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“Sure. We have an automated computer system linked to a dispensing mechanism.”
“What can you say about the accuracy of this system?”
“I’d say it’s ninety-nine point nine percent bulletproof.”
“Could you please explain?”
Cindy got it all down on her laptop. A physician would take a patient’s lab results and enter the diagnosis into the computer. The computer program would offer a menu of appropriate drugs, and the doctor would pick one. Then a nurse would pull up the patient’s name on the computer and enter her code.
“It’s a password, right? Everyone has their own code?” O’Mara asked.
“Exactly.”
“Please go on.”
“At the same moment the nurse enters her code, one of our pharmacists reviews and enters the order for that patient. This releases the brake on the machine that dispenses the drugs.”
“So it’s a kind of digital vending machine.”
“Correct,” said the witness, seemingly pleased with herself and with O’Mara for getting it right. “The nurse takes the patient’s drug out of a pocket in the machine and administers it to the patient.”
“A ‘bulletproof’ system?”
“Very close. The program can’t be altered, and the security codes leave an auditory trail.”
“I see,” said O’Mara. She walked back to her table, consulted her notes, turned back to the witness.
“Could a technician load the wrong drugs into the machine’s ‘pockets’?”
“I suppose it’s possible. . . .”
“Please answer yes or no.”
“Yes.”
“Could someone withhold a drug after removing it from the machine? Divert it, say, for personal use.”
“Yes.”
“If a physician makes a wrong diagnosis, wouldn’t the wrong medication be dispensed to the patient?”
The witness was blinking her eyes rapidly. Flustered maybe, Cindy thought, but more than that, she looked pained. So much for 99.9 percent reliability.
“Yes, but —”
“Thank you,” O’Mara cut in. “Now, isn’t it true that the number of pharmaceutical-based fatalities has increased threefold since Municipal was privatized three years ago?”
“Don’t you think this worries me? I’ve turned over every stone,” Engstrom said, her voice rising, wavering for the first time since she’d taken the stand.
“Come on, Dr. Engstrom. Just answer the question. You’re head of this department. You’re on the hospital board. Have the number of pharmaceutical-based fatalities more than tripled in the last three years?”
“Yes, but . . . Well, yes.”
“Do you dispute that my clients’ loved ones died because they received the wrong medication?”
“No, I can’t dispute that,” Engstrom said in a barely audible voice.
“So whether these fatalities are the fault of your bulletproof vending machine or human error is irrelevant, right? I mean, either way,” O’Mara pushed on, “isn’t it true that these deaths are the result of negligence on your part and the part of the hospital?”
