One Father's Crusade Reforms Medical Practices

Elaine Mandel

Attorney

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A grieving father's fight changed the system that required medical residents to work too many hours and thereby provide sub-standard care.

In 1984 eighteen year old Libby Zion died at a New York hospital. The resident caring for her had been on duty for thirty six hours. The senior resident was sleeping in a nearby building when Libby became agitated. Her temperature rose to 107 degrees. Libby suffered a cardiac arrest and died. Her father, Sidney Zion, a lawyer and journalist, decided to do something about the long-standing system that required residents to work thirty-six hour shifts. Obviously, young, inexperienced doctors who are sleep-deprived after long shifts are not going to make the best, most reasonable choices when it comes to providing medical care.

Mr. Zion filed a lawsuit for the death of his daughter and made it his mission to help reform the work hour limitations on medical residents.

Because of Mr. Zion's crusade, the New York Health Commissioner created a committee to investigate the lack of supervision of medical residents and interns.

In 1989, New York state adopted the Bell Commission's recommendations that residents could not work more than 80 hours a week or more than 24 consecutive hours and that senior physicians needed to be physically present in the hospital at all times. Hospitals instituted so-called night floats, doctors who worked overnight to spell their colleagues, allowing them to adhere to the new rules.

Until 2003. In that year, the ACGME made reduced work hours mandatory for the accreditation of residency training programs across the country. The new ACGME standards look remarkably similar to those of the Bell Commission.

This is just one example of an individual who saw a situation that needed revision and filed a lawsuit. Sidney Zion's lawsuit helped change the system and will help prevent what happened to his daughter Libby from happening again.