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Michelle Malizzo Bal-log was nervous as hospi-tal staff wheeled her intosurgery to replace a tem-porary stent in her liver. Ina procedure two weeksearlier, also at Universityof Illinois Medical Centerat Chicago, she had awak-ened too early from theanesthesia, an unsettlingexperience.

But this time she didn’t

wake up.Monitoring errors were

made while she was underanesthesia, and Ballog,whose youngest daughterhad turned 1 the day be-fore, stopped breathingand suffered cardiac arreston the operating roomtable. She lapsed into acoma and died nine dayslater at 39.

Her parents and sisterhad no idea at first thatBallog’s death was caused

Bob and Barb Malizzo, along with daughter Kristina Chavez and her son Adrian, visit their daughter Michelle Ballog’s

grave at Graceland Cemetery in Valparaiso, Ind. Ballog died after a medical error at UIC Medical Center in Chicago.

HEATHER CHARLES/TRIBUNE PHOTOS

Family lends handafter deadly errorMedical mistake spurs relativesto join hospital panel, not sue

Barb Malizzo holds a favorite photo, showing her daugh-

ter Michelle Ballog, herself and husband Bob. The Maliz-

zos and another daughter now work on hospital safety.

“We might be able to savesomeone’s life.” — Bob Malizzo

By Deborah L.SheltonTribune reporter

Please turn to Page 8

Forecast: High 83 Low 62 Weather page, back of A+E section

But take it he did. Ventura, 44, who has no mana-

gerial experience, was named thenew Sox skipper Thursday, lessthan four months after starting hisduties as a special adviser.

“The passion was there to do it,”Ventura said. “I realize I haven’tmanaged, but this is the organiza-tion that is going to give me thesupport to do the job.”

Williams said Ventura met thevery specific criteria the White

The idea of Robin Venturasucceeding Ozzie Guillen asWhite Sox manager came from sofar out of left field that evenVentura acknowledged he wassurprised when general managerKen Williams approached himabout taking the job.

Sox were looking for.“A passion for the city and the

organization, and a drive to win aWorld Series championship ...leadership, a communicative abil-ity that I think will translate wellinto working with veterans play-ers as well as our young players,”said Williams, who will be patientwith the inexperienced Ventura.

“I do not expect him to be TonyLa Russa on day one,” Williamssaid. Chicago Sports

New White Sox manager Robin

Ventura rejoined the organization

four months ago as an adviser.

CHARLES ESHELMAN/WIREIMAGE PHOTO

Surprise! It’s VenturaBy the numbers

16 seasons played

6 Gold Glove awards

2 All-Star appearances

18 grand slams, tied for fifth

most in major league history

Sox’s hiring of former3rd baseman a shockto most, including him

WASHINGTON —GOP leaders in Congressmay seem to be frequentlybending over backward toplease the most conserva-tive flank of their party —but the gymnastics don’tappear to be doing thetrick.

Like the vast majority ofAmericans, tea party ac-tivists say they, too, dis-approve of how Congressis doing its job. But thereasons they offer are no-tably different from thoseheard elsewhere.

In interviews, severalleading activists said Re-publicans were too quickto compromise and tooaccommodating to Demo-crats. They don’t cite aninsufficient effort on jobcreation, the top concernvoiced by most Ameri-cans, but an inadequateattempt to rethink the roleof government.

They urged lawmakersto be more aggressive andstick to a pattern of brink-manship that has brought

Obama, activistsurge action as divisions mount

For years, HOPEUnited Church of Christadvertised on its frontlawn plans to build achurch on 14 acres it ownsjust southwest of Naper-ville, and the ministerthere says he never heardso much as a peep ofdispleasure.

But those plans fellthrough, and now that thechurch wants to sell theproperty to another reli-gious group, protests haveerupted at the NapervillePlanning and ZoningCommission. Handmadesigns critical of the deal

have sprouted on utilitypoles.

This time around theIslamic Center of Naper-ville wants to buy the landand someday build amosque there, saidHOPE’s pastor, the Rev.

Timoth Sylvia. In his view,that’s the difference.

“This display of trueignorance … breaks myheart, raises my concernand honestly angers me,”Sylvia wrote to congre-gants and friends earlier

this week. “The IslamicCenter of Naperville hashad to fight so hard for allthat they have, and thisnext chapter of their storyappears as if it may play

Mosque resistance questioned

A notice-of-public-hearing sign marks the Will County site that the Islamic Center of

Naperville wants to buy, annex to Naperville and someday build a mosque on.

CHUCK BERMAN/TRIBUNE PHOTO

Uproar ensues asplan switches fromchurch to mosque

By Mick Swaskoand Ted GregoryTribune reporters

Please turn to Page 9

Michael Phillips’ review in A+E

HHH for George Clooney’s ‘Ides of March’

Ratcheting up the pres-sure on Republican oppo-nents, President BarackObama on Thursdaythreatened Congress witha bitter fight over his$447 billion jobs programif a vote is not taken. Hevowed to bring it to Con-gress piece by piece, ifnecessary.

Obama insisted his pro-posal would give a jolt tothe economy. He said hewould use his re-electioncampaign to highlight theGOP’s opposition — agamble, based in part onObama’s knowledge thatwhile his approval ratingshave plummeted, Con-gress is even less popular.

Soon afterward, Repub-lican leaders zeroed in onthe tax increases thatDemocrats proposed topay for the plan, includinga surtax on millionaires.

“This bill is the samewasteful spending, thesame burdensome uniongiveaways and the sametemporary tax policy thathas failed the Americanpeople the last two years,”said Senate RepublicanLeader Mitch McConnell.

Nation & World, Page 14

ALEX WONG/GETTY PHOTO

President turns upheat on Congressto pass jobs bill

Tea party sets its sights on GOP establishmentBy KathleenHennesseyTribune Washington Bureau

Please turn to Page 15

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by preventable medical er-rors, of which the monitor-ing problem was only thefirst. When they found out,they were livid. Bob Maliz-zo, Ballog’s father, remem-bers angrily asking doctors:“How could this happen?”

To the family’s astonish-ment, hospital officials didnot duck their questions,cover up their mistakes orhide behind lawyers. In-stead, they shared the tragicdetails.

As a result, the familymade a surprising decisionof their own: They chosenot to sue and joined thehospital’s safety reviewcommittee to help themedical center avoid mak-ing such errors in the future.

In their role as lay mem-bers of the committee, Ma-lizzo, his wife, Barbara, andtheir daughter KristinaChavez hear about medicalerrors and near-misses thatoccur at UIC and otherhospitals, with the goal ofhelping to figure out howsuch mistakes can be avoid-ed. They offer a uniqueperspective that often islacking in meetings thattypically focus on pro-cedures, processes andpractices.

Sitting in his living roomin Hobart, Ind., next to apillow memorializing hisoldest daughter, Malizzoexplained the family’sthinking in joining thepanel: “We might be able tosave someone’s life.”

Patient safety expertspraise the hospital for beingtransparent about the er-rors and said the case high-lights the important rolethat patients and familiescan play in helping to fix acomplex, intractable prob-lem.

Patient advocates arepushing for greater involve-ment on the part of patientsand families to reducemedical errors — every-thing from encouragingthem to be assertive inraising concerns withhealth care professionals toenlisting more consumersto serve on hospital safety

committees.“We’re really on the edge

of something new, givingconsumers more powerover (important) informa-tion, and I think that’s areally good thing,” said Su-san Hinck, policy consult-ant to the Missouri HealthAdvocacy Alliance.

The presence of patientson such panels, however,means disclosing inside in-formation that many hospi-tals don’t feel comfortablesharing.

No one knows exactlyhow many medical errorsoccur, but a landmark re-port in 1999 by the Instituteof Medicine estimated thatas many as 98,000 Ameri-cans die as a result of amedical mistake in any giv-en year.

Newer studies publishedin the journal Health Affairsin April suggest that signifi-cant adverse events mayoccur in as many as 1 in 3hospital admissions. TheCenters for Disease Control

and Prevention found that100,000 people die annuallyfrom health care-acquiredinfection alone.

Patient safety was high-lighted in the Chicago areaearlier this year whenJames Tyree, president ofMesirow Financial andchairman of Sun-Times Me-dia, died at University ofChicago Medical Center asa result of an error thathealth officials say shouldnever happen.

Tyree, 53, served on thehospital’s board of direc-tors, proving that medicalerrors can happen to any-one.

After Ballog’s death in2008, officials at UIC Medi-cal Center immediatelyshared their suspicions thatfatal errors might have beenmade. They promised toinvestigate quickly and re-port back to her family. Assoon as they realized theyhad done something wrong,they apologized and pro-vided an explanation. And

they speedily offered a fi-nancial settlement to pro-vide for Ballog’s two daugh-ters, who were 1 and 7 at thetime.

They also vowed never torepeat the errors.

“As head of patient safetyin the hospital, I made itvery clear that, at the end ofthe day, most of this restedon me,” said Dr. TimMcDonald, the hospital’schief safety and risk officerfor health affairs. “We, theinstitution, had let themdown. Had we done the jobwe were supposed to do,this would not have hap-pened.”

Within 12 hours of Bal-log’s cardiac arrest, themedical center changed itsprocedures to require thatan anesthesia specialist bepresent for the kind ofprocedure she was under-going. Ballog’s case wasamong those providing in-formation used to help de-velop national guidelines onthe use of a capnograph, adevice used to monitor car-bon dioxide concentrationsin the blood of a sedatedpatient.

The medical center alsohas developed a program toprevent and respond toharm caused by medicalerrors, with an emphasis onbeing patient-centered andtransparent. Under a fed-eral grant, UIC helps otherhospitals set up similar pro-grams.

For their part, Malizzo,his wife or his daughterdrive about an hour eachway once a month to attendmeetings of the hospitalsafety review committee.

“We don’t want ourdaughter to die in vain,” saidMalizzo, a former mayor ofHobart who runs a medicalstaffing company.

In one meeting, Malizzo

and his daughter wereasked the best way to ap-proach family members of apatient who died of a medi-cal error after being trans-ferred to another facility.They suggested that offi-cials go to the family’shome, where they would bemore comfortable, insteadtelling them in the hospital.

Malizzo said his trust inthe medical center has beenrestored and he goes thereregularly for treatment of aheart condition.

“We have seen at UICthat they are trying theirvery best to eliminate medi-cal errors,” he said. “I trustthem to this day with mylife.”

Martin Hatlie, CEO ofProject Patient Care,praised the medical centerfor being open about asensitive issue and for tak-ing the lead in finding solu-tions.

Errors are “a stubbornproblem rooted in the wayour health care system isorganized and a (medical)culture that historically hasbeen quiet about things thatgo wrong,” said Hatlie,whose Chicago-basedgroup seeks to preventmedical errors and improvehealth care quality.

Among the obstacles toreporting and reducing er-rors are health profession-als’ fear of litigation and lossof reputation, lack of train-ing in how to communicatewith families after harmoccurs, worries about losingtheir jobs, and feelings ofguilt, said Hatlie.

On the patient side, barri-ers include apprehensionabout angering health pro-viders and feeling too intim-idated to ask questions orraise concerns.

But that is exactly whatpatients need to do, said

Hatlie, because speaking upcan help correct minorproblems before they wors-en and cause serious harm.

To health professionals,he says: “Listen to patientswhen they are expressingconcerns, because theyprobably know somethingyou don’t.”

Knitasha Washingtonhas seen the problem fromboth sides — as a healthprofessional and as a daugh-ter whose father died be-cause of a medical error.

Patients have to be as-sertive and proactive, “ask-ing, probing and doing yourown research, whateverthat might be,” said Wash-ington, president of the Chi-cago Midwest chapter ofthe National Association ofHealth Services Executives.“You can’t take informationas if it’s golden; you have toask questions.”

The Malizzos say theirwork to help eliminatemedical errors and promotetransparency is a legacy totheir daughter’s generousand loving spirit. They planon serving on the hospital’ssafety committee for therest of their lives.

“You come to the realiza-tion that there’s nothing youcan do — it happened,”Malizzo said. “They made amistake. Where do we gofrom here?”

dshelton@tribune.comTwitter: @deborahlshelton

Hospital is more open about errorsContinued from Page 1

Bob Malizzo and daughter Kristina Chavez attend a patient safety review committee meeting at UIC Medical Center in

Chicago. They joined after the death of Michelle Ballog, his daughter and her sister.

HEATHER CHARLES/TRIBUNE PHOTO

Tips for avoidingmedical errorsAmong steps you can take

to minimize the chance of

something going wrong:

n Ask questions, take notes

and raise concerns (but do

it respectfully).

n Seek second opinions if

you need additional

information.

n Repeat information back

to your health provider to

make sure you understood

it correctly.

n Bring someone with you

who can serve as an

advocate while you are

hospitalized or when you go

to medical appointments.

n Learn the chain of

command so you know

where to direct your

unresolved concerns.

n Ask health providers to

wash their hands before

examining you.

n Keep important details

about your health and

health care handy, including

a list of medications you

take.

n Find out which health

providers will be taking care

of you and their level of

training.

n Consider using checklists

available from consumer

and patient safety groups.

No longer able to providepublicly funded foster careand adoption services un-less it complies with Illinoislaw, Catholic Charities inthe Diocese of Peoria an-nounced Thursday that itwill withdraw from all statecontracts and transfer itsstaff and caseload to a newnonprofit organization withno affiliation to the RomanCatholic Church.

Run by a five-personcommunity board, the Cen-ter for Youth and FamilySolutions will take on theentire caseload of fosterchildren from Peoria Catho-lic Charities starting Feb. 1.

Meanwhile, CatholicCharities in the dioceses ofJoliet and Springfield, aswell as Catholic Social Serv-ices of Southern Illinois inBelleville, asked a state ap-pellate court to halt thetransition of foster carecases to other agencies nowunder way in those threedioceses and reconsiderwhether the state’s decisionto sever foster care con-tracts with the three agen-cies violates their religiousfreedom.

“We are adamant about

going forward,” said GlennVan Cura, executive direc-tor of Catholic Charities ofJoliet. “We feel that there’sno reason to discontinue.”

After Illinois recognizedcivil unions this year, Cath-olic Charities told the stateit would refer aspiring fos-ter parents in civil unions toother agencies, in order toabide by Catholic teachingthat defines marriage asbetween a man and a wom-an. The state declined torenew its contracts with theagencies, saying that cou-ples in civil unions have tobe treated the same asmarried couples.

Frustrated by the lack ofclarity in the law, CatholicCharities in Rockford ter-minated its foster care serv-ices. An independent childwelfare agency, Youth Serv-ice Bureau of Illinois Valley,stepped up to take on the330 children and hire mostof the caseworkers and sup-port staff.

The new organization inPeoria, which will have noallegiance to the church,has agreed to serve couplesin civil unions, said MikeDrymiller, of Moline, aCatholic financial adviserand one of the foundingboard members.

To give the new organi-zation time to prepare, Illi-nois’ Department of Chil-dren and Family Serviceshas agreed to let CatholicCharities supervise theexisting cases through Jan.31.

“We commend CatholicCharities of Peoria forputting children first,” saidDCFS spokesman KendallMarlowe. “They have aproud tradition of servingchildren and families inneed, and today’s decisionmeans that legacy lives on.”

Patricia Gibson, generalcounsel for the Peoria Dio-cese, said eventually Catho-lic Charities of Peoria willrely exclusively on privatefunding because the agencyplans to withdraw from allof its state contracts. Annu-ally, the agency receives upto $23 million from thestate. More than $15 millionof that goes toward fostercare and adoption services,and many of them overlap,she said.

“It’s certainly somethingvery sad to us,” Gibson said.“The main thing everybodywants is stability for theclients we serve.”

mbrachear@tribune.comTwitter: @TribSeeker

Catholic Charities-Peoriato transfer foster care aidBy Manya A. BrachearTribune reporter

chicagotribune.com/mistakes

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