Comments on: Death in Illinois ER Ruled a Homicide

By: Babs RN

Babs RN — Tue, 26 Sep 2006 01:57:46 +0000

Gone in 60 seconds, wow. But here’s what you’re missing: 30 years ago people weren’t showing up in ERs for primary care, ERs weren’t overflowing with narcotics addicts and drama queens (at least as much as they are now) and they weren’t utilizing it as the “Bargain Basement” of healthcare. Shoot…30 years ago “healthcare” was two words, not one, and we didn’t live in such a litigious society where people have to double & triple cover their asses. We also had a lot fewer drive-by shootings drug deals gone bad. Society wasn’t ideal but it wasn’t nearly as violent and “entitled” as it is now. All this contributes to ED conditions that will, tragically, sometimes allow a truly sick individual to fall through. It is hard for me to fathom that the triage nurse sent this patient back to the waiting room but I am still wondering what the conditions behind those ED doors were at the time and if they genuinely had the physical and personnel resources available to handle another potentially critical patient at that moment. I absolutely agree that the very same processes that people put into place to ensure quality defeat that very purpose, particularly in a fast-paced truly emergent situation. I also think we have a much larger crisis on our hands simply due to modern society and this kind of thing can be a symptom of it. If so, I hope that this opens peoples’ eyes.

Also wonder if the patient involved was a known drug-seeker. Cry Wolf Syndrome and all that. No excuse if that’s the case, but it could make more sense….

And if everything was fine and that nurse was truly negligent, then let her hang.

By: gone in 60 seconds

gone in 60 seconds — Mon, 25 Sep 2006 04:00:17 +0000

Triage, of itself, has become another wall between the patient and medical care. 30 years ago there was none and people weren’t dying in ER waiting rooms. As additions are made to the process of emergency care, patient care is diminished, especially on the time line. Basically, medical care in ER is going south. In fact, the quality of the facility seems to be inversely proportional to the quality of patient care. With more money for facilities brings more process and more process brings lower quality patient care.

By: GruntDoc

GruntDoc — Sat, 23 Sep 2006 15:47:37 +0000

20%? No way.

I wondered about gender bias and chest pain, too, when I read the article. I have to think the triage nurses’ defense will be ‘I thought it was GI”, which isn’t much of a defense but is more common in this age group of women than heart disease.

By: funky chicken

funky chicken — Sat, 23 Sep 2006 13:38:57 +0000

Do you think if this patient had been male the MI symptoms would have gotten more attention? I’ve read that women’s heart disease often goes undiagnosed.

By: Supremacy Claus

Supremacy Claus — Sat, 23 Sep 2006 11:50:03 +0000

Perhaps, this error is a homicide. The 20% of innocent people on death row, after months of trial and appeals, $1 million in legal costs, then qualifies for homicide by all parties involved.

By: scalpel

scalpel — Thu, 21 Sep 2006 08:28:27 +0000

All pain is 10/10 in triage, isn’t it?

By: nhmind

nhmind — Thu, 21 Sep 2006 01:47:49 +0000

Chest Pain, nausea, shortness of breath. From my experience with a family member, call 911. Do not go to the ER on your own. Ambulance arrival at a hospital receives far more scutiny and attention (higher triage level) than any walk in. As for homicide, this just doesn’t seem to fit. Tragic, yes. Negligent, possibly. Homicidal, a big strech.

By: healthnut

healthnut — Thu, 21 Sep 2006 01:31:07 +0000

I believe there are two aspects to this story to be considered:
1) the failure to provide immediate care given the symptoms (already discussed in other posts) and 2)the “unprecedented” homicide ruling. I read on the coroner’s website that the jury is made up of 6-7 county residents who must make a decision based solely on the deputy coroner’s (Barrett) testimony. Additionally, the jury report (available on CNN) shows only four possible rulings. Something is amiss.

By: Steve White

Steve White — Wed, 20 Sep 2006 16:49:02 +0000

I’m an academic doctor in Illinois. If one goes to the ‘about’ page of the hospital’s website, one will see that the hospital has modern cardiac cath facilities and a modern emergency department.

When a patient comes in with 10 out of 10 chest pain, nausea and shortness of breath, that triad screams ‘MI!!” to good ER nurses and doctors. Such a patient moves immediately to the head of the line, and appropriately so.

We (the medical profession) know that prompt treatment with nitrates, oxygen, clot-dissolving drugs, beta-blockers, and aspirin substantially reduce the immediate risk of death. We also know that if the hospital has a cardiac cath lab, getting the patient there within the first two hours of presentation for diagnosis and treatment of the coronary blockage reduces mortality further.

This episode has me shaking my head in disbelief. I don’t know whether it’s properly a ‘homicide’, but a horrific blunder? Without question. However, having the medical examiner involved is proper — whenever there is a suspicion concerning a death, having the ME involved will lay to rest concerns that could be raised later about ‘cover-up’ and so on.

By: DK

DK — Tue, 19 Sep 2006 21:44:12 +0000

shadowfax, legally, the coroner IS the first step in the prosecutor-judge-jury cycle. effectively, the coroner is the triage nurse of the legal system, responsible for deciding only whether your case gets in the door, not what the treatment will be.