‘We Did Nothing Wrong’

Victor Garcia considers himself lucky to be alive. Three years ago, a combination of cancer and miscalculation almost killed him.

The former distribution manager for fragrance maker Chanel now can feel the hot Panamanian morning sun stream through his living-room window. He can smell lunch cooking in the kitchen. He can sit in an armchair surrounded by pictures of his six children and six grandchildren and talk to his wife. Simple pleasures he almost lost following a software malfunction. In November of 2000, Garcia and 27 other patients at the National Cancer Institute in Panama were jolted with massive overdoses of gamma rays partly due to limitations of the computer program that guided use of a radiation-therapy machine.

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In the 40 months that have passed, 21 patients have died. While it’s unclear how many of the patients would have died of cancer anyway, the International Atomic Energy Agency (IAEA) said in May 2001 that at least five of the deaths were probably from radiation poisoning and at least 15 more patients risked developing “serious complications” from radiation.

Garcia, being treated for prostate cancer, survived but suffered damage to his intestines. He now has a colostomy. “I am very lucky,” he says, shaking his head in wonderment. “That’s what the [investigating] doctors from Houston told me. ‘You are so lucky.'”

The three Panamanian medical physicists who used the software to figure out just how much radiation to apply to patients are scheduled to be tried on May 18 in Panama City on charges of second-degree murder. Under Panamanian law, they may be held responsible for “introducing changes into the software” that led directly to the patients’ deaths, according to Special Superior Deputy Prosecutor Cristobal Arboleda.

The physicists, of course, thought they were helping the patients. Having consulted a doctor at the hospital and the software’s manual, they thought they had figured out how to place five radiation shields over each patient’s body, instead of four, to protect against possible overdoses. “I thought I was home free,” one of them, Olivia Saldaña, recalls now.

This is not a cautionary tale for medical technicians, even though they can find themselves fighting to stay out of jail if they misunderstand or misuse technology. This also is not a tale of how human beings can be injured or worse by poorly designed or poorly explained software, although there are plenty of examples to make the point. This is a warning for any creator of computer programs: that software quality matters, that applications must be foolproof, and that-whether embedded in the engine of a car, a robotic arm in a factory or a healing device in a hospital-poorly deployed code can kill.

In this case, a St. Louis company, Multidata Systems International, has found itself in and out of courts in two countries for much of the past three years, fending off charges that its product is at fault in a score of fatalities. The deaths occurred more than 2,000 miles from its home, at an installation of a customer it claims it did not even know it still had-until the death toll began mounting.

Now Multidata may face judgments that could damage-if not destroy-the company itself, if the firm is found guilty and is forced to pay damages sought by the victims. No one can accurately predict the amount Multidata would have to pay if the victims succeed in suing in the U.S. So far the plaintiffs have failed. But each of the 28 victims could be entitled to as much as $500,000 to $1 million of compensation for such factors as pain and suffering, lost wages and the number and age of surviving dependents, according to Brian Kerley, a defense attorney at a leading New York malpractice firm. Using those numbers, Multidata could be facing total damages in the range of $14 million to $28 million. Multidata, which is privately held, says it has about $2 million in annual sales and fewer than 15 employees.