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Severe Emergency Room Neglect; What Do I Do Next?

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barry1817

Senior Member
malpractice?

Malpractice needs negligence, harm caused by that negligence and a financial component. One then needs a doctor to testify that the treatment was below the standard of care before it can even be considered.

Completely off the thread

Was just thinking about this case with the idea of government run health care. Wonder if the people in England, who can't get medication because they are two old, or have to wait so long to see a doctor could ever sue because of the harm done, negligence, in that system.

Wonder if it is negligence if a hospital ER is not staffed to give one on one observation to a person.


Wonder what I would do if my loved one checked themself into a hospital with suicidal tendencies and in fear that suicide might be a fast approaching option--don't think I would come for a visit, check in and come back later.
 


Proserpina

Senior Member
Was just thinking about this case with the idea of government run health care. Wonder if the people in England, who can't get medication because they are two old, or have to wait so long to see a doctor could ever sue because of the harm done, negligence, in that system.

Wonder if it is negligence if a hospital ER is not staffed to give one on one observation to a person.


Wonder what I would do if my loved one checked themself into a hospital with suicidal tendencies and in fear that suicide might be a fast approaching option--don't think I would come for a visit, check in and come back later.
(I was born and raised in England)

Generally one cannot sue the National Health Service for negligence based upon not being able to get a fast appointment. Other than time issues (which occasionally might be a factor, but this is somewhat uncommon) medmal suits in the UK work similarly to here in the US - both the individual physician/provider and the NHS itself can be sued.

Realistically it's quite uncommon to have to wait longer than (at most) a couple of weeks to see your physician when you're in the UK, although elective surgeries can take upwards of 6 months to schedule depending on where you're located, nearest hospital facilities etc. If the patient needs urgent (but not emergency) care help is generally a phone call or two away.

For most medication there is a standard prescription cost of around $10/per prescription (regardless of the drug's actual cost) and if you're elderly, unemployed or otherwise without an income the meds are generally provided free of charge. There are exceptions to this (newer cancer drugs for example) and that's where some patients struggle. Even if that is the case though there's usually no liability where the NHS and provider are concerned.

Going back to my "help kiddo colour inside the lines" afternoon. ;)
 

summerpoem

Junior Member
Warning - this will be long...

Catching up on the thread and dumbfounded at the statements written here. This IS a legal medical malpractice forum. Correct? Why then does the information conflict completely with that of our hospital attorneys?

A statement by someone here implied that the legal seminars are probably just trying to scare the nurses into being overly cautious. Like "lya," I too took offense. Our legal seminars are based on authentic malpractice cases. It's a slap in their face to say the attorneys are taking liberties with the truth, and a slap at the nurses that they would NEED to! Surely, we're all above that.

But there's many other statements that I also found offensive. First the portrayal of the OP as a troll. It's very easy to understand why she didn't return. Look at how she was treated! Note the date and time of her posting. Just eleven minutes later she received her first reply and was told she had NO case. End of story. (Obviously based on a thoughtful and respectful perusal of her case. Yeah, right.) The next three replies were within the hour and they ignored the OP completely. They simply chuckled and high-fived each other. Nice...

So she's sitting there on HER side of the computer, feeling the condescension and ridicule. (Mentally ill people get a lot of that from others.) She decided there would be no help for her at this forum, and saw no reason to stick around for more abuse. She never dreamed someone would come along with a different perspective. So she left. That does NOT make her a troll. It makes her a hurting human being who still had some dignity, despite this forum's blatant attempts to destroy it.

I didn't read her post until the 10th. As I said, I got angry at the wrong replies, so I registered and voiced my opinion. Apparently, she's never read any of it which makes me sad for her. Because she is still not aware that she DOES have a case. And it's NOT false hope. If this happened to one of my loved ones, I guarantee you there would be recompense.

The hospital was liable and nothing can negate that responsibility. They had a legal obligation to keep her safe after she voiced suicidal ideation. She came to the hospital for HELP to prevent self-harm, not to end up nearly dead, in ICU on a ventilator. This is NOT standard of practice for a suicidal psychiatric crisis. Hospitals MUST provide staff for a suicidal patient. Not a legal excuse that you're "not staffed" for them. Too bad. You're still legally responsible.

This is my area of expertise. It happens often on my unit. I don't always have the staff either. But I call the nursing supervisor and she finds the help. I don't have to badger her or explain it either. She already knows the legal issues!

I DO know what I'm talking about here. No, I'm not an attorney. I don't know the other legal areas. Don't pretend to. But I DO know the psychiatric legal issues.

The OP did suffer negligence. She does have damages. Please don't insult my intelligence by suggesting she has no case for pain and suffering due to being unconscious. Being unconscious is NOT a normal state of being. Having an ET tube down your throat, and hooked up to a ventilator to breathe, is NOT okay, no matter how much you'd like to minimize the whole situation. (And yes, most everyone here HAS minimized the suicide attempt!)

By the way, I reminded the OP of other possible injuries b/c she may very well indeed have suffered them and not been aware that they were caused by the ET tube. I doubt if the hospital would volunteer that information if she was having trouble swallowing. Therefore, she may not have any idea what really caused it.

It was pointed out by another that she could have poked her eye out with her finger and the hospital would not have been liable. Okay, I'll grant you that - to a point. As long as she hadn't been poking her eye PRIOR to the gouging, then yes - the hospital would be on safe ground. (They still would have been required to provide immediate intervention though. It would not be okay to have her eyeball found on the bed by her partner! That wouldn't fly either.) However, IF she had been poking at her eye repeatedly before the gouging, then YES, they'd be absolutely liable for her injuries. They have a legal obligation to prevent her from self-harm. They may not like it but that's the way it is.

If a patient tries to harm him or herself, we are required to take measures to prevent it, including restraints (with a physician's order.) There is a case that was recently in the headlines of a mental health facility that allowed a patient to bang her head repeatedly over a hundred times. They did not restrain her. Did not notify her doctor to get an order for it. Several people in the chain of command, including some of the top brass, lost their jobs and are facing legal issues.

Oh, yeah. The debate about memories, hypoxia, and retrograde amnesia. I'm not a neurologist. I AM a nurse who has sat at the bedside of countless number of patients who have come to our unit from ICU, rescued from near-hangings, carbon monoxide poisioning, plastic bag over-the-head incidents, and horrible trauma. They have shared with me their devastating and detailed memories of the moments prior to their attempts. Are they lying? Trying to impress me?

In my experience, most of the patients with very foggy memories have drugs and alcohol in their systems at that time. They often don't even remember the day it happened, much less any of the moments around it.

That's just my experience. Not always one way or the other. Just things I've noticed. Which makes me believe that, absent alcohol or drugs, the emotional trauma alone is enough to etch the memories in stone for them.

By the way, someone took umbrage at the fact that I used Sept 11th as an example of emotional trauma. That person lost a dear friend and felt I was being insensitive. Well, I am sorry for their loss. I lost a dear friend then too. It was a horrible day and none of us can say we have cornered the market on that day of grief. A little understanding goes a long way...

The most surprising and abysmal statement of legal ignorance though I read here was by several people who said it was entirely the OP'S fault that she nearly died and ended up in ICU. They think she should pay her own huge medical bills, resulting from the suicide attempt. Righteous and indignant, they want to know where she gets off even trying to claim a case.

Folks, hello? She's mentally ill. Normal people do NOT try to kill themselves. Get a clue. Please read up on the legal issues of the mentally ill and the liability involved by the providers of their care. (NOT just hospitals!) It is my fervent hope though that if you really ARE attorneys that you never take on a client with mental illness. You could not do them any justice whatsoever. They are already so beaten down by the world in general. Please don't add any more torment.

Sorry to be so down about this forum but I'm completely disillusioned. I expected more.

Still wondering too why no one said what they would do in a similar situation. It seemed to be conveniently side-stepped. Don't say it can't happen either. We've had attorneys on our unit too. Mental illness does not discriminate - it affects all socio-economic groups, all ages and both genders.

I realize I'm not welcomed with open arms here. That's okay. But I just want to remind you that IF you or one of your loved ones ever DO need psychiatric help, you are going to be so thankful that people like me are there to speak up for those who cannot speak for themselves...

Sorry for the lengthy post. I felt I had to address many various issues. Got to go to work now though. It really IS an important job I do...
 
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Proserpina

Senior Member
You have absolutely no knowledge whatsoever relating to the background, work history or psychiatric status of anyone who has responded here.

None at all.

OP received advice from at least one attorney, and that advice was legally accurate.

End of story.

ETA: to answer the question of what we would do if it happened to us or a loved one, I'd hazard that most of us would accept the reality of the situation and stop grasping at malpractice straws when there isn't a case.

I know that at least one poster has dealt with losing a loved one where questionable acts led to the need to consider a medmal suite.
 
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summerpoem

Junior Member
No, I don't know the background or psychiatric status of anyone who responded here. That wasn't the point of my post! My point was to illustrate how poorly the OP was treated, and the LACK of legal knowledge about psychiatric issues here, on a LEGAL forum.

That was my point. End of story.
 

lealea1005

Senior Member
I realize I'm not welcomed with open arms here. That's okay. But I just want to remind you that IF you or one of your loved ones ever DO need psychiatric help, you are going to be so thankful that people like me are there to speak up for those who cannot speak for themselves...

Sorry for the lengthy post. I felt I had to address many various issues. Got to go to work now though. It really IS an important job I do...

Yes, summer, I guess it IS your cross to bear. :rolleyes:
 

Proserpina

Senior Member
No, I don't know the background or psychiatric status of anyone who responded here. That wasn't the point of my post! My point was to illustrate how poorly the OP was treated, and the LACK of legal knowledge about psychiatric issues here, on a LEGAL forum.

That was my point. End of story.
Oddly enough that's what I thought when I read YOUR posts.

Hang around on these boards a bit more. Read. Learn. And accept that the collective Troll-dar is usually pretty reliable.

Either way, OP hasn't returned; time to let the thread reach its natural conclusion.
 

You Are Guilty

Senior Member
No, I don't know the background or psychiatric status of anyone who responded here. That wasn't the point of my post! My point was to illustrate how poorly the OP was treated, and the LACK of legal knowledge about psychiatric issues here, on a LEGAL forum.

That was my point. End of story.
Although I have no clue who this reply was directed at, given that my posts appear multiple times, and you continue to argue at least one of my points, I'll take it as directed at me.

While I actually happen to welcome another professional to the site, simply because you're a nurse, even for years, even if you worked in patient psych, doesn't give you any special insight as to a med mal case. As I mentioned, I happen to have years of med mal defense work, so I tend to think I know what I'm doing. So for a third time, your conclusion that the hospital here is automatically negligent, apparently by virtue of the sole fact that the OP ended up intubated, is simply not legally accurate.

I've already spelled out a few factors to consider so I won't repeat myself, but there are a number of potential defenses for the hospital. Does it mean there absolutely is no negligence? Of course not. But it's possible and for you to keep suggesting otherwise is doing a disservice.

And with respect to:
Please don't insult my intelligence by suggesting she has no case for pain and suffering due to being unconscious. Being unconscious is NOT a normal state of being. Having an ET tube down your throat, and hooked up to a ventilator to breathe, is NOT okay, no matter how much you'd like to minimize the whole situation.
Please provide me one, single, solitary cite to a case, in any state, from this century (that hasn't been overruled) where an unconscious patient was awarded pain and suffering for the period they were unconscious. Just one, that's all I ask. Until then, you stick to nursing, I'll stick to the law, and you won't have to worry about your intelligence.
 

lya

Senior Member
I am only going to say this: If the OP's accounting of the hospital's failure to monitor a patient in seclusion by providing 1 to 1 with every 10 or 15 minutes visual assessment of the patient and to document the same, the standards of care were violated and the violation is of the most serious kind.

I believe the failure to provide mandated observation and documentation is not defensible; therefore, a medmal suit may have much more potential for success than not.

Quite honestly, in this described event, I would not want to be the employee or the employee's supervisor or the hospital.
 

summerpoem

Junior Member
Last Thoughts on this topic...

Thank you, lya! Your words echo that of our hospital attorneys. This is what they have told us repeatedly - that self-injury to a patient caused by failure to provide mandated observation and documentation is NOT defensible. We ARE liable. Furthermore, they have clearly stated it is NOT an ambiguous legal issue. We don't get to choose our course of action when a patient threatens self-harm.

In fact, our protocol of observation and documentation was set up BY our hospital attorneys. We follow it with exact precision. As I've said, I notify my nursing supervisor when I need to implement 1:1 observation; seclusion, and/or restraints. SHE too has been educated by the hospital attorneys, so she sends me the necessary staff immediately. She knows the issue is not up for discussion. It is cut and dried.

This has been drummed into my head for so many years. That is why the "legal" replies on this forum have left me so dumbfounded. I find it hard to believe that I'm even having to argue this issue. With attorneys?

'Dogmatique' replied that I don't know the legal issues. Since I got my legal information from our hospital attorneys, his beef is really with THEM. So to clarify. What he's actually saying is that our hospital attorneys don't know their legal issues. Interesting. Wonder how they would respond to that...

Someone else (sorry, can't remember all the names) mentioned that my job was my "cross to bear." Working with the mentally ill is not a cross. My cross is dealing with insensitive and condescending attitudes by OTHERS toward the mentally ill. THAT'S the cross.

'You Are Guilty' said that unconsciousness is not a criteria for pain and suffering. He's one person to whom I DO owe an apology. I admit I spoke in error. I realize I really don't know the legal criteria and ramifications of it. I'm sorry I went off the deep end on that. It seemed to me though to just be a matter of common sense that being intubated on a ventilator would involve pain and suffering. However, I don't know the legal issues with THAT area of this case.

However, as stated I DO believe the OP has a case. If it should prove to be for nothing else than to get her huge medical bills paid. She went to the hospital for safety. I would argue til doomsday that she should not be financially responsible for THEIR negligence. I wouldn't pay them a dime!

Also I still don't think the OP was a troll but I admit I AM surprised she has never returned to the forum. I'm also acknowledging the slightest possibility that maybe someone IS sitting back right now and having a little fun. I hope not. If that is ever proven to be true though, I will start a thread of abject apology and will humbly accept all nanners thrown my way. Sad if that would be true...

I believe I'm still right, even if this IS a hypothetical case. Regardless, I DO agree it's time to let go of this issue. Thanks to all for listening and for all who tried to hear what I was saying...
 
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lealea1005

Senior Member
I am only going to say this: If the OP's accounting of the hospital's failure to monitor a patient in seclusion by providing 1 to 1 with every 10 or 15 minutes visual assessment of the patient and to document the same, the standards of care were violated and the violation is of the most serious kind.

I believe the failure to provide mandated observation and documentation is not defensible; therefore, a medmal suit may have much more potential for success than not.

Quite honestly, in this described event, I would not want to be the employee or the employee's supervisor or the hospital.

Absolutely! I said, somewhere waaay back in this thread, that OP should have been placed on 1:1 observation at least until psychiatric personnel and/or transfer could occur. However, I still question the validity of OP's dramatically detailed memory immediately prior to the event.
 
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lealea1005

Senior Member
Someone else (sorry, can't remember all the names) mentioned that my job was my "cross to bear." Working with the mentally ill is not a cross. My cross is dealing with insensitive and condescending attitudes by OTHERS toward the mentally ill. THAT'S the cross.
No, I didn't say your job was your cross to bear. Go read it again. Gee, summer, I thought you were a Psych Nurse.
 

Proserpina

Senior Member
He, btw, is a she.

Assuming (since there's quite a lot of that going on in this thread) none of us are suffering from a chronic case of lastworditis, it is time to let the thread die.
 

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