Public hospital won't say how much it paid in colonoscopy death case

A western Iowa woman died from a botched colonoscopy at a county-owned hospital, but the public isn't being told how much the hospital's insurer paid her family in damages.

Iowa law says settlements made by government agencies or their insurers are public records. But the leader of Crawford County Memorial Hospital contends he can’t release this one because of a judge’s order sealing records in the patient’s estate. A leading Iowa open-records advocate disputes the contention, saying he fears other public officials will try similar gambits to keep settlements secret if this one is allowed to stand.

The settlement was reached in April in a lawsuit from Eugene Christiansen, whose wife, Carole, died in November 2014. The lawsuit said surgeon Dennis Crabb, who worked for the hospital, accidentally punctured Carole Christiansen’s colon during a colonoscopy. The surgeon recognized the error and stopped the procedure, but he did not immediately operate to fix the inch-long tear, the lawsuit said.

A follow-up surgery was performed the next day, but the tear had allowed intestinal contents to leak into Carole Christiansen’s  abdomen, causing a severe infection, the lawsuit said. Christiansen, 67, died at the University of Nebraska Medical Center eight days after the colonoscopy.

A longtime critic of the public hospital, Rich Knowles, recently requested a copy of the facility’s settlement agreement with the Christiansen family. The hospital’s chief executive officer, Bill Bruce, denied the request, saying a judge in a separate case had ordered the settlement sealed as part of the woman’s estate.

The hospital is owned by Crawford County taxpayers and is overseen by a publicly elected board of trustees.

Knowles brought the dispute to The Des Moines Register’s attention this week. The Register contacted Bruce, who repeated his contention that despite state law, the settlement was confidential because of a court order sealing records in Carole Christiansen’s estate.

“There’s nothing I have to hide in this thing,” he said. “I feel like we’re caught in the middle here.”

The Carroll Daily Times Herald newspaper filed a motion in court this week asking the judge who sealed the estate records to release the settlement agreement between the hospital and the family. The newspaper cited the Iowa open-records law, which says settlements paid by government agencies or their insurers “shall be a public record.”

Bruce said he believes in openness and would comply if the judge orders the record's release. However, he said he did not plan to formally support the Carroll newspaper’s request that the agreement be unsealed.

Randy Evans, executive director of the Iowa Freedom of Information Council, said he hopes a judge clarifies that the settlement agreement may not be kept secret just because a copy of it is contained in a sealed estate file.

"If that is allowed to continue, then the whole purpose of (the open-records chapter) is quickly moot," said Evans, a former Des Moines Register editor whose group's members include the Register and the Carroll Daily Times Herald. He predicted other government agencies would use similar legal approaches to bury embarrassing settlements.

Crabb, the surgeon who performed the colonoscopy, retired in May, the hospital said. He declined comment to the Register. He was not personally sued in the case, and he has not been publicly sanctioned by the Iowa Board of Medicine, which licenses physicians.

Knowles, who raised the open-records issue, has repeatedly challenged leaders of the Denison hospital. He contends the organization is poorly run and overly secretive.

He filed a formal complaint last year with the Iowa Public Information Board about the hospital’s refusal to identify volunteers who drove patients to appointments. The hospital and its foundation alleged the information could be used to harass or intimidate employees and should not be considered a public record since the volunteers were unpaid. Knowles contended the public had a right to know whether the volunteers serving the public hospital had safe driving records. The state information board agreed with Knowles that the names should be public. The hospital then released the names of the 35 volunteer drivers.

Open-records law on settlements

Here is Iowa Code Section 22.13, requiring public release of legal settlements by government agencies:

"When a government body reaches a final, binding, written settlement agreement that resolves a legal dispute claiming monetary damages, equitable relief, or a violation of a rule or statute, the government body shall, upon request and to the extent allowed under applicable law, prepare a brief summary of the resolution of the dispute indicating the identity of the parties involved, the nature of the dispute, and the terms of the settlement, including any payments made by or on behalf of the government body and any actions to be taken by the government body.  A government body is not required to prepare a summary if the settlement agreement includes the information required to be included in the summary.  The settlement agreement and any required summary shall be a public record."