Bleed Out 2018

Bleed Out opens by introducing Judith Burrows, the mother of the comedy director Stephen Burrows, portrayed as an independent, globe-trotting, retired schoolteacher who loved to travel. The film then shifts to June 2009, when Judith is rushed to a hospital in Milwaukee, Wisconsin after a fall from her bike leaves her with a hip fracture. She undergoes hip surgery and a period of rehabilitation, returning home only to endure a slow, grueling recovery despite physical therapy.

Five months later, Jud Judith falls again and is rushed back to the hospital. She spends eight days in the hospital, stabilized with painkillers as doctors try to pinpoint the source of her pain. After a week, doctors determine that she has fractured her hip once more and requires a rapid partial hip replacement. Steve Burrows explains that his mother had been taking Plavix, a blood thinner, and that patients are usually advised to stop such medication a few days before surgery. Despite the blood thinner, Jud Judith is cleared for the operation, but the procedure leaves her with a dramatic loss of blood—about half of her body’s volume.

Judith endures the surgery and is placed in the hospital’s intensive care unit (ICU). The first night on the unit, the floor has no on-site ICU physicians; instead, Judith is in an electronic intensive care unit, or eICU, monitored by a team of doctors who watch through cameras from an airport facility. The eICU team can hear alarms, see patient monitors, and view details via microphones and video feeds. Within an hour, Judith’s blood pressure plummets to dangerous levels, and she falls into a coma without anyone noticing. Two days later, a neurologist evaluates her and confirms that she is in a coma. She remains unresponsive for nearly two weeks before waking, only to be diagnosed with severe cognitive and physical disabilities due to oxygen deprivation to the brain.

The documentary rails against the broader issue of medical errors, tracing a Johns Hopkins study that labels medical errors as the third leading cause of death in the United States. Dr. Marty Makary, a surgeon from Johns Hopkins, is featured to explain why he sees medical errors as a “silent epidemic” and why they appear to be increasing.

As the family reviews Jud Judith’s care, they uncover troubling inconsistencies in the anesthesiology records from her second surgery, noting they appear overly clean and flawless for a case with substantial blood loss. This fuels a desire to seek accountability, and Jud Judith’s uncle, Dr. Ted Payne, persuades Stephen Burrows to investigate further and consider a medical malpractice lawsuit. Steve consults with a malpractice attorney, Lynn Laufenberg, who explains that Wisconsin has a strong legal landscape for doctors and that patients win only a small fraction of malpractice cases. Undeterred, Steve begins recording his mother’s experiences as potential evidence.

While pursuing legal avenues, Stephen Burrows also battles the practical burdens: mounting medical bills, Medicare limitations, and the reality that Jud Judith’s long-term care may not be fully covered. He eventually secures a malpractice attorney, Mike End, who lays out the obstacles posed by Wisconsin law, including a provision he cites as a barrier to testimony among physicians. End warns that the case could take three years or more to reach trial.

Judith’s condition gradually improves, but she survives with spastic paraplegia and can only walk with a walker. Her cognitive function does not recover, and a neuropsychologist deems her incompetent with the cognitive ability of an eight-year-old. Steve tries to communicate with his mother about her prognosis, but Judith resists acknowledging how serious her condition is and insists on returning home. The family ultimately moves Jud Judith to a rehabilitation center. Four years after the incident, Judith transitions from Medicare to Medicaid as her savings—approximately $200,000—are exhausted by ongoing care and bills. Steve continues to navigate a maze of insurance rules, hospital practices, and medical bills.

Steve’s investigations lead him to meet with people connected to Jud Judith’s care, including Bauer, the hospital’s surgeon, and a risk manager from Aurora West Allis Medical Center. He records these conversations with spy cameras. Bauer voices concern about why the ICU lacks on-site physicians and calls the eICU “sloppy medicine.” Bauer ultimately suggests that Steve speak with Aurora Health Care, and Steve meets with a risk manager who implies the hospital would offer financial help if they felt they had erred.

The narrative then shifts again to a phone call that reveals Judith has been rushed to the hospital after a stroke, later treated for what is described as a seizure. She is diagnosed with permanent brain damage, unable to speak, and connected to a catheter. The film then returns to Makary’s critique, emphasizing that the medical community still has much to learn from its mistakes.

Jumping ahead to 2013, depositions begin in the lawsuit. Thirty depositions are taken, but each participant assigns blame to others for Judith’s brain injury. A deposition from an ICU nurse named Emily notes that cameras in the ICU are not always on to respect patient privacy. Another deposition from the eICU manager reveals that cameras are often off in patient rooms and that an eICU physician cannot replace a physical ICU physician, given that eICU physicians may oversee hundreds of patients per day.

After these proceedings, Steve consults with Charles M. Harper Jr., a Mayo Clinic neurologist, who discusses how medicine and patient care could benefit from prioritizing quality and health outcomes over financial incentives.

The film then leaps to 2016, when the case finally goes to trial. The courtroom focuses on whether there is solid evidence of medical negligence, weighing the conduct of the hospital and its staff against the devastating consequences Judith endured.