‘Betty’s Law’ pushing for transparency inside freestanding ERs and urgent care clinics

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AUBREY, Texas (KXAN) — Jeremy Wattenbarger said things at home are much quieter now after his 7-year-old’s death.

Jeremy Wattenbarger set up an office in his daughter Betty’s bedroom. As he pushes for legislation in Texas, he said he wanted to have her favorite things nearby. (Courtesy Jeremy Wattenbarger)

“One thing she really loved — being autistic — was music, classical music, especially Bach, Beethoven. We can’t even listen to it anymore. It’s too hard,” he explained. 

Wattenbarger said Betty died Jan. 31, 2019 from flu complications. He said according to her autopsy report it was caused by pneumonia and sepsis, which is the body’s severe response to an infection.

The family said they had called her pediatrician and were told to take her to a pediatric urgent care near Dallas-Fort Worth. 

Lack of transparency

Wattenbarger explained that he thought Betty was being treated by a doctor at the urgent care, but it was actually a nurse practitioner. He said she wasn’t wearing a badge and didn’t introduce herself. 

Wattenbarger acknowledged that he didn’t ask for that information in the moment, either. 

“We would have known that she was an advanced practicing nurse and said, ‘You know what, she probably doesn’t have the skills to see Betty based on … the way she looked that day. The way she was feeling. We would have taken her somewhere else. We would have gotten a second opinion or asked her to call the doctor,” Wattenbarger said. 

The family has been working with State Rep. Jared Patterson, R-Frisco, to make changes that could impact that lack of transparency. 

House Bill 2596 or “Betty’s Law,” filed earlier this month, would require healthcare workers providing direct patient care and practicing in freestanding ERs and urgent care clinics to wear a photo identification badge. 

The bill states that the badge must include a first or last name, the department which the healthcare worker is associated with and the type of license held. 

“Although no effort of mine will ever bring justice to this terrible situation, I hope that greater transparency surrounding the healthcare professionals that are practicing in urgent cares and freestanding ERs will allow for patients and their families to make the most informed decisions,” Rep. Patterson said. “As a father of young children, I cannot imagine what this family has endured, but I am thankful for their desire to make a difference.”

According to the bill, if there are violations, then the medical care facility could be fined by the Health and Human Services Commission. 

The bill explained that the amount of penalty imposed may not exceed $1,000 for “each violation, and each day a violation continues or occurs is a separate violation for the purpose of imposing a penalty.”

The attorney general may sue to collect the penalty. 

Standard across the state

The Texas Association of Freestanding Emergency Centers, or TAFEC, supports the bill and any measure that increases transparency and protects patients. 

“We checked with many of our TAFEC members and found that 100% of those queried were already in compliance with photo identification badges, just like large hospital ERs,” said Dr. Eric McLaughlin, TAFEC Board Member. 

The Texas Nurses Association, or TNA, said the Nurse Practice Act already has a lot of the requirements detailed in the bill and reported violations can result in disciplinary actions taken by the Texas Board of Nursing. 

“Anyone who identifies themselves as a nurse — whether they are registered nurse, licensed vocational nurse or an advanced practice nurse — they’re still required to adhere to what is already in our Nurse Practice Act,” said Serena Bumpus, Director of Practice for TNA. “They are supposed to identify themselves as one of those titles with any other certifications or credentials that they may have and with their name on it as well.”

Bumpus explained that the big difference in this particular bill is the penalties for the facility. She said they have not heard of any reports of violations across freestanding ERs or urgent cares. 

“There are many policies that exist, specifically hospital policies or organizational policies, that mandate identification requirements. But, by having state policy that’s very clear and transparent, it reduces the variability that you see between institutions and heightens the level of importance and visibility and statutory requirement, in fact, to make sure that individuals wear identification,” explained Dr. Debra Patt, an oncologist and chair of the Council on Legislation for the Texas Medical Association

Dr. Patt said it’s all about transparency and patients should always know who is treating them. 

“We have many members in the health care team, all of whom are incredibly important: nurses, nurse practitioners, physician assistants, physicians/ And, we all play roles, but it’s important to know who you’re dealing with in those roles,” she said. 

The Wattenbarger’s said Betty would be 9-years-old now. They said they hope “Betty’s Law” passes so no other family questions who is treating their loved one. (Courtesy Jeremy Wattenbarger)

Betty’s family explained that it would have helped them make a more informed decision about the care of their daughter. 

“It just gives you an additional, you know, ‘Hey, I know who I’m talking to. I recognize your credentials, but let’s find someone who actually is an expert in what is happening right now,” Wattenbarger said. 

The family has filed a lawsuit against the urgent care and the healthcare workers who treated Betty, alleging medical negligence.

The defendants’ attorney said he does not respond to the media on pending litigation. 

In a legal response to the lawsuit filed on behalf of the family, the defendants deny the allegations stating, “the injuries and damage alleged were not caused by the negligence of any party.”

The court document also said that Betty’s cause of death was due to pre-existing health conditions. 

KXAN investigator Arezow Doost has tried repeatedly to reach the urgent care and the nurse practitioner, but calls have yet to be returned. 

The supervising doctor for the nurse practitioner told Doost he had no comment. 

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