OT: When does an ER become negligent?

Mods, feel free to move this. I just wanted it here to get some quick visibility.

I got a text from my mom saying she has been up all night nauseous and severe abdominal pain. She went to the ER at 9:00 this morning. As of 2:00 she is still sitting in the same 17ing chair that she sat down in 5 hours earlier with no hint of seeing a doctor. I won't mention the hospital yet but it is a delta town on Highway 82. Is that kind of wait now par for the course or is this just gross incompetence? I told her to walk out the door and go across the street and call an ambulance but she said she's now too weak to do that.

When people use it as their regular family practioner because they have the sniffles or a nagging cough. I've been to the one in Oktibbeha County 3 times. 1. I was barely able to walk and gasping for breath through the pain of acute appendicitis (they came running and carried me straight to the back as soon as they saw me come in). 2. I had a large sliver of dried resin from work lodged under my upper eyelid (again, straight back. they don't screw around with eye injuries). 3. I busted a knuckle working on my brakes and needed stitches and a buddy drove me there. I sat there for about 30 minutes dripping blood on the floor while several people that seemed to only have a mild cough or nothing noticably wrong with them went ahead of me. I guess 'mild cough' ranks ahead of 'dripping blood' in their triage priorities there.

I waited 8 hours in Baltimore one time with a broken humerous, every ligament in my shoulder completely torn, and my bicep no longer attached to my shoulder.

The lady in front of me had been stabbed in the stomach and she waited damn near as long as I did. She wasn't bleeding bad or anything, but she had been stabbed. Some incoherent guy in a wheelchair in the corner and soiled himself. Stank really bad. He was there the whole time and was there when I left.

But that was Baltimore where people get shot daily. That's pretty bad to have someone with severe stomach pain sitting around for 5 hours. Could be minor, but they can't know that without examining her.

I wheeled my wife into the ER in agonizing pain from kidney stones. She fainted filling out paperwork. They took her straight back and started an IV. This was Baptist on State Street.

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Originally Posted by Mjoelner34

When people use it as their regular family practioner because they have the sniffles or a nagging cough. I've been to the one in Oktibbeha County 3 times. 1. I was barely able to walk and gasping for breath through the pain of acute appendicitis (they came running and carried me straight to the back as soon as they saw me come in). 2. I had a large sliver of dried resin from work lodged under my upper eyelid (again, straight back. they don't screw around with eye injuries). 3. I busted a knuckle working on my brakes and needed stitches and a buddy drove me there. I sat there for about 30 minutes dripping blood on the floor while several people that seemed to only have a mild cough or nothing noticably wrong with them went ahead of me. I guess 'mild cough' ranks ahead of 'dripping blood' in their triage priorities there.

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It's almost like promoting preventative care and figuring out an insurance plan for everyone that doesn't break the bank and covers preventative care for sniffles and coughs would help clear up ERs to handle true emergencies.

At five and a half hours they finally got her in a triage room with an IV and something for pain.

My dad had to go to the ER several times for excruciating pain he had after a recent colonoscopy. My dad, who never complained about pain said it was the worst pain he had ever felt. After a couple trips to the ER, and 8-12 hours waits, they told him he just had a bad case a hemorriods. They told him go home and don't come back. Literally don't come back, they were tired of seeing him. After finding a dr that would finally see him again a few days later, it was discovered his intestines were ripped open from the colonoscopy. They scheduled surgery the following Monday. He died a couple days later due to his heart giving out. The pain had put such a stress on him, his heart just quit. So the last days of his life he spent in excruciating pain thanks in large part to ER doctors not giving a shit about helping him.

I've always been told to tell them you are short of breath and they will take you immediately. Don't know whether that's true or not, just what I was told.

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Originally Posted by MadDawg

My dad had to go to the ER several times for excruciating pain he had after a recent colonoscopy. My dad, who never complained about pain said it was the worst pain he had ever felt. After a couple trips to the ER, and 8-12 hours waits, they told him he just had a bad case a hemorriods. They told him go home and don't come back. Literally don't come back, they were tired of seeing him. After finding a dr that would finally see him again a few days later, it was discovered his intestines were ripped open from the colonoscopy. They scheduled surgery the following Monday. He died a couple days later due to his heart giving out. The pain had put such a stress on him, his heart just quit. So the last days of his life he spent in excruciating pain thanks in large part to ER doctors not giving a shit about helping him.

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My deepest condolences on losing your dad in that manner. While different circumstances, I lost mine early and untimely and it's not easy to deal with or accept.

From several years of experience in dealing with health care and EMS, it is not strange to wait several hours in the waiting room. ER nurses are trained to triage patients as they come through the door as in severe trauma over minor wrecks, chest pain over chronic headaches. Now abdominal pain with nausea can be concerning because chest pain in women is often referred as abdominal pain.

Now dealing with your mom, I hope the nurse at least triaged her first before sending her to wait 8 hours. In triage she should have gotten an EKG performed which would have been signed off on by the doctor. If nothing was serious then she would have been put on the list for a room. Abdominal pain should be a higher priority then others because of a lot of organs and tissue located within the cavity. I have waited over 4 hours with a patient on my stretcher at some of these local hospitals. And it's not the doctors our nurses; it's the mentality of the public.

The ER becomes negligent if and when they do not triage in a timely manner or delay care for an unnecessary reason (other higher acuity patient care.). Alpha is right. When nonemergent patients take up the time and resources of the ER, it slows down everything and costs society 10x more than the same and appropriate care in a clinic. A few years ago, a study came out citing 4 hours as a national door-to-doctor time. Sad but true.

Hope your mom is well.

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Originally Posted by Activated Alpha

From several years of experience in dealing with health care and EMS, it is not strange to wait several hours in the waiting room. ER nurses are trained to triage patients as they come through the door as in severe trauma over minor wrecks, chest pain over chronic headaches. Now abdominal pain with nausea can be concerning because chest pain in women is often referred as abdominal pain.

Now dealing with your mom, I hope the nurse at least triaged her first before sending her to wait 8 hours. In triage she should have gotten an EKG performed which would have been signed off on by the doctor. If nothing was serious then she would have been put on the list for a room. Abdominal pain should be a higher priority then others because of a lot of organs and tissue located within the cavity. I have waited over 4 hours with a patient on my stretcher at some of these local hospitals. And it's not the doctors our nurses; it's the mentality of the public.

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To my knowledge she sat in the waiting room of the ER with nobody having done anything for 5 hours. But I'm not sure. Haven't heard anything in over an hour now.

Wow I will never complain about the VA again. Seriously though I get dam good service at the Coast VA.

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Originally Posted by MadDawg

My dad had to go to the ER several times for excruciating pain he had after a recent colonoscopy. My dad, who never complained about pain said it was the worst pain he had ever felt. After a couple trips to the ER, and 8-12 hours waits, they told him he just had a bad case a hemorriods. They told him go home and don't come back. Literally don't come back, they were tired of seeing him. After finding a dr that would finally see him again a few days later, it was discovered his intestines were ripped open from the colonoscopy. They scheduled surgery the following Monday. He died a couple days later due to his heart giving out. The pain had put such a stress on him, his heart just quit. So the last days of his life he spent in excruciating pain thanks in large part to ER doctors not giving a shit about helping him.

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Sorry to hear that. He isn't from around the coast area is he? I had a second or third cousin where the same thing happened.

So she hadn't even been triaged ... was just sitting there for 5 hours? That's really unacceptable.

Best I can tell, around here as soon as you walk in you're triaged, then you may sit for a while if your complaint isn't life threatening. Last summer, I left the house heading to the golf course, but arm and chest pains made me detour by the ER. They saw me immediately and I left the hospital about 6 days later wearing veins where three arteries had been.

So yeah, in my opinion, they should have seen her, then decided if immediate attention was necessary. They apparently didn't do that. As someone said, you might need to call an ambulance for immediate attention.

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Originally Posted by starkvegasdawg34

Mods, feel free to move this. I just wanted it here to get some quick visibility.

I got a text from my mom saying she has been up all night nauseous and severe abdominal pain. She went to the ER at 9:00 this morning. As of 2:00 she is still sitting in the same 17ing chair that she sat down in 5 hours earlier with no hint of seeing a doctor. I won't mention the hospital yet but it is a delta town on Highway 82. Is that kind of wait now par for the course or is this just gross incompetence? I told her to walk out the door and go across the street and call an ambulance but she said she's now too weak to do that.

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those delta hospitals could really use that expanded Medicaid funding.......

hope she's doing better, Stark.

Obama Care!

Called the hospital. Woman at front desk said she hadn't been admitted, but she transferred me to the ER. They said she wasn't there so they must have sent her home. Five minutes later I get a text from my mom...still at the hospital. So nobody knows she's there evidently, but she's still there. Anyway, they said she has two kidney stones.

In bigger cities, like here in Houston, there are Emergency centers popping up as stand alone businesses all over town, because no one wants to go to a hospital ER and sit for hours.

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Originally Posted by Boodawg

I've always been told to tell them you are short of breath and they will take you immediately. Don't know whether that's true or not, just what I was told.

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Chest pain (even hinting at it) will get you back without a wait.

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Originally Posted by starkvegasdawg34

Called the hospital. Woman at front desk said she hadn't been admitted, but she transferred me to the ER. They said she wasn't there so they must have sent her home. Five minutes later I get a text from my mom...still at the hospital. So nobody knows she's there evidently, but she's still there. Anyway, they said she has two kidney stones.

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This is nothing new either. Depending on capacity for inpatient beds (if they've decided to admit her), people can wait in the ED for hours on end. Not to mention, patients do get "forgotten" about if it's a busy night.

I had a kidney stone early last year and it was the absolute worst pain I've ever experienced. I finally validated for my wife, with the help of others, that it's more painful than childbirth. I'm sorry that she's going through this. Hopefully, they'll go in and zap them to tiny particles without her having to pass them naturally.

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Originally Posted by starkvegasdawg34

Mods, feel free to move this. I just wanted it here to get some quick visibility.

I got a text from my mom saying she has been up all night nauseous and severe abdominal pain. She went to the ER at 9:00 this morning. As of 2:00 she is still sitting in the same 17ing chair that she sat down in 5 hours earlier with no hint of seeing a doctor. I won't mention the hospital yet but it is a delta town on Highway 82. Is that kind of wait now par for the course or is this just gross incompetence? I told her to walk out the door and go across the street and call an ambulance but she said she's now too weak to do that.

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Nausea and abdominal pain generally isn't a life threatening emergency. It sucks but an ER is supposed to treat those first. She might have been better served going to her family doctor, esp at 9AM.

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Originally Posted by Liverpooldawg

Nausea and abdominal pain generally isn't a life threatening emergency. It sucks but an ER is supposed to treat those first. She might have been better served going to her family doctor, esp at 9AM.

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There are even issues with that. Because of some insurances, if you want to get a scan, it is to be authorized by the insurance company. So, if a patient goes to a primary care clinic with severe abdominal pain, more often than not, you should order a CT scan, whether that is without contrast to identify if a kidney stone is present or with contrast to evaluate whether there is appendicitis or some other organ involvement. With some insurances, you order the test and have to wait 2-3 days to see if it is authorized before you schedule it.

I've had patients see me in my clinic before with right lower quadrant abdominal pain and a white count of 21 thousand. That's appendicitis till proven otherwise, and you have to get a CT scan with contrast to evaluate this properly. I've had to tell some of these patients to go to the ER because in the ER, you don't have to get authorization to get the scan. If I attempt it, it might be 2 days before the patient gets the scan. By then, that appendix may have ruptured, and you have all sorts of problems on your hands.

When my son was 3, he got a gastro bug and essentially had intractable vomiting. I took him to my local ER, which is in the system I am an employee of. We went there at around 9 PM. My son couldn't keep anything down. He was getting deydrated. Finally, at about midnight while we were still in the waiting room, he started drinking some tea and keeping it down. I took the buzzer back to the desk and told the receptionist that "I can call him in some phenergan gel now that he is drinking fluids." So, I left the ER and went to the 24 hour walgreen's, told them that I was a doctor and needed some phenergan gel for my son.

I've been on both ends, as I have worked some as an ER physician in small towns. Some of the crap that people come to the ER for just infuriates me.

I was working a shift at LeBonheur during my third year of residency at night, and we were getting slammed. It was one after another, and there were probably 4-5 of us physicians working that night. I was intubating kids and doing lumbar punctures on neonates. At 3AM, I see a kid with the complaint of ear pain. So, you go from respiratory distress or a fever of unknown origin in a neonate to ear pain in a 13 year old. That gets frustrating.

Turns out she's the proud owner of two 7mm kidney stones. Admitting her tonight and crushing them in the morning.

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Originally Posted by KB21

There are even issues with that. Because of some insurances, if you want to get a scan, it is to be authorized by the insurance company. So, if a patient goes to a primary care clinic with severe abdominal pain, more often than not, you should order a CT scan, whether that is without contrast to identify if a kidney stone is present or with contrast to evaluate whether there is appendicitis or some other organ involvement. With some insurances, you order the test and have to wait 2-3 days to see if it is authorized before you schedule it.

I've had patients see me in my clinic before with right lower quadrant abdominal pain and a white count of 21 thousand. That's appendicitis till proven otherwise, and you have to get a CT scan with contrast to evaluate this properly. I've had to tell some of these patients to go to the ER because in the ER, you don't have to get authorization to get the scan. If I attempt it, it might be 2 days before the patient gets the scan. By then, that appendix may have ruptured, and you have all sorts of problems on your hands.

When my son was 3, he got a gastro bug and essentially had intractable vomiting. I took him to my local ER, which is in the system I am an employee of. We went there at around 9 PM. My son couldn't keep anything down. He was getting deydrated. Finally, at about midnight while we were still in the waiting room, he started drinking some tea and keeping it down. I took the buzzer back to the desk and told the receptionist that "I can call him in some phenergan gel now that he is drinking fluids." So, I left the ER and went to the 24 hour walgreen's, told them that I was a doctor and needed some phenergan gel for my son.

I've been on both ends, as I have worked some as an ER physician in small towns. Some of the crap that people come to the ER for just infuriates me.

I was working a shift at LeBonheur during my third year of residency at night, and we were getting slammed. It was one after another, and there were probably 4-5 of us physicians working that night. I was intubating kids and doing lumbar punctures on neonates. At 3AM, I see a kid with the complaint of ear pain. So, you go from respiratory distress or a fever of unknown origin in a neonate to ear pain in a 13 year old. That gets frustrating.

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I spent 3 days in the hospital once with the same symptoms and diagnosis of appendicitis (started with my GP and my white count was through the roof). I still own my appendix. It was probably stress in all honesty. At the time they eventually diagnosed it as a food allergy. (nuts) I didn't eat nuts for 20 years. I was never sold on that. I eventually tried nuts again. I eat a handful every night now so that was obviously NOT what was going on. The moral of the story: Those docs did EVERYTHING right and still missed it. That's the way medicine is. It used to be more of an art than a science. In some respects it still is. I have Dr. in front of my name now by the way (NOT a physician but in a healthcare field).

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Originally Posted by starkvegasdawg34

Turns out she's the proud owner of two 7mm kidney stones. Admitting her tonight and crushing them in the morning.

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NOW, in order to determine if she was ill treated we need to know what was ahead of her. Kidney stones HURT, but there are worse things to have.

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Originally Posted by Liverpooldawg

NOW, in order to determine if she was ill treated we need to know what was ahead of her. Kidney stones HURT, but there are worse things to have.

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That is true. But my issue is it took them almost 10 hours to figure that out. In the meantime they had a 73 year old woman with complaints of severe nausea, abdominal pain, and blood in her urine that started 8 hours before she got there and then they made her wait another 5+ before even so much as taking her blood pressure. In hindsight it turned out not to be life threatening but they had no way of knowing. Or this could be the ramblings of a son who's already lost his dad and was scared shitless something was seriously wrong with his mom and pissed beyond measure they weren't right on top of it.

Greenwood? When visiting my family in the Delta, I have standing orders to drive me to St D or Baptist unless I'm bleeding out. My son sustained a fairly serious, non life threatening, injury near Greenwood, I set a record getting him to St. D, no way would i have taken him to Greenwood or Grenada. I refer to Greenwood Leflore Hospital as the roach motel (young pups google it), you check in, but you don't check out.

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Originally Posted by starkvegasdawg34

Turns out she's the proud owner of two 7mm kidney stones. Admitting her tonight and crushing them in the morning.

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Prayers for your mom. Hope everything turns out well. Sorry she went through that.

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Originally Posted by viverlibre

Greenwood? When visiting my family in the Delta, I have standing orders to drive me to St D or Baptist unless I'm bleeding out. My son sustained a fairly serious, non life threatening, injury near Greenwood, I set a record getting him to St. D, no way would i have taken him to Greenwood or Grenada. I refer to Greenwood Leflore Hospital as the roach motel (young pups google it), you check in, but you don't check out.

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Ding. Ding. Ding. Ding. We have a winner. I cal it the Greenwood vet clinic.

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Originally Posted by starkvegasdawg34

Ding. Ding. Ding. Ding. We have a winner. I cal it the Greenwood vet clinic.

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I've heard good things about Ruleville, however.

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Originally Posted by viverlibre

Greenwood? When visiting my family in the Delta, I have standing orders to drive me to St D or Baptist unless I'm bleeding out. My son sustained a fairly serious, non life threatening, injury near Greenwood, I set a record getting him to St. D, no way would i have taken him to Greenwood or Grenada. I refer to Greenwood Leflore Hospital as the roach motel (young pups google it), you check in, but you don't check out.

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I worked in Hazlehurst and the nurse at our plant formerly worked at the Hazlehurst ER. He always said he would rather die in an ambulance going to Jackson than die in the waiting room at Hazlehurst. My wife when we were at MSU went to the Oktibbeha ER for a kidney stone (we didn't know it at the time). After sitting in the ER with her almost passing out, we finally were seen. They said it is probably a kidney stone and sent her home with a pain killer. We get the painkiller and it is extra strength Tylenol. We then drove to Tupelo where they actually gave her something for the pain and some stuff to help her pass the stone. Starkville ER literally did less than I had done for her at home.

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Originally Posted by starkvegasdawg34

My deepest condolences on losing your dad in that manner. While different circumstances, I lost mine early and untimely and it's not easy to deal with or accept.

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Thank you. It's been 3 years but it's still not easy. Hope your mom gets the care she needs.

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Originally Posted by dparker

Sorry to hear that. He isn't from around the coast area is he? I had a second or third cousin where the same thing happened.

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No, not from the coast and it happened almost 3 years ago. Kind of disheartening to hear someone had a similar experience.

The Greenwood hospital is being horribly mismanaged by the city. They go out of their way to find the worst administrators possible. When given good advice by competant doctors on how to correct the downward spiral, they scoff and go the opposite direction. They are running off the good MDs that are still there. Sheer and utter incompetance by the administrators and governing board. That hospital will not be in existance for long.