Woman dies after being arrested for refusing to leave ER

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TheVrolok

Lifer
Dec 11, 2000
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In my experience tests are run, be they repeated or new ones, until the problem is found or I'm transferred to a specialist to rinse and repeat. But then, like I said, I have insurance.

So in my above example, I should receive serial CTs every 3 hours as long as I keep coming back? What if all the tests indicate that the current benign diagnoses is correct and there is no reason to assume otherwise? Should I, the patient, dictate what tests are done regardless of physician's opinion?
 
Oct 16, 1999
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So in my above example, I should receive serial CTs every 3 hours as long as I keep coming back? What if all the tests indicate that the current benign diagnoses is correct and there is no reason to assume otherwise? Should I, the patient, dictate what tests are done regardless of physician's opinion?

You run tests and/or observe until you find the problem. I can't think of anything more inappropriate than a healthcare provider saying "Well, I can't find anything wrong with you, get out." But to say that to someone three hours away from death, and to have them arrested on top is tragically absurd.

Edit: Oh, and I actually have very reasonable (re: low) expectations of medicine in this country. They just weren't apparently low enough not to find this scenario shocking. But don't worry, expectations adjusted accordingly.
 
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TheVrolok

Lifer
Dec 11, 2000
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You run tests and/or observe until you find the problem. I can't think of anything more inappropriate than a healthcare provider saying "Well, I can't find anything wrong with you, get out."

They didn't find nothing wrong with her, it seems the testing/clinical picture still fit her history of an acute ankle sprain. You're making incorrect assumptions. It wasn't "we have no idea what's wrong with you, so get out" it was "well, you have a history of an ankle sprain, you're complaining of leg pain, we've done an ultrasound which is negative, there's nothing to indicate there's any further need for testing, so you're discharged." Those are vastly different scenarios.

I'll ask again, though, do I get CTs every 3 hours as long as I keep returning? If I get admitted with a negative exam for observation and a day goes by with no clinical changes, do I get another CT? Can I be discharged then if I still have a complaint?
 

TheVrolok

Lifer
Dec 11, 2000
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Is severe abdominal pain consistent with the diagnosis of an ankle sprain?

Is it consistent with the diagnosis of a PE or DVT? What was her abdominal exam like? Was the pain diffuse, localized? What quadrant? Guarding, point tenders? Rebound? HSM? Distended? Was she writing in pain? Was she sitting normally when describing it? What were her vital signs? Did she get an US of the abdomen? Blood work? CT? Oh, you have absolutely no idea.

If they had improperly worked her up, do you honestly believe the investigation would have ignored that?
 
Oct 16, 1999
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Is it consistent with the diagnosis of a PE or DVT? What was her abdominal exam like? Was the pain diffuse, localized? What quadrant? Guarding, point tenders? Rebound? HSM? Distended? Was she writing in pain? Was she sitting normally when describing it? What were her vital signs? Did she get an US of the abdomen? Blood work? CT? Oh, you have absolutely no idea.

If they had improperly worked her up, do you honestly believe the investigation would have ignored that?

Actually there is video of exactly what kind of shape the woman was in as she was dying on the jail cell floor.

This woman had:
1) new symptoms
and/or
2) persistent symptoms unabated by the previous treatment.

Specifics beyond that don't change the fact that either one alone warrants further examination and treatment.
 

TheVrolok

Lifer
Dec 11, 2000
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Actually there is video of exactly what kind of shape the woman was in as she was dying on the jail cell floor.

This woman had:
1) new symptoms
and/or
2) persistent symptoms unabated by the previous treatment.

Specifics beyond that don't change the fact that either one alone warrants further examination and treatment.

1) New symptoms, you mean the abdominal pain? How do you know it wasn't worked up? Also, in regard to the severe abdominal pain, I actually just watched the video of her sitting inside the police cruiser - surely doesn't appear that she's in severe abdominal pain. I, obviously, have no idea what her exam would have been like at that point, but she's not in an obvious distress at that point.
2) What persistent symptoms? Leg pain? Reaching a pain level of "0" with an ankle sprain isn't necessarily possible; it's highly variable from person to person.

A PE from an undetected DVT could kill her very rapidly from an asymptomatic state.

I'll ask again, if she were improperly worked up on the final visit, do you think the investigation would have ignored it? Is it your belief that the investigation done, and report rendered, is wrong?
 
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Oct 16, 1999
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1) New symptoms, you mean the abdominal pain? How do you know it wasn't worked up?
2) What persistent symptoms? Leg pain? Reaching a pain level of "0" with an ankle sprain isn't necessarily possible; it's highly variable from person to person.

A PE from an undetected DVT could kill her very rapidly from an asymptomatic state.

I'll ask again, if she were improperly worked up on the final visit, do you think the investigation would have ignored it? Is it your belief that the investigation done, and report rendered, is wrong?

Wrong? No, I'm quite sure now telling people in pain and three hours from death to leave the ER is perfectly acceptable medical practice here. /nosarcasm
 

umbrella39

Lifer
Jun 11, 2004
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I've had tests re-run to make sure nothing was missed or changed in the time between. But then I have insurance.

LMAO, sorry man but people demand a lot of shit in the ER's I have worked and it doesn't mean you get it done. You think that just because you have insurance you get to tell us what test to run and re-run on you and that your insurance is just going to pay?! Come on man... they did the proper tests and DVT was ruled out more than once, we don't do Q2hr ultrasounds to check for DVT in the ER.
 
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TheVrolok

Lifer
Dec 11, 2000
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Wrong? No, I'm quite sure now telling people in pain and three hours from death to leave the ER is perfectly acceptable medical practice here. /nosarcasm

People are discharged with pain all the time, I honestly can't see how that is mind blowing to anyone. It's just the way is, having pain isn't necessarily a criterion for continued work up or admission. You keep insisting something was done wrong on part of the hospital, but the investigation states that everything was appropriate ... with which you.. agree?
 

umbrella39

Lifer
Jun 11, 2004
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In my experience tests are run, be they repeated or new ones, until the problem is found or I'm transferred to a specialist to rinse and repeat. But then, like I said, I have insurance.

Your experiences are full of crap. That's not how ER's work. The specialist in is the hospital, you aren't transferred to one. You are talking about office visits with your primary care and being referred to a specialist. Not sure why you are trying to make this out to be something it isn't and comparing apples to oranges...
 

umbrella39

Lifer
Jun 11, 2004
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Is severe abdominal pain consistent with the diagnosis of an ankle sprain?

No and it's not a sign or symptom of DVT either and what makes you think they didn't diagnose and treat her abdominal complaints? You continue to bounce around and continue to not have any first hand knowledge of how ER's work and what does and doesn't fit the criteria for admission.
 
Oct 16, 1999
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This woman didn't just have pain. She had pain from a life-threatening condition. But you're right, with a healthcare industry responsible for outright killing 100,000 people annually this shouldn't be mind blowing. I'm sure they did everything by proper procedure and any investigation accurately reflects it.

The arrest and fatality are just bonuses.
 
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TheVrolok

Lifer
Dec 11, 2000
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This woman didn't just have pain. She had pain from a life-threatening condition.

Wait, what? How do you know that? You do know that abdominal pain is not a symptom of a DVT nor a PE? How do you even know she had any abdominal pathology whatsoever? Could it have been chest pain that she poorly described as abdominal pain? Maybe, I don't know, but neither do you. Everything you're saying is complete conjecture that you're spouting as gospel.
 

TheVrolok

Lifer
Dec 11, 2000
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with a healthcare industry responsible for outright killing 100,000 people annually this shouldn't be mind blowing.

Are you referring to the statistics regarding mortality from medical error? If so, yes, it absolutely does happen. However, this case does not seem to be medical error.
 

umbrella39

Lifer
Jun 11, 2004
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GTB, I can assure the healthcare industry does suck and people die every day, but to paint this incident as something to do with her lack of insurance is dishonest and wrong.

Being so close to Detroit, a good portion of our patients abuse the hell out of the ER because they have medicaid. Yes, they are insured and they get treated no better that someone without insurance.

I actually have an active disdain for the disinterested bitch medicaid mom talking or texting on her cell phone with her sniffly nosed baby rolling around who is there because she is to stupid to realize that kids get sick and unless it is a EMERGENCY your kid should be seeing his doctor in the morning or at most going to an urgent care which are every where now. All those people out there waiting to be seen shouldn't have to wait for your dumb ass to be told your kid has a cold.

We gladly show these people the door no sooner or later than someone without the means to pay. We don't admit them extra special just because they have medicaid or run extra test we can't justify or bill for. We still have to justify their admit, insurance or not. We still have to prove indications for anything we do to get reimbursed.
 

Hayabusa Rider

Admin Emeritus & Elite Member
Jan 26, 2000
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This woman didn't just have pain. She had pain from a life-threatening condition. But you're right, with a healthcare industry responsible for outright killing 100,000 people annually this shouldn't be mind blowing. I'm sure they did everything by proper procedure and any investigation accurately reflects it.

The arrest and fatality are just bonuses.

You need a sense of perspective. Heres a thread dealing with this situation. http://forums.anandtech.com/showthread.php?t=2112762&highlight=black
 

umbrella39

Lifer
Jun 11, 2004
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Clueless hit and run thread crap troll fail. Your disadvantages keep getting more obvious.
 

5150Joker

Diamond Member
Feb 6, 2002
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www.techinferno.com
Haven't read the thread, don't have time to read b.s. debates but the case is very simple: The ER nurses or physicians could have easily tested for Homans sign and determined if she had a DVT. If I had a patient come in complaining of ankle pain and I saw they were in distress, I'd perform it just to be sure even if its not 100% reliable (better than doing nothing). A lot of ER nurses and doctors suck and are largely apathetic, especially towards the poor who cannot afford to pay.
 
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Zebo

Elite Member
Jul 29, 2001
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Apparently when someone has sprained their ankle and then comes back complaining about leg pain (not ankle pain) they check for clots here in the UK, this is what i'm told, they don't let them out until they have checked for it because it's a common thing.

Of course, we have that dreaded universal health care which is much worse.

I think not having to care about any sort of insurance does help when giving care, no one cares who the patient is, the care is the same and paid for in full for everyone.

And yet we pay less IN TAXES PER CAPITA than you do, with your insurances you pay four times as much for less care.
Yeah but you don't have CEOs of insuance/pharma/medical devices/paper work pushers making hundreds of millions either. So there.
 

alkemyst

No Lifer
Feb 13, 2001
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Haven't read the thread, don't have time to read b.s. debates but the case is very simple: The ER nurses or physicians could have easily tested for Homans sign and determined if she had a DVT. If I had a patient come in complaining of ankle pain and I saw they were in distress, I'd perform it just to be sure even if its not 100% reliable (better than doing nothing). A lot of ER nurses and doctors suck and are largely apathetic, especially towards the poor who cannot afford to pay.

you really living in south florida as an ER nurse?