# Woman in labor claims hospital ignored her



## Aidey (Dec 12, 2009)

> Abney said she screamed in pain for six hours at UMC while she waited to be treated. She also said she unsuccessfully sought treatment at Valley Hospital Medical Center before finally giving up and going home. She gave birth to a baby girl who died less than an hour later. The 25-year-old woman had not known she was six months pregnant.





> Wall said that after nine hours, she was able to see a doctor.
> "Once I got in back, everything was all right," Wall said. "They said I had a cardiac episode."



http://www.lvrj.com/news/hours-of-c...at-two-hospitals-for-area-woman-78628332.html

http://www.lvrj.com/news/umc-moves-to-fire-six-employees-in-probe-of-ignored-patient-79119652.html


http://www.lvrj.com/news/scrutiny-of-hospital-increases-78949342.html

What do you guys think? Was the patient abused and neglected by staff or is this the unfortunate consequence of a public ER that is probably very busy? Do you think how liable the hospitals are should be affected by the fact they left? What kind of wait times for patients have you noticed at the ERs you go to? (ie. you come back 6 hours later to drop another one off and the same person is still waiting). 



Reading the articles was slightly annoying because most of them are emotionally slanted towards the patient (Like the concentration camp quote). A lot of the articles and headlines make it sound like the hospitals deliberately ignored her and then refused to treat her. 

As I quoted above, a woman having chest pain at UMC had to wait for 9 hours, that indicates to me that the ER was pretty backed up and that everyone was having to wait, not just this couple. I skimmed through some of the comments on the articles and a lot of people have posted saying they had 6, 8, and 10 hour wait times in this same ER. Unfortunately none of the articles I found had facts on wait times in those ERs. Making someone wait because more acute patients are there is not the same as refusing to treat, and the concept of triage isn't being explained at all in any of the articles. 

While it does sound like the customer service this couple received was poor, I'm not sure that makes the hospital criminally liable for the baby's death since the patient left on her own. I think they definitely have a civil case for pain and suffering, but I'm not sure about criminal. It does sound like her triage score should have been increased due to her level of pain even if her vitals were ok, but then again I don't know what else was coming to that ER. I can see where some of the comments made by staff sound very harsh, but I can also see where the staff may have been coming from.

Where I interned the public hospital (can't remember the name) was notorious for long waits and problems in the waiting room(lots of gang issues). If UMC is anything like that hospital I can see how the staff may be aggressive in trying to squash any problems before they start in the waiting room. 

Something else that seemed odd to me that popped up in a couple of articles was that family reports the couple was trying to get pregnant. If so, why no home pregnancy test after 6 months without a period? I know she said her periods were irregular, but if you are trying to have a baby why not check?


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## VentMedic (Dec 12, 2009)

> What she first thought was the beginning of a menstrual period,


 
If she had called 911 she would probably have been told to go by POV.




> "He asked me how long I had been in pain, and I told him *two days*," Abney said. "He told me that since I had been in pain that long, another 45 minutes wouldn't make any difference."


 
How many times has this same statement been made on the EMS forums?



> "I didn't know I was pregnant," she said, shaking her head Tuesday.


 
After 6 months?


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## scottyb (Dec 12, 2009)

VentMedic said:


> After 6 months?



I guess.  

My wife watches a show that is all about women who don't know they are pregnant until they are giving birth.  It's called I didn't know :"I was pregnant", not sure what network it is on.  She says it is hilarious.  

I personally think it is just a bunch of women who ignore the signs and symptoms or explain them away as something else.


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## VentMedic (Dec 12, 2009)

scottyb said:


> I guess.
> 
> My wife watches a show that is all about women who don't know they are pregnant until they are giving birth. It's called I didn't know :"I was pregnant", not sure what network it is on. She says it is hilarious.
> 
> I personally think it is just a bunch of women who ignore the signs and symptoms or explain them away as something else.


 
I have seen this myself but it usually has been with teenagers who had been afraid to tell their parents they were pregnant and the parents were too wrapped up in their own little world to notice anything different about their own child.

The other situations have been where the woman was still spotting or having "light periods" to  where they did not think anything different except for it to be a blessing to have a "light period".

The woman in the article was not married so who knows what her reasons were for not believing she could be pregnant after 6 months of Amenorrhea


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## Onceamedic (Dec 12, 2009)

scottyb said:


> I personally think it is just a bunch of women who ignore the signs and symptoms or explain them away as something else.



you do do you?  sounds to me like it was a man that ignored the signs and symptoms in this particular case.  And as far as pregnant women in general, usually a man is involved in that particular situation as well.


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## atropine (Dec 12, 2009)

If she cal;led 911 in LA co she would have gone by ambulance, the privates must make $$ somehow.


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## VentMedic (Dec 12, 2009)

atropine said:


> If she cal;led 911 in LA co she would have gone by ambulance, the privates must make $$ somehow.


 
Thank goodness for the privates of LA county since the Paramedics of LAFD would be of no use if you are any example. 

Oops, my mistake. You are not a Paramedic or even a FF.


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## Onceamedic (Dec 12, 2009)

atropine said:


> If she cal;led 911 in LA co she would have gone by ambulance, the privates must make $$ somehow.



As a medic working for a private, at the very least she would have received a proper assessment and the patient advocacy she obviously needed to get her condition treated.  I always ask my female patients if there is a possibility of pregnancy and when they deny it, I inquire in detail about LMP,  and menses in general.  

PS..   and I get a whole 8 bucks for it too....


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## atropine (Dec 12, 2009)

VentMedic said:


> Thank goodness for the privates of LA county since the Paramedics of LAFD would be of no use if you are any example.
> 
> Oops, my mistake. You are not a Paramedic or even a FF.



No I guess Iam not my IAFF membeship must be not valid, howvere if she need to some the whine about the lack of ems education, or try to remember the glory days of ems I guess a could have beenor fnever was such as yourself would have helped her greatly.


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## scottyb (Dec 12, 2009)

Kaisu said:


> you do do you?  sounds to me like it was a man that ignored the signs and symptoms in this particular case.  And as far as pregnant women in general, usually a man is involved in that particular situation as well.



In that statement I was speaking specifically of the women in that show.  Not this particular case.  Sorry, I must not have made that as clear as I meant to.


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## Aidey (Dec 12, 2009)

We don't know if they did ask her though, and she said "Oh no, there is no way I could be pregnant. Yeah, I haven't had a period in a while, but they are irregular and we always use protection". How many times have you guys heard that line? 

Personally I think if you have irregular menses then you need to be proactive about your pregnancy status if you are sexually active. Sorry if TMI, but I've always been irregular and after it was a concern I did a home pregnancy test if more than 8 weeks had gone by, just to be on the safe side. It wasn't that I ever really thought I was pregnant, but I wanted to make sure just in case.


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## bunkie (Dec 12, 2009)

I've had two friends find out they were pregnant around their 6 month mark. Both had irregular periods, negative at home pregnancy tests. Went to the doc, got a positive blood hcg and ultrasound confirmed EDD and fetal gender that day. Both had random symptoms, knew something was strange but had no idea until their doctors finally confirmed. Both delivered healthy baby boys just a few months later. 

The accuracy of home tests can be argued with several factors to consider. Both the HCG sensitivity of the particular test, the dye and the HCG level in the mothers urine as well as over all HCG levels in the pregnancy thus affecting the overall HCG levels in the urine... which is a whole other beast to factor in concentration, hydration, etc. 

As far as feeling the baby is concerned, it depends a great deal on the position of the baby, location of the placenta, general activity of that particular fetus, mothers diet and sometimes the size of the mother even comes into consideration. So it is understandable when some women dont feel movement and often what they do feel brush it off as gas.

So the question, how can you not know you are pregnant at the 6 month mark isn't exactly absolute. It's not as if we have a 100 pound woman 9 months pregnant with triplets saying she didn't know she was pregnant with classic symptoms including the absence of her menses. You always have to consider all the factors. 


In this womans case however, a blood HCG should have been done, especially if they "Suspected pregnancy". As it should be done on all women. The argument of who the blame lies on could go to anyone really. The hospital failed to provide proper follow through for the pt's condition. And the pt was eating pain meds for days which could have been the result of fetal death and/or caused the premature labor. As for the waiting time in the ER.. it sucks but anyone knows you are going to wait in an ER, the pt shouldn't have left. Both screwed up IMO
I can't get through my ER with out at least one urine and one blood HCG. :wacko:


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## redcrossemt (Dec 12, 2009)

Aidey said:


> What do you guys think? Was the pat...eted while patients are waiting for a ED bed.


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## redcrossemt (Dec 12, 2009)

bunkie said:


> In this womans case however, a blood HCG should have been done, especially if they "Suspected pregnancy". As it should be done on all women. The argument of who the blame lies on could go to anyone really. The hospital failed to provide proper follow through for the pt's condition. And the pt was eating pain meds for days which could have been the result of fetal death and/or caused the premature labor. As for the waiting time in the ER.. it sucks but anyone knows you are going to wait in an ER, the pt shouldn't have left. Both screwed up IMO
> I can't get through my ER with out at least one urine and one blood HCG. :wacko:



Good point. Was the Urgent Care able to do a blood HCG?

And regarding the transfer, that could be a problem... Did they offer appropriate ambulance transportation? Sounds like they should have if the patient needed a higher level of care.


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## Aidey (Dec 13, 2009)

bunkie said:


> The argument of who the blame lies on could go to anyone really. The hospital failed to provide proper follow through for the pt's condition.



How so? The pt never made it out of the waiting room to see a provider, so what could they have followed up on? Do you mean that she should have been retriaged when her condition got worse? 

I also don't know if a pregnancy can be done as part of the triage screening. It may be something that varies from hospital to hospital. Maybe a urine pregnancy on any female with abdominal pain/bleeding/etc should be part of the traige process. Or part of the triage process if the wait time is going to be longer that 2 hours or something. 

The urgent care ordered a urine pregnancy along with a regular urine dip, but the pt couldn't produce a sample. It was at that time they sent her to the ER. If the Urgent Care had the ability to do a blood HCG they may have figured that they were sending her to the ER either way, so they might as well let the ER do it (That is pure speculation). I haven't seen anything published stating if they did or did not offer ambulance transport, so who knows.


What if the pt had been transported via ambulance, and placed in triage anyway. If the ambulance crew had missed the contractions do you think that would make them liable? Would it change the hospital's liability?


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## Aidey (Dec 13, 2009)

redcrossemt said:


> If she had been discharged without proper treatment, it would be a different story, but from what you guys are saying she walked out AMA. I'm not sure any other laws apply here.



Is it still considered AMA if they leave from the waiting room before seeing a doctor?


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## bunkie (Dec 13, 2009)

Aidey said:


> How so? The pt never made it out of the waiting room to see a provider, so what could they have followed up on? Do you mean that she should have been retriaged when her condition got worse?
> 
> I also don't know if a pregnancy can be done as part of the triage screening. It may be something that varies from hospital to hospital. Maybe a urine pregnancy on any female with abdominal pain/bleeding/etc should be part of the traige process. Or part of the triage process if the wait time is going to be longer that 2 hours or something.
> 
> ...



It said in the article I read that they did a urine HCG and they "suspected pregnancy". If they had, they should have done a blood HCG right away.


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## VentMedic (Dec 13, 2009)

Aidey said:


> Is it still considered AMA if they leave from the waiting room before seeing a doctor?


 
It is only AMA if one has been given medical advice to go against.

However, if the clinic informed her that she needed a higher level of care that might be the case.   

She might also have been given the choice, since the ED was not far, to go by POV instead of a $600 ambulance ride.


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## Aidey (Dec 13, 2009)

bunkie said:


> It said in the article I read that they did a urine HCG and they "suspected pregnancy". If they had, they should have done a blood HCG right away.



I think it was the other way around, the Urgent Care ordered a urine HCG because they suspected pregnancy (and it is routine in a female of childbearing age with an abdominal complaint). But the pt wasn't able to produce a urine sample, so the urine HCG was never actually done. 


Hmm, I may have to do some research on medical law and see what I come up with. I am curious to know if it is considered going AMA against the clinic. Technically she did follow their instructions, she just didn't follow through. I wonder if that actually increases her liability and not the hospital's. 

If a patient was treated with IV antibiotics and told 'come back in 12 hours for your second dose' and they didn't come back, that is AMA and the hospital wouldn't be liable would they? 

Is there a legal difference between someone not being compliant with their medications against their MDs advice, and someone who is told "you need X treatment" and they refuse and sign a waiver? 

Just thinking out loud, my curiosity is piqued.


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## VentMedic (Dec 13, 2009)

Aidey said:


> I think it was the other way around, the Urgent Care ordered a urine HCG because they suspected pregnancy (and it is routine in a female of childbearing age with an abdominal complaint). But the pt wasn't able to produce a urine sample, so the urine HCG was never actually done.


 
They may have known she would also get X-Rays such as a KUB at the hospital.   And their lab may not be able to do the blook HCG which could be an overnight send out for them.


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## boingo (Dec 13, 2009)

VentMedic said:


> Thank goodness for the privates of LA county since the Paramedics of LAFD would be of no use if you are any example.
> 
> Oops, my mistake. You are not a Paramedic or even a FF.



+100   ^_^


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