Chapter 10
Chapter Ten
HARPER
The twelfth floor conference room was an impressive space, meant to frighten and amaze in the same breath.
Floor-to-ceiling windows overlooked the city with a view of the river curling through downtown.
The carpet was expensive and high-end art hung along the walls.
A long walnut table dominated the room, Italian leather chairs ringing it.
The room radiated power.
I arrived early, toting my tablet, leather portfolio, and binder full of notes. Dr. Rice was already there, seated at the head of the table, scrolling her phone.
She glanced up, then checked her watch. “Perfect timing. Take the far end by the projector. I’ll handle the introductions, then you’ll walk through your findings. We’ll field their questions after.”
No pleasantries. Just orders issued in that fake professional tone.
I walked to the far end and set my things down. After connecting my tablet to the display, I took my seat and tried to ignore the nervous flutter in my stomach.
Two attorneys from Morrison & Chase, the hospital’s legal counsel, arrived next, taking their seats at the table—Adrienne Westfield and Gerald Clark. The rumor mill said they billed nearly a thousand dollars an hour. They looked like they billed a thousand dollars an hour.
Dr. Webb entered, choosing a seat next to me. He was a great department chair, but an even better politician. He knew how to read a room, how to protect his interests. Or himself.
“Morning, Harper,” he said.
I nodded as everyone settled into an uneasy quiet.
Then the door opened again.
Diane Hart entered the room, and though we’d never met, I knew her immediately.
A petite woman in her mid-fifties with a salt-and-pepper short natural cut, she maintained a mask of composure that couldn’t hide what her body revealed—eyes puffy and red-rimmed, shoulders slumped, hands pale as they clutched her bag.
This was a woman who’d lost someone she loved, who was looking for answers.
Or she was looking for someone to blame.
My job, as I saw it, was to give her some peace. And to make sure she didn’t find those answers at Cole’s expense.
Behind Diane came Rachel Gaines, in a designer suit with a Hermès briefcase.
I’d done my homework. Rachel specialized in medical malpractice with a formidable track record.
Seventy-three percent settlement rate, with the remaining cases going to trial where she’d won more often than not.
She was ruthless and expensive. She didn’t take cases she couldn’t win.
The fact that she was here meant she saw an opening.
“Good afternoon,” she said, her voice pitched to carry without being loud. “I’m Rachel Gaines, attorney for the Hart family.”
Introductions went around the table. When Rachel got to me, her handshake was firm, her piercing blue eyes giving me a quick assessment.
“Harper Sutton is our Director of Risk Management and Patient Advocacy,” said Dr. Rice. “She’ll be presenting the majority of the material today.”
“Ms. Sutton,” Rachel replied. “I’ve heard good things about your work.”
I doubted that was true, but I smiled anyway. “Thank you.”
Rachel guided Diane to a chair, then took the seat beside her. She pulled a legal pad and pen from her briefcase, then folded her hands and glanced at Dr. Rice.
The room felt smaller, the air thicker. My pulse thrummed in my ears.
Dr. Rice began. “We want to first express our deep sympathies to you and your family, Mrs. Hart. I can’t begin to imagine how hard this has been for you.
” She didn’t even glance at Diane as she said it.
“We’re committed to transparency as we work through the facts in this case, and we welcome any questions you may have today. ”
She hit all the right notes without committing to anything. Or admitting anything.
Rachel listened with a neutral expression, her pen tapping against her legal pad. Diane stared at the table, jaw working like she was trying not to cry.
“Ms. Sutton has prepared a comprehensive review of Mr. Greene’s care,” Dr. Rice continued. “Harper, would you walk us through your findings?”
I stood, picked up the remote, and moved to a position where I could see both the screen and the table. “Thank you, Dr. Rice.”
I looked at Diane first, making eye contact.
“Mrs. Hart, losing someone you love is never easy, and I know the circumstances of your grandfather’s death have raised questions for you and your family.
I’ve spent the past several days reviewing every aspect of Mr. Greene’s care.
I’d like to walk you through that timeline and answer any questions you have. ”
I clicked to my first slide. “Mr. Greene arrived at the ER at 1:17 PM, unresponsive with dangerously low blood pressure and a distended abdomen. An ultrasound revealed a ruptured aortic aneurysm—essentially a burst in the main artery carrying blood through the abdomen. This is a life-threatening emergency with a ninety percent mortality rate. The trauma team made the decision to transfer him immediately to surgery.”
I advanced to the next slide.
“At 1:52 PM, our staff reached out to you regarding Mr. Greene’s care. We left word to please call back at your earliest convenience.”
Rachel stopped tapping her pen.
“Surgery began at 2:11 PM. Despite aggressive resuscitation, transfusions, and attempts to repair the rupture, Mr. Greene’s condition continued to deteriorate. He went into cardiac arrest at 2:27 PM. Dr. Vaughn called time of death.”
I let the silence settle, then clicked forward to my final slide.
“Mrs. Hart, I know this detail doesn’t make the loss any easier.
However, I can assure you that your grandfather received appropriate, aggressive care from a highly skilled team.
Every decision was consistent with standard trauma protocols.
The outcome was tragic, but it wasn’t due to failure to care for him. ”
Diane’s face crumpled. She pressed a hand to her mouth, shoulders shaking with silent sobs. Rachel placed a hand on her arm—a gesture that was both comforting and possessive. Then she looked at me.
“Ms. Sutton, that was very thorough. Thank you.”
“Of course.”
“I do have some questions.”
I’d been expecting that. I nodded, kept my expression open. “Please.”
Rachel flipped back through her notes, not appearing to be in any hurry. I seethed. I despised this courtroom trick, designed to transfer dominance and control of the room to her.
“What exactly did the message from RMC Emergency Room to Mrs. Hart say?”
I pulled up the documentation. “The nurse identified herself, said she was calling from Ridgeway Medical Center ER, and asked her to call back.”
“The nurse didn’t note the severity of Mr. Greene’s condition. She didn’t use the words ‘life-threatening emergency.’ Not ‘your grandfather is dying.’ Just…call back?”
“You know as well as I do that there’s only so much we can convey in a voicemail message due to privacy laws—”
“The message didn’t convey severity within privacy laws,” Rachel said.
“Mr. Greene was in the sunset of his life with several comorbidities, and Brookside often called an ambulance for the slightest inconvenience. It was not unusual for Mrs. Hart to receive a call about her grandfather being seen. So there was nothing in the message that translated to the need to rush to the hospital.”
I measured my words carefully. “Our priority is stabilizing the patient and notifying next of kin. We follow established protocols to ensure the standard of care is the same across—”
“How many attempts were made to reach Mrs. Hart before surgery?” Rachel asked.
I checked my notes, though I knew this case by heart. “We placed a call six minutes before Mr. Greene was transferred to the OR.”
“One call. One voicemail. Six minutes.” Rachel looked around the table. “That’s reasonable effort? That’s established protocol?”
“In emergency situations,” Gerald said, “informed consent is implied when a patient is unable to consent and family is unavailable. The phone call is a courtesy.”
“The one phone call that doesn’t convey severity? If this were your grandfather three hours away, would you understand ‘call us at the hospital’ to mean he was actively dying?”
“I can’t understand any situation where a call from the hospital doesn’t indicate urgency,” I argued. “The priority is saving the patient’s life.”
“If the outcome was almost certainly fatal, the family had a right to decide whether their loved one should die in an operating room or with dignity.”
A choked sob poured from Diane, soft but devastating.
“Our protocols require documentation of family notification,” said Dr. Rice. “That documentation exists.”
“Your protocols don’t require that the family actually be reached or be given enough information to make an informed decision,” Rachel argued.
“Mrs. Hart learned her grandfather had died via a cold, impersonal phone call. She didn’t get to say goodbye.
She didn’t get to hold his hand. She didn’t even get to make the decision about whether surgery was what he would have wanted.
Because no one gave her the option to rush to the hospital. ”
Rachel let the moment sit. Then she looked at me.
“Who made the decision to proceed with surgery without next of kin authorization?”
“Dr. Cole Vaughn, the on-call trauma surgeon.”
“And Dr. Vaughn made that decision without speaking to anyone in administration? Literally no one backing him up?”
“Our surgeons are in life-and-death situations all day,” Dr. Webb argued. “He made his decision based on Mr. Greene’s presentation, prognosis, and emergency protocols.”
“So this wasn’t a hospital decision,” Rachel said. “This was one person unilaterally choosing to proceed.”
I felt the trap closing. “Dr. Vaughn consulted with the attending and surgical team.”
“But ultimately, Dr. Vaughn decided,” Rachel pressed.