Woman, writhing in pain on an ER floor, is ignored and dies

[zver81]

http://www.latimes.com/news/local/la...la-home-center

Interesting story. Scary though...

[GeneralVeers]

Originally Posted by zver81

http://www.latimes.com/news/local/la...la-home-center

Interesting story. Scary though...

It's also interesting that the hospital continues to be run by the same people who got it downsized in the first place. Epps was reinstated as CEO, and Roger Peeks is still the medical director.

They blamed Drew, they blamed the residencies, yet the place is still failing.

[ERMudPhud]

It is really an indictment of the overwhelmed collapsing health care system particularly in our inner cities. Do you really think those doctors and nurses went in to the field so that they could ignore dying patients who were writhing in pain? Of course not. When everyday you are confronted with an unending stream of patients, some of whom are truly sick and dying and many who aren’t but think they are dying, it is hard not to become cold as you become overwhelmed. Everybody else looks at the video and sees a dying woman on the floor. The triage nurse probably saw someone who had already been through the ER many times and was probably just looking for attention. I’ve actually watched patients walk across the parking lot completely normally, only to collapse in pain at the triage desk. The resulting callousness isn’t right but it is nearly inevitable.

The really sad part comes from reading between the lines. It sounds like she had many visits to the ER with known biliary colic and was always discharged back out with narcotics. In the end she died of a perforated colon. My guess is it was a combination of caregivers assuming she was yet again presenting with biliary colic and her colon popping from narcotic induced obstipation, secondary to the narcs for her biliary colic. In the private world or even a less overwhelmed public system she would have had her bag full of stones out within days to weeks of diagnosis.

[trkd]

"the preliminary investigation suggests that the fault primarily rests with the nurse who resigned. "I think it's a tragic, tragic incident, but it's not a systemic one." "

Classic! Blame it on one person and the rest are not to blame. I love the scapegoat!

[DogFaceMedic]

Socialized medicine -- no accountability and managed by politicians.

I saw similar problems in Canada where politicians put money into clinics in their districts and cut clinics in districts that voted for the other party. This is a serious problem in rural districts where it was 1-2 hr drive to the nearest clinics.

[EC3]

Seems like someone didn't grasp the life lesson entailed within 'The boy who cried wolf.'

Very tragic, but I would guess that a history of histrionics played a very large part in this. If the ER had to be extra cautious with every histrionic patient, could you image the CF that would ensue?

[EC3]

This is also a distusting piece of yellow journalism.

"It's an indictment of everybody," he said. "If this woman was in pain, which she appears to be, if she was writhing in pain, which she appears to be, why did nobody bother … to take the most minimal interest in her, in her welfare? It's just shocking. It really is."

"Where was their heart? Where was their humanity? … When Jose came in, everybody was just sitting, looking. Where were they?"

Maybe the fact that she was previously seen and discharged only hours before, coupled with a history of repeat visits and what sounds like excessive histrionics, played a part in nobody "bothering" to take "the most minimal interest in her."

This would be no different than if someone continually called in false police reports; except ER docs don't have the option of placing folks in jail for unsubstantiated claims.

And the article does a good job of portraying the hospital workers and cold and indifferent. I've never been to King but county hospital workers usually do the type of work they do because they have a strong interest in helping the underserved. But this doesn't make as good of a news story.

[DeLaughterDO]

Originally Posted by EC3

ER docs don't have the option of placing folks in jail for unsubstantiated claims.

Although I think it would be much more interesting (and fun) if we did

[GeneralVeers]

The employees at King aren't "cold and indifferent", but rather they were forced to be jaded. The triage at King is a chaotic no-man's land with homeless people, gang members, and psych patients. 2 inches of bulletproof glass separates the patients from the triage desk. It's not uncommon to have several patients screaming, while another one bangs on the window demanding immediate service. The situation is almost impossible to deal with. I never ventured into that waiting room when I was there. It was quite frightening.

The lady described in that article is just like fifteen other IVDA patients I knew there. They would smoke crack, or shoot up, then run out of money and come to the ED. They would go into fits of histrionics for chest pain, abdominal pain, or for any other complaint. The problem was, that a small percentage of the time these people were actually sick, but you couldn't tell the difference between when they were sick, and when they were trying to abuse the system. Every time any of these people were discharged it was like a roll of the dice. Apparently the physician who last discharged this lady lost that dice roll.

[beyond all hope]

King's waiting room was a zoo.

Saw lots of drama in an attempt to get in. My favorite was the guy who looked meaningfully at me, walked up to the window, put his hand to his forehead and slumped backwards to the ground in a faint.

I clapped. Wonderful drama. Waited patiently for him to get up and get back to his seat.

Sadly, many of these patients are truly ill, and it's tough to tell which ones because of the histrionics.

[Ceez]

Originally Posted by EC3

This is also a distusting piece of yellow journalism.





Maybe the fact that she was previously seen and discharged only hours before, coupled with a history of repeat visits and what sounds like excessive histrionics, played a part in nobody "bothering" to take "the most minimal interest in her."

This would be no different than if someone continually called in false police reports; except ER docs don't have the option of placing folks in jail for unsubstantiated claims.

And the article does a good job of portraying the hospital workers and cold and indifferent. I've never been to King but county hospital workers usually do the type of work they do because they have a strong interest in helping the underserved. But this doesn't make as good of a news story.

That's the LA Times for you. I take everything that I read from them about King-Drew with a grain of salt.

[Jejton]

Originally Posted by DogFaceMedic

Socialized medicine -- no accountability and managed by politicians.

I saw similar problems in Canada where politicians put money into clinics in their districts and cut clinics in districts that voted for the other party. This is a serious problem in rural districts where it was 1-2 hr drive to the nearest clinics.

Except this article is not about socialized medicine. Remember LA is part of the US ( for now anyways.).

[Jejton]

Originally Posted by GeneralVeers

The lady described in that article is just like fifteen other IVDA patients I knew there. They would smoke crack, or shoot up, then run out of money and come to the ED. They would go into fits of histrionics for chest pain, abdominal pain, or for any other complaint. The problem was, that a small percentage of the time these people were actually sick, but you couldn't tell the difference between when they were sick, and when they were trying to abuse the system. Every time any of these people were discharged it was like a roll of the dice. Apparently the physician who last discharged this lady lost that dice roll.

Where does it say she had a history of IVDA ?

[EctopicFetus]

Originally Posted by Jejton

Except this article is not about socialized medicine. Remember LA is part of the US ( for now anyways.).

Put dont be fooled poor inner city hospitals are basically socialized medicine.

[Jeff698]

Originally Posted by EctopicFetus

Put dont be fooled poor inner city hospitals are basically socialized medicine.

Don't be fooled, American medicine has nothing to do with the free market. Any resemblance to that went away with WWII, health insurance and Medicare.

The lable socialized medicine was started by the AMA in their opposition to Medicare. They picked that term because it linked their cause (opposition to Medicare) to the most prominent national cause of the time (the cold war).


Take care,
Jeff

[GeneralVeers]

Originally Posted by Jeff698

Don't be fooled, American medicine has nothing to do with the free market. Any resemblance to that went away with WWII, health insurance and Medicare.

The lable socialized medicine was started by the AMA in their opposition to Medicare. They picked that term because it linked their cause (opposition to Medicare) to the most prominent national cause of the time (the cold war).


Take care,
Jeff

However you label it, socialized medicine, medicare, universal coverage, it's bad for doctors. The reimbursement rates for our counterparts practicing in "socialized" countries is 1/2 to 1/3 for many specialties. Canada and Britain are two excellent examples. You can also add in their lack of physician autonomy (you can't order a CT scan when you want, or the drugs a patient needs).

[EM2BE]

and a doctor's appointment

I found this part interesting. If she was scheduled a dr's app (which is what I have seen in the one ED I have been in), I am assuming it was within those few days (what they did at said hospital). And if so, she probably didn't go.

Also if they were trying to make her sound good, this phrase is really ironic:

performed odd jobs and lived alternately with different relatives

hmm...what does that mean exactly?

[DropkickMurphy]

hmm...what does that mean exactly?

I took it to mean she did "piece work" if you follow my drift.......

Where does it say she had a history of IVDA ?

I'd say it was an educated guess.....oh well......

[EctopicFetus]

Originally Posted by Jeff698

Don't be fooled, American medicine has nothing to do with the free market. Any resemblance to that went away with WWII, health insurance and Medicare.

The lable socialized medicine was started by the AMA in their opposition to Medicare. They picked that term because it linked their cause (opposition to Medicare) to the most prominent national cause of the time (the cold war).


Take care,
Jeff

Believe me I know. I will be the first to tell you that a true free market can NOT exist in medicine because it can NEVER fill the criteria required for a true free market. That being said I am 100% against any "socialization" of medicine.

For all the far left hippies, keep in mind there are 3 necessities they are food clothing and shelter. Once we get those solved we can start worrying about throwing away more money on healthcare.

[Jeff698]

Originally Posted by EctopicFetus

For all the far left hippies, keep in mind there are 3 necessities they are food clothing and shelter. Once we get those solved we can start worrying about throwing away more money on healthcare.

How interesting. Because I think it is in our nation's best interest to find a way for our citizens to be able to afford health care, I'm a 'far left hippie'? Hmmm. If that's the definition then I guess there are worse things to be called.

Take care,
Jeff

[Miami_med]

I say this as probably one of the biggest contributors to threads related to socialized medicine on this forum:

Do we really want to make this thread about socialized medicine too? I've got about 5 in topics in healthcare on this subject on the front page.

[Quimby2]

For "The Kingdom" (King/harbor), I think this is going to be the last straw. The CMS extension on the funding ends in another month or so, and it's not going help with their appeal.

I don't really think LA County has any business running a hospital. If you the tax payers of LA want to pay for uninsured patients, so be it. But it makes the most sense to just contract the services out to the private sector.

(in essence this had already began at King/Harbor with CEP running the ED and having outside management companies)

[Wackie]

"We deserve everything, we're entitled to nothing" is kind of my family's motto.

I drive a 20 y/o truck. I have a house but wish it were bigger. I mostly pay for school. I do take out small loans to cover the rest.
I can get to the doctor when I need to. I can't go to the one that offers a complimentary massage and facial, but they will cure my sore throat.

I know people who drive big new SUV's, own huge houses, go out socializing three + nights a week that complain about how they can't afford health care and the government should provide.

I don't think we're entitled to anything money can buy. Personally I don't want the government running my health care. It'd be nice if we can elect to pay taxes towards it when government starts health care. I know that, most likely, I'll pay taxes towards it whether I want to use it or not. Freedom only after the government takes its slice. Hrmph.

[Shalom77]

Originally Posted by EC3

This is also a distusting piece of yellow journalism.





Maybe the fact that she was previously seen and discharged only hours before, coupled with a history of repeat visits and what sounds like excessive histrionics, played a part in nobody "bothering" to take "the most minimal interest in her."

This would be no different than if someone continually called in false police reports; except ER docs don't have the option of placing folks in jail for unsubstantiated claims.

She did not repeatedly call in with "false" reports.
Her repeated visits were in the three days before her death. What else was she supposed to do but go back if she didn't get adequately treated the first time (actually the first three times)? Obviously someone missed the boat not just the last time but in her three prior visits. In addition, "histrionics" is in the eye of the beholder and is also culturally determined; it's certainly not acceptable not to provide any care at all on that basis. She died of a colon perforation. Peritonitis is painful. Abdominal pain in the morbidly obese is treacherous and admittedly can be a difficult diagnosis particularly since she had the gallstone history which likely also mislead her doctors; thus missing the diagnosis is understandable. Not attending to her once she came back to the ER is not. The problem is that once you get written off as a patient it is really really difficult to get good care. Persistance in trying to get care just gets you labeled even worse.

It's easy to blame the patient - but she died because of the medical system (and no doubt because she was indigent.) There should be a thorough examination on how to prevent cases like this in the future. Obviously the hospital is unaccredited for a reason - other hospitals treat similarly challenging patient populations and don't have such gross deficiencies in care.

[EC3]

Originally Posted by Shalom77

She did not repeatedly call in with "false" reports.
Her repeated visits were in the three days before her death. What else was she supposed to do but go back if she didn't get adequately treated the first time (actually the first three times)? Obviously someone missed the boat not just the last time but in her three prior visits. In addition, "histrionics" is in the eye of the beholder and is also culturally determined; it's certainly not acceptable not to provide any care at all on that basis. She died of a colon perforation. Peritonitis is painful. Abdominal pain in the morbidly obese is treacherous and admittedly can be a difficult diagnosis particularly since she had the gallstone history which likely also mislead her doctors; thus missing the diagnosis is understandable. Not attending to her once she came back to the ER is not. The problem is that once you get written off as a patient it is really really difficult to get good care. Persistance in trying to get care just gets you labeled even worse.

It's easy to blame the patient - but she died because of the medical system (and no doubt because she was indigent.) There should be a thorough examination on how to prevent cases like this in the future. Obviously the hospital is unaccredited for a reason - other hospitals treat similarly challenging patient populations and don't have such gross deficiencies in care.

troll attempt denied. Anyone who's worked in the ER, especially some of the more "hardcore" county hospitals, knows that there is excessive drama and if doctors treated every repeat case of dramatics, nothing would actually get done; in fact, it could be very easily argued that to do so would endanger other patients.

[a_ditchdoc]

Actually, I think it is a fair piece of journalism. The simple fact is, as much as some of you would like to indict the patient, someone dropped the ball. The patient returned repeatedly for care and someone apparently rested their care on the previous diagnosis given without questioning why she was here "again". Sometimes, there is a real reason. I have seen multiple missed diagnoses before, and I am sure I will be responsible for my fair share in the whole scheme of things, but to miss one three times seems rather inexcusable.

I am not sure what the patient was like, perhaps she was whiny, needy, arrogant, bitchy, and did not bathe as regularly as she should have. Regardless, she died bacause someone dropped the ball. To insinuate that she was a prostitute, using IV drugs, and crying wolf, as a way to shift blame, is shameful.

[GeneralVeers]

Originally Posted by EC3

troll attempt denied. Anyone who's worked in the ER, especially some of the more "hardcore" county hospitals, knows that there is excessive drama and if doctors treated every repeat case of dramatics, nothing would actually get done; in fact, it could be very easily argued that to do so would endanger other patients.

Thank you for pointing this out. As someone who actually worked in that ER for 18 months, I can tell you that drama is the norm. Most of the patients have some sort of drama, because their goal is admission, free food, and narcotics. Separating out the sick from the not sick is truly challenging. This woman had a history of gallstones, and repeated visits. I really can't fault the ED physician for discharging her, as I didn't see or examine the patient. I can fault the triage staff for not responding appropriately.

[SupernovaNights]

Originally Posted by EC3

troll attempt denied. Anyone who's worked in the ER, especially some of the more "hardcore" county hospitals, knows that there is excessive drama and if doctors treated every repeat case of dramatics, nothing would actually get done; in fact, it could be very easily argued that to do so would endanger other patients.

Even if you cant fault the doctors, you CANT fault her. If you were in her position, you would have done the same damn thing and you know it. She was suffering from perforated colon, and it was missed 3 times... like it or not, no matter how busy the ER is, you're not supposed to miss something like that 3 times in a row.

Anyways, I'd imagine someone's going to be getting a fat lawsuit over this. Makes me wonder why I choose medicine over law.

[WilcoWorld]

My first thought upon reading the article was a sympathetic one.

Sympathy towards the staff who discharged that patient. I have seen the type many times before. When the man in general care who has been demanding to be seen immediatly every five minutes walks into the hallway & throws himself to the ground I think, "Well he's obviously well enough to mentate, ambulate, and act - so he can wait until after I see the woman with SOB & a heart rate in the 160's". When the woman with a CC of syncope cries "I'm going to faint!" & then looks around for a soft place to land before setting herself down I decide that I don't need the San Francisco Syncope rules to discharge this one.

HOWEVER, abdominal pain needs to be treated somewhat differently. With this black box of badness certain fatal diagnoses only present themselves by being unremittant. Sure she had a history of gallstones & an appendectomy, but that doesn't rule out a perforated viscous, aortic dissection, ascending cholangitis... As one of my attendings would say, "She failed her dischrge test."

When someone comes in with multiple vistis for the same complaint & always gets discharged it is extremely hard to stay vigilant. I know. But we must. Alcoholics and drug seekers get seriously ill too. It IS their fualt that they become the boy who cried wolf & that we are thus more prone to miss important diagnoses in them as a result. But that aint gonna hold up in court when their high school prom photo is displayed & everybody testifies about what a wonderful person he was.

I was frightened by the article because I could see myself making a similar mistake. But failing to identify where the mistakes were made by the ED in this case may doom you to repeat them.

[MatNeo]

It is a horrible situation...I highly doubt she was the only one "writhing in pain" on the floor that day, probably one of far too many that week...but she was the only one to die (otherwise there would be more news stories), so perhaps the greater problems comes from those acting in pain for attention or drugs or shelter, they made it difficult for anyone to discern between real and fake...

Obviously, something different should have been done, probably well before she was dying on the floor...but it is hard to tell if there is something that could have been done in practice that wouldn't have admitted far too many actors, thus preventing aid to those actually in distress.

Perhaps the answer is to get (force) therapy for those who "cry wolf" at the ER, because they have a mental condition that can easily harm others (although indirectly)...100% not possible to do...

[GeneralVeers]

So much for the argument of whether she was IVDA or not:


Woman at King-Harbor died of perforated bowel
By Charles Ornstein, Times Staff Writer
June 2, 2007

A 43-year-old woman who writhed in pain for 45 minutes on the emergency room lobby floor of Martin Luther King Jr.-Harbor Hospital died of a perforated bowel, the Los Angeles County coroner's office said late Friday.

Neither hospital staff nor other patients attempted to assist her as she lay dying.

The coroner's office labeled the death of Edith Isabel Rodriguez on May 9 as an accident and said it had turned over its findings to the district attorney, the Sheriff's Department and the county Department of Health Services, which are investigating the death.

Other factors contributing to Rodriguez's death were a bowel obstruction and the effects of prescription drugs and methamphetamine use.

Her bowel broke open less than 24 hours before her death, and experts have said she could have been treated if it had been caught early enough.

The coroner's office said its complete autopsy report would not be released until Monday. A news release announcing the findings was distributed after 6 p.m. Friday.

Rodriguez's death, which has prompted federal and state probes, triggered immediate outrage after it was reported in The Times last month.

A videotape of the events shows the indifference of other patients and hospital staff, according to several people who saw it. At one point, a janitor cleaned around Rodriguez as she lay on the floor.

King-Harbor, formerly King/Drew, has been trying to rebound from a string of egregious incidents that have contributed to patient deaths beginning more than 3 1/2 years ago.

The county has slashed services, spent millions of dollars on consultants and disciplined hundreds of staffers.

Even so, the hospital's future is not assured. King-Harbor is preparing for a crucial inspection next month that will determine whether it receives federal funding. If it fails, the hospital could close.

Dr. Bruce Chernof, director of the county Department of Health Services, said in a written statement that Rodriguez was not provided with compassionate service and that her death was "inexcusable."

"It is important to understand that this was fundamentally a failure of caring," he said.

A triage nurse in the emergency room, who turned away pleas from county police and Rodriguez's boyfriend to help her, has resigned.

The emergency room supervisor was reassigned and other unspecified personnel actions have been taken, Chernof said.

[GreenShirt]

Originally Posted by WilcoWorld

I was frightened by the article because I could see myself making a similar mistake. But failing to identify where the mistakes were made by the ED in this case may doom you to repeat them.

Yeah, that's the same thing I was thinking. I'm sure with lots of experience you get good at differentiating between the Oscar-worthy performances and the real-deals, but there's always a chance you'll be wrong. What do you do as an ER doc? The most humane thing would be assume the worst in each case and treat it seriously, but I'm sure if you took that approach you'd make a lot of people unhappy.

[GeneralVeers]

Originally Posted by GreenShirt

Yeah, that's the same thing I was thinking. I'm sure with lots of experience you get good at differentiating between the Oscar-worthy performances and the real-deals, but there's always a chance you'll be wrong. What do you do as an ER doc? The most humane thing would be assume the worst in each case and treat it seriously, but I'm sure if you took that approach you'd make a lot of people unhappy.

You are correct. This is the approach all of us should take. We should always assume every patient is sick, even if we know they are histrionic malingerers. In a place like King, the ER quickly grinds to a halt when abdominal CTs are ordered on all of the histrionic patients as well as the sick ones. The problem I found there was that the CT would be so backed up doing BS scans on people, that when we needed it for acute appy, bowel obstruction, or some other serious diagnosis, it would take a long time.

[knowwareman]

another "lay man's" web community's reaction to the same article:
http://www.metafilter.com/61741/Tale...of-womans-life

it's interesting to see the differences here.e

[GeneralVeers]

Originally Posted by knowwareman

another "lay man's" web community's reaction to the same article:
http://www.metafilter.com/61741/Tale...of-womans-life

it's interesting to see the differences here.e

It's interesting how people expect the system to work for them in every circumstance at their convenience. On one hand they want to be rushed back and treated when they have an actual emergency, but they also want the right to show up and be given VIP treatment when they have a cold, flu, or something else that could be handled by their primary doctor.

[EC3]

Originally Posted by GeneralVeers

It's interesting how people expect the system to work for them in every circumstance at their convenience. On one hand they want to be rushed back and treated when they have an actual emergency, but they also want the right to show up and be given VIP treatment when they have a cold, flu, or something else that could be handled by their primary doctor.

and more importantly, they don't want to pay anything for it.

[Faze2]

Originally Posted by GeneralVeers

It's interesting how people expect the system to work for them in every circumstance at their convenience. On one hand they want to be rushed back and treated when they have an actual emergency, but they also want the right to show up and be given VIP treatment when they have a cold, flu, or something else that could be handled by their primary doctor.

You couldn't have hit it more on the head. I think the number one thing I notice in the ER and what pisses me off the most is when people come in, for anything and everything, they expect everyone from the doctors to the janitors to drop whatever they are doing that second and do nothing but pay attention to them and give them whatever they want, whenever they want it. Problem is, that just can't happen. You are not the only person in this ER that is sick or in pain (if you actually are either of the two, which 9 times out of 10 you are not, that is why we don't believe you now) and you are not the center of the universe just because you have a tummy ache and think you need EMERGENCY MEDICAL TREATMENT (pretend there' s an echo).

[8744]

Originally Posted by Faze2

You couldn't have hit it more on the head. I think the number one thing I notice in the ER and what pisses me off the most is when people come in, for anything and everything, they expect everyone from the doctors to the janitors to drop whatever they are doing that second and do nothing but pay attention to them and give them whatever they want, whenever they want it. Problem is, that just can't happen. You are not the only person in this ER that is sick or in pain (if you actually are either of the two, which 9 times out of 10 you are not, that is why we don't believe you now) and you are not the center of the universe just because you have a tummy ache and think you need EMERGENCY MEDICAL TREATMENT (pretend there' s an echo).

The other interesting thing is that even if they come in for excruciating abdominal pain or a possible MI, many patients expect a resolution to their problem in thirty minutes or less. No sooner is thier pain controlled then they start to become somewhat demanding.

[GeneralVeers]

Originally Posted by Panda Bear

The other interesting thing is that even if they come in for excruciating abdominal pain or a possible MI, many patients expect a resolution to their problem in thirty minutes or less. No sooner is thier pain controlled then they start to become somewhat demanding.

I believe they call that the "29 minute guarantee" in Michigan.

[Brigade4Radiant]

Originally Posted by EC3

Seems like someone didn't grasp the life lesson entailed within 'The boy who cried wolf.'

Very tragic, but I would guess that a history of histrionics played a very large part in this. If the ER had to be extra cautious with every histrionic patient, could you image the CF that would ensue?

Read the articles please. She was in there multiple times as they gave her "treatment" and then gave her a leaflet that told her to come back if symptoms persisted.

Symptoms persisted, she came back, they didn't give a ****. But then, new symptoms such as throwing up blood and screaming on the floor in the fetal position showed up. Still nothing is given. Now the latter symptom could've been the Oscar winning performance of a crazy druggy wanting attention, but I don't think even Robert ****in' De Niro can cough up blood on demand. No one helped her for 45 minutes while she was on the floor writhering in pain and puking blood.

Yes stuff like this does happen but stop making excuses for the medical staff.

Are you saying their hands are completely clean of this?

[DropkickMurphy]

Even if you cant fault the doctors, you CANT fault her.

Wanna bet?

[budhak0n]

Originally Posted by WilcoWorld

Alcoholics and drug seekers get seriously ill too. It IS their fualt that they become the boy who cried wolf & that we are thus more prone to miss important diagnoses in them as a result. But that aint gonna hold up in court when their high school prom photo is displayed & everybody testifies about what a wonderful person he was.

I was frightened by the article because I could see myself making a similar mistake. But failing to identify where the mistakes were made by the ED in this case may doom you to repeat them.

Well if you don't think the fact that she was under the influence of and misusing both Amphetamines and Prescription Drugs during the trial, and if you don't think that these facts won't in some way affect the outcome of any such claim...

THen I think maybe just maybe you think the legal system has gone completely soft.... If the reason for her perforated bowel was an obstruction which her addictive behavior precipitated and she exacerbated this condition by injecting or snorting methamphetamines you can sure as hell count on this information being disseminated to the Jury <g>.

[budhak0n]

Originally Posted by Brigade4Radiant

Read the articles please. She was in there multiple times as they gave her "treatment" and then gave her a leaflet that told her to come back if symptoms persisted.

Symptoms persisted, she came back, they didn't give a ****. But then, new symptoms such as throwing up blood and screaming on the floor in the fetal position showed up. Still nothing is given. Now the latter symptom could've been the Oscar winning performance of a crazy druggy wanting attention, but I don't think even Robert ****in' De Niro can cough up blood on demand. No one helped her for 45 minutes while she was on the floor writhering in pain and puking blood.

Yes stuff like this does happen but stop making excuses for the medical staff.

Are you saying their hands are completely clean of this?

Haven't seen the tape.. where was she? Triage? Was she outside the ER? Was she in the ER? She was lying on the "FLOOR" ? where in the waiting room?

[budhak0n]

Oh and let's not let out the little tidbit I saw about her being a Parole Violator who was being rearrested for parole violations.

I'd just slow down a bit with all the slam dunk wrongful death claims <g>..

You can't exactly say for sure what was going on there.. but the fact that she was on the floor AND they called another facility to take her elsewhere does not bode well at all for the hospital....

[Leeny]

Did anyone read the LA Times Pulitzer Prize winning series of 5 articles on this hospital? It sounds pretty appalling.

http://www.latimes.com/news/nationwo...home-headlines

[bartleby]

This thread has been going on for a couple of months, and I've held my tongue, but the last few posts are forcing me to weigh in...

Some day when you are done with residency, you are going to work in a place that has its own star frequent flyer... This person will constantly cry wolf, coming in so often and refusing followup and so forth that it will make you want to scream.

Those who preach and moralize, thinking "there's nothing wrong with this guy" and due to their frequent presentations, "there can NEVER" be anything wrong with this guy" do so at their own peril, because like in your favorite game of hot potato from nursery school, somebody, sometime, will get caught holding the bag with this patient. Maybe not next week, or next month, but at some point, there will be something wrong with that person, and if you are the one who says, "Oh, it's just Mary complaining of her usual 'abdominal migrane' Acute dilaudid deficiency again....heheheheh" while her colon perfs (or worse), you are going to be the one in the extraordinarily UNFUNNY position of sitting in front of a bunch of humorless people at your state's physician disciplinary board who've never worked in an ER trying to make the case about why they shouldn't put your license through the paper shredder. Think medical school was fun? How about trying to pay your $250k in student loans off as a short order cook in a REAL In N Out Burger joint? That, in my book, is the very definition of uncool. I don't think we have to ask my wife what she thinks about that scenario...

The bottom line is that abuse of the system/your trust/time/energy, laziness and general stupidity on the part of the patient does not get you off the hook from doing your job. You are not the judge and jury of moral rightness or appropriate ED use. You are a doctor in an ER, and your job is to make sure that there is no life-threatening illness present and to come up with a reasonable plan for treatment and referral. If you don't think you can stomach that on somebody's 36th ER visit in 24 months, you'd better find another line of work.

[Leeny]

Well said, bartleby.

[ActiveDutyMD]

Originally Posted by Adhered

Hello to all,This is my first post. I am no longer a practicing nurse, thus I am not a medical proffesional such as those of you who post in here might be, however, this thread, and the posts in it, have moved me to want to share my thoughts and opinion of this case with you. I am hoping that would that be acceptable. If not, I shall not post again and ask that my post be removed promptly out of respect for this forum.I do currently work as an " International Patient Advocate" for person afflicted with "Adhesion Related Disorer (ARD)"and though this disorder has not been confirmed as a condition that Edith Isabel Rodriguez had, in my opinion it very well could be.It is my intentions to secure Mrs. Rodriguez's autopsy report which will offer to me a more comprehensive look into her prior medical/surgical history, which, if there is anything of a surgical nature existing in that history, will give credence to the probability that "post surgical peritoneal adhesions" were in fact a cause of her pain and multiple ER visits for pain.I can say with certanty that being on analgesics it is no wonder Edith had a bowel obstruction from constipation, which is a side affect of such a medication, and for a person who has a bowel comprimised from adhesions, obstruction is a medical emergency which can trigger the results typical of what Edith Isabel Rodriguez experienced -death surrounded by ignorance and hostility within the medical arena.Tammy Wynette died under similar curcumstances, and her death was directly related to ARD. Others have as well, unfortunately.I invite, and encourage you to please vist my web site at: http://www.adhesionrelateddisorder.com for more information on ARD.I am hoping that as medical proffesionals you will not mind taking this unfortunate situation and loss of a young mother a step further by acclimating yourselves to a most hiddious medical condition that rivals appendectomies, heart bypass surgery and hip replacements in our country, and throughout the world!Thank-you for your time and forum.

Interesting.

[IntheDraft6]

I think a part of the story that is missing is the workup that had been done on the previous visits. Did she already have 3 CTs that showed no pathology in the past week? Would any of us had gotten another CT (assuming she had already had them)? I cannot condone leaving her on the floor screaming, but as far as her medical workup goes, it is hard to judge. We all have our frequent fliers that make us cringe just at the mention of their name and they are the most dangerous patients. Every pt is a landmine just waiting to be stepped on. 36 visits in 24 months does not make a frequent flier. We have pt who visit the ER 2-3 times per day, everyday so they make 36 visits in less than a month. Of course they complain of migraines, chronic abd pain, chronic back which is worse (12 out of 10) than it ever has been or they are suffering from end stage fibromyalgia. Sometimes you just want to scream.

[Apollyon]

Originally Posted by IntheDraft6

36 visits in 24 months does not make a frequent flier.

Respectfully, I disagree heartily with this opinion. That's a visit to the ED every 20 days. Many people might define such a patient as a frequent flyer by the number of visits alone, and moreso if multiple efforts had been made to arrange follow up with primary care, for the patient to blow off every single one. I think that you will find few others to agree with you that this is NOT a "frequent flyer".