The Resident (2018) s02e16 Episode Script

Adverse Events

1 - Previously on The Resident - You led me to believe that my arrogance killed 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 died 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 killing from stock options when QuoVadis goes public.
When the truth comes out that these devices kill 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 died.
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 shot 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 kill them.
The same way it almost killed 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 killed 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 drugs 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 drugs.
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 attacks.
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 military 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 killed him.
If you move forward with this, you are putting a ticking time bomb 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 killed 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 military 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.
military 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 attack 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 knife? 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.