She Waited for 2.5 Hours in the ER. She Didn't Survive

GreekOrthodox said:

She was seen, xrayed and labs were being done. Now the one thing I find confusing is according to the report, she was sent back to the lobby.

The Milwaukee County Medical Examiner report, which can be seen in full here, explains that doctors performed “multiple tests” which included an electrocardiogram and a chest x-ray. The results showed that Ward had an enlarged heart. The Milwaukee Journal Sentinel reported that, according to Ward’s family, she was told to go back to the lobby and wait for further treatment. Ward reportedly asked the hospital worker at the front desk multiple times when she would be called back again.​

According to the medical examiner

Multiple tests were performed including an EKG (electrocardiogram) which was normal, and a chest x-ray which showed the decedent had cardiomegaly. Lab work was also performed which was all normal besides her bicarbonate level was 21. At 1927 hours, the decedent left the ER as she felt she was waiting too long and decided to go to an Urgent Care. At 2039 hours, Froedtert staff called the decedent's cell phone to check on her and her sister answered.
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So at least according to the ME, the patient left and the hospital called her an hour after she left Froedtert for an Urgent Care. Since she had not been admitted, and considering it appears that all of her lab work came back normal (and I am going to guess that a troponin test was performed and takes up to an hour to get results), the ED staff was probably keeping her under their eyes while handling other patients.

Two years ago, I was admitted to the ED with possible signs of a heart attack (severe sweating and chest pain). They did an EKG and lab work. They let me know that everything came back normal but they were going to keep me there for a couple hours in case. I think I was in the ED for about 4 hours, even though within an hour of arrival, they had pretty much ruled out a heart attack.

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Thanks for the info.

What could Froedtert have done to prevent the end result, if anything?

What would 911 or Urgent Care have done?

so sad
best to go by ambulance to hosp. instead of walk-in

past Oct wasn't feeling well in middle of night & had husband take me to our local EMTs where they did an EKG

they said I needed to go to hosp & took me by ambulance so I got ER room right away

Nithavela said:

Don't ambulance rides in the USA cost 5000 dollar or something like that?

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Well, here in TX, it's around $400-$500 for local transport (I'm talking under 5 miles.)

People keep saying, "just do it." Many people can't even afford that amount. What people should say, I think, is that ER staff triage should include the assessment as to whether the patient ought to be treated as if they came by ambulance.

Tinker Grey said:

Well, here in TX, it's around $400-$500 for local transport (I'm talking under 5 miles.)

People keep saying, "just do it." Many people can't even afford that amount. What people should say, I think, is that ER staff triage should include the assessment as to whether the patient ought to be treated as if they came by ambulance.

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NO! If you show up at an ED, that staff is going to evaluate you according to MEDICAL GUIDELINES not can you pay or how you show up as a walk-in, ambulance or helicopter (although if that person is arriving by helicopter, you are definitely in trauma). Someone might show up in an ambulance that is still a walkie-talkie (mobile and responsive) while if I stumble in off the street with a drooping face, slurred speech, the ED is going to go through stroke protocol while the other person is going to be filling out paperwork.

There is a medical guideline on how triage is to be performed. Emergency Severity Index (ESI) Implementation Handbook, 2012 Edition

The four decision points depicted in the ESI algorithm are critical to accurate and reliable application of ESI. The figure shows the four decision points reduced to four key questions:

1. Does this patient require immediate life-saving intervention?
2. Is this a patient who shouldn't wait?
3. How many resources will this patient need?
4. What are the patient's vital signs?

Each patient with chest pain must be evaluated within the context of the level-1 criteria to determine whether the patient requires an immediate life-saving intervention. Some patients presenting with chest pain are very stable. Although they may require a diagnostic electrocardiogram (ECG) within 10 minutes of arrival, these patients do not meet level-1 criteria. However, patients who are pale, diaphoretic, in acute respiratory distress or hemodynamically unstable do meet level-1 criteria and will require immediate life-saving interventions.

christine40 said:

so sad
best to go by ambulance to hosp. instead of walk-in

past Oct wasn't feeling well in middle of night & had husband take me to our local EMTs where they did an EKG

they said I needed to go to hosp & took me by ambulance so I got ER room right away

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I think part of this is that you by-pass the ED waiting room at most hospitals so you get triaged at the ambulance bay.

GreekOrthodox said:

O! If you show up at an ED, that staff is going to evaluate you according to MEDICAL GUIDELINES not can you pay or how you show up as a walk-in, ambulance or helicopter (although if that person is arriving by helicopter, you are definitely in trauma). Someone might show up in an ambulance that is still a walkie-talkie (mobile and responsive) while if I stumble in off the street with a drooping face, slurred speech, the ED is going to go through stroke protocol while the other person is going to be filling out paperwork.

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YES!

Seriously, you are saying is what I am saying. Medical assessment should be what counts, not the method of arrival. Nevertheless, the ambulance patient goes directly to a bed. A walk-in waits in the lobby until something is available. With this thread as evidence, most people suspect that those that come by ambulance get a head of the line. There is a presumption of seriousness.

I've spent countless hours in the ER on multiple occasions as the parent of a patient.

There may be guidelines, but those presumptions dominate the decision making process.

It might be heartening to see some sort of study to the contrary, but my experiences would cause me doubt it.

Not sure what went wrong for this poor Lady.

When one goes into the Kaiser ER that we use with any kind of chest or heart pain they are immediately taken in to the back rooms to see a doctor. Top priority. I think that over the years some with these ones with heart issues must have died in the waiting room?
M-Bob

Occams Barber said:

I'm assuming you forgot to put the "only kidding" smiley after this sentence.

If you're actually serious please let me know and I can give you links to five studies which suggest that the USA has one of the lowest rated healthcare systems in the developed Western world.

We can also look at comparative Life Expectancy and Infant Mortality (Under 12 months and Under 5 Years) to get an idea of where the US sits relative to similar countries on a broad measure of healthcare.

Then there's relative cost where the US spends double the OECD per-person average to get a lesser result....
OB

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Hi OB,

Yes, I'm well aware of those studies and I'm sorry that I made it so terribly difficult to see that my tongue was planted firmly in my cheek.

God bless,
In Christ, ted

Brightmoon said:

I’m actually surprised that a cardiac case didn’t get seen right away . The longer that’s allowed to go on the more damage to the heart muscle . That damage can show up in a blood test so they didn’t have to do anything invasive to determine that she was having problems. If they didn’t want to treat her because of insurance then the law says that she has to be transported (if possible) to another place that she can be treated . This is malpractice

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Whenever I read about similar articles from medical websites, they always mention the matter being quite serious.

More especially so with women as the symptoms with women tend to be more subtle than with men.

The hospital staff are supposed to be the experts and know better what to do than the patients.

.

.

miamited said:

Hi OB,

Yes, I'm well aware of those studies and I'm sorry that I made it so terribly difficult to see that my tongue was planted firmly in my cheek.

God bless,
In Christ, ted

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Sorry I misunderstood you Ted.

I should have known better.
OB