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Nov 26, 2008 11:00 pm US/Eastern
Overcrowded ERs Lead To Deadly Mistakes
BOSTON (WBZ) ―
Overcrowded and understaffed, many Massachusetts emergency rooms are in critical condition. An I-Team investigation reveals questionable care that is leading to intolerably long waits for help, and deadly mistakes.
Some experts believe that as the economy continues to worsen, more people will be forced to use emergency rooms for basic care. That will just make matters worse.
AGONIZING HOURS SPENT IN ER
As Jim Fahy's left leg started to swell, he became increasingly worried. He has a history of high blood pressured and high cholesterol.
"At that point you don't know whether it's a blood clot, or something else is going on," he said.
The nurse practitioner told Jim to go to the emergency room immediately, because he might need to be admitted. Jim and his wife Linda went to the Caritas Good Samaritan Medical Center in Brockton, but after talking to the registration nurse, things went from bad to worse.
Linda described what happened next: "She said, 'you just have to wait your turn.' So we were wheeled back out into the emergency room and sat there for seven hours -- from 4 o'clock until 11 o'clock at night."
They never saw a doctor. At that point, Linda was concerned Jim might die waiting in the emergency room to be seen.
Linda wrote to the hospital outlining their problems that night. She received a response from the hospital, which said in part that "your husband did experience an unacceptably long delay" and that the hospital had "rewritten our policy governing delays." They were also refunded their $100 co-payment.
It turned out that Jim didn't have a blood clot, but they were never able to get that piece of mind from visiting the emergency room.
Linda said, "It's deplorable to be in an emergency room for seven hours, even with a possibly life-threatening situation, and you could literally drop dead and no one would know."
A NATIONWIDE PROBLEM
That dire scenario has happened across the country. A surveillance camera in Los Angeles showed a patient who fell out of a wheelchair in the emergency room, and was ignored for 45 minutes. That patient died.
There was another disturbing case in New York. A patient collapsed and died, even as a security guard ignored his plight.
REVEALING STATE HEALTH RECORDS
Across Massachusetts, the I-Team found crowed emergency rooms with patients waiting, and waiting, to be seen.
Alan Sager, PhD, from the Boston University School of Public Health said, "You'd like to believe that people with severe problems would be seen a lot faster."
The I-Team wanted to find out what's wrong with the system, so we exclusively obtained state health records from the past two years. We searched for emergency room complaints in eastern and central Massachusetts that had been substantiated by state inspectors. Here's just some of what we found:
- In June 2007, "The emergency department did not initiate medicating the patient . . . until the patient had been in the emergency department for five hours."
- In January 2008,"Two nurses observed a mouse running around . . . and bed linens utilized in the emergency department are sometimes stained with blood and/or other substances."
- In April 2007, "A patient fell from a transport stretcher and was found on the floor in the emergency department . . . the patient later died."
There's also the case of William Ilkowtiz. He went to the emergency room at Sturdy Memorial Hospital in Attleboro last January. A lawsuit obtained by the Iteam alleges that the care he received in the emergency room contributed to his death.
"Billy", as he was known, had a history of heart problems, including a stroke and a bypass. He had been rushed to Sturdy on previous occasions. But this time, despite showing irregularities on his EKG, he was treated mostly for dehydration.
Krysia Syska, who now represents the family, explained the basis of the suit. "The emergency room physician who initially evaluated Mr. Ilkowtiz ordered a number of tests for him. One of them was an EKG. The EKG was abnormal."
She added, "The emergency room physician should have recognized that these EKG changes may have been associated with a cardiac event, or an impending heart attack."
The I-Team obtained a copy of the state's investigation, which "determined the hospital failed to ensure the patient received care in an appropriate safe setting."
The hospital's medical director tells the I-Team that they still believe that "care under the circumstances was appropriate."
Still, four corrective steps have now been put into place. They include more telemetry, or monitoring, beds, and additional training.
BUT WHY MASSACHUSETTS?
Massachusetts is considered to have some of the best health care in the country, the world for that matter. When asked what's causing so many of these problems, Karen Nelson of the Massachusetts Hospital Association said, "Patients can't get appointments elsewhere. They can't get timely appointments with their primary care physician. Some patients don't even have a primary care physician."
She attributes the lack of primary care physicians, in part, to the higher salaries available in specialized medicine.
Not being able to see a doctor is an ironic problem in a state that happens to have the most physicians per capita. The consequences of everyone jamming emergency rooms, according to Sager, are real. "When patients have to wait a long time in the emergency room to see a doctor, mistakes are waiting to happen."
Another problem making matters worse in Massachusetts is that we rank 8th in terms of number of visits to the emergency room. No one is quite sure why.
Dr. Sager also believes that emergency rooms are often a low priority for hospitals, because they often lose money and are not considered a prestigious area. As a result, resources are committed to other departments first.
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