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Crazy story about Saint Luke's in Boise especially considering its the peds trauma center for the city.
The family of a teenager who died from injuries sustained in a snowboarding accident has sued Boise doctors, an emergency transport company, St. Luke’s Regional Medical Center and Bogus Basin Mountain Recreation Area over claims that negligent emergency response and medical treatment caused the boy’s death.
The parents of 16-year-old Leo Gonzalez filed the civil lawsuit in Ada County on Wednesday. According to the suit, the Centennial High School sophomore injured his collarbone and shoulder while snowboarding, then spent time at Bogus Basin’s mountain clinic and later at St. Luke’s in Boise as his condition worsened. He eventually was transferred to Saint Alphonsus Regional Medical Center, where his family took him off life support after he had no brain activity.
Court documents argue that the ER physician and on-call cardiothoracic surgeon at St. Luke’s failed to stabilize Leo before he was transported. He had massive internal bleeding caused by a punctured subclavian artery that was perforated by his fractured collarbone, the lawsuit said.
The lawsuit cites a federal Department of Health and Human Services investigation that found St. Luke’s violated the Emergency Medical Treatment and Labor Act, or EMTALA, in its treatment of Leo. The federal law requires emergency rooms to provide care to the public and to stabilize emergency medical conditions to the best of their ability before transferring patients.
Among other issues, the report said that St. Luke’s did not “provide necessary stabilizing treatment within its capabilities.”
The Gonzalez family is asking for a jury trial and damages including Leo’s funeral and medical costs, the family’s attorney fees and possible punitive damages.
The lawsuit asks for a trial on 10 charges. Six of those are for alleged negligence by various defendants: two St. Luke’s doctors, St. Luke’s, Bogus Basin, Acute Rescue emergency transportation, and Emergency Medicine of Idaho, which is described as one of the doctors’ employer.
The other charges are two counts of vicarious liability against St. Luke’s and Emergency Medicine of Idaho, and one charge each against St. Luke’s for an EMTALA violation and negligence per se.
The family’s attorney, Boise-area medical malpractice lawyer Eric Rossman, shared with the Idaho Statesman the formal complaint filed in the lawsuit.
“In my 34 years of practice, this is one of the more egregious incidences of reckless medical care that I have ever seen,” Rossman stated in an email to the Statesman. “We look forward to helping this family find justice for the terrible loss of their child.”
A St. Luke’s representative was not immediately available for comment regarding the lawsuit. The others named in the lawsuit, including Bogus Basin and Acute Rescue and Transport, did not immediately respond to requests for comment.
Ski patrol called an ambulance and transported Leo to Bogus Basin’s mountain clinic, the lawsuit said. While ski patrol was transporting Leo, he had “an approximately 15-second episode of full-body shaking” and vomited. He was given fluids and Zofran, an anti-nausea medication. The lawsuit said that “despite Leo’s clear distress, Bogus Basin did not call for air ambulance transport.”
A ground ambulance took Leo to St. Luke’s hospital in downtown Boise. The lawsuit cited medical records stating that during transport, the teen’s blood pressure dropped to hypotensive levels, and he had “seizure-like activity,” prompting emergency medical services to call in a Priority 1 trauma alert to the hospital prior to arrival.
Leo arrived at St. Luke’s at 12:19 a.m. March 1, nearly three hours after his fall. According to the lawsuit, Leo’s bedside nurse reported that the hospital would not be following the trauma recommendation made by paramedics, and no trauma activation occurred. The ER physician in charge of Leo’s case, Dr. Bryan Shiflett, ordered a CT scan of the teen’s head, cervical spine, chest, abdomen and pelvis. Shiflett is one of the doctors named as a defendant in the case.
Notes from the doctor who interpreted Leo’s CT results pointed out that he had an active bleed from a lacerated subclavian artery and a hemothorax, or collection of blood in the space between the lungs and the chest wall, that was large enough to shift the chest cavity known as the mediastinum to the left.
According to the lawsuit, Shiflett was presented with that information by 1:17 a.m. At the same time, he requested to transfer Leo to Saint Alphonsus, with a comment on the transfer order that read, “I need to speak with the trauma surgeon.” The lawsuit said that Shiflett did not activate a trauma protocol or consult a surgeon at St. Luke’s.
Court documents said Shiflett entered a patient transfer at 1:40 a.m., and Leo’s nursing staff signed over nursing care at 1:47 a.m. At 1:50 a.m., the St. Luke’s on-call cardiothoracic surgeon, Dr. Andrew Forbes, was contacted, according to the lawsuit. Forbes is also named as a defendant.
Forbes didn’t evaluate Leo or offer any kind of consultation note or other documentation. According to the EMTALA investigation documents that are included in the lawsuit, Forbes told investigators that he wasn’t contacted until the transfer protocol had already been started, and Leo was on a gurney for transport to Saint Al’s.
“If I had been contacted earlier, I might have considered whether there was anything we could do locally, but mobilizing a surgical team here would likely have taken 45 minutes to an hour, which could have caused further delay,” Forbes told investigators.
The lawsuit said Leo’s Glasgow Coma Scale score had dropped from 15 at the time of his fall to 6. Within two minutes of arrival, Saint Alphonsus doctors inserted large-bore chest tubes that immediately drained 1,400 milliliters of blood from Leo’s chest cavity, and ultimately drained between 2,500 and 3,000 milliliters — or roughly two-thirds of a gallon of blood.
Court documents said Leo was intubated and put on a massive blood transfusion protocol, but went into cardiac arrest. An hour after he arrived at Saint Alphonsus, he was taken into cardiothoracic surgery, where surgeons found his fractured collarbone had perforated the anterior and posterior walls of the subclavian artery.
The teen needed reconstruction of the subclavian artery, as well as removal of blood clots from several other arteries, and surgery to cut through fascia to relieve compartment syndrome, or pressure buildup around muscles, on his right arm.
According to the lawsuit, Leo’s heart stopped again while he was in the cardiovascular intensive care unit, leading to myriad complications. On March 2, he underwent surgery to his right leg for compartment syndrome. The lawsuit said that when he returned from surgery, his pupils were fixed and dilated — a sign of a serious neurological issue. On March 3, tests showed Leo was brain-dead. His family opted to take him off of life support, and he was pronounced dead at 7:38 p.m.
The investigation also found apparent confusion over protocol for patients Leo’s age. St. Luke’s frequently handles pediatric cases, while Saint Alphonsus is the area’s leading trauma hospital. Shiflett told investigators that “it has been very clear in my practice that patients 14 years and younger are managed in-house, and those 15 and older are sent to (Saint Alphonsus).”
Investigators found that conflicted with the St. Luke’s pediatric trauma algorithm, which allows treatment of children ages 15 to 17 on a case-by-case basis. Shiflett told investigators that he “had never seen this algorithm,” and the investigation found the protocol “was not posted or available for staff reference” in physician work areas. The investigation concluded that St. Luke’s doctors “failed to utilize its available on-call surgical resources and specialized pediatric trauma capabilities to provide stabilizing treatment for a life-threatening vascular injury, which resulted in a critical delay in care and a fatal outcome.”
The family of a teenager who died from injuries sustained in a snowboarding accident has sued Boise doctors, an emergency transport company, St. Luke’s Regional Medical Center and Bogus Basin Mountain Recreation Area over claims that negligent emergency response and medical treatment caused the boy’s death.
The parents of 16-year-old Leo Gonzalez filed the civil lawsuit in Ada County on Wednesday. According to the suit, the Centennial High School sophomore injured his collarbone and shoulder while snowboarding, then spent time at Bogus Basin’s mountain clinic and later at St. Luke’s in Boise as his condition worsened. He eventually was transferred to Saint Alphonsus Regional Medical Center, where his family took him off life support after he had no brain activity.
Court documents argue that the ER physician and on-call cardiothoracic surgeon at St. Luke’s failed to stabilize Leo before he was transported. He had massive internal bleeding caused by a punctured subclavian artery that was perforated by his fractured collarbone, the lawsuit said.
The lawsuit cites a federal Department of Health and Human Services investigation that found St. Luke’s violated the Emergency Medical Treatment and Labor Act, or EMTALA, in its treatment of Leo. The federal law requires emergency rooms to provide care to the public and to stabilize emergency medical conditions to the best of their ability before transferring patients.
Among other issues, the report said that St. Luke’s did not “provide necessary stabilizing treatment within its capabilities.”
The Gonzalez family is asking for a jury trial and damages including Leo’s funeral and medical costs, the family’s attorney fees and possible punitive damages.
The lawsuit asks for a trial on 10 charges. Six of those are for alleged negligence by various defendants: two St. Luke’s doctors, St. Luke’s, Bogus Basin, Acute Rescue emergency transportation, and Emergency Medicine of Idaho, which is described as one of the doctors’ employer.
The other charges are two counts of vicarious liability against St. Luke’s and Emergency Medicine of Idaho, and one charge each against St. Luke’s for an EMTALA violation and negligence per se.
The family’s attorney, Boise-area medical malpractice lawyer Eric Rossman, shared with the Idaho Statesman the formal complaint filed in the lawsuit.
“In my 34 years of practice, this is one of the more egregious incidences of reckless medical care that I have ever seen,” Rossman stated in an email to the Statesman. “We look forward to helping this family find justice for the terrible loss of their child.”
A St. Luke’s representative was not immediately available for comment regarding the lawsuit. The others named in the lawsuit, including Bogus Basin and Acute Rescue and Transport, did not immediately respond to requests for comment.
Lawsuit alleges delays at Bogus Basin, St. Luke’s
Court documents say Leo was snowboarding at Bogus Basin on Feb. 28 when he fell at around 9:30 p.m. He had “an obvious deformity and bruising of the right clavicle and complained of right shoulder pain,” but was wearing a helmet and did not lose consciousness, the lawsuit said. Ski patrol assessed the teen with the Glasgow Coma Scale, which assesses consciousness and brain injury, and rated him a 15, the best possible score.Ski patrol called an ambulance and transported Leo to Bogus Basin’s mountain clinic, the lawsuit said. While ski patrol was transporting Leo, he had “an approximately 15-second episode of full-body shaking” and vomited. He was given fluids and Zofran, an anti-nausea medication. The lawsuit said that “despite Leo’s clear distress, Bogus Basin did not call for air ambulance transport.”
A ground ambulance took Leo to St. Luke’s hospital in downtown Boise. The lawsuit cited medical records stating that during transport, the teen’s blood pressure dropped to hypotensive levels, and he had “seizure-like activity,” prompting emergency medical services to call in a Priority 1 trauma alert to the hospital prior to arrival.
Leo arrived at St. Luke’s at 12:19 a.m. March 1, nearly three hours after his fall. According to the lawsuit, Leo’s bedside nurse reported that the hospital would not be following the trauma recommendation made by paramedics, and no trauma activation occurred. The ER physician in charge of Leo’s case, Dr. Bryan Shiflett, ordered a CT scan of the teen’s head, cervical spine, chest, abdomen and pelvis. Shiflett is one of the doctors named as a defendant in the case.
Notes from the doctor who interpreted Leo’s CT results pointed out that he had an active bleed from a lacerated subclavian artery and a hemothorax, or collection of blood in the space between the lungs and the chest wall, that was large enough to shift the chest cavity known as the mediastinum to the left.
According to the lawsuit, Shiflett was presented with that information by 1:17 a.m. At the same time, he requested to transfer Leo to Saint Alphonsus, with a comment on the transfer order that read, “I need to speak with the trauma surgeon.” The lawsuit said that Shiflett did not activate a trauma protocol or consult a surgeon at St. Luke’s.
Court documents said Shiflett entered a patient transfer at 1:40 a.m., and Leo’s nursing staff signed over nursing care at 1:47 a.m. At 1:50 a.m., the St. Luke’s on-call cardiothoracic surgeon, Dr. Andrew Forbes, was contacted, according to the lawsuit. Forbes is also named as a defendant.
Forbes didn’t evaluate Leo or offer any kind of consultation note or other documentation. According to the EMTALA investigation documents that are included in the lawsuit, Forbes told investigators that he wasn’t contacted until the transfer protocol had already been started, and Leo was on a gurney for transport to Saint Al’s.
“If I had been contacted earlier, I might have considered whether there was anything we could do locally, but mobilizing a surgical team here would likely have taken 45 minutes to an hour, which could have caused further delay,” Forbes told investigators.
Boise teen died after emergency care at Saint Alphonsus
According to the lawsuit, Leo left St. Luke’s by ambulance at 2:06 a.m. and arrived at Saint Alphonsus at 2:18. The physicians who received Leo wrote in their reports that the teen was not stable upon arrival.The lawsuit said Leo’s Glasgow Coma Scale score had dropped from 15 at the time of his fall to 6. Within two minutes of arrival, Saint Alphonsus doctors inserted large-bore chest tubes that immediately drained 1,400 milliliters of blood from Leo’s chest cavity, and ultimately drained between 2,500 and 3,000 milliliters — or roughly two-thirds of a gallon of blood.
Court documents said Leo was intubated and put on a massive blood transfusion protocol, but went into cardiac arrest. An hour after he arrived at Saint Alphonsus, he was taken into cardiothoracic surgery, where surgeons found his fractured collarbone had perforated the anterior and posterior walls of the subclavian artery.
The teen needed reconstruction of the subclavian artery, as well as removal of blood clots from several other arteries, and surgery to cut through fascia to relieve compartment syndrome, or pressure buildup around muscles, on his right arm.
According to the lawsuit, Leo’s heart stopped again while he was in the cardiovascular intensive care unit, leading to myriad complications. On March 2, he underwent surgery to his right leg for compartment syndrome. The lawsuit said that when he returned from surgery, his pupils were fixed and dilated — a sign of a serious neurological issue. On March 3, tests showed Leo was brain-dead. His family opted to take him off of life support, and he was pronounced dead at 7:38 p.m.
Investigation found emergency care violations in St. Luke’s treatment
The lawsuit said the Centers for Medicare and Medicaid Services, which is under Health and Human Services, investigated an EMTALA complaint against St. Luke’s on April 6-7. The Statement of Deficiencies from the investigation determined that St. Luke’s “failed to provide necessary stabilizing treatment within its capabilities” and “failed to affect a timely and appropriate transfer.”The investigation also found apparent confusion over protocol for patients Leo’s age. St. Luke’s frequently handles pediatric cases, while Saint Alphonsus is the area’s leading trauma hospital. Shiflett told investigators that “it has been very clear in my practice that patients 14 years and younger are managed in-house, and those 15 and older are sent to (Saint Alphonsus).”
Investigators found that conflicted with the St. Luke’s pediatric trauma algorithm, which allows treatment of children ages 15 to 17 on a case-by-case basis. Shiflett told investigators that he “had never seen this algorithm,” and the investigation found the protocol “was not posted or available for staff reference” in physician work areas. The investigation concluded that St. Luke’s doctors “failed to utilize its available on-call surgical resources and specialized pediatric trauma capabilities to provide stabilizing treatment for a life-threatening vascular injury, which resulted in a critical delay in care and a fatal outcome.”
