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Dennis Quaid’s baby boy, Thomas Boone Quaid, is just up from his afternoon nap. His wide-open blue eyes flash a look that says, “Play with me.” His dad cheerfully obliges, hoisting his infant son above his head in the sun-streaked living room of their manse in Pacific Palisades, just off busy Sunset Boulevard.
Quaid, 54, is enjoying a rare moment away from a film set. He’s a veteran of more than 50 movies -- highlights include The Big Easy, Breaking Away, Great Balls of Fire!, the recent Vantage Point, and an upcoming role as a football coach in The Express, the true story of the first black Heisman Trophy winner, releasing Oct. 3, 2008. He is, at this moment at least, clearly off duty, enjoying his real-life role as doting dad.
Nearby, on the sofa, T. Boone’s twin sister, Zoe Grace, sits on her mother’s lap, her eyes as summer-sky blue as her brother’s. Kimberly Quaid, 36, a slender cool-blond with kind eyes, proudly reports that Zoe’s a girly girl, even at 8 months old. Five dogs -- two labs, two pugs, one French bulldog -- banned from the living room, hang close by, panting and trespassing as often as possible.
The contrast between this happy, lazy Monday afternoon in late June and the frightening, sleepless weeks the Quaids endured after the babies were born in November 2007 is like day and night.
Less than a year has passed since his twins survived the highly publicized two-time accidental overdoses of the blood-thinner drug heparin, but those few months have dramatically upended Quaid’s life.
He’s no longer just Dennis Quaid, actor, husband, father. He’s added ‘’health activist” to that list, and he takes his new role seriously. He and Kimberly have since founded The Quaid Foundation -- thequaidfoundation.org -- dedicated to helping minimize the kind of medical mistakes in hospitals that befell their newborn twins.
“There’s a real problem going on,” Quaid says of the drug errors and other medical mistakes that are surprisingly common in U.S. hospitals, “and it needs to be addressed. I just don’t want to see something like this happen to someone else’s kids.” (Besides the twins, Quaid has a 16-year-old son, Jack, from his previous marriage to fellow actor Meg Ryan.)
The overdose incident was equally life-changing for Kimberly, a former real estate agent who’s been married to Dennis since 2004. As upsetting as it all was, and she still wells up when she talks about it, “I feel like we’re here for a reason, that this happened for a reason.”
That reason? Nothing less than to change the way health care is practiced in the United States.
These days, Dennis Quaid’s reading material includes the usual pile of movie scripts, but also medical journals. “I don’t think either of us imagined a year ago we’d be … involved in ,” he tells WebMD.
The background reading was crucial not just for launching the new foundation but also for preparing to testify before Congress recently. At a House of Representatives hearing in May, he voiced his strong opposition to preemption for pharmaceutical companies, which opponents say could undermine a patient’s right to sue drug firms if harmed by a medication.
The health theme comes up, again, in his upcoming movie, The Express, based on the moving, true story of Heisman Trophy winner Ernie Davis, played by Rob Brown.? While still a senior in college, Davis was drafted in 1961 by the NFL, only to be diagnosed with leukemia at age 22. The talented, young running back was never able to suit up and play the game professionally.
Quaid plays Davis’s hard-driving coach, toughest critic, and surrogate father, who never stops pushing the All-American athlete to go for greatness despite the color barriers of that time. But the movie is about far more than football.
“It’s about grace: living your life gracefully and dying gracefully. But it’s also about race and race relations in this country,” Quaid explains. Even though the movie is set in 1959, he adds, the messages it sends remain powerful today. Davis became an important figure in the burgeoning civil rights movement.
Also in May, Quaid joined other A-list celebrities in Beverly Hills to help launch Stand Up 2 Cancer, an entertainment industry-backed initiative that aims to speed up and fund research into the disease. A star-packed televised event will air on network channels ABC, NBC, and CBS on Sept. 5. While he hasn’t had any family members with cancer, Quaid, whose brother is actor Randy Quaid, says he’s had a half-dozen friends face the disease, beginning with a seventh-grade pal.
But most of his health activism is focused squarely on The Quaid Foundation, with its mission of minimizing medical mistakes such as the terrifying error involving the twins. They were lucky to survive. Dennis and Kimberly are all too aware that a similar heparin overdose killed three children in an Indianapolis hospital a year before.
When they were just 11 days old, T. Boone and Zoe developed staph infections and had to be hospitalized at Cedars-Sinai Medical Center in Los Angeles, as the world now knows. Because of human error and five missed opportunities to verify the dosage, Quaid says, the twins were given 1,000 times the recommended dose of heparin, a blood thinner routinely given to prevent clots from forming in intravenous medication lines.
The night the twins were given the incorrect dose, Kimberly recalls she had a “premonition” something was wrong after she and Dennis returned from visiting the hospitalized babies at Cedars-Sinai. Hospital staffers had assured them the twins were recovering well from the staph infections and told the new parents to go home. But, Kimberly says, she suddenly felt so anxious that Dennis called the hospital. They were told everything was fine, the Quaids say, but when they arrived at the hospital the next morning, they learned of the overdoses. Kimberly’s gut feeling turned out to be true.
It was 41 hours of hell, Quaid recalls, from the first overdose until the twins were stabilized. Ever since, the Quaids have been on a fact-finding mission to discover why medical mistakes happen so frequently and what can be done. Until his twins were subjected to the overdoses, the problem wasn’t on his mind, Quaid says. “I’d always gone in and trusted the doctors, that I was in a safe place and that everyone knew what they were doing. Since then, I have found out that medical errors are all too common.”
Quaid claims that Cedars-Sinai hospital personnel missed five crucial checks, leading to the twins’ heparin overdose. Sadly, this isn’t unusual. In a report issued by the federal Institute of Medicine in July 2006, the authors estimate that at least one medication error occurs per day for every single hospital patient in the United States. In an earlier report, issued in 1999, the institute estimated that up to 98,000 people die in U.S. hospitals each year as a result of preventable medical errors. As an initial step toward a more active approach to minimizing errors, that report “was clearly the turning point,” says David Bates, MD, professor of medicine at Harvard Medical School and executive director of Brigham and Women’s Center of Excellence for Patient Safety Research and Practice in Boston.
Heparin doses themselves aren’t that unusual. In September 2006, for instance, six infants at Methodist Hospital in Indianapolis were given a high level of heparin instead of the lower, correct dose, according to hospital officials, and three died. In July of this year, 17 babies at a Texas hospital, Christus Spohn Health System in Corpus Christi, were given overdoses of heparin and two died, although hospital officials have not yet stated if the heparin played a role in the deaths.
“Heparin is used to counteract the body’s normal clotting defenses, which can cause problems after certain medical procedures,” explains Bates. But if the dose is too high, bleeding can occur. How does heparin kill? “It is usually bleeding in the brain that is fatal, although bleeding can occur anywhere,” he says.
Why the continued errors? Labeling for the lower dose Hep-Lock is similar, some say, to the labeling for the stronger heparin doses. Baxter International, the manufacturer, contended the labels on the two were distinguishable, but did change the heparin labels, making the print size bigger, among other changes. Part of the problem, too, may be simply the volume of heparin uses. According to Baxter, heparin is used more than 100,000 times a day.
“I feel like we’re here for a reason, that this happened for a reason,” says Kimberly Quaid.
Safety experts most often mention two approaches to reducing medical errors: bar coding systems and computerized physician-order entry systems. Put simply, bar coding involves a health care worker going through a series of checks before giving a patient a drug—scanning his own bar-coded badge, the patient’s bar-coded wristband, and the medication bar code, then pulling up the patient’s computerized medical record to be sure it’s the right drug, right dose, and correct time to give it. If there is a conflict, the computer sends an error message.
Only about 13% of the nation’s hospitals have a fully implemented bar code medication administration technology, according to? the American Society of Health-System Pharmacists, but more are moving toward it.
Cedars-Sinai has begun implementing a “hospital-wide clinical information system, which will include bar coding and other features to even further improve our quality and patient safety,’’ says Richard Elbaum, a hospital spokesperson, with the bar coding to be initiated in the first patient-care units of the hospital by mid-2009.
Computerized physician-order entry involves a doctor inputting the order on a computer and replaces handwritten orders, which are often misinterpreted, experts say.
Dennis and Kimberly flew to Texas in July to tour Children’s Medical Center Dallas, which is launching a new bar coding system. The couple personally observed the system of built-in checks as they followed the process of ordering a drug through administering it to a patient, Quaid tells WebMD.
“The nurses there told me they resisted it at first. But now, they say they wouldn’t want to give a medication to a patient without using the new system.” Besides the general resistance many people have to new technology, some nurses cite the extra time needed to scan medications but then see that the added effort pays off in reduced risk of error.
At the congressional hearing in May, Quaid described his own family’s experience with medical mistakes and stressed the importance of preserving a consumer’s right to legal redress if he or she is subject to a serious medication error.
Experts view an upcoming case, Wyeth v. Levine, to be heard this fall by the U.S. Supreme Court, as a test of whether pre-emption applies to drug manufacturers. The case was brought by a patient who had to have her arm amputated after the use of an injected anti-nausea drug made by Wyeth allegedly led to gangrene.
Quaid is as passionate about this subject as he is about halting medical errors. “This pre-emption issue, if allowed to go through, will make all of us uninformed and uncompensated lab rats,” he insists.
Those who favor pre-emption say the possibilities of lawsuits after a drug has been approved stifle innovation and doubt lay juries can capably decide about product safety. Further, according to a statement released by the Pharmaceutical Research and Manufacturers of America, federal pre-emption “will not deny patients their day in court. State judges and juries may still levy damages against manufacturers that fail to comply with FDA standards.” Pre-emption is not about blanket immunity for pharmaceutical companies, the organization says.
The Quaids have filed a lawsuit against Baxter International, Inc., the heparin manufacturer. The suit asks for an unspecified financial amount as a result of the alleged injuries they have suffered, according to Erin M. Gardiner, a spokesperson for Baxter in Deerfield, Ill. Baxter has requested dismissal of the Quaid lawsuit on a number of grounds, including pre-emption.
Patient safety advocates applaud the Quaids’ involvement. The actor brings “a face to the issue” and higher visibility to the problem, says Diane Pinakiewicz, president of the National Patient Safety Foundation, which advocates bar coding and other measures. “The more awareness we raise, the more engagement we’ll get from patients, regulators, and policymakers.”
At the end of the at-times emotional interview in the Quaids’ sunny living room, Dennis flashes that famous grin. He’s relieved, of course, that his twins look and act healthy and are developing normally.
Watching them, though, both Dennis and Kimberly admit to a nagging worry that any parent would share: Are the kids really OK? “No one knows the long-term effect of the dose they received,” Quaid says in a somber tone. They’ve taken the high road, but anger, anxiety, and disbelief over what happened can bubble to the surface quickly.
Kimberly still tears up when she talks about the incident in depth. Dennis’s eyes get steely. Then he adds a dose of down-home perspective that reflects their shared Texas roots.
“It made the media because I am in the movies, but a lot of people responded. Because of how fragile [the twins] were, a lot of people really got it,” Dennis says. “I think maybe people felt if it happened to a family like ours, it could happen to anyone.
“These kids are going to change the world,” he is fond of saying. And if his movie-star status is what it takes to make hospitals and health care safer, he’ll work it for all it’s worth. “If celebrity is good for anything,’’ says Dennis, “this is what it’s good for, you know?”