Death after 2-hour ER wait ruled a HOMICIDE

[MountainLaurel]

A coroner's jury has declared the death of a heart attack victim who spent almost two hours in a hospital waiting room to be a homicide.

Beatrice Vance, 49, died of a heart attack, but the jury at a coroner's inquest ruled Thursday that her death also was "a result of gross deviations from the standard of care that a reasonable person would have exercised in this situation."

A spokeswoman for Vista Medical Center in Waukegan, where Vance died July 29, declined to comment on the ruling.

Vance had waited almost two hours for a doctor to see her after complaining of classic heart attack symptoms -- nausea, shortness of breath and chest pains, Deputy Coroner Robert Barrett testified.

http://www.cnn.com/2006/US/09/15/er.homicide.ap/index.html

:wow: :wow: :wow:

So, this is just a coroner's board ruling on the cause of death, but that's still pretty goddamn brave of them.

[Warpy]

1. Standard of care for those symptoms

is to rush the person into the ER immediately and get to work. Paperwork can wait.

There had to be a communications breakdown, a new clerk who didn't know his/her job, something.

Ms. Vance's relatives are going to get rich quick from this one.

[Skittles]

6. OR

the ER was terribly busy taking care of people who have no recourse but to use emergency care due to lack of insurance

[don954]

8. That doesnt matter, as soon as a cardiac event patient comes in

the staff all should be paged, called on the intercom, etc, they then drop what they are doing and go to the code-blue. I was in the hospital alot when i was a teen due to a tumor and experienced this several times, my doctor would be in the middle of checking me out and get a page, he would take off running like someone lit his but on fire... :)

[kestrel91316]

13. That's NO excuse. A few years I had to go to the ER for a

cardiac problem (irregular heartbeat with dizziness and shortness of breath) and as soon as I told the clerk what I was experiencing - even though I walked in, and looked fine - they RUSHED me right in to the back. They put me in front of everybody with their minor booboos and sniffles. For all they knew I was on the verge of heart stoppage, so they got serious. Fast.

I have learned my lesson about caffeine, BTW. I became hypersensitive to it, and have to be a GOOD GIRL from now on. Heart stays fine unless I overindulge in dark chocolate or tea.

[Warpy]

14. No, the standard of care is the same

If somebody presents with chest pain, they get taken in immediately, even if a non critical patient is transferred from a gurney in a cubicle to a chair in the hall to make room for him.

You can trust me on this one.

[SmokingJacket]

2. I wonder if she had insurance. nt

[MountainLaurel]

3. Or if she was a person of color

Both of which have been documented to affect the care you receive.

[Hell Hath No Fury]

10. The victim was a WOMAN...

that is enough! There have been studies that show women who present at emergency rooms with heart attack symptoms at are treated VERY differently than men! From the the seriousness that their sypmtoms are taken to the vigor of testing/treatment, woman do not have the same experience as men.

There was such a stir caused by the report that (I thought) there was a big move to get Drs. to look at women with heart attack symptoms (often times more subtle symptoms than men present with) more agressively.

[MountainLaurel]

12. Absolutely!

As an awareness issue, here are the signs of a heart attack for women:

What are the common symptoms of a heart attack?
The most common symptoms of a heart attack are:

Chest pain
Shortness of breath
Sweating
Pain in one or both arms

Chest pain is the most common symptom of a heart attack. Women often describe their chest pain as pressure, tightness, or an ache. But many women do not experience severe pain during a heart attack; for this reason, women should also take milder chest pain seriously. When chest pain occurs, it usually feels like discomfort in the center of the chest that lasts for more than a few minutes; this pain may come and go.

Many heart attack patients do not feel any chest pain. This is especially true for women. In the study of 515 women who suffered heart attacks, 43% did not experience any type of chest pain or pressure during their heart attack.1 About one third of the women in the study did feel chest pain, but most did not describe the sensation as “pain,” instead describing the feeling as “pressure,” “aching,” or “tightness.” Although you may not consider what you are feeling to be pain, chest sensations may indicate heart disease or a heart attack.

Shortness of breath may occur at the same time as the chest pain or it may occur before it. Shortness of breath has been found to be more common in women, whereas sweating is more common in men.

What are some "atypical" symptoms?
"Atypical" symptoms are symptoms other than the ones mentioned above; however, the term "atypical" is misleading because these symptoms are actually relatively common. “Atypical” symptoms include (but are not limited to):

Back, neck, or jaw pain
Nausea
Vomiting
Indigestion
Weakness
Fatigue
Dizziness
Lightheadedness

Women experience more "atypical" symptoms at the time of a heart attack than men. In one study, women were more than twice as likely as men to experience nausea, vomiting, or indigestion as heart attack symptoms.


What are pre-heart attack symptoms?
Pre-heart attack or prodromal symptoms are symptoms that occur before a heart attack, generally from about 4 to 6 months to 1 week before (though some people report these symptoms up to 2 years before their heart attack).

Common pre-heart attack symptoms include:

Unusual fatigue
Sleep disturbance
Shortness of breath
Chest pain
Indigestion
Anxiety
Pain in shoulder blade or upper back

Shortness of breath seems to be a particularly important symptom for men and women, though it is often not thought of as a serious medical concern. In a study of nearly 18,000 men and women (40% were women), those who experienced shortness of breath were 3 to 5 times more likely to die from heart disease than those who did not have this symptom. This symptom seemed to be a particularly good indicator of heart troubles for people who were not previously aware that they had heart disease.

http://www.hearthealthywomen.org/patients/treatment/signs__symptoms.html

[hyphenate]

4. Good

I remember when I had my first heart attack when I was 43, and the fuckers at the hospital didn't take me seriously, either. One told me to stop hyperventilating and that I was having a panic attack, and then on my second heart attack, an ER doctor gave me a prescription for Ativan (a tranq) and sent me home. I was going to sue, but the lawyer told me that since I was still alive, I didn't have much to sue for. Perhaps now this will change things.

[don954]

9. you had a suck ass lawyer

the mostly untreated heart attack most likely damaged your heart. You will now have less survivability on your next attack, i hope you are seeing a good cardiologist.

[hyphenate]

15. It was 7 years ago now

and yes, I now have an excellent cardiologist. But only since I moved back to Massachusetts. I got diddly out in L.A.

[AndyA]

5. What a sad story.

Care and compassion abound in today's America, don't they? And this after 6 years of Christian, conservative leadership. Seems to not be working so well.

Perhaps the superior values of the progressives can put America back on track.

I'm sure Mrs. Vance is in a better place now, but that's little solace for her family who no doubt suffered with her through the last agonizing hours of her life.

[insane_cratic_gal]

7. Could be some issue with Volume that night

I work in an ER.. I'm a paper pusher, but there are nights when people with more serious issues do have to wait and usually it's because the ER is jam packed, usually from cases that are not as serious.

But i've seen this happen before, and usually it's always because of volume.

Hospitals work on a cycle. So if there is a free room for a pt to be admitted to, great! Otherwise that pt will remain in the ER until (especially a fib pts) someone is discharged or moved to another floor that can occupy an er room for an entire night.

I won't even go into detail about the amount of minor issues that come in on any given night and suck up a room trying to avoid paying a Doctor Copay. Usually happens with state insurance, seems the majority of people on state insurance (welfare) tend to abuse the system badly! They use the ER as a form of health care vs paying the 20 bucks to see their regular physician. But we won't go their because it's an issue that drives me bonkers. Not all of them do it, I don't want to blanket anyone, but it seems when you do have an ER co Pay or if they did.. they might be less likely to come into the er for sniffles or a sliver.

[skyblue]

17. UNDERSTAFFED. I have a huge ER copay vs. regular physician copay, perhaps

there should be a higher copay then for ER than for visiting the Doctor.

And perhaps the hospitals should HIRE MORE PEOPLE INSTEAD OF BEING GREEDY. Or more people should sue the hospital and the staff for not delivering the prompt care that they need instead of allowing them to become more sick and even die on their watch.

[insane_cratic_gal]

18. to be fair it might of been lack of a room

not lack of ER staff.



Either way I'm sure there some form of neglect but it might not of been a lack of staff, sex, or income.


In the hospital ER I work at, we have 15 rooms, and 4 hall beds, I have seen it jam packed before were and it doesn't take much to fill those up. there are 3 nurses on each side (so 6 total) 2 doctors, 2 until secretaries and 2 phlebologist

I understand to patients it might seem like your being ignored, but if there are beds the most serious cases get shoved right to the back. If all the serious cases are already in the back and the er is unable to move those serious cases up to a floor because the hospital is at max capacity(I've seen people spend the entire night in an er room heart attack people waiting on a bed!

But pts also miss what is going on with in the back of the ER. The ER could of been on a condition code red, were you are at max amount and unable to take anymore ambulances, people can still stream through the door but
your just unable to accommodate the bodies coming in until a room frees up. Those people are also told this as they come in.

I guess what I am saying is it could of been a situational event, we really don't know the circumstances outside of the fact that someone passed while waiting for treatment. It's tragic but I'd hate to believe that anyone could neglect a patient or intentionally harm another being from apathy.

[Sgent]

20. Anything is possible

but the ER is in trouble unless they were already on divert, this person drove himself in, and he was triaged via whatever protocol was in place.

Although the above is possible, I somehow doubt it happened.

[benEzra]

22. For us, an ER visit costs hundreds, vs. a $20 copay for a doctor visit

but if the doctor's office closes at 5:00, and "Urgent Care" is only open until 6:00, where do you go when you have an urgent-care crisis at 6:15? To the ER...unless you can wait the 14 to 18 hours it'd take to get into a doctor's office.

One possible solution to this crisis (at least in part) would be to have 24-hour urgent care centers that can take care of non-life-threatening stuff that people would otherwise go to the ER for.

[Celebration]

11. that is something

Homicide means criminal charges, most likely. Second degree murder? Manslaughter? Criminally negligent homicide?

Whatever, we are talking about the possibility of someone doing serious time.

[Orrex]

16. A sad but amusing tale from 30+ years ago, when I was a toddler

My father spent a long afternoon chaperoning me as I jumped repeatedly into my aunt's pool. I was young enough to be wearing a life jacket (much like the ones that Quint offered to Brody and Hooper in Jaws), but my dad would catch me and pull me back to the surface quickly. This went on for hours.

That evening, my mom and aunt took him to the ER because he was having chest pains. Almost before he described his symptoms to the triage nurse, they had him on a gurney and hooked him up to a bank of monitors. He was amazed that they'd taken him back so quickly, and as it turned out he'd merely (well, not so merely--pretty seriously) strained his pectoral muscle while catching his robust young son a million times over the course of the afternoon. But he'd expected to wait several hours before getting checked out.

We later learned, however, that about an hour before my father showed up at the ER, another guy around his age came in with chest pains, and they'd given him a clipboard full of forms to fill out. The guy took a seat in the waiting room, put pen to paper, and keeled over dead.

Again, this was 30+ years ago, so I don't know what the standard of care was at the time...

[oscar111]

19. "you can go home now". Watch out for this manipulative phrase at ER

it is used to surprise patients who have never heard it before. Befuddled and weak, patients dont know how to react.

They want more treatment, but at times, are nudged out the door with this phrase.

[Warpy]

21. The guy who dropped dead filling out the forms

is one of many such cases that caused the drastic change in the standard of care.

Like I said, this lady's family is going to get rich quick. This is a definite case of negligent homicide.

[Celebration]

23. Yes and PERFECT example

Why punitive damages should not be eliminated. IMHO, the threat of punitive damages is the only thing that keeps things like this from becoming more commonplace. They are rarely applicable, but surely would be in this case.