In 2000, Helen Haskell's healthy 15-year-old son underwent elective surgery at Medical University of South Carolina to correct a congenital condition called pectus excavatum, or a sunken chest.
Four days later, Lewis Wardlaw Blackman died.
"He was a ball of energy," Haskell said. "We thought he was going to be a person who really put South Carolina on the map."
MUSC admitted that a chain of negligent acts by inexperienced staff led to Lewis's death. The hospital settled for nearly $1 million, money Haskell used to establish a scholarship.
Her son's legacy has grown to include legislation, an endowed chair and most recently the Lewis W. Blackman Patient Safety Champion Awards.
Dr. Rick Foster, vice president for quality and patient safety with the hospital association, said Haskell "has taken what was obviously a very sad situation with her son and turned it into a positive."
She feels gratified and humbled to see her son's legacy continue, Haskell said. "I am well aware that few children who die are able to leave a public legacy. That's more than most bereaved parents have."
Soon after Lewis' surgery, his condition worsened. He wasn't producing urine. He grew pale, broke a cold sweat and suffered great abdominal pain.
But Haskell's concerns went unheeded. She asked several times for a veteran doctor, to no avail.
Then, Lewis' pain suddenly stopped, a sign that a more experienced physician might have read as impending death.
Within hours, Lewis was pronounced dead. An autopsy revealed he bled to death from a perforated ulcer, a known risk of the painkiller Toradol.
In 2005, the Lewis Blackman Hospital Patient Safety Act became law and required all clinical staff in hospitals to wear identification tags, labeling job and status. The law also mandated that patients be informed of how they can contact an experienced doctor or summon help quickly.
A plaque bearing her son's likeness will be hung in a simulation center at MUSC, where health care workers can practice procedures and rapid response. The center, scheduled to open in June, along with several sites across the state, is the work of Dr. John J. Schaefer, the Lewis Blackman chair for patient safety.
Simulation, a training technique already used in aviation and the military, allows students to practice without the risk of injury to patients, Schaefer said. Simulating crisis situations also helps rapid response teams practice together and understand their roles before reaching the bedside, he said.
Although Schaefer was not at MUSC at the time of Lewis' death, he said, "If people had gotten to the bedside earlier, would it have changed things? Possibly, yes."
Dr. Jerry Reves, dean of the Medical University of South Carolina's College of Medicine, said, "Lewis Blackman was a healthy young man who died and showed things go wrong from time to time." While human error will never be eliminated, Reves said, systems can be reviewed and improved.
When Haskell started her advocacy shortly after her son's death, she said, she was a voice in the wilderness of the medical establishment.
"They were against us, but that has changed" said Haskell, the first patient consumer to sit on the S.C. Hospital Association Quality Council.