Thursday, June 14, 2007

An American Medical Tragedy

They call it a "bizarre" tale of a woman that dies after not receiving treatment at an emergency room. I call it for-profit health care.

The story doesn't say it, but what do you bet that she didn't have health insurance?

Los Angeles woman dies on emergency room floor

Companions tried to get an ambulance to take her to another hospital

By Charles Ornstein and Francisco Vara-Orta
Los Angeles Times
Copyright 2007 Los Angeles Times
All Rights Reserved

LOS ANGELES — In the 40 minutes before a woman's death last month at Martin Luther King Jr.-Harbor Hospital, two separate callers pleaded with 911 dispatchers to send help because the hospital staff was ignoring her as she writhed on the floor, according to audio recordings of the calls.

"My wife is dying and the nurses don't want to help her out," Jose Prado, the woman's boyfriend, told the 911 dispatcher through an interpreter.

He was calling from a pay phone outside the hospital, his tone increasingly desperate as he described how his 43-year-old girlfriend was spitting up blood.

The Los Angeles County Sheriff's Department dispatcher struggled to make sense of his predicament, then urged him to contact a doctor or nurse.

"Paramedics are not going to pick him up, or pick his wife up, from a hospital, because she's already at one," the dispatcher said.

Eight minutes later, an unidentified woman, apparently another patient, dialed 911 and reached a different dispatcher. After a short debate about whether the call was an emergency, the dispatcher scolded her and insisted that it was not. The 2 1/2 -minute call ended on a hostile note.

"May God strike you too for acting the way you just acted," the frustrated caller told the dispatcher, just before 2 a.m. on May 9.

"No. Negative ma'am, you're the one," the dispatcher responded before disconnecting.

The patient, Edith Isabel Rodriguez, was pronounced dead at 2:17 a.m., the victim of "inexcusable" indifference by staff at King-Harbor, county health officials later acknowledged.

Rodriguez lay untreated on the ER lobby floor for 45 minutes before dying. A video camera captured the episode, showing that staffers and patients stood by as a janitor cleaned the floor around her. She was buried in Tehachapi on Tuesday.

The county coroner ruled that Rodriguez died of a perforated bowel, with the injury probably occurring in her last 24 hours of life. Experts have said that the condition might have been treatable if caught earlier.


Rodriguez's death was just one of the King-Harbor issues discussed Tuesday during a meeting of the county Board of Supervisors. Also at that meeting, the county health services director disclosed that the hospital had replaced its medical director, citing his handling of an unrelated lapse in patient care. In that case, a man with a brain tumor languished without treatment in the ER for four days before he was taken elsewhere by family and friends for emergency surgery.

In Rodriguez's case, the 911 recordings were released by the Sheriff's Department in response to California Public Records Act requests by The Times. Both illustrate how confounding it was for the emergency response system to handle a bizarre scenario in which a patient dying in plain sight at a hospital could not get treatment there.

"What's real confusing ... was that she was at a medical facility," said Sheriff's Capt. Steven M. Roller, who is in charge of the Century Station, which handled the calls. "That poses some real quandaries."


In the days leading up to her death, Rodriguez had sought care in the King-Harbor emergency room three times. Each time she was released after receiving prescription drugs for pain. On May 8, however, she did not leave the hospital but instead lay on the benches in front of its main entrance.

County police officers found her there and helped escort her to the emergency room. There, a triage nurse told Rodriguez that nothing could be done to help her.

Meanwhile, police ran a computer check on Rodriguez and found that she had a no-bail warrant for her arrest. As she was being taken to a squad car to be placed in custody, she became unresponsive. She died a short time later in the ER.

Here is the real reason why she probably didn't get treatment:

On Tuesday morning, Rodriguez's family gathered at a Pico Rivera memorial chapel to bid farewell to the California native, one of 13 siblings. They had delayed a funeral service for more than a month because they didn't have money to pay for it. One of her sisters arranged fundraisers, selling homemade tamales to pay the about $7,500 tab.

This is another one of those "this shouldn't happen here" stories.


Anonymous said...

I am a Registered Nurse, and I call this "murder"....murder by apathy, predjudice, and greed on the part of a disgusting healthcare system. The police force are no better...instead of protecting the innocent, they helped to kill her. I am ashamed of the American medical profession and how pathetic and greedy it has become. As for the Triage nurse that said she couldn't help her...may someone leave you dying on the floor of the ER someday! Harsh words, yes, but, needed ... the American medical profession needs a wake-up call. I pray this woman's family obtains good legal counsel and takes them for all they're worth.

OkieLawyer said...

Technically, it is probably closer to a case of involuntary manslaughter:

Involuntary manslaughter is a killing in which there is no intention to kill at all. It occurs when the killing is the result of the commission of a crime that is neither a felony nor an act likely to cause great bodily harm or when it is the result of a lawful act done in a criminal manner, e.g., a case of negligence.

The question then will become: who had the proximate cause. Who had the last legal duty to help this woman? Then, who failed in that legal duty?

Most medical malpractice suits end in favor of the defendant (some 80%). However, something tells me that this one will end up in favor of the plaintiff. The only argument will be one of damages. Still, the cost of bringing a successful medical malpractice suit will be over $100K, mainly due to the cost of expert witnesses.

Due to the woman's age, her case would normally not be worth that much money, but the failure on the behalf of the hospital was so egregious that the possibility of punitive damages cannot be ignored. I don't know if California has limited punitive damages, but, if so, this case would be a perfect example of the fallacy of such a policy.