Discharged to Die: The Price of Medical Complacency, by Fransiscus Nanga Roka

A discharge from a hospital is a medical judgment which may result in permanent damage. As shown by Dan Haas’ case, discharging a patient requires the same level of evaluation and consideration as the process before the discharge.

The jury for Mobile County, Alabama awarded a $50 million judgment on March 12, 2026, against cardiologist Dr. John Galla and Cardiology Associates of Mobile in connection with Haas’ death after he was discharged after undergoing a cardiac catheterization procedure in December 2020. The $50 million award not $50 billion should be understood as a jury verdict and not as confirmation that the award has been paid or that all possible appeals have been made.

According to the plaintiff’s trial testimony, Haas experienced severe pain in the area between his shoulder blades as well as difficulty breathing following a hunting excursion. On December 28th, testing indicated that Haas had an abnormal cardiac condition. Two days later, a catheterization procedure revealed a significant coronary artery block. However, despite these findings, Haas was released from the hospital, cleared to undergo an optional ophthalmology procedure and advised to stop taking blood-thinning medications until after the procedure. Haas passed away that evening.

The question of concern is why a non-emergency surgical procedure was able to override the cardiac risk that has been identified by the plaintiff’s expert witnesses.

The experts testified that if Haas had been hospitalized and immediately treated with blood thinners, his chance of survival would be greater than 99%. This statistic is not a universal treatment guideline or a treatment rule for all coronary blockages; it is case-specific expert testimony. However, the significance of the statistic is that it supports the argument that Haas’ death could have been prevented with appropriate care.

Judgment is required in medicine, and that judgment must be explained if symptoms, the result of investigations, and the proposed discharge plan appear to conflict with one another. The completion of a catheterization does not provide evidence that a patient may safely be discharged.

The importance of the legal significance of the award is another factor to consider. In Alabama, wrongful-death damages serve to punish and prevent future wrongdoing, not as compensation for lost wages or family distress. Although there is a general cap on punitive-damages awards in Alabama, wrongful death actions are exempt from this limitation, but all awards continue to be reviewed by courts. If one calls the award merely a $50 million compensation plan, they miss what it represents – the protection of human life through accountability.

The problem with treating verdicts as insurance events by healthcare institutions is that they undermine deterrence. If the correct way to handle these issues involves making changes to the decision making process prior to the time a patient leaves the hospital, then the proper reaction would be to do so.

The first step is to have a requirement that all discharge documentation for patients who may be at risk for an unstable heart condition include a reconciliation of the patient’s symptoms, test results, treatment plan, and remaining risks. It is important to remember that electronic check lists are meant to assist in clinical decision making and will not take the place of it.

Second, if there’s a need to postpone emergency cardiac treatment in order to provide for non-emergency surgeries then the reasons for the delay, alternative options and the person(s) who made the decision to delay the treatment should be documented.

Give nurses and other clinicians a direct path to report concerns about a patient’s safe discharge. Reporting a problem with a doctor who has more experience than you should be considered an obligation of providing quality care, not a risk of losing your job.

Fourth, create and maintain contemporaneous records and audit trails. Investigators need to consider discrepancies in a balanced way and any contested documentation should not automatically imply dishonesty.

Review of unexpected deaths as soon as possible after discharge, and publicize what was done to fix those issues. Those who oversee the healthcare system must separate when there is some doubt in whether an outcome could have been different, from when there was a failure that could have been prevented; all the while allowing for due process.

A family shouldn’t have to wait five years through a lawsuit to determine if a health care facility was justified in discharging their loved one. This is the strongest point made by the jury’s decision regarding what should happen next.

Fifty million dollars won’t make Dan Haas return. However, it should motivate hospitals to consider if the patients being released from the hospital are on the path to health and recovery, or if there is still a potential risk that exists outside of the hospital’s control.

Fransiscus Nanga Roka

Faculty of Law University 17 August 1945 Surabaya and Managing partner Law Firm Victorious Indonesia