Should the essence of that meeting - the doctors' explanations and apologies - be confidential? Or should lawyers be able to query doctors about it on the witness stand?
This is a relatively new, controversial, and unresolved question in Pennsylvania - and at the heart of two bills stalled in the legislature.
These meetings represent one of the most significant trends in medicine today. Regulators are increasingly encouraging hospitals and doctors nationwide to hold such talks with families, trying to change the age-old culture of secrecy in medicine. But should those admissions be fair game at trial?
Destinee's case
According to court records and people familiar with the case, this is what went wrong in Destinee's care:
The newborn needed to be fed intravenously. Her doctor threaded a catheter no thicker than a human hair through her veins, intending it to stop where her biggest vein reached the heart. The nutritional fluid was so concentrated that it needed the largest possible vein and maximum amount of blood to dissolve safely into the bloodstream.
Her heart was the size of an adult thumb, and the catheter went a few millimeters too far, entering the heart. In the vein, the blood flow keeps the catheter away from the vessel wall. But inside the heart, blood doesn't move as rapidly, and her catheter rested against a heart wall.
The fluid actually seeped through the wall, into the sac surrounding her heart. That sac began to fill with fluid - a teaspoonful, but enough to stop the heart.
A chest X-ray is always taken to confirm proper placement. But in Destinee's case, the X-ray wasn't read in time.
