I want to know what why my grandma died. But I don't want any of my family to know that I want to know. Do I have options?

December 14, 2007 8:19 AM

Besides researchers, In the US, who is allowed access to a person's Protected Health Information (tm) after they're dead? Who can get their death certificate (listing cause of death)? If these people aren't me, what can I do to cope with feeling that a loved one died because of someone's uncaring/ineptitude/etc?

I would like to access my grandmother's records to know why she was released from the hospital when she was. I'm not the executor of her will or her husband (still living). Nobody had been given power of attorney for her before she died. Is this something I can legally find out? I am in the US, but I don't want to say which state.

So here's the story: Grandma, who hadn't been in the hospital in decades (so was not quite a sickly-old-person yet), goes in for an acute, sudden onset condition that, while it can quite possibly take you out the moment it happens, if it does not, can be treated and fixed, and prevented from reocurring in the future. Think heart attack or aneurism but more along the lines of "since you lived through it, we'll put you on meds from here on out so we know this won't happen again."

She goes in to the hospital, and the doctor says, in my presence, that she will receive an IV drip of Drug A for 3 to 5 days, and will be given drug B in pill form from then on. He says that she will have to be observed for at least 24 hours after going on Drug B, so she won't be going home until she's finished her IV and taken the Drug B pill. He tells us we're looking at 6 to 7 days before she goes home.

About 4 days after her admission, the same doctor comes in and asks her if she wants to go home. She's had some serious issues with dementia and it's questionable whether she truly grasps that she's not at home in the first place (None of the ever-changing shifts of nurses, nurses-aides or doctors seem to really grasp that she has dementia either, especially since she she still talks a good game. We kept telling the nurses, and they would ask her questions that would clearly demonstrate profound disorientation to time and place, but we often never saw the same person twice - this was over a holiday weekend, probably making things worse than normal). She's felt fine since they started her on Drug A 4 days ago, so, naturally, she says "Sure." They disconnect the IV from her and send her home with my even older grandpa. We're all pretty suprised and confused, but assume the doctor knows what's best.

She goes home feeling really good, the next morning wakes up and takes Drug B. She starts feeling bad, and spends the entire day feeling worse and worse. Eventually my grandfather calls an ambulance for her and she dies shortly thereafter, that same evening. One day after being released from the hospital. My grandpa never, at any point, connects the symptoms she's having with the new drug she's taking. I feel that he's absolutely blameless in this regard. I can't question him about it, but he'd have done anything for her, and took action to have her seen to even while they were at home that day. Nobody's apparently making that connection. He may have even forgotten that she took that new medicine that morning. He's *really* old and just flat out doing the best he can at all times.

I work in a medical-type field. After her funeral I return to work and relate the events (and I was not suspicious - I had been entirely focused on the fact *that* my grandma had died, not at all *why* - I couldn't even immediately answer what she'd died of, no one had said - it was in the answering of my coworkers' questions, them asking her symptoms, etc., that dots became connected), and the resounding response from my coworkers, including multiple doctors, is that Drug B killed her. The doctors I work with said that it's pretty questionable to prescribe something as "nasty" - in one doctor friend's words - as Drug B to a person with dementia in the first place. The dosage is tricky, and she should have been observed while taking it. It's easy for Drug B to do you in without proper precautions.

So here's the kicker. Most of my family has decided, and pretty firmly believes, that the doctor surely found something terribly wrong with grandma, like cancer or something, and "sent her home to die". My grandfather and mother, etc. were telling people this at the visitation, even mentioning cancer specifically, when visitors sort of gently asked what happened. I very strongly feel that if they believe this, then it's best for them to continue on doing so. I know that this is not how hospitals operate. I feel that it's not possible that this is what has happened. But whatever brings them peace is 100% good. I don't want to arouse even the slightest suspicion with them.

So anyhow, I'm in a situation where I cannot consult my family at all about this ... But I'm really bothered by the situation and would like to know simply *why* she was released from the hospital so much earlier than planned. Did insurance (medicare) run out? Did they stop caring about her? Did they screw her charts up with another patient's? Did they need her bed? Can I find these things out? Can I find out what they listed her cause of death as? If a hospital is not really positive why someone dies (and they never told anything specific to the people present at the time of her death), and nobody wants an autopsy, what do they put on the death certificate? Nobody in the family really seems to know what she died of at all. Nobody's wondering, either. She was quite old, to be sure, although feeling quite spry until the end. It's as though the family thinks she was killed by some 24-hour cancer.

I've been really suprised at how deeply affected I've been by not knowing the answer to that simple question. The feeling that someone didn't seem care at all about someone so precious to me is just heartbreaking. It's been weeks and I'm in tears every day about it.

She was my grandmother, she was old and I'm an adult, and I understand I'm supposed to really quickly get over it. Some time has passed, and I don't feel comfortable mentioning it at work to ask about it anymore. But it's gnawing at me even more as time goes on.

Please note that no matter what, I'm not trying to sue a doctor or hospital or hold anyone "responsible" for anything. I'm not even looking to write a nasty letter. Nothing of that sort would make me feel better, anyways. She's gone, and nothing will bring her back - I'm just thinking I can somehow gain some peace of mind by knowing what happened to her. And wondering if I can find out without involving anyone else from my family, who've found their peace of mind elsewhere.

I'd love any other advice as well. "Just get over it" won't help much; I've been trying that unsuccessfully.

posted by anonymous to Food & Drink (9 answers total)

Who can get their death certificate

As this is a public record, I believe anyone can. Check with the town clerk in the town she died in.

who is allowed access to a person's Protected Health Information (tm) after they're dead?

I’m in the same boat, trying to access my grandfather’s records. Although I haven’t gone through the process, apparently in Massachusetts you can petition the courts to become the executor of someone’s estate. As long as nobody disputes it, you can do it. It’s a long process involving forms and legal notices and whatnot, but it’s one avenue to pursue.

What you should do is call the medical records office at the hospital where she stayed. Obviously, they’re not going to give you access to their records, but they might tell you who they will give access to and what you can do to eventually get access. They deal with this sort of stuff all the time. That’s how we found out about becoming the executor of an estate.

Good luck.
posted by bondcliff at 8:51 AM on December 14, 2007

This could be a simple case of malpractice. Talk to a malpractice attorney, and her records would be released upon a subpoena.

If you are really motivated, you can subpoena them yourself. HIPAA freely allows records out upon subpoena.

You, on the other hand, really want to confront this doctor. Not in a "i'm going to kick your ass" kind of way, but you want to know from the horse's mouth what happened. There's no way that's going to happen except through a deposition, and you'll need an attorney for that.

This is all assuming you want to keep your grandfather out of this. Otherwise he could sign you a limited power of attorney and you'd be all set.
posted by taumeson at 8:56 AM on December 14, 2007

Who can get their death certificate

As this is a public record, I believe anyone can. Check with the town clerk in the town she died in.

I forgot to answer this. Yes, they're public records, but the cause of death may very well be "myocardial infarction" even if it was caused by a bad reaction to a drug.

It's a good place to start, though.
posted by taumeson at 8:57 AM on December 14, 2007

Call her primary care doctor's office and make an appointment to see her/him. Do not go there with a confrontational attitude--that won't help you learn anything. Bring written-out questions with you. And remember, you lost your grandmother, and this doctor lost a patient.
posted by Carol Anne at 9:40 AM on December 14, 2007

Just to play devil's advocate, there are other possibilities besides "Drug B killed her," such as: The 6-7 day estimate was the upward end of the estimate (as to not get your hopes up.) Her treatment plans were changed. She may have really just coincidentally had a heart attack or an aneurysm. The staff may have been well aware of her dementia and noted it on her chart but felt that she had passed criteria for being able to make decisions. And yes, they really may have determined that their initial diagnosis was incomplete and that it turns out there was little else that they could do for her.

My family, particularly on one side, has chosen to believe some interesting "theories" about why some of my relatives got sick or died, compounded by weird complicated family drama and secrecy. I'll never really know what was wrong with my grandmother in the years before she died; I'll likely never be sure what my favorite great-aunt died of either. So I feel ya.

Seconding that at least accessing the death certificate is a good place to start. Sorry for your loss.
posted by desuetude at 9:46 AM on December 14, 2007

I remember going through this with my father's unexpected death following a surgical procedure. Needing to know these details (particularly is there is any suggestion that something could have been done differently) is actually a form of grieving. You are angry. You need to ascribe blame. Do as much as you need to get the answers, but please keep in mind that there may be no simple solution.

My father had a leg amputated. It was the first time he had ever been in hospital in his life and he hated it. While he was recovering and due to come home, he began to bleed from a stomach ulcer. He never told a soul because he was afraid they would not discharge him. By the time he was so ill they noticed, it was too late and he bled out into his abdomen.

The anger when a death is unexpected and where someone is under the care of a physician is very strong. We expect them to be miracle workers. But sometimes there really is no-one to blame.

I understand your pain. My condolences.
posted by Wilder at 10:31 AM on December 14, 2007 [1 favorite]

I don't have any knowledge to share related to most of your question, but this part really caught me: She was my grandmother, she was old and I'm an adult, and I understand I'm supposed to really quickly get over it. I don't believe you're supposed to get over this sad event in your life on any particular timetable, or to feel less sad because she was old. So, I'm very sorry you're going through this, and I hope you find some peace about the reasonable questions you have, and whether or not you do, I hope you can be patient and caring to yourself about your grief.
posted by daisyace at 5:38 PM on December 14, 2007

Medical information relating to cause of death is usually not available on newer death certificates in most states for privacy reasons. Older death certificates list very minimal information, just a line or two about cause of death, unless the cause was foul play, suicide, or abortion-related. You should probably try to go after a copy of her hospital records instead of hoping the death certificate would be helpful.
posted by Asparagirl at 9:48 AM on December 15, 2007

I've heard that most hospitals have someone who can talk about a death with family members. And I think they often do an investigation if someone dies in their care and so if someone was just released and died, you could potentially request a similar investigation. I'm not sure how the next-of-kin stuff would work. (If someone who has worked at a hospital shows up here and says I'm wrong, I am, this is all a faint memory from a family conversation a few years back.)
posted by salvia at 10:29 AM on December 15, 2007