Man Dies Outside ER after hospital tells police to call 911

[Morzh]

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Man Dies Outside ER after hospital tells police to call 911

This article is just sad for so many reasons. I think it represents the dangers of what can happen when common sense is crippled by the atmosphere of uber-regulations and protocols that is so prevalent in our healthcare system.

Granted, the poor man was unresponsive for some 20+ minutes by the time he was even found, so getting him inside immediately might not have made any difference, but thats beside the point.

What does EMTALA actually dictate in a situation like this? I've worked as ancillary staff (HUC) in a regional trauma center for about 2 years now and while I've never heard of someone actually dying because of it, this isn't the first time I've heard of this type of incident happening. In fact I specifically remember one time a nurse commenting on how several years ago there was a bad accident right off of the hospital's property and even though everybody knew about it they wouldn't allow anybody to go to the scene - they just had to wait until EMS transported them.

Anyone with actual experience with EMTALA care to offer their opinions or enlighten my understanding of the subject?

 

[gettheleadout]

Something's definitely not right, either the officers or the hospital staff is lying and I bet it's not the former.

The title of the article just suggests so many problems with our healthcare regulations. Did no one think maybe taking immediate action was better than following protocol when the patient is essentially at the hospital already?

Judy Leach, a hospital spokeswoman, said emergency room staff was told it was a car crash and they were following the proper protocol by instructing police to summon an ambulance crew.
"With an automobile accident you don't know if the patient needs to be extricated or transported," Leach said Friday. "There are protocols in place to ensure the right thing is done for the right patient at the right time."

👎

 

[apumic]

This bizarre to say the least. At the trauma center where I work, we extricate pts from cars in our parking lot somewhat regularly (probably at least a couple of times/wk across all shifts). I've had to do extrications of spinal-injured pts who are sitting in their car after several-hundred-mile drives to get to our trauma center (yes, I've had pts drive with a spinal injury as much as an entire state's length to get to our hospital for treatment...why they didn't stop at one of the hospitals closer to their origin or call 911 for an ambulance is beyond me). Yes, technically EMS has more experience doing these sort of extrications, but we all have the training and background to know what to do and it saves time. It seems very odd to me that they didn't simple send a couple of techs (or even a MERIT team) out to check on the situation.

 

[dbeast]

Maybe I'm being a little too optimistic, but it sounds like somebody saw the car crash with an unconscious guy inside, reported it as a car crash, and then they wanted to wait for EMS to arrive who are more experienced at extractions... Sounds like nobody even knew he was having an arrest and assumed he was knocked unconscious by the crash?

Either way, negligence or misunderstanding, it's really really sad.

 

[Morzh]

This bizarre to say the least. At the trauma center where I work, we extricate pts from cars in our parking lot somewhat regularly (probably at least a couple of times/wk across all shifts). I've had to do extrications of spinal-injured pts who are sitting in their car after several-hundred-mile drives to get to our trauma center (yes, I've had pts drive with a spinal injury as much as an entire state's length to get to our hospital for treatment...why they didn't stop at one of the hospitals closer to their origin or call 911 for an ambulance is beyond me). Yes, technically EMS has more experience doing these sort of extrications, but we all have the training and background to know what to do and it saves time. It seems very odd to me that they didn't simple send a couple of techs (or even a MERIT team) out to check on the situation.

Ah yes I think I missed the part where he was already on hospital property the first time I read through it. I thought he crashed on a public road leading towards the ER. Either way.. its really odd if, in a situation where time is of the essence, protocols still kept the nearest trained health professionals from responding.

 

[apumic]

Ah yes I think I missed the part where he was already on hospital property the first time I read through it. I thought he crashed on a public road leading towards the ER. Either way.. its really odd if, in a situation where time is of the essence, protocols still kept the nearest trained health professionals from responding.

I suppose unless there was some fear of an explosion or some other potential hazard (which seems highly unlikely and, honestly, EMTs are no more trained to deal with that kind of stuff than most seasoned CENs; even if they were, most EDs require their ED Techs to be at least EMT-B if not higher in training). It sounds to me like some major mistakes were made....

 

[45408]

Maybe the ER staff were all sitting around eating donuts and drinking coffee, but maybe it was complete insanity in there, with other people dying, and rather than sending 4-5 people out to help do something they don't normally do, they said to call 911. An ER nurse isn't trained to extricate someone from a car, and if they're busy hanging a nitro drip for someone with crushing chest pain, it probably seems like a misuse of manpower.

 

[motomed]

obviously a sad situation, but don't jump to too many conclusions, this has nothing to do with laws or regulations. Putting a patient on a board who drives up to your door is a little different than going into a garage to investigate a car accident. Had it simply been reported as an unresponsive man, I'm sure the hospital would have had people responding quickly. The inside of an ER is crazy enough, there has to be a boundary somewhere. I'd also like to see some actual times on how long it took medical personnel to arrive. It may have seemed to the police officers like they were doing CPR forever, but I'm betting the actual response was much faster than they are guessing.

Sad story, unusual circumstances, I doubt there's much to investigate. a bad outcome doesn't always require knee jerk reactions and finger pointing.

 

[StephenMaturin]

Maybe the ER staff were all sitting around eating donuts and drinking coffee, but maybe it was complete insanity in there, with other people dying, and rather than sending 4-5 people out to help do something they don't normally do, they said to call 911. An ER nurse isn't trained to extricate someone from a car, and if they're busy hanging a nitro drip for someone with crushing chest pain, it probably seems like a misuse of manpower.

Agree. First off, reporters suck and they almost always get the story wrong or miss key points. Second, it's easy with hindsight to say what the right thing to do was. Someone at the moment had to make a decision based on limited information. Even if with hindsight we find that the decision was wrong, that doesn't mean it was an unreasonable decision at that time. Sending er staff off on a wild goose chase to pick up a dead guy in a car sounds like a total fiasco.

 

[alwaysaangel]

Unfortunate of course, but I don't necessarily believe something evil happened here.

First of all, stories need to get straight since the reporter has two different accounts from hospital and police. I have a feeling the reporter has something wrong.

Second, as others have said. Procedures are in place for a reason and it was reported as a car accident. EM docs are not trained in extrications and it would not necessarily be safe or in the patients (or the 50 other patients in the ED) best interest for them to go running out to play hero.

Lastly, I don't respect any news story that relies completely on emotional response from readers instead of actually relaying facts"

"They left him to die," Luis Garcia said.

He was already dead. Police failed to resuscitate him. Considering only 5% of resuscitations are successful this isn't surprising. If no one has explained that to the wife that is pretty bad.

 

[alwaysaangel]

This bizarre to say the least. At the trauma center where I work, we extricate pts from cars in our parking lot somewhat regularly (probably at least a couple of times/wk across all shifts). I've had to do extrications of spinal-injured pts who are sitting in their car after several-hundred-mile drives to get to our trauma center (yes, I've had pts drive with a spinal injury as much as an entire state's length to get to our hospital for treatment...why they didn't stop at one of the hospitals closer to their origin or call 911 for an ambulance is beyond me). Yes, technically EMS has more experience doing these sort of extrications, but we all have the training and background to know what to do and it saves time. It seems very odd to me that they didn't simple send a couple of techs (or even a MERIT team) out to check on the situation.

Where do you work and why is your parking lot so dangerous?

When we're talking about extrication we are talking about the fact that the ED had been informed that there had been an MVA. If there was damage to the vehicle then he would have needed to be extricated from the vehicle using equipment that fire depts have.

We aren't talking about just dragging someone out of a normal undamaged car...

In general, EM docs are not trained in EMS and extrication so when a car accident is reported it is appropriate to call 911 for APPROPRIATE response.

 

[apumic]

Where do you work and why is your parking lot so dangerous?

When we're talking about extrication we are talking about the fact that the ED had been informed that there had been an MVA. If there was damage to the vehicle then he would have needed to be extricated from the vehicle using equipment that fire depts have.

We aren't talking about just dragging someone out of a normal undamaged car...

In general, EM docs are not trained in EMS and extrication so when a car accident is reported it is appropriate to call 911 for APPROPRIATE response.

I should rephrase that. We drag people with ridiculous injuries (for driving; e.g., probably serious spinal injuries) out of undamaged cars fairly regularly. On occasion, however, I have actually had someone drive a wrecked car in. We have some crazy people around here. I am in a decent size metro area but to the south, there really isn't anything for a few hundred miles. Sometimes, we get people who injured themselves in the middle of nowhere (MVA w/ a deer, for instance) and drive themselves in a wrecked but still drivable car instead of calling 911. Just yesterday we had a woman drive up to the ambulance bay and pound on the glass door to let us know her husband was coding in the car....

 

[alwaysaangel]

I should rephrase that. We drag people with ridiculous injuries (for driving; e.g., probably serious spinal injuries) out of undamaged cars fairly regularly. On occasion, however, I have actually had someone drive a wrecked car in. We have some crazy people around here. I am in a decent size metro area but to the south, there really isn't anything for a few hundred miles. Sometimes, we get people who injured themselves in the middle of nowhere (MVA w/ a deer, for instance) and drive themselves in a wrecked but still drivable car instead of calling 911. Just yesterday we had a woman drive up to the ambulance bay and pound on the glass door to let us know her husband was coding in the car....

Well all of that is not uncommon for an ED. But its still very different than being told "hey there is an accident in the parking structure on the other side of the campus...come help." They didn't know how damaged the car was and it wasn't in the ambulance bay.

 

[apumic]

Well all of that is not uncommon for an ED. But its still very different than being told "hey there is an accident in the parking structure on the other side of the campus...come help." They didn't know how damaged the car was and it wasn't in the ambulance bay.

True. I guess I took it as the parking structure was close to the ED entrance. If it was on the other side of the hospital campus, that's a different story. The truth is that you're right, we don't have all the information to make even an informal "judgment."

 

[gettheleadout]

The man wrecked 125 feet from the ER entrance.

 

[apumic]

The man wrecked 125 feet from the ER entrance.

Birgilio Marin-Fuentes had driven to Portland Adventist Medical Center shortly after midnight Wednesday, unable to sleep or stop coughing, then crashed his car into a pillar and wall inside the first level of the hospital parking garage under an "emergency parking only" sign about 125 feet from the emergency room entrance.

Read more: http://www.foxnews.com/us/2011/02/1...ncy-room-hospital-tells-police/#ixzz1DmDg7y8m
​

You're right... that must have been where I got the idea that the parking structure was right in front of the ED. I guess it could have simply been too busy for them to spare the staff to go outside for an extrication, though. It really is impossible say. Ever ED is different. At mine, we typically have a tech and a nurse (sometimes 2-3 techs during peak times) specifically assigned to triage at all times, so for us it would not be unreasonable for the triage tech to hand off to the nurse for a few minutes and call another tech to assist in a 2-man extrication (assuming, of course, that the pt was accessible in the vehicle without jaws of life and such, which seems to be implied if the POs were able to do CPR on the man while they waited).

 

[LizzyM]

I recall a similar situation with a kid who was shot in Chicago some years ago:
http://www.nytimes.com/1998/05/19/us/national-news-briefs-hospital-drew-line-at-door-of-er.html

 

[halethsonofhama]

I'm assuming that since the Officers already started CPR, the patient was already out of the car. I'm sure the third officer who told the ER was sure to explain that to them (if the nurse even let him get that far before telling him to call 911).

Nothing against nurses... but all the one's I have come in contact with, have been pretty lazy (ok... that is against nurses). Chances are, she thought the officer was over reacting (because, what do Cops know about medical issues they didn't go to nursing night school) and so why should she make any additional effort on her part if its probably nothing. The pt. wasn't through her doors yet so it wasn't her problem.

Could there have been a miscommunication? probably yes, but the nurse could have cleared up any confusion had she actually shown an interest instead of trying to pass the officer off to 911.

All in all, did she do everything right? By the books, yes. I can only assume that she is one of those "battle hardened" who have lost all forms of compassion (you know the kind); as a result, any ability to go above and beyond the call of duty for the good of others has been wiped out.

 

[apumic]

I'm assuming that since the Officers already started CPR, the patient was already out of the car. I'm sure the third officer who told the ER was sure to explain that to them (if the nurse even let him get that far before telling him to call 911).

Nothing against nurses... but all the one's I have come in contact with, have been pretty lazy (ok... that is against nurses). Chances are, she thought the officer was over reacting (because, what do Cops know about medical issues they didn't go to nursing night school) and so why should she make any additional effort on her part if its probably nothing. The pt. wasn't through her doors yet so it wasn't her problem.

Could there have been a miscommunication? probably yes, but the nurse could have cleared up any confusion had she actually shown an interest instead of trying to pass the officer off to 911.

All in all, did she do everything right? By the books, yes. I can only assume that she is one of those "battle hardened" who have lost all forms of compassion (you know the kind); as a result, any ability to go above and beyond the call of duty for the good of others has been wiped out.

Hmm... not the RNs I've met.... The RNs I work with are quite hardworking as are the techs. Who knows what happened....

 

[Dial71]

Sending er staff off on a wild goose chase to pick up a dead guy in a car sounds like a total fiasco.

Not really, I work as an ER tech and I've pulled several dead guys from cars in our parking lot; it's no big deal. This was clearly a "grab-and-go" situation.

Obviously, I don't have all the information, but this looks like a major SNAFU on the hospital's part. Really, all they had to do was send 2-3 techs with a gurney out to assess the situation. If they had, it seems like they could have had this gentleman in a tramua bay within a few minutes. If the cops could access him to perform CPR, then I doubt that fire services were needed to extricate him.

Most hospitals have a protocol in place to respond to medical emergencies that occur on campus. Either there was major miscommunications involved or just plain laziness on the part of the staff. I am certain that the widow will recieve a large settlement before this case ever gets to court.

All that said, it sounds like the police are posturing and making media statements to wash their own hands. I doubt we're being told the whole story.

 

[alwaysaangel]

The man wrecked 125 feet from the ER entrance.

Which I'm sorry is not a short distance. Its not directly outside the ED where they could see what was going on and know it wasn't a bad wreck.

Additionally, I question the reporters ability to report facts. They are clearly depending heavily on emotional response to that article so they are probably twisting things to get the best possible response. Who knows if the parking structure entrance is 125ft from the entrance...or if the vehicle was actually 125 ft from the entrance but he was on the 5th floor, etc. etc.

http://www.adventisthealthnw.com/AboutAMC_DirMaps.asp

That med center has 5 parking structures. If a nurse was just told "someone crashed in the parking structure." Then she doesn't know which one. I doubt the cop said..."someone crashed in a parking structure 125ft from here!"

You guys are assuming a lot to blame the hospital, and are still forgetting that the man was ALREADY dead. They didn't 'let' him die.

And to halethesonofhama...good luck when you get to third year rotations...

 

[halethsonofhama]

And to halethesonofhama...good luck when you get to third year rotations...

My hospital experience has been limited to 2 ER's only (within the same medical group however). Very limited I'll admit. Once I meet more nurses who don't just do the bare minimum. I'll change my opinion.

Not the worst example, but this is encompasses the typical attitude of all the nurses I've interacted with:

A eldery pt calls to get help to goto the bathroom (A nurse needed to help, I couldn't). Nurses response was "man! Room 3 ALWAYS needs to use the bathroom" as she continues to look for furniture on craigslist for an hour and a half (while telling the pt, "I'll be right there" everytime he called).

 

[Dial71]

You guys are assuming a lot to blame the hospital, and are still forgetting that the man was ALREADY dead. They didn't 'let' him die.

I agree 100% with this statement. He was probably DOA and had a slim chance of survival. It baffles me why people who actually need ambulances refuse to call 911 (while so many chronic toe pains see it as a taxi service). However, good luck convincing a lay jury that the hospital responded appropriately to this situation.

The fact is that a man died on hospital property, without so much as the triage tech going out to take a look (given the facts reported in the article). If that isn't negligence, what is? EMTALA is pretty clear that if a critically ill patient is on hospital grounds, you have an obligation to provide assessment and stabilization in a timely manner.

 

[45408]

I'm assuming that since the Officers already started CPR, the patient was already out of the car. I'm sure the third officer who told the ER was sure to explain that to them (if the nurse even let him get that far before telling him to call 911).

Nothing against nurses... but all the one's I have come in contact with, have been pretty lazy (ok... that is against nurses). Chances are, she thought the officer was over reacting (because, what do Cops know about medical issues they didn't go to nursing night school) and so why should she make any additional effort on her part if its probably nothing. The pt. wasn't through her doors yet so it wasn't her problem.

Could there have been a miscommunication? probably yes, but the nurse could have cleared up any confusion had she actually shown an interest instead of trying to pass the officer off to 911.

All in all, did she do everything right? By the books, yes. I can only assume that she is one of those "battle hardened" who have lost all forms of compassion (you know the kind); as a result, any ability to go above and beyond the call of duty for the good of others has been wiped out.

How do you know they talked to a nurse? Maybe they talked to a secretary.

I agree 100% with this statement. He was probably DOA and had a slim chance of survival. It baffles me why people who actually need ambulances refuse to call 911 (while so many chronic toe pains see it as a taxi service). However, good luck convincing a lay jury that the hospital responded appropriately to this situation.

The fact is that a man died on hospital property, without so much as the triage tech going out to take a look (given the facts reported in the article). If that isn't negligence, what is? EMTALA is pretty clear that if a critically ill patient is on hospital grounds, you have an obligation to provide assessment and stabilization in a timely manner.

...and in an appropriate fashion. Having EMS deal with an MVC on the hospital campus is probably their protocol, so I doubt they could be successfully sued. We've got limited information, obviously.

Besides, there's no malpractice to be found. He was dead already, and there's virtually 0% chance they could have revived him after 20 minutes.

 

[gettheleadout]

I think the issue here, regardless of all the technicalities of how long he was dying there before someone found him, what the officers/hospital staff did or didn't do, how the reporter is spinning this or how the facts are skewed, is that the irony of a man dying in his car on hospital premises just sucks.

At face value, that situation is something that people don't want to accept is possible or common (if it is at all.)

 

[FIREitUP]

Considering this was a life or death situation, the officers could have neglected c-spine stabilization and carried him to the ER. Secondly, it says "A third officer, Andrew Hearst, went to the ER intake desk and told them what was happening", I don't know if you guys have ever worked with triage nurses before, but I have, and their instructions to call 911 doesn't surprise me. Plus, who wants to get involved if it means your license is on the line? So, lack of initiative to carry the patient in + incompetent and callous triage nurses + liability concerns = death of patient. Not too far-fetched to me.

@ Prowler: Unless the officer went to the coding and billing department, I would say that odds are good that he encountered a nurse or at least a CNA.

@ AlwaysAAngel: The person could have easily asked for the exact location. Either way, I'm sure the cop had a car (since there were three of them) and they could have easily hopped into the police car and checked it out IMO. But then again in this age of litigiousness why even bother (I wouldn't doubt that this is why the hospital guidelines are to let EMS handle it)? I think liability is probably the culprit more than anything else. I remember my dad used to tell me as a resident that he would help people who were in car accidents and was told by an officer he knew well to stop doing that since it isn't worth the liability. It's like suing the guy who gave you a broken rib while they gave you the heimlick to save your life.

 

[apumic]

Considering this was a life or death situation, the officers could have neglected c-spine stabilization and carried him to the ER. Secondly, it says "A third officer, Andrew Hearst, went to the ER intake desk and told them what was happening", I don't know if you guys have ever worked with triage nurses before, but I have, and their instructions to call 911 doesn't surprise me. So, lack of initiative to carry the patient in + incompetent and callous triage nurses = death of patient. Not too far-fetched to me.

@ Prowler: Unless the officer went to the coding and billing department, I would say that odds are good that he encountered a nurse.

While it's true they could have neglected c-spine, many regions don't require POs to have anything beyond BLS and some basic first aid (if that). While I've met a few who are certified First Responders and EMT-Bs, most I've met lack any formal medical trng and probably wouldn't feel comfortable making the decision to neglect c-spine stabilization (no matter how obvious it may be to you and me that this case qualifies). Also, while some EDs have the triage RN up front, the larger ones I've been in often have only a tech up front and may have security booths and a pt registration person up front as well. It's possible the PO spoke to a tech, security officer, or pt registration staff member.

 

[FIREitUP]

While it's true they could have neglected c-spine, many regions don't require POs to have anything beyond BLS and some basic first aid (if that). While I've met a few who are certified First Responders and EMT-Bs, most I've met lack any formal medical trng and probably wouldn't feel comfortable making the decision to neglect c-spine stabilization (no matter how obvious it may be to you and me that this case qualifies). Also, while some EDs have the triage RN up front, the larger ones I've been in often have only a tech up front and may have security booths and a pt registration person up front as well. It's possible the PO spoke to a tech, security officer, or pt registration staff member.

Personally I think everyone's at fault. If the PO's had no formal training other than first aid they're protected under the Good Samaritan Act and should have carried the guy in. The officer who asked for help should have been more aggressive, as a man of the law, and went into the actually ED (if he didn't) to ask for help from a medical professional or someone who is actually competent. If the officer did encounter a medical professional and that person advised him to call 911, that person is at fault, too. It just seems like it's a lack of initiative mixed with incompetence (and as I mentioned earlier, possibly liability) that caused this man to perish in the parking lot. Now what we get is a lot of finger pointing because no one wanted to take responsibility then and they don't want to take it now.

 

[StephenMaturin]

You guys are going into the wrong profession. Your ability to look back on a situation with 20/20 hindsight, and even then knowing only the the most superficial of details, and be so confident about placing blame and calling people incompetent would make you a great lawyer or politician.

The real world is messy. People have to make decisions in real time with limited resources and knowledge. Even very competent people with the best of intentions screw up all the time. You have to accept that there is going to be a certain amount of error in a system.

Whatever. I've screwed up enough in my life to be grateful it has never seriously hurt me or anyone else. But we're all going into a profession where we are going to screw up at some point despite our best intentions, and it is going to hurt someone in a serious and life-altering way, and that is something that we will have to accept and live with for the rest of our lives. We might even have some lawyer at some point call us incompetent, callous, or worse because of it. If I were you I wouldn't be so quick to pass judgement on others.

 

[Socrates25]

Maybe the ER staff were all sitting around eating donuts and drinking coffee, but maybe it was complete insanity in there, with other people dying, and rather than sending 4-5 people out to help do something they don't normally do, they said to call 911. An ER nurse isn't trained to extricate someone from a car, and if they're busy hanging a nitro drip for someone with crushing chest pain, it probably seems like a misuse of manpower.

This is a joke right? Yeah I'm sure every single nurse/doctor in the ER that night was busy treating critically ill patients. 🙄

If you want to call EMSA at the same time while sending ER people out there in case of a complicated extrication, thats fine. But for somebody to sit behind an ER desk and say "we cant help you, call 911 and we'll treat him when he actually comes in the door" is total crap.

This case is absurd. I hate lawyers but I hope the hospital gets the **** sued out of them. Absolute nonsense.

 

[Socrates25]

obviously a sad situation, but don't jump to too many conclusions, this has nothing to do with laws or regulations.

Wrong, it has EVERYTHING to do with laws and regulations. The hospital is scared of getting sued if they respond to a car crash and accidentally paralyze somebody because they didnt properly extricate/restrain/c-collar the patient.

However, one silly set of "gotcha" games shouldnt inspire stupidity like it did in this case. Nobody is saying that the ER staff should just charge out there with bolt cutters and the jaws of life and pull this guy out. If it really was a complicated car extraction then by all means WAIT for EMSA. But the ER idiot DIDNT EVEN ATTEMPT TO ASSESS THE SCENE. Thats outrageous.

Putting a patient on a board who drives up to your door is a little different than going into a garage to investigate a car accident. Had it simply been reported as an unresponsive man, I'm sure the hospital would have had people responding quickly.

Thats the real problem here. The ER DIDNT EVEN ATTEMPT to go outside and see what was going on. Thats absurd.

 

[Socrates25]

Agree. First off, reporters suck and they almost always get the story wrong or miss key points. Second, it's easy with hindsight to say what the right thing to do was. Someone at the moment had to make a decision based on limited information. Even if with hindsight we find that the decision was wrong, that doesn't mean it was an unreasonable decision at that time. Sending er staff off on a wild goose chase to pick up a dead guy in a car sounds like a total fiasco.

The "right decision" in this case is to actually go outside and see whats happening.

The error in this case was not that the ER failed to bring him into the ER area. Its the fact that they ignored the situation completely withotu even bothering to check it out.

 

[ILikeDrugs]

Do you think ER workers would have rushed out there if it was the dean/chief of medicine that was in the car on the hospital campus, or would hospital policy still keep them from going out there? 😉

 

[apumic]

Do you think ER workers would have rushed out there if it was the dean/chief of medicine that was in the car crash on the hospital campus, or would hospital policy still keep them from going out there? 😉

Depends... Is their chief of medicine any good?

[YOUTUBE]http://www.youtube.com/watch?v=RLuBguBY_6U&feature=related[/YOUTUBE]

 

[Suenya]

This is a joke right? Yeah I'm sure every single nurse/doctor in the ER that night was busy treating critically ill patients.

I've seen it happen in my old job. Sometimes bad stuff happens all at once. I guess you haven't seen it, but given my major dearth of experience, since I have seen it I doubt it's impossibly rare. At least at busy ERs.

 

[Suenya]

I'm assuming that since the Officers already started CPR, the patient was already out of the car. I'm sure the third officer who told the ER was sure to explain that to them (if the nurse even let him get that far before telling him to call 911).

Nothing against nurses... but all the one's I have come in contact with, have been pretty lazy (ok... that is against nurses). Chances are, she thought the officer was over reacting (because, what do Cops know about medical issues they didn't go to nursing night school) and so why should she make any additional effort on her part if its probably nothing. The pt. wasn't through her doors yet so it wasn't her problem.

Could there have been a miscommunication? probably yes, but the nurse could have cleared up any confusion had she actually shown an interest instead of trying to pass the officer off to 911.

All in all, did she do everything right? By the books, yes. I can only assume that she is one of those "battle hardened" who have lost all forms of compassion (you know the kind); as a result, any ability to go above and beyond the call of duty for the good of others has been wiped out.

You judge a whole profession by the few you've met? Certainly there are places where malignant individuals cluster... I've dealt with it on specific units and in certain hospitals with both doctors and nurses, where the average seems to be bad instead of good. But even so, I doubt every one of the nurses was lazy.

Let's give you the benefit of the doubt, though. Assume every single nurse you met was not only lazy, but rude, uncaring, inconsiderate, and liked kicking kittens (and puppies!). Even assuming that's the case, it's absolutely idiotic to generalize that to a whole diverse profession.

 

[darlin]

Maybe the ER staff were all sitting around eating donuts and drinking coffee, but maybe it was complete insanity in there, with other people dying, and rather than sending 4-5 people out to help do something they don't normally do, they said to call 911. An ER nurse isn't trained to extricate someone from a car, and if they're busy hanging a nitro drip for someone with crushing chest pain, it probably seems like a misuse of manpower.

👍

I have a hard time believing something like this would done intentionally. I mean, someone would have to think about how this would look to outsiders before making a conscious decision to ignore a potentially deadly situation. Some times people slip through the cracks, I guess.

 

[alwaysaangel]

I'm really curious what all the premeds in this thread who are arguing that they did something wrong think should have happened?

The ED docs should have run outside, leaving their patients, and taken over doing CPR? Which the police were already doing?

Or should they have drug out some 100lb non-mobile equipment to try to do ACLS?

Or maybe just a big pile of meds so they could try throwing some epinephrine etc. at the patient?

I'm honestly curious as to what you think would have happened if an ED doc went outside and how that would have changed the outcome for a man who likely had already been dead 20 min?

You are outraged against the policy or procedure which "killed" this man. Yet, there is a reason that policy is there - its not because they were trying to dodge a lawsuit, its because its ridiculous to think that hospital equipment can be pulled outside to treat a man in a car. The reason such policies in place are because EMT is best equipped to handle such a situation.

 

[apumic]

I'm really curious what all the premeds in this thread who are arguing that they did something wrong think should have happened?

The ED docs should have run outside, leaving their patients, and taken over doing CPR? Which the police were already doing?

Or should they have drug out some 100lb non-mobile equipment to try to do ACLS?

Or maybe just a big pile of meds so they could try throwing some epinephrine etc. at the patient?

I'm honestly curious as to what you think would have happened if an ED doc went outside and how that would have changed the outcome for a man who likely had already been dead 20 min?

You are outraged against the policy or procedure which "killed" this man. Yet, there is a reason that policy is there - its not because they were trying to dodge a lawsuit, its because its ridiculous to think that hospital equipment can be pulled outside to treat a man in a car. The reason such policies in place are because EMT is best equipped to handle such a situation.

No. At least I don't think that would be appropriate. However, we (techs) go out w/ backboards and backboard pts in parking lots who are a few hundred feet from the ED entrance and haul them in all the time. At one of the EDs where I was a tech, our emergency resus rooms were probably a good hundred feet (at least) from the entrance to the ED (since you had to go through the waiting area, past triage and down the hallway to our ED's high acuity care unit. We could get people there within 15-20 seconds when we needed to but it was still a bit of walk to get them to our resuscitation rooms. Going out the same amount into the parking lot as the resus rooms were from the entrance of the ED doesn't seem all that bad, really. Now, if you don't have the staff to spare at that moment, that's a different story. Sometimes, EDs really are just too busy to deal with things outside the unit itself.

 

[alwaysaangel]

From another article: http://www.reuters.com/article/2011/02/11/us-hospital-crash-idUSTRE71A0NM20110211

A Portland Adventist official, David Russell, said the hospital did not have a policy against responding to emergencies in its own parking lot.

"In fact, we always call 911 and send our own staff into these situations whether they are gunshot wounds, heart attacks or any other medical emergency. And we have done that many times in the past year alone," Russell, hospital vice president of the business development, said in a written statement.

"We advised the officer immediately call 911 because EMS have the mobile equipment to respond to a car accident," he said. "Before the officer left our emergency department, our charge nurse directed a paramedic to go immediately to the scene." The charge nurse also dispatched "first responders" to the scene, he said.

Marin-Fuentes was pronounced dead at 1:22 a.m., said Damon O'Brien, deputy coroner in the Multnomah County Medical Examiner's office. "He died of heart disease. There was no trauma."

Russell said about eight minutes elapsed from the time the first police officer came into the ER and the patient arrived.

Drastically different than the first article.

Also, notice...no trauma. The man crashed because he succumbed to his MI, no one found him for 20 min. No course of events was going to save him. While its unfortunate, its never going to result in a successful lawsuit because the hospital did nothing wrong.

 

[apumic]

From another article: http://www.reuters.com/article/2011/02/11/us-hospital-crash-idUSTRE71A0NM20110211



Drastically different than the first article.

Also, notice...no trauma. The man crashed because he succumbed to his MI, no one found him for 20 min. No course of events was going to save him. While its unfortunate, its never going to result in a successful lawsuit because the hospital did nothing wrong.

That is drastically different and sounds like standard procedure. Way to dig that up.

 

[MedicFL]

While I agree a 125 feet isn't very far from the entrance, but it does say it was in a parking garage so it may not even have been within sight of the entrance. I can tell you that from working at a Level 1, we will take people out of cars who drive up into our ER entrance overhang, however anything that happens in a parking garage we call 911 and DO NOT respond. Trying to bring a person in from a parking garage acrossed streets isnt the safest way to handle the situaiton..

 

[Dial71]

Going off the Rueter's article, it sounds like the ER did everything necessary to treat the guy. I retract my earlier statement.

Funny how the Fox News piece completely failed to provide an accurate account. I wonder what that implies for the rest of their reporting?

Has anyone seen that Glen Beck clip where he cries about waiting in an ER for treatment of his chronic back pain? It's priceless.

 

[45408]

This is a joke right? Yeah I'm sure every single nurse/doctor in the ER that night was busy treating critically ill patients. 🙄

No need to be a smartass. The cops almost certainly went to the front desk, and they talked to either a triage nurse, or maybe just a nurse's aide. Their perception is either "We're really busy right now," or "We're not busy right now." The point is not that they could be certain that no nurses were on smoke breaks at that time, but that they may have actually been busy saving lives.

This case is absurd. I hate lawyers but I hope the hospital gets the **** sued out of them. Absolute nonsense.

They won't. The guy was dead, and the highly salient details omitted from the original article are:

"We advised the officer immediately call 911 because EMS have the mobile equipment to respond to a car accident," he said. "Before the officer left our emergency department, our charge nurse directed a paramedic to go immediately to the scene." The charge nurse also dispatched "first responders" to the scene, he said.

 

[Swagster]

Maybe the ER staff were all sitting around eating donuts and drinking coffee, but maybe it was complete insanity in there, with other people dying, and rather than sending 4-5 people out to help do something they don't normally do, they said to call 911. An ER nurse isn't trained to extricate someone from a car, and if they're busy hanging a nitro drip for someone with crushing chest pain, it probably seems like a misuse of manpower.

This is roughly what I was thinking. Manpower dictates how you respond. If the staff was stretched to their max, then doubling as EMTs might not have been feasible at that point in time. I find it hard to believe that anyone trained in medical response would let that happen without a good reason.

 

[GrantN]

Thank god I wans't born in the US, "protocol" dictating someones death makes perfect sense. More like they didn't want to spend money. Which when your whole healthcare system is based on profit, why help?

 

[motomed]

Funny how the Fox News piece completely failed to provide an accurate account.

what is even more funny to me is that a bunch of people who think they're going to be doctors someday didn't have enough sense to consider the possibility that maybe the policies were sound, the people involved were competent and well intentioned, and that sometimes bad things just plain happen. No, that can't be. It is clearly the case, based on one detail free news report, that the hospital and staff are going through the motions, collecting a paycheck, and following protocols designed solely to prevent lawsuits and require the minimum amount of effort. The hospital staff clearly went about their usual business afterwards, and never had any conversations whatsoever about what might have been done differently in this situation, this much is clear from the article!!

I'm going to hope the snap judgments and stupidity correlate with lack of actual experience, and that IF you ever get the chance to get real experience you'll have that all knowing chip knocked off your shoulders.

 

[dice404]

what is even more funny to me is that a bunch of people who think they're going to be doctors someday didn't have enough sense to consider the possibility that maybe the policies were sound, the people involved were competent and well intentioned, and that sometimes bad things just plain happen. No, that can't be. It is clearly the case, based on one detail free news report, that the hospital and staff are going through the motions, collecting a paycheck, and following protocols designed solely to prevent lawsuits and require the minimum amount of effort. The hospital staff clearly went about their usual business afterwards, and never had any conversations whatsoever about what might have been done differently in this situation, this much is clear from the article!!

I'm going to hope the snap judgments and stupidity correlate with lack of actual experience, and that IF you ever get the chance to get real experience you'll have that all knowing chip knocked off your shoulders.

this.

Yes, this is very unfortunate, but it's amazing how naive many of you can be. We don't live in a perfect world. The hospital is certainly no exception.

 

[apumic]

what is even more funny to me is that a bunch of people who think they're going to be doctors someday didn't have enough sense to consider the possibility that maybe the policies were sound, the people involved were competent and well intentioned, and that sometimes bad things just plain happen. No, that can't be. It is clearly the case, based on one detail free news report, that the hospital and staff are going through the motions, collecting a paycheck, and following protocols designed solely to prevent lawsuits and require the minimum amount of effort. The hospital staff clearly went about their usual business afterwards, and never had any conversations whatsoever about what might have been done differently in this situation, this much is clear from the article!!

I'm going to hope the snap judgments and stupidity correlate with lack of actual experience, and that IF you ever get the chance to get real experience you'll have that all knowing chip knocked off your shoulders.

Wow. One premed passing judgment on other premeds -- how... uncommon. The truth is that the first article's spin had the hospital violating its protocols. Once that came to light, things made more sense. Perhaps, someday you'll actually get to work in a hospital and experience some of this yourself. Mistakes are made in hospitals all the time. In this case, it looks like things were actually handled quite well. The man was dead long before the hospital could have gotten to him but the response time was just a few short minutes.

 

[motomed]

The truth is that the first article's spin had the hospital violating its protocols.

Nope, it didn't.