02x16 - Adverse Events

[bunniefuu]

- Previously on The Resident...
- You led me to believe

that my arrogance k*lled my patient.

It was a company
that makes defective valves

and owns you.

You've already lost a son, and
I want to do everything possible

to ensure that doesn't happen again.

With our VNS poster child,
Henry Barnett. Has he been admitted?

Brought in with a possible seizure.

The VNS is being featured at the
Innovation Summit tomorrow.

If any issue comes up,
I want it handled.

Quietly.

The QuoVadis device malfunctioned.

Every three minutes

it fired and stopped
Henry Barnett's heart.

And each time,
we managed to bring him back,

but it got harder and harder every time.

Until Dr. Hawkins managed to
locate the programming wand...

that deactivates the VNS.

And the only reason
that Henry's alive...

is because it malfunctioned
in the hospital.

It's not the first time
a QuoVadis device has failed.

A former resident d*ed
from a defective heart valve.

Which is why we're here.

I've halted the use of all
QuoVadis devices at Chastain.

We believe it's best

to sever ties with Gordon Page
and his company immediately.

As bad as this is, we're talking
about isolated incidents.

All medical devices come with risk.

QuoVadis insisted the VNS was safe.

So far, our partnership with Gordon
Page has been a resounding success.

Volume, revenue... they're both up.

And let's not forget we
stand to make a k*lling

from stock options
when QuoVadis goes public.

When the truth comes out
that these devices k*ll people,

there will be no IPO.

There will, however, be lawsuits

that could bankrupt this hospital.

QuoVadis is hosting
an innovation summit today

with investors coming from all over.

Let's not rush to any conclusions.

Randolph, you brought Gordon to us.

Yeah, I did.

And a child nearly d*ed.

And I cannot live knowing
we'd allow that to happen again.

Can you?

You're telling me the hospital
won't break with QuoVadis?

Few things are harder
than making a large corporation

renounce a profitable revenue stream.

Bell didn't even try
to convince the board?

Believe it or not,
Randolph did the right thing.

Well, he'll turn on a dime
whenever it suits him.

We can't count on him for anything.

The court of public opinion
is our best sh*t now.

Well, that's good.

Zoey's furious.

She's dying to talk
to the press about QuoVadis.

Well, a statement to the press

from a mother who almost lost
her child will go a long way.

Keep me posted.

Sergeant Jones served two tours.

Fought bravely beside our men and women

in the Kandahar Province and is
the recipient of a Purple Heart.

But like so many of our brave soldiers,

he has debilitating nightmares.

The QuoVadis VNS has been approved

to treat a range of conditions,
from epilepsy to depression.

And now... PTSD.

And it is going to end Sergeant
Jones's suffering for good.

And he's not the only one we'll help.

Later today, 20 more veterans

like Sergeant Jones will receive
their very own QuoVadis VNS.

And to show how simple

and safe a cure can be,

we will be streaming
these surgeries live

from VA hospitals across the country.

Meanwhile, "Waaa!"

"Who is that?"

"It's Nic!"

"Hey, Conrad! I came to help!"

"Sure. Great."

"Just because I wear
casual clothes does not mean

I'm not a doctor!"

Hey, buddy, how you feeling?

Okay.

He drew this.

What?!

Wow. Who is this?

That's Nic. See the cape?

Yeah, I see the resemblance.

How you feeling?

You need to get some rest.

I'll be fine.

You're gonna get to make that
statement about the VNS to the press.

Hopefully today.

I know you're concerned about Henry...

I'll make time.

I think I can get the reporters
to interview you here.

All you have to do is tell
the truth about what happened.

Of course.

Is Henry gonna be all right?

For now, yes.

Eckart thinks
we should consider moving Henry

to Duke University Hospital.

And... I agree.

Duke has a comprehensive program
for pediatric epilepsy

with new surgical options.

They're experimental,
but they're our best hope

to get Henry off the meds.

The issue is,

most health insurance won't
cover experimental procedures.

But don't worry.

We will figure this out.

You got to see this.

Gordon Page is putting the VNS

in 20 soldiers today to cure their PTSD.

And 100 more will be implanted
over the next few weeks.

There is no proof
that it's gonna do anything

for PTSD. It might even k*ll them.

The same way it almost k*lled Henry.

Well, we have to stop this.

Is the hospital coming out
against QuoVadis?

No. But Zoey Barnett is.

In an hour, she'll be on
all three local news channels.

She's telling them
the VNS nearly k*lled her son.

The optics here are a disaster,
and the timing couldn't be worse.

- Where is she now?
- At Chastain with the child.

Have the boy's seizures returned?
Is he on multiple dr*gs again?

Dr. Bell isn't returning
our calls. We're in the dark.

Get me everything there is
to know about her and the kid.

Okay.

Incision to close in two hours.

- Nice work, Dr. Bell.
- Thanks, Paul.

I'll check on Mr. Flynn in the ICU.

You leave any blood in the patient?

What'd you do? Saw him in half?

A liver resection. You know
how the liver bleeds, Simon.

Yeah, so I noticed.

You in for scratchers this week?

Oh, yeah,
I got a feeling today's the day.

You've had that feeling before,
and how much have we lost

- on the lotto already?
- The only reason

why we haven't won the jackpot
yet is you're bad luck.

Then why do you play with me?

Oh, I got a soft spot for the ugly ones.

You all right?

Yeah. Getting old... it sucks.

Guess it's better than the alternative.

Let me see that.

Your feet swollen, too?

Ah, been eating too much salt lately.

You've eaten too much salt
all your life. This is new.

- I'd like to run a couple tests.
- And I'd like to have a date

with a Rockette, but
that ain't gonna happen, either.

Come on. You're already in a hospital.

I'm gonna come and find you.

Pain in the ass.

Excuse us. Sorry. Where is he?

Okay. Come on. Excuse me.

Sorry. Excuse us.

Excuse us.

- Hi. Sorry.
- Hey, welcome.

Can I get your, uh, name?

Uh, Marilyn Spoelstra. I just...

Oh! Okay.

Here, let me get you a chair.

Three hours in a hatchback.

Wouldn't even let us stop and stretch.

I raised a drill sergeant.

Well, it wasn't some joyride, Ma.

I was doing 75 to save your life.

What brings you in today?

Oh, just a little bit
of stomach pain. Comes and goes.

Any past medical issues?

Marilyn has diabetes, high
cholesterol, high blood pressure.

She also has perfect pitch and
two majestic German shepherds.

- Oh, just one. Phineas passed.
- No, not Mr. Phin.

Wait. How do you guys know each other?

Uh, we're from Cecil, Alabama.

Dr. Shaw used to come
with his mobile clinic.

Parked outside our church once a month.

And Kay always made sure
that they were first in line.

When you didn't show
two months in a row,

I looked online,
saw you on Chastain's website.

Her pain's never been this bad.

Where exactly is the pain?

It's over here.

That's right upper quadrant.
Could be gallstones.

Oh, God! And there it is again.

We should probably get you to the ER.

Uh, we have an ultrasound machine.

Let's try to figure out
what's wrong here first.

Is all this really necessary?

Nothing's too good for Chastain's
longest-serving employee.

Oh, can I get a '65 Mustang instead?

You can buy it yourself.
You're winning that lottery.

This is gonna be cold.

O... kay.

How have you been sleeping?

Fine, when I'm in my recliner.

But when I lie flat,
I feel like I'm drowning.

And then, I've been
getting these chills.

Chills? Since when?

Mm... last Tuesday, I think.

I hear you're Chastain's
unofficial historian.

Keeper of secrets.

Oh, I've seen a few things.

I was here when Randolph was a resident.

Keep in mind before you continue,

that as CEO, I can fire you.

I did not know
you did your residency here.

Oh, he was as green as new mown grass.

His first week,

I'm putting supplies away,
and who do I find

in a custodial closet?

Young Randolph Bell.

Yeah. He tried to play it off

that he was lost,
but he wasn't the first resident

I found hiding from his attending.

You're fired.

All right, spit it out, boys.

That's not supposed
to be on my heart, is it?

No.

It's called a myxoma.

It's probably been growing there
for months.

Thing got so big, it started to block

- the blood flow to your heart.
- Which explains

the fluid buildup and pitting edema.
It's all signs of heart failure.

The good news is

we caught it early
while it's still operable.

When Bell brought you in for testing...

he probably saved your life.

Well... I guess being friends with you

finally did me some good.

I'm not sure the myxoma explains
all of Simon's symptoms.

- It was confirmed on the echo.
- Yeah, but there could be

a coexisting condition, and
that would complicate surgery,

so I'd just like
to run a few more tests.

Delaying his tumor resection is
just gonna worsen his prognosis.

But if there is something else going on,

it would increase his risk
for perioperative complications.

Yeah, okay. Yeah, fine. Run your tests.

But I'm not gonna postpone
the surgery much longer.

Well, barring any issues,
we'll still get it done today.

Okay.

How's Henry?

Uh, well, his...

heart's not stopping anymore.

But he has a long road ahead.

It happened because you told Zoey
the VNS was safe when it wasn't.

You put profits over patients, again.

I pulled all QuoVadis devices
as soon as I learned

the VNS was flawed.

Good for you. But Gordon Page

is still putting patients
at risk, now more than ever,

actually.

I've done everything I can to stop him,

and you have no idea
what I've sacrificed

to protect patients from this man.

He's coming for me next.

So you save your morality lesson.

I'll let you take that.

Feeling a bit better?

Yeah, thanks to your dr*gs.

Are you single, honey?

Kay's got a boyfriend,
but it isn't serious.

- Ma, quit.
- Oh, you can fuss

over me, but I don't get
to be involved in your life?

I see gallstones.

But there's no
gallbladder wall thickening.

You're right,
no sign of acute cholecystitis.

That's a good thing?

Yes and no.

We've controlled your flare-up today,

but I think you'll need surgery
soon to remove your gallbladder.

Well, let's do it now, get it over with.

I can't take this pain much longer.

That won't actually be possible here.

You don't have insurance, and
Chastain is a private hospital.

They're not gonna do that surgery unless
your situation is life-threatening.

So I got to be dying to get some help?

Well, who the hell made these rules?

Well, we could refer you
to County to get it scheduled.

They take uninsured patients.

Typically, their wait list
is months long.

Well, we can't wait here. Uh-uh.

We got no place to stay.

- We're gonna have to go home.
- You'd make her go home

and suffer like this, for months, maybe?

And what if she suddenly gets worse?

You know what?
I have a friend at County.

Let me reach out, see if they
can get her in right now.

- All right, then.
- Thank you.

You know, Bell told me about you.

He said you are one
real pain in the ass.

I'll take it. Pain-in-the-ass
people get things done.

You know...

when Randolph was young,
he was a lot like you.

I remember his second year
as a resident.

He got into a real shouting match

with his chief of surgery.

He wanted to stop doctors
from smoking in the hospitals.

Said it was no good for anyone's health,

patients or doctors.

Everyone, they just thought
he was no fun.

But... he was right.

And eventually, they banned smoking.

And the very next year...

- he helped me quit.
- Oh, Bell,

a reformer?

That's hard to believe.

This place has a way of changing people.

Just wait.

Change you, too.

Hey.

- Hey.
- You need anything?

- No.
- You ready?

Yes. I want to do this.

Yeah, you're gonna be great.

We'll be all set for you in
about ten minutes, Ms. Barnett.

Thanks.

I'll be with Henry until they need me.

Yeah. Go.

W-What's your favorite kind of game?

On the story mode games,

there's a bad guy that you have to stop

with missions that connect

- to each other.
- Oh.

- And it's really cool.
- So you're hunting bad guys.

- What are you doing here?
- Ms. Barnett.

I came here to check in
on you and Henry.

Mom, he gave it to me.

Look, I understand that you're upset.

I am, too.
That's why I'm here... to help.

Hey.

I was just coming to check in.

What's going on?

Mr. Page was just leaving.

You all right?

Yes.

Well, they're ready for you.

I'll stay with Henry.

Thanks, Nic.

Hear me out. Henry had
a very rare adverse event.

Is that what you call it?

Every new lifesaving device has
glitches in the first few years,

and then we adjust and we learn.

He's going to Duke. They'll help him.

Now, please leave us alone.

And who's paying
for his treatment at Duke?

If the surgery is experimental,
insurance won't cover it.

Will you be able to keep your job

while you're with your
son in North Carolina?

Without a job, will you
even have health insurance?

- What do you want?
- Henry's condition is likely permanent.

I'm here to tell you
that QuoVadis is willing

to cover all his medical bills...
not for a month, not for a year...

for his whole life.

- I don't believe you.
- I'll put it in writing.

It's the least we can do.

And in return, I'm guessing...

you don't want me
to go talk to the press.

Don't make me your enemy.

Take the offer.

And if you go public with a grievance
against QuoVadis, now or ever...

this deal goes away.

We're ready for you now, Ms. Barnett.

How much?

How much was Page's offer?
I heard he was here.

There were more zeroes than
I've ever seen in one number.

You can't take it.

We'll find another way to pay for
Henry's treatment, I promise you.

- You can't promise that.
- Yes, I can.

I do promise that.
Zoey, you need to speak out,

or people will die if you don't.

I get it, I get it... that
kind of money, it is tempting.

Even all that money, it can't be enough

to stop me from waking up every night

and running into Henry's room
to make sure

he didn't stop breathing. It won't...

It won't bring his brother back.

I signed already.

QuoVadis wired the money.

It's done.

I am not a horrible person.

I will help arrange...

for Henry's transfer to Duke.

We need to get him there
as quickly as we can.

Thank you, Conrad.

For everything.

Good luck, Zoey.

What about cancellations? There's
got to be some way to get her in.

Okay, thanks, man.

Nope. I understand.

They wanted to schedule Marilyn's
surgery seven weeks out.

I talked them down to three.

- This isn't your fault.
- No, in a way, it is.

The mobile clinic helped me stop
crises before they happened.

I am sure that you encouraged Marilyn

to live a healthier
lifestyle many times.

I mean, there's only so much we can do.

This is the situation,
so we have to deal with it.

Okay, how?

Where's your RV?

- It's down the street.
- Pull it around.

We're gonna have a working lunch.

Welcome to Le Château Shaw.

- Château what?
- Come on.

You're mere steps from the best
medical care Atlanta has to offer.

What on earth... ?

- Oh, my.
- We provide our guests

with the utmost privacy.

Unfortunately, the pool's closed
for renovation indefinitely.

Are you sure this is okay?

It should be fine until
your mom has the surgery.

And there's a supermarket
within walking distance.

Yeah. And there's a kitchen in the
clinic... use it anytime you need.

But...

no more fatty foods.

They'll only worsen your
gallbladder att*cks.

Listen to Dr. Shaw on this.
It's very important.

No more peanut butter.

No fried chicken.

No chocolate, no dairy.

And... definitely no more bacon.

- Well, then what's left?
- Fruits,

veggies, whole grains, lean protein.

No bacon? Harsh.

Mina said you're storming the castle.

We're going.

Bradley's dead. Julian is still missing.

I'm not gonna just sit around while
Gordon keeps hurting patients.

His Innovation Summit is open to the
public... we can walk right in.

We need to get the truth about the
VNS to the m*llitary leaders there

who can actually stop this thing.

Wow. Leaking what
the VNS did to Henry...

now, that would be a violation of HIPAA.

Which is why we're removing

anything that would reveal
the patient's identity.

Go get 'em.

One of my investigators
was able to locate

a former QuoVadis employee

who witnessed fraud at the company.

- Will they come forward?
- No, they're afraid of Gordon.

So we'll have to find proof ourselves.

What proof?

Zoey's out.

The VNS surgeries are in a few hours.

- We're running out of time.
- I know.

I figured you'd be halfway
to QuoVadis by now.

I can't leave. I got critical patients.

There's one now.

I got to go.

He's not responding to fluid boluses.
Still hypotensive.

You thinking cardiogenic shock?

He's vasodilated.

His fever just spiked to 103.
This is septic shock.

Draw a lactate,
set up for a central line.

We've already got blood cultures.

Let's get him started
on vancomycin and cefepime.

Hang norepinephrine
and titrate to a MAP of 65.

Stay with us, buddy.

I'm seeing Osler's nodes.

Those splinter hemorrhages
weren't there two minutes ago.

Cardiac mass must be infected.
It's not just a myxoma.

He's got endocarditis as well.

I've only seen two patients
with both in my entire career.

And did they survive?

One did.

Well, at least his pressures
are starting to come back up.

Obviously, under normal circumstances,

we would recommend holding off on
surgery with such a recent infection.

But with Simon's valve deteriorating

and his heart failure worsening,
he needs it soon.

His surgery just got
a whole lot riskier.

Let's broaden his antibiotics to
cover any possible resistance.

Do we still go forward?

If he does nothing, he'll live

for a couple more months.
Operating under

these circumstances
might mean he never wakes up.

I'll talk to him.

It's his decision.

This was all they had left.

- Apparently, the word is out.
- You know, if I got sick,

half this hospital
would pop a bottle of champagne.

Why? The other half don't drink?

Okay.

So, how bad is it?

Surgery's risky.

Even in Austin's hands, uh...

the odds of survival aren't great.

What happens if AJ doesn't cut
this thing out of me?

What then?

Then the tumor will
completely obstruct your heart,

and...

you'll have a month,

maybe two.

Get your affairs in order.

So my choices
are risking dying on the table

or...

start saying goodbye.

Yeah, I'm afraid so.

Want to take a day
and-and think about it?

I'm a betting man.

I've beaten long odds before.

No.

Let's do it.

All right.

All right.

You know,

I love my job.

Pay's not great.

But every day, I...

get to help you save lives.

And I sleep like a baby.

Oh, it's been a while
since I slept through the night.

You love this place as much as I do.

I know you'll do whatever you
have to to make things right.

Hey.

You better get ready.

The VNS stopped

the patient's heart every three minutes.

It's a miracle he survived.

It nearly k*lled him.

If you move forward with this,

you are putting a ticking time
b*mb in every one of these vets.

I'm sorry, wh-who are you again?

We're doctors who work at Chastain.

The device is FDA-approved.

But the FDA doesn't do
independent testing.

And they're notorious
for grandfathering devices

based on previous ones
that don't even work.

We're satisfied with the trial data

Gordon Page provided us.

Look.

That's Raptor's mentor,

the one that recommended the
heart valve that k*lled Bradley.

I don't suppose punching him
would do us any good, would it?

Come on.

May I have your attention, please?

Our presentation will begin
shortly in the main lobby.

Dr. Benedict, I'm Dr. Okafor.

I met you with Dr. Austin.

Yeah, who could forget?

We're here because Gordon's VNS
is as deadly as his heart valve.

And it's about to endanger
dozens of lives

if we don't stop it.

Give AJ my best.

Dr. Benedict, you still have
a reputation to protect.

If you know anything... No, no.

The greatest betrayal of Austin's life

was when his birth parents
abandoned him,

throwing him away like trash.

You were a close second.

That's how much your friendship
meant to him.

That's how much he trusted you.

The man you used to be

and the one you can be again.

When Mina said the VNS will fail,

you weren't surprised. Why?

I didn't have a choice.

We had to get the device to market.

- You and Gordon?
- I swear...

- I didn't know at first.
- Know what?

Let's take a walk.

Your pre-op numbers look
quite reassuring, my brother.

Once that tumor's removed, we'll see
about finding you that Rockette.

Ah, I thought I'd seen this room
from every angle.

But I've never seen it like this.

Okay, transfer on three.

One, two, three.

Starting the propofol.

Randolph.

Yeah.

Try not to make a mess.

She's on the floor.

It looks real bad.

- The pain usually goes away.
- And it's gotten worse.

We need to get her to Chastain.

Marilyn, one of your gallstones
is now causing an infection.

It's a good thing
you didn't head back to Alabama.

This could've happened
on the road, with nowhere to go.

Ultrasound shows pericholecystic fluid.

And her white count is
at 20,000. No fever.

I'm Dr. Nolan. I'll be removing
your gallbladder today.

Oh, hallelujah.

- Don't usually get that reaction.
- You can take it out now?

Now it's an emergency.

Get her prepped for surgery.

I'll see you in the OR, okay?

I can't thank you enough.

Whatever you've done,

it is not too late to make it right.

- Talk to us.
- What do you know?

What has QuoVadis done?
How can we stop this?

I want to talk to AJ.

He deserves the truth.

Just him, not you.

All right.

Here we have the QuoVadis
vagus nerve stimulator.

All cities are online.

The surgeries are about to begin.

Dr. Stevenson presiding.

The patient is David Jones.

Date of birth 8/6/1989.

Procedure to be performed
is surgical implantation

of a vagus nerve stimulator.

Let's begin. 10 blade.

I can't reach Austin.

I've called three times.

He's in surgery.

- What is going on?
- Abe doesn't trust us.

He'll only talk to Austin.

He knows something that can help.

I'm on it.

All right, let's start rewarming Simon

and get his heart pumping again.

Defib paddles to me.

Charge to ten joules.

Clear.

He's in V-fib.

Give 300 of amio and try again.

I'm here. I'm here.

And clear.

He won't stay out of V-fib.

His electrolytes are normal.

I've given him more magnesium,
but it's not doing anything.

Get the intracardiac epi ready.

Just worried his heart sustained too
much damage during the procedure.

Injecting one milligram

of epi.

I can't get to him.

You have to.

I can't. His patient could die.

Let's get him on a balloon pump.

Charge to 20.

Clear.

Come on, Dr. Benedict, please,
tell us whatever you know.

Where's the balloon pump?!

General?

My name is Marshall Winthrop.

I'm chairman of the board
at Chastain Park Memorial.

We'll be cutting ties with QuoVadis

because of some information

I thought you'd be interested in seeing.

Don't you understand
that lives are at stake here?

Please.

- Come on.
- Let's go.

Come on.

Mr. Page wants to speak with you.

QuoVadis is engaged

in wide-ranging fraud.

All of their devices, including the VNS,

are being shipped in from China

and then relabeled as made in the USA.

By law, the m*llitary cannot use any
medical device not American made.

And those are shipping records

over the last few months.

You have more proof there
than you'll ever need.

What happened?

What happened is the U.S. m*llitary
partnered with a liar and a fraud.

Our contract is now null and void.

All surgeries are canceled.

Austin said Simon's heart was too weak.

There is nothing anyone could have done.

He would have hated this.

What did you tell them?

I didn't tell them anything.

I wouldn't do that to you.

Good.

I knew I could count on you.

We have some storm clouds ahead.

But we will weather it
if we all stick together.

Talk tomorrow.

Hey. I hear Marilyn's out of surgery.

Yeah, it went great.

Uh, Nolan did it laparoscopically,

so she and Kay get to go home
in the morning.

Great.

It smells good. What is that?

Eight piece, extra crispy,
with a side of crunchy.

And a milkshake.

Everything we told her not to eat.

She didn't forget our advice. She
knew exactly what she was doing.

She just took matters
into her own hands.

She gave herself a gallbladder att*ck

to get surgery right away.

What's wrong with a hospital system

when patients have to put
their own lives in jeopardy

just to get access to treatment?

I, uh, was thinking
about what you said earlier.

Made me wonder
if you regret taking this job.

Well, it's complicated.

No. I mean, I get it.

We're saving people from drowning.

You want to teach them to swim.

Look, you got us up and running.

I understand if you want
to go back on the road.

Yeah, you know, I may.

But, uh...

You know why I stay, don't you?

You're here.

We make a great team.

Yes, we do make a great team.

But it feels like maybe
there's something more.

Um, it's late. I'm gonna take
this stuff home to wash it,

- and I'll see you tomorrow.
- Yeah. Okay.

Good night, Alec.

It's done.

Well done.

Well, the investigators
came through just in time.

It was a team effort.

And the board?

I've already canvassed them all.

We're out.

Is QuoVadis finished?

It was a big financial blow.

But they have hard assets.

So if they find an angel investor

to get them back on their feet

and pull them out of this mess...

Well, then we have to deliver
a death blow.

We'll find one.

You saved more lives than I did today.

It's a big shock today for the
Atlanta-based QuoVadis Corporation.

The medical device manufacturer suffered

a very public rejection
of its hottest new device,

the vagus nerve stimulator,

or, as it's better known, the VNS.

QuoVadis CEO and founder Gordon Page

had orchestrated a l...

Gordon. This is Marshall Winthrop.

Oh, what do you want?

Twist the Kn*fe?

Just the opposite.

Do you know how I made my fortune?

By taking over companies
on the verge of collapse.

And making millions
for everyone involved.

We should talk.