Woman dies in ER lobby as 911 refuses to help

[skibum]

Adding onto Ruff's post... What would the legal ramifications be if the dispatcher contacted the Hospital Administration on behalf of the pt.?

-skibum

[Just Plain Ruff]

after the 2nd 911 call from the er waiting room I'd have been on the phone to the hospital personally.

[Dustdevil]

Adding onto Ruff's post... What would the legal ramifications be if the dispatcher contacted the Hospital Administration on behalf of the pt.?

Probably the same as they are going to be now.

She'd get fired.

Then it comes down the the academic discussion of whether it is better to be fired for doing the wrong thing, or for doing nothing at all.

[medic001918]

We've been dispatched to the hospital grounds before. You CANNOT refuse action when someone calls 911. That's called negligence. We've had people call 911 and step outside the doors and state they want to go to another hospital for treatment. They sign out AMA from said hospital and we transport. You can't tell them no as long as they sign out from the first hospital.

I have been dispatched to the hospital too, in the parking lots most commonly. There is a difference between someone being inside of a legally defined and registered emergency department and just being at the hospital. That line changes things significantly. If you're in the ED, the hospital is being negligent and not the EMS service. If the patient is outside somewhere, or outside of a designated "patient care area" then EMS has a duty to act and could be found negligent.

Based on how your post is worded, someone who is tired of waiting in the ED (patient room or waiting room) can simply call 911 and we'll come in and take them from the site of higher care to go somewhere else. Patient care areas and emergency department are the key words here...not hospital grounds.

Shane

NREMT-P

[JPINFV]

^

My understanding is that EMTALA is in effect for a 250 yard radius around the hospital's main building as long as it's on hospital property.

[brentoli]

I don't think my agency (911) has any protocols for this, but I would probably disconnect with the caller and contact the security for that hospital. First off that keeps me away from any sense of "inaction." Secondly she is inside the facility and I can't see how EMS can transport from there with out orders.

Luckily for me, the hospitals in my county all fall under the city's jurisdiction and they have their own 911

[scratrat]

^

My understanding is that EMTALA is in effect for a 250 yard radius around the hospital's main building as long as it's on hospital property.

I have heard that too.

ruffems..

I don't put the blame on anyone but the hospital. BUT.....they could walk outside and call 911. EMTALA might be a problem, I'm not the legal expert. It's been done and as far as I know, we've never received any flack. I'm not saying that makes it right though.

Even though I feel wholeheartedly that this hospital is to blame, I still have problems with the dispatch end of it.

First, the hospital should be fined big time or closed. They should also be sued. As much as I am against frivolous lawsuits, this one doesn't fit that bill. At least not in my mind.

On the dispatch end of it, someone called 911 and asked for help. If someone calls 911 and says they want police, fire, EMS, etc., you cannot just say no. Some one has to respond. You can't just tell the person no. I think they are going to get successfully sued for this one, big time. All the family needs is a few doctors who state that given her present condition, if she would have received proper care at XYZ hospital in XYZ amount of time, she'd be alive today. Thats it. I don't think it's going to be a far stretch from that point, to go after negligence.

Think about this one, someone calls 911 because their big toe hurts after they stubbed it. Is this an emergency? No. Does it warrant evaluation by an ER physician? No. Probably not. Can you legally tell this person that it's not an emergency and refuse to respond? I'm going with no.

Granted, this scenario didn't include calling from an ER. But I still believe they should have covered their butts and sent what was requested.

[p3medic]

The idea that EMS should dispatch an ambulance to a hospital ER that is a recieving facility of said EMS system is rediculous. The patient is already at the hospital! The job of EMS is to deliver the patient to the emergency department, and the patient is already there, mission accomplished. The ER staff should probably have been contacted by the dispatcher as a point of courtesy, but I think EMS should be off the hook on this one, although I'm not a scumbag attorney.

[medic001918]

I think they are going to get successfully sued for this one, big time. All the family needs is a few doctors who state that given her present condition, if she would have received proper care at XYZ hospital in XYZ amount of time, she'd be alive today. Thats it. I don't think it's going to be a far stretch from that point, to go after negligence.

I'll see your doctors that state that "given her present condition, if she would have received proper care at XYZ hospital in XYZ amount of time, she'd be alive today" with doctors of my own that state that the hospital has the abilities to manage this patient and I'll back it with case studies demonstrating previous cases within the hospital that have been managed appropriately.

A law student could handle that defense without much trouble. The case against the hospital is a whole separate issue however.

This isn't a case of a patient going to an inapproriate facility and being refused transfer and dieing. This is a case of a patient being neglected in the hospital. This is a case that from the sounds of things should have been able to be managed by the hospital, they just chose not to do anything with the patient. You could have the negligence case against dispatch IF (and only IF) you were to demonstrate the hospital was unable to provide care for the patients condition (due to medical level, not staffing) and that dispatch refused them an ambulance while the dispatchers knew the patient was not at an appropriate facility. Example: A patient having an MI in a facility without a cath lab.

Let's change the call slightly. Dispatch sends an ambulance and they transport to another facility and the patient dies on the way to the hospital. Who's at fault now? You've taken a patient away from a capable treatment facility and taken them farther from care. Now who's negligent? In that case, by all means go after EMS and the dispatchers.

So the bottom line remains, the patient was at the ED of a facility that should have been capable of managing the condition. They didn't manage the case properly (if at all) and the patient died (suffering "damgages" for legal terms). EMS or the dispatchers contributed to the patients condition or deterioration. They were at an appropriate emergency medical facility.

Shane

NREMT-P

[katbemeEMT-B]

I believe ultimately the hospital is responsible for the death of this patient. I also believe, if the story is true to it's word, the dispatcher holds some responsibility.

If a call came into our dispatch from or near the ED, dispatch would force the hand of the ED staff to see the patient by calling them and letting them know that the call is being recorded. They would make the nurse or doc go to the patient and bring them into an ED patient room before they hung up if it was an emergency such as this one. They would not dispatch us to the ED or the hospital grounds unless there happened to be a massive patient backlog and the ED staff felt it was best for the patient to seek medical attention else where.