Woman dies in hospital waiting room

[Texsox]

http://www.cnn.com/2008/US/07/01/waiting.r...eath/index.html

Surveillance video shows a woman lying on the hospital floor for almost an hour before anyone helped her. Esmin Green was involuntarily admitted to the psychiatric emergency department of Kings County Hospital Center on June 18 for what the hospital describes as "agitation and psychosis."

 

Upon her admission, Green waited nearly 24 hours for treatment, said the civil liberties union, which was among the groups filing suit against the facility last year seeking improved conditions for patients.

 

The surveillance camera video shows the woman rolling off a waiting room chair, landing face-down on the floor and convulsing. Her collapse came at 5:32 a.m. June 19, the NYCLU said, and she stopped moving at 6:07 a.m. During that time, the organization said, workers at the hospital ignored her.

 

At 6:35 a.m., the tape shows a hospital employee approaching and nudging Green with her foot, the group said. Help was summoned three minutes later. Watch the surveillance video »

 

In addition, the organization said, hospital staff falsified Green's records to cover up the time she had lain there without assistance.

 

"Contrary to what was recorded from four different angles by the hospital's video cameras, the patient's medical records say that at 6 a.m., she got up and went to the bathroom, and at 6:20 a.m. she was 'sitting quietly in waiting room' -- more than 10 minutes since she last moved and 48 minutes after she fell to the floor."

 

The New York City Health and Hospitals Corporation, which oversees the hospital, released a statement Tuesday saying it was "shocked and distressed by this situation. It is clear that some of our employees failed to act based on our compassionate standards of care."

 

 

[Balta1701]

Best health care in the world!

[santo=dorf]

But if she was in Canada she would've died after waiting for a month.

[vandy125]

What I don't also get is not only the negligence of the hospital staff, but also the other people who are just sitting there. Is it normal to see someone just passed out on the floor? I know I would have said something. It's just sad all around.

Edited July 3, 2008 by vandy125

[shipps]

What I don't also get is not only the negligence of the hospital staff, but also the other people who are just sitting there. Is it normal to see someone just passed out on the floor? I know I would have said something. It's just sad all around.

Its somewhat normal to see crazy people laying on the floor.Sometimes psych patients get ignored because they will do crazy stuff just for attention.But 24 hours is ridiculous.

[BearSox]

But if she was in Canada she would've died after waiting for a month.

It is ridiculous how long Britain and Canada make you wait for treatment. Yet, all the politicians don't have to go through the same system as everyone else.

[Balta1701]

It is ridiculous how long Britain and Canada make you wait for treatment. Yet, all the politicians don't have to go through the same system as everyone else.

It's equally ridiculous that people continue to make this argument when 15% of this country is fully uninsured and has to wait essentially infinite time to get treatment, another 10-15% is underinsured and often has enormous wait times while they try to afford things, and the treatments for which we're so good at getting people fast service are often the ones provided by Medicare, because service providers know they'll get paid for the treatment.

[Texsox]

And no way we could do something better then Canada!

[southsider2k5]

How would you add 15% more people to our current medical care capabilities without completely collapsing the system. We can't create more doctors, nurses, hospitals etc. How exactly do we improve the system?

[Rex Kickass]

Just to let you know, since I've heard a bit more about this story, that the woman was involuntarily committed, and was waiting for a bed. Because there were none available.

[Texsox]

How would you add 15% more people to our current medical care capabilities without completely collapsing the system. We can't create more doctors, nurses, hospitals etc. How exactly do we improve the system?

I am not certain what you mean. At least in my corner of the country, these people are being treated, often for minor ailments, in hospital ERs. The hospitals are not being compensated, or only partly compensated for these services. So it would seem the question is which is economically best. The providers picking up the tab and passing it on to their patients, or some other plan. Basically it is about the same as the uninsured motorist cost on our auto insurance, only better hidden.

 

In most cases your for profit insurance company is making decisions on what treatments you will receive. Patients without insurance either visit the ER where they know they will be treated, or treat it themselves. While the "handle it themselves" sounds fine, communicable diseases pass from the uninsured to the insured just as easy.

 

I'm also a big fan of small business in America. They are the most likely to invest in their community and not move their jobs off shore. It is tough for them to offer health care benefits to their employees. And someone making $25,000 a year cannot afford to spend 25% or more of their net income for health insurance. And unlike cars and homes, the cost cannot be shared. Four people living in one house divides the rent, but they cannot divide one insurance premium, at least not legally.

 

I think any changes should be in small steps, but just because Canada or Britian has not found a better way, doesn't mean we cannot. We should be able to learn from their mistakes and make our system better. I also think any system will need a private pay option. We may be creating a two tier health system, but even that could be an improvement.

[EvilMonkey]

The discount clinics offered in many drug stores, Costcos and Wal Marts is a good step also. For most of the minor things these people go to the ER for, this place would do very cheaply. BUt of course, doctors groups are opposed to this, as it eats into their business. Sounds like a union complaint to me.

[southsider2k5]

So giving people more health care, and less reason to be judicious about the care they seek is going to improve those conditions?

[NorthSideSox72]

So giving people more health care, and less reason to be judicious about the care they seek is going to improve those conditions?

While I agree with your general point, you do open up an interesting sub-set here... Under the current system, where most have health insurance, there is already very little incentive to be judicious about it. Just something to keep in mind.

 

Really, when you look at the whole issue, the fact that there are insurance providers sitting between consumers and health care providers is the cause of many of the roadblocks to a good solution. But, you really have to have it - its a necessary evil. This is the crux of the issue, IMO.

 

[Texsox]

So giving people more health care, and less reason to be judicious about the care they seek is going to improve those conditions?

 

No, of course not. That would have to be addressed. Are you suggesting that is an unsolvable problem?

[southsider2k5]

No, of course not. That would have to be addressed. Are you suggesting that is an unsolvable problem?

 

Where would we find the health care facilities and professionals to treat something like 50 million more people (the 15% of people number that is being thrown about)?

[bmags]

Sorry to de-rail, but man, we have 3 hospitals in town. My friend had heartburn and couldn't keep food down and pain all in her abdomin. She went to the county general. When they treated her, they said it was just acid reflux and to not come back for 7 days unless it's still hurting. So she went to the Mizzou hospital, and it turned out she had appendicitis and obviously needed emergency surgery. Can you imagine had she heeded first advice? Don't you initially feel better when your appendix bursts? Awful. So...I'd suggest getting second opinions.

[Texsox]

Where would we find the health care facilities and professionals to treat something like 50 million more people (the 15% of people number that is being thrown about)?

 

I believe many are being treated already. In hospital ERs, without compensation to the hospitals. One area for improvement is moving these patients from ERs into a more appropriate venue.

 

But that does brings up an interesting point. Perhaps the level of health resources in this country cannot support all the people here and having uninsured people is a good thing?

[southsider2k5]

I believe many are being treated already. In hospital ERs, without compensation to the hospitals. One area for improvement is moving these patients from ERs into a more appropriate venue.

 

But that does brings up an interesting point. Perhaps the level of health resources in this country cannot support all the people here and having uninsured people is a good thing?

 

To where? I don't think I have ever heard of an underutilized facility. How many unemployed Doctors are there that we can use for people?

[hitlesswonder]

So giving people more health care, and less reason to be judicious about the care they seek is going to improve those conditions?

 

One could argue with equal validity that lack of health care and preventive medicine leads to worse long-term health and people getting treated in ERs where costs are much higher than in a clinic. Forcing people to be "judicious" about health care by making treatment too expensive for them is not a solution to me. Other countries have equal or better healthcare compared to the US at less cost, so clearly it is possible to cover a greater percentage of the population without skyrocketing medical costs.

 

Germany in particular has an interesting system, which has strong government involvement but is not state-run. In particular, people with private insurance get preferential. I have no problem with people who have more money getting better healthcare than poor people. What I dislike is people getting no health care (or healthcare at bankrupting cost) due to losing a job or having a "pre-existing condition".

 

 

 

 

[Texsox]

To where? I don't think I have ever heard of an underutilized facility. How many unemployed Doctors are there that we can use for people?

 

Doctor's offices instead of ERs. Outpatient clinics instead of ERs.

 

Currently, many uninsured and indigent people will show up in an ER with symptoms that do not require emergency procedures. Doctors can, and will, turn them away if they cannot pay, hospitals generally will not. Also, small things become bigger when ignored. When they cannot afford a Doctor and wait, a small infection becomes bigger and they are in the ER. A lack of prenatal care causes some pregnancies to go astray. That is what I meant by a more appropriate facility. Basically what Alpha pointed out with the chain stores offering low cost options.

 

Another local issue here are the expectant mothers from Mexico who just "happen to go into labor during a visit to the US". Generally they cannot pay and their children receive automatic US citizenship. I'm in favor of eliminating the automatic citizenship.

[southsider2k5]

Doctor's offices instead of ERs. Outpatient clinics instead of ERs.

 

Currently, many uninsured and indigent people will show up in an ER with symptoms that do not require emergency procedures. Doctors can, and will, turn them away if they cannot pay, hospitals generally will not. Also, small things become bigger when ignored. When they cannot afford a Doctor and wait, a small infection becomes bigger and they are in the ER. A lack of prenatal care causes some pregnancies to go astray. That is what I meant by a more appropriate facility. Basically what Alpha pointed out with the chain stores offering low cost options.

 

Another local issue here are the expectant mothers from Mexico who just "happen to go into labor during a visit to the US". Generally they cannot pay and their children receive automatic US citizenship. I'm in favor of eliminating the automatic citizenship.

 

Like I said, how many doctors out there do you know of that are underutilized? Between recently having a vacesectomy, sick kids, routine doctor visits, and the wifes follow ups after pregnancy, I have yet to see a doctor that had a bunch of open slots to just accept a bunch of new people. Every doc I have talked to had weeks worth of wait for anything that wasn't an emergency.

[santo=dorf]

To where? I don't think I have ever heard of an underutilized facility. How many unemployed Doctors are there that we can use for people?

I'm sure there are plenty of qualified doctors in India who would be willing to come here and practice. They already come for our schooling.

[StrangeSox]

Like I said, how many doctors out there do you know of that are underutilized? Between recently having a vacesectomy, sick kids, routine doctor visits, and the wifes follow ups after pregnancy, I have yet to see a doctor that had a bunch of open slots to just accept a bunch of new people. Every doc I have talked to had weeks worth of wait for anything that wasn't an emergency.

 

This is especially true for family/ general practice doctors. There are fewer and fewer because more and more medical students are getting into the high-paying specialties. When you're looking at upwards of $500k in student loans for some schools and a $50-$300k difference in salary, its no wonder why they are making these choices.

 

Now, on the other hand, if less people were being treated in the ER for non-ER situations or for situations that could have been corrected much, much earlier, ER's will start to be under-utilized and those doctors could switch over to general practice.

[Texsox]

Like I said, how many doctors out there do you know of that are underutilized? Between recently having a vacesectomy, sick kids, routine doctor visits, and the wifes follow ups after pregnancy, I have yet to see a doctor that had a bunch of open slots to just accept a bunch of new people. Every doc I have talked to had weeks worth of wait for anything that wasn't an emergency.

 

How many ERs are underutilized? Here it is a 6-7 hour wait in an ER on a good day.

 

I see your point, and it is a excellent one and would have to be addressed for any improvements to our system to work. But which is more feasible, more Doctors and clinics like at Cosco or more ERs offering treatment for no renumeration? Perhaps if providers were actually being paid for treating these patients we would decrease crowding in ERs and Doctors offices could actually expand and shorten up those wait times? I don't think that having millions of patients receiving treatment for free is a good for the system either.