Mercy Iowa City, ENT face new lawsuit after woman’s death

IOWA CITY — Adding to the lawsuits and settlements mounting for Mercy Iowa City and its affiliates is one filed earlier this year by the husband of a Mount Pleasant woman who died in April 2022 after making nearly 20 trips to various providers over two months for what started as complaints of sinus pressure and earaches.

Emily C. Williamson died April 24, 2022, at age 36 after lack of oxygen to her brain resulted in a heart attack, complicated — among other things — by a “failed intubation,” according to a lawsuit her husband, Aaron Williamson, filed in February in Johnson County against 14 defendants — including seven doctors or health care providers and seven health systems, clinics or hospitals.

Corporate defendants include the Great River Health System in West Burlington; Burlington’s Ear, Nose and Throat Clinic; Mercy Hospital in Iowa City; ENT Medical Services, also in Iowa City and affiliated with Mercy; and Infectious Disease Physicians of Iowa City, a Mercy Iowa City affiliate.

Individually named defendants include Thomas Simpson, medical director of the Iowa City Ambulatory Surgical Center and otolaryngologist with ENT Medical Services and Mercy, and three other providers who at the time were affiliated with Mercy.

In response to the lawsuit, Mercy last week filed a response either denying allegations, claiming lack of information, or indicating allegations might have been “taken out of context and/or inconsistent with the medical records.”

The lawsuit is pending and hasn’t been set for trial.

In March 2022, a Johnson County jury found Mercy Iowa City and its affiliated OB/GYN Associates negligent and responsible for a newborn’s brain damage during delivery — awarding the parents more than $97 million.

Financial woes

All this comes as Mercy navigates major management changes — announcing in April, for the second time, plans to end its partnership with Des Moines-based MercyOne, hire an operations improvement consultant and appoint new leadership, including a new chief executive officer.

Moody’s Investors Service in March downgraded Mercy Iowa City’s credit rating three spots — from B1 to Caa1 — due to “severe cash flow deterioration, from historically weak levels, which has resulted in material and rapid cash burn.”

That downgrade was based on financials disclosed through December. Mercy on May 26 updated its disclosures with the Municipal Securities Rulemaking Board showing more losses — with cash and equivalents down to $3.9 million from $6.3 million at the end of June 2022.

Where Mercy’s total assets last summer were at $229.2 million — which was below its pre-pandemic asset total of $277.8 million in June 2018 — it was down to $188.4 million at the end of March, according to Mercy’s new financial filings.

Admissions at the hospital for the three months ending March 31 were up over the same period in 2022 from 1,510 to 1,760. But they were down from the three months that ended Dec. 31. And Mercy’s total patient days, occupancy rate, length of stay and surgeries all were down in March from December’s three-month report and from the same period in spring 2022.

Mercy reported a 25 percent occupancy rate in its most recent filing, down from 30 percent last year. Its total patient days dipped below 5,000 to 4,890 — from 7,212 over the same period in 2018.

Lawsuit accusations

The Williamson lawsuit gives the following account of events precipitating Williamson’s death:

She sought care Nov. 10, 2021, at the Burlington Ear, Nose and Throat Clinic for chronic sinusitis, fullness and ringing in an ear, facial pain and pressure, and decreased hearing. Upon further examination, a physician found swelling and inflammation in her sinuses and placed a tube the next day.

Three weeks later, Williamson returned with ear drainage, pain and poor hearing and received antibiotic drops. She came back a week later with the same symptoms, despite having used the drops.

The clinic took a culture and scheduled a CT scan, which five days later showed an infection by the tube. Struggling to breathe, with copious amounts of drainage, Williamson’s primary care provider prescribed a steroid.

On Dec. 22, 2021, Williamson returned to her primary care provide struggling to breathe, now with wheezing and chills, and was told to finish the steroids and antibiotic drops.

On Christmas, she went to the Henry County emergency room with shortness of breath and constant wheezing. A CT scan showed swelling and narrowing of her airway, and she was given a different steroid.

Three days later, Williamson went to her primary care doctor, “who documented no shortness of breath and good air movement despite several days and medical appointments indicating otherwise.”

After another visit to the ENT clinic with more pain and drainage, Williamson returned to the ER Jan. 2, 2022. An MRI four days later found Williamson’s ear was completely clouded and full of fluid, compelling her to seek a second opinion in Iowa City.

“On top of her previous symptoms, she now also had a sore throat with hoarse voice for three weeks and a bloody cough,” according to the lawsuit.

Placed on another steroid and antibiotic, Williamson was told to come back in a week. Before that time lapsed, though, she went to the Mercy Iowa City ER with difficulty breathing, swallowing and talking.

“She had been unable to sleep for more than 45 minutes as her throat fills with mucus,” according to the lawsuit.

Williamson was admitted to Mercy and placed on IV steroids.

A doctor noted her condition was more consistent with a chronic inflammatory or autoimmune disease — like “granulomatosis with polyangiitis,” which causes inflammation in the nose, sinuses, throat and lungs. But he urged against a biopsy “given her poor improvement in voicing and swallowing.”

Discharged three days later with a diagnosis of sepsis, Williamson had tested positive for antibodies signaling an autoimmune disorder — although “no rheumatologist was ever consulted.”

A week later, Williamson went back to her local ER “in more severe distress than ever,” with throat swelling causing severe respiratory distress. Finding her oxygen levels too low, doctors intubated Williamson — or tried to, but ran into a “soft tissue mass protruding in front of the cords.”

After two tries, doctors used a mask to ventilate Williamson, who went into cardiac arrest.

Kept alive with CPR and a “surgical airway,” Williamson was airlifted to the University of Iowa Hospitals and Clinics, where physicians found she had suffered a brain injury due to lack of oxygen. It was at UIHC that Williamson was diagnosed with the autoimmune condition “granulomatosis with polyangiitis,” causing her airway inflammation and lack-of-oxygen-induced heart attack.

Although now under rheumatology care, Williamson’s condition deteriorated and she became comatose, dependent on a feeding tube. In April, the family decided not to escalate care and she died a few days later.

Her husband, in his lawsuit, accused the defendants of negligence for — among other things — failing to order appropriate tests, diagnose her autoimmune disorder, and treat it. He also accused them of failing to disclose information “that a reasonable patient should know and be apprised of in making decisions about health care.”

“The facts and information of which Emily Williamson was deprived were material and would have led a reasonable patient put in this or a similar position to make a different decision.”

Vanessa Miller covers higher education for The Gazette.

Comments: (319) 339-3158; vanessa.miller@thegazette.com