911 Operators Did Little to Help Dying Woman in ER

[itcheroni]

Not doubting you personally, but that really is incredible. Then again, I've things like that happen in DC and Baltimore.

At that point, you wondering if the community will simply continue to reap what they have sown....

A bad hospital is better than no hospital. Goodness gracious, our health care in this country is forcing us into these situations. And I don't even have health insurance...

 

[Mechcozmo]

the county wanted to close it, but the community voiced the otherwise. king/drew's history means quite a bit to the neighborhood.

Of course, how many of those that had voted to keep the hospital open have actually had surgery at the hospital?

Besides, wasn't it Henry Ford who said, "History is bunk"?

 

[Mechcozmo]

History of substandard care?

King/Drew set the standard for substandard care.

 

[Abstract]

It seems to be more the hospital and the police officers' fault. It was at least understandable that the 911 operator was confused.

Agreed. If you're that operator and heard that someone is at a hospital and dying, I can imagine making the same mistake.

 

[Counterfit]

King/Drew set the standard for substandard care.

Let's stop now before it gets confusing.

 

[Dave00]

It is always comforting to know that the second largest city in America has inadequate hospitals, unable to care for a woman dying in their emergency room.

My college town of a population of 25,000 has a better hospital.

I'd bet your college town has a somewhat lower incidence of gunshot wounds and other trauma. I'd reserve criticism until you've walked a mile in the shoes of someone trying to work in that setting.

 

[Dave00]

One huge problem with the article is that they considered the situation in a vacuum. Big difference between whether the woman came in while there were other traumas being seen, or if they weren't busy at all. There was a comment that someone was "just watching her", but you don't know if that was a nurse or a maintenance worker. Big part of emergency medicine is triaging, or deciding who needs to be seen most immediately. Someone can look not that serious on initial presentation, and then go down the tubes in a hurry. Also, in defense of the 911 operator, it would in most cases be extremely irresponsible to transport someone from one ER to another without them having been stabilized by the first ER. And this patient - with a perforated bowel - almost certainly would've died during transport to a different hospital.

 

[nbs2]

A bad hospital is better than no hospital. Goodness gracious, our health care in this country is forcing us into these situations. And I don't even have health insurance...

In many cases, no hospital is better than a bad hospital. An ambulance is only required to take you to the nearest hospital - if the bad isn't there, then your nearest is somethine better. For those in the immediate vicinity, yes, having that bad hospital is a convenience. But, for the majority of the community, it would make sense to shut down the failure. In my community, our local hospital is panned as the place you go to almost die - when you're about to pass, you get sent somewhere else where they'll try to perform a miracle. If that hospital was shut down, there would be several others to pick up the slack. They would receive more grant money (they would serve a larger community area) and could continue to provide superior service. For those closest, they would need to travel several minutes in various directions, but I don't believe that the number of moments that are THAT critical is enough to outweigh the benefit to shuttering the place.

And how is the health care in our country forcing us into the situation that developed? At what point did the insurance companies stop the ER staff from treating her? At what point did the hospital perform (an illegal) wallet biopsy on the lady? At what point did the lady say "I can't afford the proper treatment, if I take two aspirin I'll be ok"? Clearly it wasn't the health care system that failed. People from around the world come to the United States to receive care from American hospitals. Our technology and education systems are at the forefront of treating ailments of various types. If there was a country in which this woman stood a chance to live, it was the one she was in. So it isn't health care in our country that failed. She was ailing, she was dying, and she wasn't attended to. In her attempt to receive propert medical attention, she was rebuffed by an operator and perhaps some hospital employees. The incompetence of one cannot condem a system.

There was a failure, but it had nothing to do with the "health care in this country" or your lack of insurance.

 

[itcheroni]

And how is the health care in our country forcing us into the situation that developed? At what point did the insurance companies stop the ER staff from treating her? At what point did the hospital perform (an illegal) wallet biopsy on the lady? At what point did the lady say "I can't afford the proper treatment, if I take two aspirin I'll be ok"? Clearly it wasn't the health care system that failed. People from around the world come to the United States to receive care from American hospitals. Our technology and education systems are at the forefront of treating ailments of various types. If there was a country in which this woman stood a chance to live, it was the one she was in. So it isn't health care in our country that failed. She was ailing, she was dying, and she wasn't attended to. In her attempt to receive propert medical attention, she was rebuffed by an operator and perhaps some hospital employees. The incompetence of one cannot condem a system.

There was a failure, but it had nothing to do with the "health care in this country" or your lack of insurance.

This is quite a touchy topic and I admit I don't know a lot about it. But if healthcare was a good as you say, why is there such a strong assumption that it's "in a state of crisis." Why are a third of Americans without health insurance? Why is Michael Moore making a movie purely about America's healthcare? You're seriously the first person to tout America's healthcare. I don't disagree. It is great. If you can pay the price.

The article was very inconclusive about many things from which you draw assumptions.

...I'm still incredibly surprised by your defense of our healthcare system. I'm lived in a few different countries(France, Japan, Canada, Burma aka Myanmar) and have received some care in each. Although they are fundamentally different, it is clear that America has the most to work out. It is the only country I've had to wait over 2 hours in an emergency room, among other things.

Check out the world health care rankings. We're right in between Costa Rica and Slovenia. It's funny, I've lived in the first and last countries on the list.

http://www.photius.com/rankings/healthranks.html

http://www.aflcio.org/issues/healthcare/whatswrong/

http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=364436

 

[notjustjay]

...Although they are fundamentally different, it is clear that America has the most to work out. It is the only country I've had to wait over 2 hours in an emergency room, among other things.

I live in Ottawa (Canada), and I routinely wait 2-4 hours in the ER for treatment of non-life-threatening issues (e.g. dislocated joint, fractured wrist). Sometimes the smaller town places are better as they can see you much quicker. I'm not sure what condition you had when you waited 2 hours, but that seems about inline with my experiences.

Of course, it was free (well, nowadays we pay a couple hundred bucks a year for the Ontario Health Care Premium )

 

[itcheroni]

I live in Ottawa (Canada), and I routinely wait 2-4 hours in the ER for treatment of non-life-threatening issues (e.g. dislocated joint, fractured wrist). Sometimes the smaller town places are better as they can see you much quicker. I'm not sure what condition you had when you waited 2 hours, but that seems about inline with my experiences.

Of course, it was free (well, nowadays we pay a couple hundred bucks a year for the Ontario Health Care Premium )

Like I said, it's fundamentally different. If I broke my arm right now without health insurance, I just flatout won't get treated in America. If I bought the minimum healthcare I can afford through my school, it would be over $3000 a year. And that would force me to pay a co-pay every time I needed to go to the hospital or get service in any way. And some things won't even be covered. And I expect it's like car insurance. You can't buy the insurance after you've had the accident. Is it my imagination or didn't the Kids in the Hall make it clear you guys were better in this regard?

 

[floriflee]

This is quite a touchy topic.... <snip>

I think you may have misread nbs2's last post. I don't think he was saying that the health care system is absolutely fabulous (it certainly has its flaws), but rather, that in this case, it wasn't the health care system that failed. It was the people involved. The lady didn't die because she was refused treatment because she didn't have insurance, or because there wasn't the proper facility to treat her. She died due to incompetence of the people involved. The health care system seemed to have little to do with it (in this case).

Not to go too OT, but part of the problem with the US health care system and its horrendous costs has to do with the fact that there are so many frivolous malpractice lawsuits. One thing that will certainly have to change to improve things on that matter is the malpractice legislation. It's been needing an overhaul for decades now. I fear losing my wonderful OB because she's threatened to quit as soon as the contract with the hospital expires and she has to start paying her own malpractice insurance again. So sad. Things will only continue to get worse as the profession becomes less able to sustain the costs that it incurs. Skilled doctors and would-be doctors will get out of the practice because they won't be able to support themselves and/or their families because 50%+ of the salary will have to go towards covering their butts. That would certainly make me think twice about entering that profession.

 

[itcheroni]

I think you may have misread nbs2's last post. I don't think he was saying that the health care system is absolutely fabulous (it certainly has its flaws), but rather, that in this case, it wasn't the health care system that failed. It was the people involved. The lady didn't die because she was refused treatment because she didn't have insurance, or because there wasn't the proper facility to treat her. She died due to incompetence of the people involved. The health care system seemed to have little to do with it (in this case).

I read it as him meaning both-it wasn't the system that failed in this case and that our health system is one of the best.

Not to go too OT, but part of the problem with the US health care system and its horrendous costs has to do with the fact that there are so many frivolous malpractice lawsuits. One thing that will certainly have to change to improve things on that matter is the malpractice legislation. It's been needing an overhaul for decades now. I fear losing my wonderful OB because she's threatened to quit as soon as the contract with the hospital expires and she has to start paying her own malpractice insurance again. So sad. Things will only continue to get worse as the profession becomes less able to sustain the costs that it incurs. Skilled doctors and would-be doctors will get out of the practice because they won't be able to support themselves and/or their families because 50%+ of the salary will have to go towards covering their butts. That would certainly make me think twice about entering that profession.

I thought so too at one point, because it's taken as such a given, but I doubt you can provide any references to back it up. No offense to you, but most of those arguments are mainly for political rhetoric. And just because the insurance rates are so high, does not necessarily mean it's for just cause. It's sort of like gas prices; in any normal economy, you would think less product, less profits, rather than record profits. High insurance premiums do not necessarily mean more litigation, especially when hospitals aren't really hurting either. And, overall, there are less cases entering our courts now than 30 years ago. But, in the interest of full disclosure, I am a law student. However, I'm not interested in medical malpractice litigation. I'm more into international business and arbitration.

By the way, I'm not promoting litigation for the sake of it. I just think a person who has been wronged should have the right to sue for damages that they deserve. Litigation is just a great scapegoat politically because there is no real entity. HMO's, large hospitals, and insurance companies, on the other hand contribute heavily to political campaigns-and IMO are the larger contributors to our healthcare problem. And there is also no incentive to provide healthcare for everyone. Why would anyone want to provide healthcare to the poor? It would be unprofitable.

And while we're on it, at what point should a person not be allowed to sue? In a situation, such as amputating the wrong leg, most people would agree the patient should have a right to sue. But what about the current situation with Rodriguez? Should the hospital be immune from suit? Maybe she could sue an employee of the hospital but a person making 30K-50K a year can hardly be able to satisfy what would most likely be damages that would surpass six figures. If the goal is to limit litigation against hospitals and doctors, this would be a most likely place to draw the line.

 

[GFLPraxis]

Yeah, disgustingly mishandled. My mom has actually seen things like this happen at a badly managed hospital in Italy, where someone was having an asthma attack and everyone was ignoring him while he almost choked to death.

Seems more the fault of the hospital staff than the operator. Why attack the operator? Sue the hospital staff for criminal negligence.

The operator's job is to get someone to take the patient to a hospital. It's extremely easy to understand why a 911 operator would not want to send out an ambulance to move the patient from one hospital to another; the 911 operator has to assume the hospital does their job, and moving patients between hospitals for the preference of the patient might be viewed by the operator (or the operator's boss) as misuse of resources (that's the hospital's job, not the emergency response team's).

Operators deal with a lot of panicked people and they have to assume that once someone gets to a hospital they are taken care of; once the operator gets someone to the hospital, their job is done.

I'd blame the hospital staff.

 

[hana]

It's been a bad couple of months here for the City of Angels:
1. May Day melee
2. Lost the bid for the US city for the Olympics to Chicago.
3. Paris Hilton jail drama.
4. Mayor announces separation and wife files for divorce.
5. Another mishandled patient at King Harbor Drew (whatever they call that institution)

 

[3nm]

History of substandard care?

ha! i guess you can say that!

i'm a bit too young to know all the details, but king/drew's the result of the LA riot and the fact that underprivileged minorities were not getting equal treatment in health care. in addition, drew university, which used to have king/drew as its teaching hospital, was established to train MDs to work in the area. and perhaps most importantly, majority of the people that work in the hospital are underrepresented minorities. we can certainly see why the community has a strong sense of ownership in king/drew.

At that point, you wondering if the community will simply continue to reapwhat they have sown....

agreed. imho, i think if the community wants to keep the hospital open, they need to demand accountability and the same standards that keep other hospitals open.

 

[3nm]

It is always comforting to know that the second largest city in America has inadequate hospitals, unable to care for a woman dying in their emergency room.

My college town of a population of 25,000 has a better hospital.

i agree with Dave00. just to give you a little perspective.

One huge problem with the article is that they considered the situation in a vacuum. Big difference between whether the woman came in while there were other traumas being seen, or if they weren't busy at all. There was a comment that someone was "just watching her", but you don't know if that was a nurse or a maintenance worker. Big part of emergency medicine is triaging, or deciding who needs to be seen most immediately. Someone can look not that serious on initial presentation, and then go down the tubes in a hurry. Also, in defense of the 911 operator, it would in most cases be extremely irresponsible to transport someone from one ER to another without them having been stabilized by the first ER. And this patient - with a perforated bowel - almost certainly would've died during transport to a different hospital.

i see your point. in any case, the way the incident is reported does not favor the hospital, or the triage nurse in particular. it shows that s/he did not use her/his best judgment, or the evaluation was done rather poorly. pain management plays a vital role in emergency medicine. a 40-something y/o who had severe pain complaints in the abdominal area and was vomiting "blood" (wish it was more specific) should not be taken lightly.

however, it's hard to say the woman would not have faced the same fate if she was in another hectic, over-crowded ER filled with blood-coated patients. but the fact that it happened at the already troubled "killer king," where medical personnels were previously reported to be indifferent, makes it easier to jump into our own conclusions.

fwiw, the autopsy report shows that the death was caused by megacolon, and methamphetamine use was a contributory factor.

 

[notjustjay]

I didn't try to read the whole autopsy report because of the poor quality scan/fax that made it difficult to read, but one of the first pages lists the number of visits this lady made to the hospital in the days before her death. I wonder if there was any "boy who cried wolf" element to the hospital staff, who had already seen her complain about pain, given her medications, and told her to leave, 5 or 6 times in the days before she finally died. They also all seemed to know she was heavy into drug use.

Not that I excuse that behaviour -- in my world as an engineer, if I try the same solution to a problem 5 or 6 times and the problem keeps coming back, my reaction would be to try a different solution.

 

[3nm]

I wonder if there was any "boy who cried wolf" element to the hospital staff, who had already seen her complain about pain, given her medications, and told her to leave, 5 or 6 times in the days before she finally died. They also all seemed to know she was heavy into drug use.

i'd not be surprise if the nurses thought that she was a "frequent flyer," and the woman would probably die in a silly way (i.e. OD) anyways even if she was saved. but when someone is writhing and vomiting blood, the triage nurse should really take the matter way more seriously. instead of getting a doctor to treat the woman, s/he decided to ask the police officers for "help" and led to the woman's arrest.

 

[eRondeau]

Give me a break!!! It is the job of a 911 Operator to assess the needs of the caller and send out a police car, a fire truck, or an ambulance. 911 operators are not hospital managers, doctors, triage nurses, lawyers, dogcatchers, or power line workers for that matter. In this case the victim was already right where they needed to be!!! If you're sick, you need to be in a hospital. The 911 calltaker assessed the situation correctly and acted appropriately; in this case, doing nothing was completely appropriate. It would not make any sense to send an ambulance to the waiting room of a hospital!!! The fault in this case lies with two people -- whoever was in charge of assessing the victim's medical condition at the hospital, and the victim's caretaker for not expressing their concerns clearly enough to the hospital staff. Abuse of the 911 system is a growing problem and as far as I'm concerned calling 911 to complain about hospital treatment is abuse.

 

[Mechcozmo]

I thought so too at one point, because it's taken as such a given, but I doubt you can provide any references to back it up. No offense to you, but most of those arguments are mainly for political rhetoric.

There are a number of malpractice lawyers who tell a patient "We'll sue. I won't charge you anything, but if we win, I get 50%" Often times, they use the 'fact' that the patient is still in pain... a day after surgery as justification for malpractice. Or the patient doesn't take their antibiotics, gets an infection, and then sues because of the complications that arise from the infection. John Kerry's running mate in 2004, Mr. Edwards, was a malpractice lawyer whose methods were later ruled to be inaccurate and not allowed in a courtroom. After he made millions. (Edwards just happens to be a great example of a man who wanted to reform health care but didn't know anything about it. I have nothing against Democrats, but I do believe Mr. Kerry needs better taste in Vice Presidents.)

By the way, I'm not promoting litigation for the sake of it. I just think a person who has been wronged should have the right to sue for damages that they deserve. Litigation is just a great scapegoat politically because there is no real entity. HMO's, large hospitals, and insurance companies, on the other hand contribute heavily to political campaigns-and IMO are the larger contributors to our healthcare problem. And there is also no incentive to provide healthcare for everyone. Why would anyone want to provide healthcare to the poor? It would be unprofitable.

Should the hospital be immune from suit? Maybe she could sue an employee of the hospital but a person making 30K-50K a year can hardly be able to satisfy what would most likely be damages that would surpass six figures. If the goal is to limit litigation against hospitals and doctors, this would be a most likely place to draw the line.

Actually, she can name any number of people. And then, if she wins, choose who pays. Even if the doctors listed in the suit only had 5% responsibility, they could end up paying 60% of the money. Or however much the defendant chooses It's California Law. Wonderfully fair.

Also, King/Drew has a reputation for murder. I read some articles that were scary, just downright scary, about the place. But anybody who wants to enact major changes (closure?) is accused of racism. Sadly, and ironically, it would be helping the various minorities of the area if the hospital were to close.

 

[itcheroni]

There are a number of malpractice lawyers who tell a patient "We'll sue. I won't charge you anything, but if we win, I get 50%" Often times, they use the 'fact' that the patient is still in pain... a day after surgery as justification for malpractice. Or the patient doesn't take their antibiotics, gets an infection, and then sues because of the complications that arise from the infection.

Actually, she can name any number of people. And then, if she wins, choose who pays. Even if the doctors listed in the suit only had 5% responsibility, they could end up paying 60% of the money. Or however much the defendant chooses It's California Law. Wonderfully fair.

A contingency fee is a normal part of the law in the U.S. It has its drawbacks but it does allow plaintiffs who normally would not have the opportunity to file a legitimate suit to do so. Or else only people with money could ever sue.

And your latter point is purely California's choice. And I'm not sure about other hospitals, but I believe Kaizer tried to implement a clause that limited their liability(no class actions, no punitive liability) and it was only found unconscionable on other grounds. So it is probably possible for hospitals to cover themselves.

 

[twistedlegato]

I plan on being a doctor when I get old enough.

I swear nothing as messed up as this will happen in my hands

 

[itcheroni]

Here is the lawsuit.

http://news.yahoo.com/s/ap/20071106/ap_on_re_us/troubled_hospital_lawsuit

 

[John Jacob]

Check out the world health care rankings. We're right in between Costa Rica and Slovenia. It's funny, I've lived in the first and last countries on the list.

http://www.photius.com/rankings/healthranks.html

[Off Topic]

Anybody else find it strange that Afghanistan (173 on the list) is ranked above South Africa (175), the country that pioneered the world's first heart transplant?

[/Off Topic]