states that benevolent gestures expressing sympathy, or a general sense of benevolence relating to the pain, suffering, or death of a person involved in an accident and made to the person or to the family of that person is inadmissible as evidence of an admission of liability.

So be comfortable doing what you learned in kindergarten! Your world will be a better place because of it.