[HN Gopher] US hospital told family their daughter had checked o...
___________________________________________________________________
US hospital told family their daughter had checked out when in fact
she'd died
Author : howard941
Score : 365 points
Date : 2024-08-21 20:07 UTC (20 hours ago)
(HTM) web link (www.theguardian.com)
(TXT) w3m dump (www.theguardian.com)
| JumpCrisscross wrote:
| > _an autopsy that could have indicated whether there had been
| medical malpractice associated with her death was "rendered
| impossible", according to the lawsuit_
|
| This crosses into criminal liability.
| blackeyeblitzar wrote:
| This is just horrible but I'm not surprised since I have read
| so many stories of malpractice recently, from the skull flap
| thing to the Texas hospital triple booking surgeons to other
| stuff
| CatWChainsaw wrote:
| Triple booking surgeons? Do they think patients in need of
| surgeries are just going to up and cancel, and hospitals are
| behaving like airlines?
| toomuchtodo wrote:
| Lack of accountability leads to outcomes. As a patient, you
| don't know your trust is being violated (in this specific
| scenario).
|
| https://www.seattletimes.com/nation-world/texas-heart-
| surgeo...
|
| https://www.justice.gov/usao-sdtx/pr/texas-medical-center-
| in...
| malfist wrote:
| Texas also has "tort reform", limiting you to a maximum
| of $250k in damages. Good luck suing a big hospital for
| malpractice, you gotta pay the lawyer too out of that
| $250k.
| mandmandam wrote:
| > you gotta pay the lawyer too out of that $250k
|
| On average, a medical malpractice case might require
| anywhere from 500 to 1,000 hours of legal work, with more
| complex cases potentially requiring over 2,000 hours.
|
| Average lawyer cost in 2022 was $313/hr.
|
| So we're basically looking at, generously, 750 hrs x
| $300, or $225k to the lawyer.
|
| And that's just one side - the hospital presumably pays
| near the same.
|
| ... Huh.
|
| Once again, I am stunned at the American legal system
| being so obviously and cartoonishly evil.
| arcticbull wrote:
| The Texas legal system to be specific.
| ToValueFunfetti wrote:
| Texas is probably limiting malpractice suit damages
| because they are a significant contributor to our insane
| healthcare costs. The math above where a hospital is out
| a minimum of $200k for any suit that isn't thrown out is
| not restricted to Texas; this is a national issue with
| some Texas duck tape slapped on.
| vkou wrote:
| They are more likely limiting malpractice suit damages
| because hospitals and clinics donate to political
| campaigns, but people hurt by medical malpractice don't.
|
| The end result is that doctors are essentially lawsuit-
| proof (as the minimum cost of a suit exceeds the maximum
| possible recovery) in Texas, and you have _no recourse_
| if yours was at fault.
|
| It's a beautiful system.
| blackeyeblitzar wrote:
| That's a good argument for it that I didn't think of. But
| I can't help but think this was likely just some business
| friendly thing that was lobbied for under the misleading
| label of "reform"
| 0xcde4c3db wrote:
| I hope that limit only applies to punitive damages. For
| medical malpractice in the US, actual damages could
| easily exceed $250k.
| phonon wrote:
| https://crosleylaw.com/blog/texas-personal-injury-law-
| change....
| voxic11 wrote:
| The cap applies to actual damages, specifically non-
| economic actual damages such as pain and suffering,
| mental anguish, and loss of companionship. It does not
| apply to economic actual damages such as lost wages and
| medical costs.
|
| Before tort reform punitive damages were already capped
| in Texas at a value twice the amount of economic damages
| plus the amount of non-economic damages, so tort reform
| does also have a effect of sometimes reducing punitive
| damages.
| blackeyeblitzar wrote:
| https://www.usatoday.com/story/news/health/2024/06/25/baylo
| r...
|
| In Texas, three hospitals (Baylor St. Luke's Medical Center
| (BSLMC), Baylor College of Medicine (BCM) and Surgical
| Associates of Texas P.A. (SAT)) agreed to pay $15m as part
| of a settlement with the DOJ. These doctors/surgeons were
| booked for multiple simultaneous procedures that they could
| not have possibly conducted, even though they recorded
| things to make it look like they conducted all the
| surgeries. In reality many procedures were performed by
| unqualified residents and other caretakers and not who the
| patient was told would be performing the procedure.
|
| > To make it seem as if the teaching physicians were
| present during the "entire" operation, they would lie on
| medical records, the court filings say. The medical staff
| also would not tell patients that the surgeon planned on
| leaving the room to perform another operation, the
| documents continued.
|
| This only came out because of a whistleblower, and because
| the DOJ pursued it. It is nearly impossible for a patient
| to know if they are wronged or harmed this way because they
| are put under for these procedures, and because
| friends/family are typically not allowed to observe or
| record anything (likely to prevent accountability). And
| then there's the cost of lawsuits, the stress, and
| limitations under law (like tort reform in Texas) - it's
| just lucky that this was pursued by a government agency
| (DOJ).
|
| > Under the False Claims Act, the private whistleblower who
| reported the allegations will receive over $3 million from
| the settlement, the Justice Department said.
|
| We need more incentives like this, but we also need greater
| penalties and jail time for the practitioners and literally
| everyone who knew. They should be investigating who was in
| the room, what was recorded in logs, and who accessed
| records, and go after all of them. Right now, this
| settlement achieves nothing. Some articles claimed that
| these hospitals made more than $150 million off these
| procedures for which they are settling the lawsuit for just
| $15 million.
| SkyPuncher wrote:
| More common than you think.
|
| A lot of hospital care is done by residents with surgeons
| overseeing and stepping in for the most difficult parts.
|
| Our healthcare system would literally collapse without
| residents doing the heavy lifting. It won't change until we
| stop artificially limiting the supply of doctors or give
| mid level practitioners more power.
| CatWChainsaw wrote:
| Or both, both would be nice.
|
| Until then I guess we all just have to make sure we never
| need to use the healthcare system we all pay so much for.
| blackeyeblitzar wrote:
| Yep professional medical organizations and universities
| are causing this artificial supply limit to benefit those
| who are already practicing and part of this ecosystem.
| ben_w wrote:
| Without claiming the two systems have the same limiting
| factors, the UK health system is also struggling, and
| there the staff shortage is the government's limits on
| (1) how many spots universities have, (2) immigration.
|
| This is despite health in general, and the HNS in
| particular, being a major source of interest for the
| electorate.
| OJFord wrote:
| Alternatively (or also) pay scales and _em_ igration.
| There are doctors leaving for Australia (which advertised
| golden handshakes & Australian lifestyle in the UK to UK
| doctors) and nurses for better pay/conditions in private
| care facilities; it's not (just) a supply of trained
| people at source issue.
|
| Salaries are also much more compressed than in North
| America - UK junior doctors generally earn more than NA
| residents, but then not that much more (maybe 4-5x from
| lowest to highest, not >10x to reach hundreds of
| thousands) as consultants (attendings). Locum pay &
| additional private work can make up for some of that, but
| probably not all, and I assume similar could be done in
| NA if you wanted to earn more (or open their own
| practice, pharma sponsorship, etc.)
|
| It's probably true in general (relatively compressed
| salary ranges) actually, not just in medicine.
| pyuser583 wrote:
| It's absolutely insane how many people don't show up for
| doctors appointments, including surgery.
| spondylosaurus wrote:
| Dare I ask about "the skull flap thing"?
| blackeyeblitzar wrote:
| https://lawandcrime.com/lawsuit/lawsuit-claims-emory-lost-
| pa...
|
| Basically they had to cut into someone's skull as part of a
| surgery. They did not label and catalog skull parts
| properly. Because they lost the skull part they had to use
| a synthetic skull flap, and they charged the patient for
| it. The synthetic flap caused an infection. The patient was
| on the hook for something like $150K for all of this (the
| synthetic part, the procedure of placing it, the infection)
| which was due to the hospital's own criminal negligence. An
| investigated showed that the hospital was not properly
| labeling and cataloging parts for many patients and
| basically had a mess of random skull parts that would not
| make their way back to all those patients, so it is a
| systemic issue and not just an unfortunate one off mistake.
| All of this is alleged and there is a lawsuit pending, but
| it seems to me like the part about a systemic issue of
| mishandled parts is confirmed.
| sva_ wrote:
| Sounds like material for the next Dr. Death season. The
| first two seasons were both pretty great.
| munificent wrote:
| I'm just imagining some refrigerator in the nurse's
| breakroom with a big fiesta bowl of what looks like odd
| tortilla chips with a Post-In note labeled "skull bits do
| not eat".
| ForOldHack wrote:
| I hate when that happens:
|
| Obligatory.
|
| Lawyer: "Doctor, before you performed the autopsy, did
| you check for a pulse?"
|
| Witness: "No."
|
| Lawyer: "Did you check for blood pressure?"
|
| Witness: "No."
|
| Lawyer: "Did you check for breathing?"
|
| Witness: "No."
|
| Lawyer: "So, then it is possible that the patient was
| alive when you began the autopsy?"
|
| Witness: "No."
|
| Lawyer: "How can you be so sure, Doctor?"
|
| Witness: "Because his brain was sitting on my desk in a
| jar."
|
| Lawyer: "But could the patient have still been alive
| nevertheless?"
|
| Witness: "Yes, it is possible that he could have been
| alive and practicing law somewhere."
| wrsh07 wrote:
| This is truly horrifying and also illustrates a massive
| incentive problem. The hospital probably made money
| through its negligence (until the inevitable lawsuit)
| jb1991 wrote:
| It's amazing how many stories like this come out of the U.S.
| Normally, one can say "you get what you pay for" but what
| American hospitals charge for this level of quality is so
| expensive compared to other countries.
| wil421 wrote:
| Anywhere with a hospital and medical care can have issues.
| Here's a few high profile cases in the UK.
|
| https://www.howellslegal.co.uk/news/post/The-5-Largest-
| Perso...
| jklinger410 wrote:
| I'm glad we pay for the most expensive medical care in the world
| in the US. That's what keeps the quality so high.
| realo wrote:
| Sorry but I think you pay for the most expensive _doctors_ in
| the world...
|
| It would seem that the actual care you receive is only remotely
| related to that.
| pinkmuffinere wrote:
| The comment you're replying to was sarcastic, I think they
| probably strongly agree with you.
|
| (Not your fault not to notice though, sarcasm can be very
| subtle)
| anonzzzies wrote:
| It should have /s I guess, however, I am not native English
| and could not read that differently than /s.
| bourbonjuggler wrote:
| _" Dignity Health, which operates Mercy San Juan..."_
|
| It appears they need a name change after this lawsuit
| LiquidSky wrote:
| As usual when entities have these noble names, they don't mean
| your or my dignity.
| evantbyrne wrote:
| Low quality places have the most absurd names in this
| country. For example, there is a trailer park nearby with a
| "Manor Lane". At least they put it by "Shady Lane" to balance
| expectations.
| Aloha wrote:
| any apartment complex that advertises 'luxury' is by
| definition not.
| The_Blade wrote:
| Blind date with the chancer
|
| We had oysters and dry lancers
|
| And the check when it arrived we went dutch, dutch, dutch,
| dutch
|
| A redder shade of neck on a whiter shade of trash
|
| And this emory board is giving me a rash
|
| I'm flat out
|
| You're so beautiful to look at when you cry
|
| Freeze, don't move
|
| You've been chosen as an extra in the movie adaptation of
| the sequel to your life
| ljm wrote:
| Sanatoriums, asylums, mental institutes, and retirement
| homes... all called Mount Pleasant.
| diego_sandoval wrote:
| M'unpleasant.
| Nuzzerino wrote:
| Dignity health is god awful. I've never had a good experience
| with them.
| debo_ wrote:
| The "in" in "indignity" is silent.
| HorizonXP wrote:
| I read the headline expecting that it was a simple
| misunderstanding or clerical error, with limited impact to within
| 24 hours.
|
| The article is so much worse and the headline buries the lede. I
| would be horrified. My condolences to the family.
| bluSCALE4 wrote:
| Completely agree. I can't imagine being lead on a wild goose
| chase looking for a loved one only to be told by police that
| said party lied to me. I guess there's a lesson here: talk with
| nurses. I'm sure some would toe the line but if something
| smells fishy, I'm sure someone will crack. Then again, maybe
| only one nurse would know the truth so it's may not be easy.
| smcin wrote:
| It's worse than that, it's like burying a double or even
| triple lede:
|
| - it's not just that the hospital told her family totally the
| wrong thing for a day or a year...
|
| - or even negligently cremated or buried her in a pauper's
| grave...
|
| - but they also mishandled the corpse, which IIUC is a
| misdemeanor (corpse desecration, which is a felony, might not
| apply), by shipping her decomposing body to an off-site
| warehouse morgue.
|
| - and failing to timely issue a death certificate or do an
| autopsy prevents determining whether there had been medical
| malpractice associated with her death.
| ghostly_s wrote:
| and _they_ didn 't even know she was dead - the death
| certificate was not completed until her body had been
| rotting in their facility for a year.
| bluSCALE4 wrote:
| I wonder if it's possible that she checked herself out but
| immediately died outside the hospital which would explain why the
| paper work was in order. I would not explain why after being
| ID'd, why family wasn't informed or how she was placed into
| offsite storage facility. Gross incompetence and criminal
| negligence. I hope the family gets the 5x the jury award as
| requested. Didn't know you could even do that.
| cogman10 wrote:
| > I wonder if it's possible that she checked herself out but
| immediately died outside the hospital
|
| I find that really unlikely.
|
| I mean, for starters, they had her body and knew it was her
| body in storage. That doesn't happen if they don't have IDs
| attached to the corpse. I find it unlikely that the hospital
| wouldn't be ringing the family like crazy because of a body
| they want to unload. Especially if they have the paperwork
| showing that she'd checked out. There'd be no reason not to
| almost immediately say "Hey, actually, we found her right
| outside the hospital dead, sorry for your loss".
|
| I'm guessing an obvious fuck up killed her like 10xing her
| insulin dosage by mistake. Or administering something other
| than insulin.
|
| And it wouldn't surprise me if, conveniently, 17 or 24 months
| just happens to be the retention policy for medical records.
| Terr_ wrote:
| > And it wouldn't surprise me if, conveniently, 17 or 24
| months just happens to be the retention policy for medical
| records.
|
| This was in California, where the law [0] is 7 years minimum,
| potentially more if the patient was a minor.
|
| AFAICT every state wants at least ~5 years of retention.
|
| [0] https://www.law.cornell.edu/regulations/california/22-CCR
| -72...
| sonotathrowaway wrote:
| Or they needed to keep the body long enough that any evidence
| of malpractice could be hidden.
| geor9e wrote:
| Like she died and the medical examiner took her directly? It
| doesn't sound like it from this: "The 31-year-old died in the
| care of Mercy San Juan medical center in Sacramento in April
| 2023. The hospital shipped her body to a storage facility"
| bluSCALE4 wrote:
| I hear you but they also say that she signed herself out.
| That means she signed a waiver.
| Retric wrote:
| Perhaps someone signed a waiver. Based on the rest of the
| story I don't think we can assume they are telling the
| truth without any evidence here.
| bluSCALE4 wrote:
| Completely agree. It's the sort of case that their should
| be jail time, just not financial consequences.
| 015a wrote:
| Hospital management: "What new system or form can we add so our
| liability is limited in this happening again? Just one more
| e-signature bro, it'll work this time I swear, this is the one,
| just one more."
| djmips wrote:
| They'll get it added to your Disney+ subscription.
| khaki54 wrote:
| Crazy. I wonder if they made a mistake, somehow killing her, but
| thought she was indigent or mentally ill, and that's why they did
| all this. Then again, it sounds like she was treated many times
| by this hospital. I cannot fathom the circumstances where the
| actions after her death could have been a simple mistake, but
| they've had 16 months to come up with a story and destroy all the
| evidence, so we may never know the truth.
| primitivesuave wrote:
| Honestly, this was the first thought I had when I read the
| article. I worked in this space for several years and
| interacted with many doctors - just like in any other
| professional industry, some people have stellar reputations
| that precede them, while a few are infamous for their
| malpractice and unethical behavior. The perverse incentive
| arises when a hospital has a publicized malpractice lawsuit or
| criminal investigation - everyone who works at that for-profit
| medical institution has an incentive to protect its reputation
| (i.e. its profitability). This has allowed "angel of death"
| doctors/nurses to kill hundreds of people over the years, since
| there isn't much incentive to dig too deeply into "excess
| mortality" statistics (a famous example being Harold Shipman
| who could have easily been detected 2 years and over 100
| victims earlier).
|
| Covering up a case of medical malpractice by surreptitiously
| filling out discharge paperwork is certainly possible. A
| surprisingly large component of healthcare processes is to
| blindly trust that doctors are manually entering information
| truthfully and accurately. The fact that they couldn't locate
| her body for an entire year strongly suggests a criminal
| conspiracy to hide the body.
| yosito wrote:
| As a victim of medical malpractice, it's terrifying to me
| that someone could have killed me to cover it up.
| jofer wrote:
| You'd be amazed how bad hospitals can be at keeping track of
| fairly critical things.
|
| I had a cousin who voluntarily checked himself into the hospital
| related to severe withdrawal symptoms (and had bouts of psychosis
| related to said with withdrawal - meth addictions are nasty). His
| mother stayed for awhile but had to leave for work. She was
| repeatedly guaranteed by multiple doctors and nurses that he
| could not check himself out and would be there for several days
| at least. They told her to come back the next morning.
|
| Late that night, he was discharged. Not even "he checked himself
| out". The hospital discharged him (and that's over an hour ride
| away from home, btw - no hospitals in rural areas these days).
|
| He had no phone and no wallet. According to staff, he tried to
| call his mother to pick him up, but couldn't remember her cell
| phone number (it had changed recently). He called his sister and
| left a message, but she was traveling and didn't get it until
| much later. According to the hospital, he tried to call several
| different numbers trying to get a ride home and they made him
| stop and made him leave. In a quite rough downtown area he was
| not familiar with. While clearly not in his right mind. At 2am.
| With no wallet, no phone, no nothing.
|
| The hospital had his mother's contact info. They did not give it
| to him even when he requested it. They did not attempt to contact
| her in any way.
|
| We still don't know what happened afterwards. His body was found
| four days later in the river and it had been there for awhile.
|
| Forcibly discharging someone under those circumstances and
| refusing to even contact their emergency contacts is beyond
| belief. I'm furious about it. Apparently it's common and not even
| something there's any recourse for.
| mrinfinitiesx wrote:
| Reading that makes me incredibly outraged. I'm sorry that
| happened and your family had to go through that.
| JohnMakin wrote:
| When I was a teenageer a school counselor incorrectly perceived
| me to be in a crisis and had me sent to 72 hour hold (which
| stays on certain records for quite a while and can be
| incredibly disruptive, but that's besides the point) - for some
| reason I was sent almost 40 miles away in another county in a
| city I'd never been. The hospital doctors took one look at me
| and realized I didn't belong there, but to do a discharge
| apparently is a pretty lengthy process once this process is
| initiated - almost 20 hours later (again, being held completely
| against my will for no reason) they released me. I asked them
| where I was supposed to go and if I could call my dad. They
| said no, but they gave me two (2) bus tokens, which wasn't
| enough to get back where my car was parked at the school, plus
| I had no idea how to use the bus system in that county, and
| didn't have my glasses, phone, or wallet.
|
| I really don't know how long it took or how I made it, but many
| many hours later I made it back to my car. I had to beg for
| money and walk the last several miles once I recognized finally
| where I was. It really sucked, and ever since then I've had a
| great deal of sympathy for people that are churned through this
| terrible system and spit right back out with no dignity
| whatsoever, let alone empathy. This incident disrupted my life
| irreversibly (ended up missing tests and having to do a medical
| withdrawal from school, lost scholarships, etc) and derailed a
| lot of things I had wanted to do for many, many years. The
| hospital/medical care industrial complex doesn't optimize for
| empathy. They're just trying to get the bodies through as
| quickly as possible.
| FireBeyond wrote:
| > in a crisis and had me sent to 72 hour hold
|
| Oftentimes it's not even that, or can go to the opposite
| extreme. It can be "or until evaluated by a psychiatrist or
| MHP".
|
| I'm a paramedic in Washington. The biggest example of this I
| remember was a 14yo, intentional pharma overdose. We brought
| her in, "invol". Four and a half hours later, call goes out,
| same address, 14 year old girl, overdose. We checked with
| dispatch, was there a glitch?
|
| Nope. Psychiatrist had spoken to her, determined she was "no
| threat to herself". Parents drove her home, and within
| fifteen minutes she'd locked herself in the bathroom again,
| and taken more of the same meds.
|
| Was furious. Between the psychiatrist, parents not locking up
| the meds, hell, the ER, she probably still had drugs in her
| system.
|
| "Maybe hold on to her for more than four hours this time."
|
| Also, tangentially, if EMS wants to transport you
| involuntarily, we actually need Law Enforcement involvement -
| they don't even necessarily need to talk to the patient, but
| they do need to complete the paperwork that takes them into
| custody, which they then "assign" to us. EMS generally has no
| power to treat you against your will (however, if you are
| actively a threat to yourself, we can act on that, usually
| restraint and sedation. Or there is 'implied consent' where
| if you lose the ability to effectively consent, the law
| assumes that a rational person would want aid to be
| rendered).
| JohnMakin wrote:
| I'm aware of a lot of this dynamic and have written
| extensively about it elsewhere - in this case though,
| especially looking back, it was ridiculous. I was extremely
| stressed about finals and didnt know what to do. Was
| borderline homeless and struggling to support myself. I had
| never seen a counselor or therapist before and was mildly
| depressed. she asked me a few leading questions like "how
| would you feel if you failed your finals and dropped out?"
| and I said something along the lines of "I guess I'd feel
| suicidal." then, "do you feel suicidal now?" and I said I
| wasn't sure. Then she goes, "so you cant tell me if you go
| home right now, you cant guarantee me you won't kill
| yourself?"
|
| now at this point I had zero ideation even, no plan, no
| intentions of killing myself, but being a pedantic dork
| studying philosophy I said I wasn't sure about that,
| because I really wasn't sure what to say. 10 minutes later
| a cop shows up, puts me in handcuffs, parades me off campus
| in them and people I knew saw it. I had absolutely no clue
| what was going on and had to sign papers I didn't want to
| sign and when I protested the answer was basically "you can
| come voluntarily or with force, your choice."
|
| It ended up doing _far_ more harm than good for me. I know
| physicians personally that will often throw people into 72
| hour holds in the ER "just to be safe," either not
| understanding or caring the long term consequences of being
| put in an involuntary hold. These same physicians have told
| me she did the "right" thing but anyone with common sense
| and experience could figure out very quickly I was not a
| danger to anyone. I was just trying to find some help
| because I was overwhelmed.
| FireBeyond wrote:
| I am very sorry for your experience - that's entirely
| horrible.
|
| I'm the same as you, too, and pondering the deeper,
| thinking answers.
|
| That whole process sounds messed up. I would say over 99%
| (and that's not an exaggeration, but literal) of our
| invol patients do not have police involved (other than to
| submit paperwork to the hospital), let alone cuffs. Our
| EMS protocols DO require soft restraints _during_
| transport, but we generally make a point of being
| apologetic about it, putting them on at the last moment
| and that we will take them off ASAP (essentially once the
| ambulance is in Park). Even this is only because,
| unfortunately, some of those patients have attempted to
| exit a moving ambulance, sometimes at freeway speeds.
|
| I'm curious what papers were put in front of you, though,
| as the whole point of the involuntary custody process is
| that your acknowledgement is not necessary (at _that_
| point - after the mental health hold hearing, in front of
| a judge - you are asked to acknowledge /sign, but not
| required).
| JohnMakin wrote:
| This is california law and I believe the code is 51-50
| but this is over 20 years ago so I'm a little fuzzy. I
| think looking back they were just liability papers the
| university was having me sign, I remember having to
| acknowledge things (that I didnt have time to read) that
| I wouldnt be able to purchase a firearm for 7 years and a
| whole bunch of other legal gobbledegook about being
| detained and what my rights were. The whole time a cop is
| standing above me making me sign it though and no one was
| answering my questions. I was extraordinarily confused
| for most of it until the cuffs went on and I had kind of
| a vague understanding I had said something wrong. At no
| point did anyone tell me what I did other than to tell me
| stuff like "you're very ill and are being looked after
| for your own safety, care will be provided to you and you
| will be ok" kind of stuff. I cannot stress enough that
| this assessment was based on less than a 10 minute
| conversation with me. They even had a followup with me I
| was forced to go to, because I had missed the finals
| (because i was gone for like 3 days) and therefore
| actually failed. So they then convinced me to do a
| medical withdrawal to save my grade which very ironically
| led me to actually dropping out because I lost all my
| scholarships and grants. I would have probably been fine
| had I never sought help, and I suspect although my
| experience was extreme and probably malfeasant, that this
| treatment of people undergoing difficult mental things is
| probably very commonplace within the system.
| alostpuppy wrote:
| This happened to a friend of mine in the last year. He
| went to the ER for something and joked about feeling
| suicidal. Meanwhile people I know who are actually
| suicidal are impossible to get admitted. Sorry that
| happened to you. I really wish there was a better
| feedback mechanism in American healthcare
| JohnMakin wrote:
| Thanks, ironically this is one of those policies that has
| misaligned incentives everywhere. The doctor does not
| have any incentive other than to "play extra safe" and
| punt anyone they think is having a crisis into other
| hands - they're usually very busy, especially in the ER,
| which is typically full of mentally ill people. This has
| the opposite effect of actually helping people though -
| what happens to your friend if he actually is feeling
| suicidal in the future? 0 chance he seeks help, it's way
| too risky to even state outloud. And when people have no
| outlet for this kind of problem or thoughts, bad things
| happen.
|
| Looking back with a more historical lens I think at the
| time this happened for me was shortly after columbine and
| everyone was freaked out about mentally ill people
| shooting up a place because that had at that time been a
| shocking incident.
| aidenn0 wrote:
| > The hospital/medical care industrial complex doesn't
| optimize for empathy. They're just trying to get the bodies
| through as quickly as possible.
|
| That must be why health care is so affordable (/s)
| BartjeD wrote:
| Profitable
| romwell wrote:
| >When I was a teenageer a school counselor incorrectly
| perceived me to be in a crisis and had me sent to 72 hour
| hold
|
| How could they do that without notifying your parents and
| telling them exactly where you've been sent to, and what they
| should do?!
|
| How could they've done that without giving the hospital your
| parents' contact info? How could the hospital accept you
| without requesting it, given that you were sent from _school_
| , where you have limited rights because they _have the
| responsibility_ for your well-being?
|
| How could have they discharged without allowing you to
| contact your family yourself?
|
| This should be grounds for a civil lawsuit, if not criminal
| prosecution. I am not a lawyer, but I really hope that anyone
| reading this would contact one if they end in a situation
| like that.
|
| _> They're just trying to get the bodies through as quickly
| as possible._
|
| I don't think taking 30 seconds over those 20 hours to
| contact your family would've slowed them down any.
|
| This is not about efficiency. They should not be allowed to
| operate.
| JohnMakin wrote:
| I was an adult and had been independent since 17. I do not
| recall the hospital ever asking me for contact info. I had
| nothing on me except my keys, no id. and frankly by the
| time I had got there in cuffs and realized what was
| happening was not in a great mood to cooperate, either.
|
| I know for a fact the school never contacted my emergency
| contacts but there wasn't really anyone to contact to begin
| with so I don't fault them for that.
|
| What should have happened was I referred to a school
| therapist or actual doctor.
|
| To explain further what this place was like - it was the
| county mental facility at a large hospital. imagine a toned
| down version nurse ratchet kind of setting, people
| defecating on themselves, screaming, people in straight
| jackets. and then me, a slightly disheveled kid who was
| stressed about finals. they wanted me out of there
| immediately once they realized what was going on because
| they were already full. then when they process the paper
| work you get shuffled to a front desk behind a window who
| just wants you out of their sight ASAP. I remember I had to
| actually argue for the bus tokens and the woman seemed
| exasperated with even that.
| ClumsyPilot wrote:
| > shuffled to a front desk behind a window who just wants
| you out of their sight ASAP
|
| That's their problem, especially if they deal with proper
| mental issues, you can't just dump these kind of people
| on the street.
| soco wrote:
| In these times having people dumped on the streets seems
| rather like a feature, not a bug. Liberty! _screech_
| adamredwoods wrote:
| https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_o
| f_1...
| colechristensen wrote:
| Are they suing the hospital and care team for many millions of
| dollars? That's the level of neglect of responsibility that
| should get you enough money to own the hospital that did that
| kind of thing.
|
| I regularly have to aggressively bully medical care teams for
| myself and others to get them to do the right, obvious things.
|
| I do not trust doctors, they do not care to figure out
| problems, ignore so many people's problems, and make wildly
| stupid mistakes all of the time.
| ghostly_s wrote:
| > Are they suing the hospital and care team for many millions
| of dollars?
|
| Did you try clicking the link? They are. 5 million dollars. I
| expect they will win, and that still won't make them whole.
| tailspin2019 wrote:
| You're replying to someone who in turn was asking the GP a
| question about their comment, not about the article.
| nostrademons wrote:
| I wonder how much this correlates with socioeconomic status.
|
| When my kids were born, the hospital had this incredibly
| elaborate, incredibly detailed checklists of things that needed
| to be in order before they would let you leave. Did you have a
| carseat? Did you have a ride home? Did the doctor come by and
| give you discharge instructions? Do you have all the belongings
| you came with? Did you fill out the birth certificate
| application? Have all your discharge papers been signed?
|
| They actually wouldn't let my wife walk herself down - they had
| to call Transport, and she had to be wheeled down in a
| wheelchair with the baby's carseat on her lap, and I had to be
| waiting at the designated curbside to pick her up. She was
| perfectly capable of walking herself down, and we were both
| capable of putting the carseat into the car in a normal parking
| spot, but everything had to be done in the presence of an
| orderly.
|
| This is the same health care company mentioned in the article,
| but at a pretty affluent suburb of Silicon Valley.
| ghostly_s wrote:
| None of those checklist things are done out of an interest in
| care - it is about avoiding liability.
| munificent wrote:
| I don't understand the completely unnecessary cynicism in
| this comment.
|
| Do you really believe that everyone working in maternity
| wards in hospitals cares absolutely nothing about babies?
| iamthepieman wrote:
| But your not being taken care of by a person. Your being
| taken care of by the system. The nice nurse goes home in
| 3 hours, the nice doctor has 9 other patients. The
| secretary relies on the information in The computer. The
| people may very well care a lot. The system does not.
| elgenie wrote:
| Checklists have been demonstrated to improve care quality
| because when it's the not-so-nice nurse that's on shift,
| and the doctor's been awake for 60 hours straight, the
| stuff that's on the checklist still gets done.
| cqqxo4zV46cp wrote:
| "It's the corporations, mahn!"
| cwillu wrote:
| One can be forced to mindlessly perform ridiculously
| constricting duties that have everything to do with
| limiting liability and nothing to do with outcomes, while
| also caring about babies.
| lupusreal wrote:
| Have you seen the itemized bills for giving birth in an
| American hospital? They'll even try to mutilate an infant
| boy _and charge you for it_ unless you emphatically opt
| out.
| Der_Einzige wrote:
| I want to see the criminals in the medical ethics
| community who ever greenlit this nonsense to have justice
| served upon them. Europeans would jail American doctors
| for what they do to babies here.
| prmoustache wrote:
| are you talking about circumcision? Do they do that
| automatically to all newborns?
| mensetmanusman wrote:
| It is not automatic, but it is default behavior.
| unbrice wrote:
| Re: Understanding the cynicism: For example it is
| intriguing that they insisted on using a wheelchair to
| get in the car, but not to get out. But what's even more
| revealing is that the child had to be in a car seat while
| on his mother's lap.
| CoastalCoder wrote:
| There are some circumstances where people don't realize
| they can just say "no".
|
| I suspect this is one such case.
| lolinder wrote:
| They didn't say that, they said the checklist is there
| for liability reasons and not for genuine care reasons.
|
| The "won't let mom walk to the door" thing is a great
| microcosm of that--it's a blanket policy applied to all
| mothers regardless of need.
|
| My wife had our youngest at home but we had to take her
| to the hospital afterward because her lungs were a little
| sticky and she needed a respirator for ~4 hours. I took
| our daughter in and my wife followed a few hours later,
| walking all the way into the hospital.
|
| The NICU wouldn't discharge us for two days (which is a
| whole liability > care story of its own), but when they
| finally did they insisted that my wife--who had had the
| baby at home and driven to and walked into the hospital
| while mere hours postpartum--needed to be in a wheelchair
| to the curb.
|
| We liked that shift of nurses, they clearly cared, but no
| one in that room looked at my wife standing by the warmer
| and thought "she needs a wheelchair". They had a
| checklist and they were going to be darn sure they
| followed it.
| beaglesss wrote:
| You can always refuse. They can't kidnap you or the baby
| if for whatever reason you don't want a wheelchair, and
| it's almost always illegal to block the exits without a
| court order or documented altered mental status.
| lolinder wrote:
| After 48 hours of putting up with hospital rules in order
| to avoid an AMA discharge, we were just happy to be done.
| They certainly didn't frame it as optional, and it wasn't
| worth the fight.
| secstate wrote:
| I appreciate your willingness to push for your rights
| here. But the situation is surprisingly similar to
| refusing to let a cop search your trunk. You can say no,
| but that K-9 unit is going to take four hours to get
| there from the station 20 minutes away. They will make
| your life hell.
|
| I've definitely been in hospital situations with my
| children where I was honestly afraid (perceived or real
| threat, I still don't know) that they were going to
| report me for child abuse if I took my kids home and
| refused care. People with authority are kinda scary, and
| while I love for us to all choose rights over security,
| sometimes I just don't want to have to fight for
| everything.
|
| And this is where police states evolve from.
| Zak wrote:
| > _You can say no, but that K-9 unit is going to take
| four hours to get there from the station_
|
| Holding someone for longer than the traffic stop requires
| to wait for a drug dog is illegal in the USA. That's not
| to say it never happens, but it's grounds to exclude any
| evidence found, and for a lawsuit.
|
| https://en.wikipedia.org/wiki/Rodriguez_v._United_States
| michaelmrose wrote:
| Over half the population doesn't have the funds to
| enforce that and effectively ultimately has no such
| rights in this situation and many like it.
| lolinder wrote:
| Not to mention that proving that the drug dog didn't
| actually need to take that long would probably be
| extremely difficult.
| Zak wrote:
| How long the drug dog needs is irrelevant; if they want
| to use a dog without consent or probable cause to search,
| they need to get it there while they still have legal
| grounds to detain the suspect. A traffic violation is
| grounds to detain someone long enough to issue a
| citation, but not longer.
|
| The judge won't be amused if the police say it took them
| 45 minutes to write a speeding ticket.
| cscurmudgeon wrote:
| None of what you said supports that checklist following
| is only for decreasing liability and not towards patient
| wellness. It may be the case but it doesn't really follow
| though.
| Dylan16807 wrote:
| The story doesn't prove "only" by itself, but it's a good
| example of the checklist doing something for liability
| and not wellness.
| lolinder wrote:
| It doesn't _prove_ anything, but I consider it to be a
| strong anecdote supporting the argument that individual
| wellness is not the primary motivation for these
| checklists.
|
| I can see an argument that it's about increasing average
| wellness across all people ever taken care of by that
| NICU, but from the perspective of an individual patient
| there's no difference between the two motivations--the
| point is that _your own care_ is not the important thing
| to the hospital at that time, what 's important is the
| rules and regulations.
|
| In our case, we both felt that our care was actually
| actively hampered by NICU discharge rules that were
| designed for premature babies and were completely
| inappropriate for our late-term baby. The wheelchair was
| just the last hurrah of the situationally-inappropriate
| hospital regulations.
| Flop7331 wrote:
| Everyone in maternity wards is underpaid and overworked,
| and the checklist is there and rigorously followed so we
| don't have mothers with c-sections tearing open on the
| way out because no one brought a wheelchair.
| Dylan16807 wrote:
| I don't understand that one very much. If walking _is_
| going to tear them open, isn 't it better to have that
| happen at the hospital instead of half an hour later at
| home? I don't think much healing is going to happen in
| between.
|
| Is the risk sufficiently on a per-step basis to make that
| worth it?
| Der_Einzige wrote:
| Is go further and say that all doctors who work in those
| wards and perform male genital mutilation must _hate_
| babies, otherwise I have no explanation for how they can
| ignore the fact that their European peers would throw
| most American doctors in jail for the things they do to
| newborns.
| nostrademons wrote:
| ...which might still be socioeconomically correlated.
| People who make half a million a year can afford lawyers.
| People who make $50K/year generally cannot.
|
| The interesting point here is about how so many
| institutions become so much sloppier when the legal system
| becomes unaffordable for a majority of residents.
| Unsurprising, but it has pretty far-flung consequences if
| you're trying to root-cause why so much of America seems
| like a 3rd-world country today.
| brvsft wrote:
| I get tired of the constant deferral to socioeconomics as
| an excuse. It's pretty simple, we don't allow people to
| be born with zero documentation in the US. This would be
| a massive fuckup, and it doesn't matter if the kid is
| poor, they still need a birth certificate to get a social
| security number. They've had a long time to put whatever
| systems in place prevent that from getting missed, even
| in the poorest zip codes.
|
| And as far as safety, it's not always legal liability.
| I'm sure a good portion is, but we're talking about
| newborn babies right now. Most people don't want to have
| any part in a newborn being harmed, so it's trivially
| easy to get employees to take that stuff seriously.
| guerrilla wrote:
| Nobody's excusing anything. It's an explanation. You're
| comparing apples to oranges: things that are free and
| done by the state compared to things that cost done by
| for-profit corporations.
| mensetmanusman wrote:
| We do let millions of people in without documentation,
| and they are nearly all poor. The underclass somehow
| manages while the upper class ducks everything up.
| cowsandmilk wrote:
| Going to disagree hard here, numerous studies have shown
| checklists improve patient outcome. Similarly, they improve
| safety in numerous industries. And requiring two person
| sign off on dangerous actions in the hospital also improves
| outcomes. Sure, following these practices is helpful in a
| lawsuit, but primarily because they are best practices.
| opello wrote:
| I'm pretty sure that the person you're replying to isn't
| making a claim about the utility of checklists but the
| content of the enumerated checklist items.
| prmoustache wrote:
| Only in the USA will you see people being rolled in a
| wheelchair at the door.
|
| The only reason is people love to sue for anything in
| this country. This is unrelated to best practices.
| pyuser583 wrote:
| Those checklists have done a good job preventing infant
| kidnapping.
| monetus wrote:
| > _They actually wouldn 't let my wife walk herself down -
| they had to call Transport, and she had to be wheeled down in
| a wheelchair with the baby's carseat on her lap, and I had to
| be waiting at the designated curbside to pick her up. She was
| perfectly capable of walking herself down, and we were both
| capable of putting the carseat into the car in a normal
| parking spot, but everything had to be done in the presence
| of an orderly._
|
| I have tonic-clonic seizures; at least 4 hospitals have
| wheeled me out that way, suffering no argument otherwise. I
| guess it is common.
| mlinhares wrote:
| A lot. A friend worked for years in a well known hospital in
| PHL (that closed somewhat recently), and they were pushed to
| get people with no insurance out as fast as they could.
|
| If they know you won't be paying, they will try to kick you
| out as fast as they can and consequences be damned, if you
| don't have insurance you likely don't know/understand your
| rights and wouldn't sue them.
| protocolture wrote:
| We had the opposite. They tried on multiple occasions to
| evict my wife after a C section while she was in an
| incredible amount of pain.
|
| They kept giving her an oxy in the morning, then after it set
| in, asking her to rate her pain level, and recording it.
| Which is backwards.
|
| Then they blamed her for not asking for more pain meds, which
| she had.
|
| Then they told her to just ask for more pain meds, which we
| did.
|
| Then the nurse told her that shes not allowed to have any
| more pain meds. At which point I went full Karen, got our
| stay extended by 2 nights.
|
| Apparently the midwives expected her to be walking up and
| down the corridor, which was not a requirement and not part
| of the treatment, just to demonstrate her pain levels.
| vegardx wrote:
| Having a low child mortality is important, and we've done so
| many good things in the last couple of decades, but I'm
| starting to think we're at the point now where the money you
| have to spend to make a meaningful difference is better spent
| in other areas of health care.
|
| A classical example of this is in Norway. There's nothing
| that gives you access to more resources than being pregnant
| or being in care of a newborn. You can suffer from all kinds
| of mental health issues for your entire life, struggle to be
| a productive member of society and be in and out of temporary
| treatment and be on social benefits. But the moment someone
| is pregnant they get will be top priority for anything that
| is even remotely connected with child mortality, almost
| regardless of how benign something is.
|
| I personally know several people that finally got the help
| they had been so desperately been begging for, just because
| they got pregnant. We could have saved them from literal
| decades of suffering by just providing good treatment early.
| I'm willing to bet that we'd even be in a position to spend
| even more money on reducing child mortality, because when you
| start doing the math of how much they ended up costing
| society it really adds up.
| SCUSKU wrote:
| Good lord that's awful, I'm sorry for your loss.
| lupusreal wrote:
| Such professionalism and high quality care like this are why
| American doctors deserve their huge salaries, massive houses
| and vacation properties, boats and sports cars, and of course
| are entitled to our thanks and adoration. Truly, a saintly
| class of people who all got into this line of work to help
| people.
| shiroiushi wrote:
| I think the doctors aren't the ones to blame here, it's the
| hospital administrators.
| lupusreal wrote:
| American doctors want the public to believe they are
| powerless victims of the system that makes them wealthy
| while bankrupting patients.
| rxyz wrote:
| News flash - most doctors all over the world are doing it for
| money and status. It's a job.
| unethical_ban wrote:
| To force someone out who was guaranteed wouldn't be; to
| withhold documented caretaker/relative phone numbers from them
| when they have no other help; then to force them from the
| premises with no resources.
|
| I want this to be a lie, but I don't treat HN comments that
| way. This is horrible, absolutely appalling.
| Arrath wrote:
| > You'd be amazed how bad hospitals can be at keeping track of
| fairly critical things.
|
| Got to experience that first-hand when my partner lost her
| pregnancy. We went in for the procedure to remove the nonviable
| fetus and were advised we had 14 days to arrange for a mortuary
| to take the remains if we wished to keep them, which we did. At
| 7 days when the mortuary tried to arrange for pick-up, we were
| informed that the hospital had disposed of the remains. It was
| "very uncommon" for people to want to take the remains, so they
| got lax in following their procedure and jumped the guns. Left
| us nothing to take home. It still sucks.
| nick3443 wrote:
| That sucks. I hope you will get to take home a healthy baby
| in your future.
| Arrath wrote:
| Thank you, we're hoping so too.
| DoctorOetker wrote:
| that stuff is worth a lot, probably went to the highest
| bidder, tissue banks, stem cells, ... they probably tell the
| same to all the parents, to redirect the anger towards some
| average Jane and Joe... while trying not to visualize the ice
| and careful packaging in which they got it "disposed off"
| through some medical courier.
|
| (sarcasm warning) But who can fault them, imagine they had to
| explain to each pair of parents from scratch what is
| happening behind the scenes, and how such decisions are being
| made with little to no public discussion let alone democratic
| oversight? The time it would take compared to the harvesting
| itself would be intolerable. Intolerable! Not to speak of
| having to invest in bulletproof panes from behind which they
| would quickly learn to explain all this.
| shifto wrote:
| That's some conspiracy stuff, got proof? I mean... You're
| not even a real doctor, you make pizza's.
| alborzb wrote:
| I'm not OP but John Oliver had a pretty good episode
| about hospitals, organ donation organisations and even
| non-profits, all benefit from a opaque system
| intentionally designed to hide where bodies go when
| "disposed" -- Here's a youtube link to the episode (may
| be blocked in certain regions due to copyright)
| https://www.youtube.com/watch?v=Tn7egDQ9lPg
| ghufran_syed wrote:
| if it's true that he was discharged and didn't leave against
| medical advice, that sounds like a fairly straightforward and
| expensive lawsuit against the hospital. And some hospitals only
| change their behavior when beaten by large expensive
| lawsuits...
| nyokodo wrote:
| > Forcibly discharging someone under those circumstances and
| refusing to even contact their emergency contacts is beyond
| belief
|
| I don't know what it is _legally_ but _morally_ that is
| negligent manslaughter.
| caseyy wrote:
| One time I went to A&E in the UK, I saw a young unconscious
| woman outside, laying next to a wheelchair. I told the
| receptionist and was told she had to come in for treatment.
| Another patient tried to get her into the wheelchair but
| ultimately I got an ambulance involved to bring her in.
|
| The nurse then recognized the woman, for it was the very nurse
| who had rolled her out for fresh air some time ago.
|
| It was a cold night, as well. I think there was some snow, or
| it was about to snow.
|
| There is definitely an over-reliance on schematics in emergency
| medicine. The moment a slightly more complicated patient is
| involved or one falls outside the schematic otherwise, their
| risk of serious health injury or death goes up a lot.
|
| This was always interesting to me. I went to medschool, and I
| remember my peers as people who genuinely wanted to help
| others. Few would have refused to help someone collapsed
| outside in the cold. But our medical system has changed a lot,
| many more people do it for the pay slip. Most probably still
| care about the patients but I suppose some portion genuinely
| don't. If it's not on the schematic, they won't care for it.
| hnlmorg wrote:
| Being overworked will do that to you.
|
| It's like asking a software engineer to write a hundred new
| features in a given sprint while the rest of the application
| is in flames. Eventually you stop aspiring to build good
| software and just hope enough of your code works that it's
| good enough for some people.
|
| Unfortunately medical services are literal life and death
| services. So we have it _much_ easier as software engineers.
| agos wrote:
| that is, until people who work in literal life and death
| services have to use software written by overworked
| engineers...
| theblobawakens wrote:
| I don't know why I read the last part "medieval services
| are literal life and death services".
| itronitron wrote:
| I've always had the experience that all employees at
| hospitals act like contractors. Usually great at what they do
| but no sense or willingness to look beyond their direct job
| responsibility.
| chaostheory wrote:
| There's a common reason for that: overworked, over
| stressed, and underpaid. Eventually the exhaustion will
| turn you into a numb zombie clocking in and out. There's no
| easy solution since healthcare is already expensive.
| prmoustache wrote:
| I have worked in an hospital and that is clearly not true.
| akira2501 wrote:
| > Apparently it's common and not even something there's any
| recourse for.
|
| It's a sad fact but hospitals have no one who is responsible
| for advocating for your care. I think it's a major ethical flaw
| in our entire healthcare model. People are not medical experts
| or legal experts and when they are suffering they're even less
| capable of handling that burden.
|
| To expect the hospital with a financial incentive to do this is
| absolute folly. It just doesn't happen. They'll _absolutely_
| get your insurance information, even when you're laying in the
| ER and doctors are still attending to you, but they'll provide
| you less than nothing when it comes to understanding your care
| and your options.
|
| We afford people public defenders as disinterested third
| parties when they're accused of the most petty of crimes, yet,
| you're absolutely on your own when it comes to the hospital.
| This is a complete social moral failure.
| Der_Einzige wrote:
| The number one actual reason to have kids is to guarantee
| that you have your own de facto "medical advocate" who will
| do all of what you described for you.
|
| Those who don't have kids will learn quickly how hospitals
| treat those without children. It's not pretty.
| romwell wrote:
| I am so sorry for what happened to your brother and your
| family.
|
| The hospital is directly responsible for your cousin's death.
|
| The fact that they assured the mother that they'll keep him,
| specifically told her to come the next day, and then forcibly
| discharged him at 2am without either calling his mother or even
| providing mother's contact to him should be grounds for
| criminal prosecution.
|
| This is beyond negligence. They _lied_ to the mother and
| _knowingly_ forced him out when they were responsible for his
| well-being.
|
| It would've cost them $0.00 to dial his mom's number. The fact
| that he asked for his mom's phone and they _refused_ means they
| did it on purpose. This sounds very much like and indication of
| malicious intent to me.
|
| I hope your family sues the bejeesus out of the hospital, and
| that someone will get a felony charge over this.
|
| This hospital mot merely betrayed the trust of your family. It
| is literally a public health hazard. It should not continue
| existing.
| lhamil64 wrote:
| Last time I went to the ER, they checked me in under the
| completely wrong name. Like it wasn't even close. Luckily I
| noticed the wrist band was wrong and pointed it out, but they
| then had to re-do tests since they had been done under the
| other person. It really makes me think how bad that could have
| been though. What if I went unconscious, and they used the info
| on the wrist band to look up medical history? What if they gave
| me medication based on that incorrect history? And at the very
| least they wouldn't have the right emergency contact info...
| jb1991 wrote:
| > You'd be amazed how bad hospitals can be at keeping track of
| fairly critical things.
|
| should be
|
| > You'd be amazed how bad hospitals _in the States_ can be at
| keeping track of fairly critical things.
| croes wrote:
| >Mercy San Juan hospital failed in its most fundamental duty to
| notify Jessie's family of her death
|
| Despite the misconduct, I think saving people's lives is the most
| fundamental duty of a hospital.
| dgfitz wrote:
| Yeah: "we failed at our one job" should have been IMMEDIATELY
| expressed to the family.
| layer8 wrote:
| There can be multiple most fundamental duties:
| https://proofwiki.org/wiki/Maximal_Element_need_not_be_Uniqu...
| vsuperpower2021 wrote:
| This is one of those things where people think that because
| they learned something in set theory 101 or intro to
| computers that it maps perfectly to real life situations.
| ghufran_syed wrote:
| Ok, let me translate it into non-math for you - there can
| be a goal that is a "highest priority" for the organisation
| in the sense that no other goal is a _higher_ priority, and
| yet there are other goals for the organization that are
| _equal_ to it in priority.
|
| Isn't "a Maximal Element need not be Unique" a more elegant
| and much more succinct way of saying the same thing?
| bigstrat2003 wrote:
| Look, that's a great proof and all but it has nothing to do
| with the situation at hand. Just because mathematics say
| there can be two maximal elements doesn't mean morality
| agrees - and this is the domain of morality, not mathematics.
| layer8 wrote:
| I disagree. When you say "I just had the most exhilarating
| experience", that doesn't mean that there can only be a
| single most exhilarating experience. And, independent of
| that, morality also doesn't imply that there can be only
| one most fundamental duty.
| vsuperpower2021 wrote:
| Ridiculous. Stop playing pointless language games.
| croes wrote:
| But it says "its" not "one of its", that suggests only one
| maximum.
| layer8 wrote:
| That doesn't follow. "John failed in his duty to regularly
| check the logs" doesn't imply that John can't
| simultaneously have had any other duties. You have to parse
| it as "its (most fundamental duty to notify Jessie's family
| of her death)", not as "(its most fundamental duty) to
| (notify Jessie's family of her death)", so to speak.
| polartx wrote:
| You are interpreting "fundamental" as 'highest priority', which
| is not the only, (or most commonly expressed) definition of the
| word.
|
| Fundamental is also defined as "so basic as to be hard to
| alter, resolve, or overcome."
|
| I would argue that 'saving lives' is not a 'basic' process; it
| is complex. However, informing someone's next-of-kin of their
| passing, is a basic (ie fundamental) role of a healthcare
| facility.
| EE84M3i wrote:
| This might sound silly, but technically speaking how does this
| kind of notification work in relation to HIPAA? Is there some
| kind of a carve out that allows hospitals to tell your family
| you've "been discharged against medical advice"? How does next of
| kin notification work for death?
|
| To put it another way, clearly the outcome in this story was
| unacceptable, but what was the correct outcome?
| primitivesuave wrote:
| You're conflating information privacy guidelines (i.e. HIPAA)
| with next-of-kin reporting which is usually specified by state
| law. If you check out the probate process which distributes an
| estate after death, it can vary considerably from state to
| state and has a lot more judicial involvement. HIPAA is not an
| enforced statute or law, it's a set of civil rights guidelines
| which allow hefty fines to be levied by OCR (Office of Civil
| Rights) when a violation is reported and investigated.
|
| HIPAA does specifically allow for the sharing of PHI with
| family and friends of a with substantial leeway given to
| medical professionals to document their reasoning for sharing
| information if it is "in the patient's best interest". In the
| hypothetical scenario where concerned family/friends are
| inquiring about a discharge, it would be perfectly acceptable
| to share certain details of the discharge if the healthcare
| provider is willing to document and possibly defend their
| decision.
|
| In this case, not reporting to next of kin was certainly not in
| the patient's best interest and a _prima facie_ case of
| misconduct. As someone who sat at the intersection of health
| and law for several years, I can 't see any possible legal
| justification or loophole for the hospital to avoid a hefty
| settlement. As some of the other comments on this thread
| suggest, this shocking oversight may not be an isolated case,
| so a hefty monetary penalty is the only realistic way to force
| the other for-profit health systems of America to implement
| better processes for this.
| EE84M3i wrote:
| I see, that makes sense, thanks!
|
| So, after the patient died, what is the mechanism by which
| the family should have been contacted?
|
| Later, if that failed and the family came to ask the
| hospital, the correct answer was "they're dead", not "we
| can't tell you" (and especially not "they were discharged
| against medical advice"!). How does the hospital authenticate
| and authorize the inquiry party?
|
| Edit: also, is being dead PHI?
| mlyle wrote:
| If a hospital becomes aware of a death, they need to let
| the medical examiner know. In turn, they or the medical
| examiner issues a death certificate, etc.
|
| You can't just truck the body off to storage and then
| forget about it.
| cowsandmilk wrote:
| Death certificates can be shared with parents, siblings, and
| children of the deceased in every state; and most states they
| are public records that everyone can access.
|
| Obviously the death certificate here was quite delayed, but
| this shows that generally the fact of death is something that
| can be shared with those suing.
| tppiotrowski wrote:
| Personal story:
|
| A couple of years ago I climbed Mt Whitney in California. One of
| the climbers that day was from the east coast and failed to show
| up for work a few days later. The family became concerned and
| called the car rental agency in Las Vegas where he flew to and
| rented his car. The agency said the car had been returned. After
| another day of him missing they called the car rental agency
| again to confirm and once again the agency said the car was in
| the lot. The next day the rangers found the car was still parked
| in the Mt Whitney parking lot and search and rescue was finally
| dispatched.
|
| In this case I believe it didn't make a difference because the
| climber appeared to die from acute injury on the mountain the day
| of his climb but in another scenario maybe those 2 days would've
| been the difference between being rescued or dying from exposure.
| pyuser583 wrote:
| I recently faced a personal catastrophe because a low ranking
| clerical worker mixed up a form.
|
| I'm not mad about it. I'm mad there's no apology because the
| company insists they did nothing wrong.
|
| Another company, the one reading the form, is responsible for
| services rendered in regards to the form. Clearly not the form-
| fillers fault.
| aidenn0 wrote:
| Oh so many systems take "pass the buck" to an insane level.
| My employer switched insurance providers recently. Twice we
| were referred to a specialist for one of my kids and each
| time it took about a week for the referral to be approved
| (apparently the PCP referring you isn't enough with this
| HMO).
|
| The only thing that has changed is my HMO; the kids still
| have the same pediatrician with the same office staff for
| which referrals were never a problem in the past. However,
| the insurance company made sure to tell me that they are not
| the ones delaying it, because it's technically the
| administrative department of my pediatrician that has to do
| the referral review. The fact that insurance company mandates
| that the referral review must be performed by a licensed
| nurse and follow a byzantine process, of course, has
| _nothing_ to do with the delay.
| victor106 wrote:
| > according to a civil lawsuit against the hospital.
|
| Shouldn't this be a criminal case?
| ikiris wrote:
| Only if a prosecutor wants it to be.
| onlypassingthru wrote:
| Only if the likelihood of guilt is beyond a reasonable doubt,
| which the DA may not want to try. In civil suits the bar is
| lower as it's only a requirement for a preponderance of
| evidence.
|
| Odds are the hospital will settle this out of court for an
| undisclosed sum because they can't realistically have their
| records on the matter brought to light. Was it medical
| malpractice?! We'll never know.
| bpodgursky wrote:
| What specific criminal laws are you suggesting were broken?
|
| Obviously a lot of crap happened here but there's not a legal
| obligation to be helpful to next-of-kin. Suing for vague
| "damages" is going to be far more productive.
| burnished wrote:
| I think those are orthogonal. If I wrong you I can be brought
| up on criminal charges, and independently, you can sue for
| damages.
| maronato wrote:
| This is very sad. My condolences to the family. Reading the
| timeline, I can't help but speculate that there's a darker side
| to this.
|
| Two days before "checking out", the daughter called the mom to
| say she was better and was about to leave. Soon after that,
| something bad happens (possibly malpractice) and she dies. An
| autopsy would reveal the true cause of death, so the hospital
| quietly ships her to an off-site morgue, doesn't even fill a
| death certificate, and fabricates her checking out.
|
| Now the body is beyond decomposed and an autopsy is impossible.
| The hospital claims it was a simple mix-up and gets away with a
| bit of bad press and a negligence charge.
| polartx wrote:
| I was reading something recently about pleading the fifth,
| (like if someone at the hospital was called to testify), I read
| that in criminal cases, pleading the fifth could not be used
| against the defendant. However in civil cases, jurors are
| instructed to assume their refusal to testify would implicate
| their guilt. I didn't verify what I read, so take it with a
| grain of salt.
| consp wrote:
| It says she was taken in due to a diabetic episode.
|
| What on earth is that? Hypo/hyperglycaemia? You'd have to have
| extremely poorly managed type 1 diabetes for that to become fatal
| without a massive screwup at that age.
| GuinansEyebrows wrote:
| this sounds very close to victim blaming in a country where
| insulin is not considered a human right, let alone the fact
| that many people in America only effectively have access to
| human insulin instead of analogs with higher efficacy and
| shorter absorption time. also people can develop t1d well into
| adulthood. we don't have any information about this persons
| life nor should we need any.
|
| this event is just one more reason i'm terrified to be diabetic
| in this country.
|
| honestly the way you posed this question is awful and I invite
| you to reconsider your intent. hopefully the benefit of my
| doubt is not misplaced.
| theparanoid wrote:
| My classmate from nursing school is an RN at that hospital, I'm
| not surprised.
| register wrote:
| If this happened in any of the majour european countries we would
| have that news in the headlines of newspapers and newscasts for
| several days. How come that is not the same in the US even more
| so given that the health sector is mostly privatized and
| therefore "should be" more efficient ( when in fact is clear that
| it is a complete failure compared to European standards) ? .
| snowpid wrote:
| I think it is worth pointing out that many European health
| systems do have strong private elements (e.g. most of them pay
| pharma companies for making medicine) and NHS in the UK as a
| goverment focused health system is still quiet bad compared to
| other European countries.
|
| But to your original question: As you are hanging around these
| website, I notice (and you too maybe), that even the most
| educated Americans have an "only American" world view. They
| consider it is the best country in the world anyway and don't
| care about other parts of the world.
|
| In German news on German problems (e.g. Digitalisation)
| journalist sometimes point other countries as a positive
| example or role model (here Estonia or rarely Ukraine). On
| American problems it does not happen and we (as a I assume you
| live on my site of the Atlantic) just nodding our head why it
| does not change. It would need to change a deeply entrenced
| attitude. On this discussion page here they dont discuss how
| other countries do it. Not a single example how to make it
| better. Because the US is on the top of the hill anyway.
| BodyCulture wrote:
| I recently had an opportunity to learn something about software
| used in hospitals and it was a shock. Are you laughing about the
| JS or web developer meme as a symbol for clueless people? Well, I
| need to tell you that every JS or web dev is a code guru compared
| to the guys I have seen in medical / hospital software.
|
| While your web dev has a very good idea about infrastructure and
| code maintenance these guys are usually clueless about CI, git,
| secrets management etc. but still they now all want to migrate
| their stuff to azure, because it's cool... to say the truth I
| didn't understand the reason why they want to. People that are
| basically relying on Microsoft wizard based development.
|
| Shocking was that this was not only some bureaucracy software,
| but systems that are used for actual operations and patient
| management.
|
| I guess that many people died already because windows developers
| but nobody did a systematic investigation so we don't know.
| blcknight wrote:
| I hope they get awarded 100x what they're asking for.
| louthy wrote:
| I can't be the only person that thought about the Arrested
| Development 'literal doctor' [1] when reading the headline?
|
| [1] https://youtu.be/0BUBd9dQvtY
| fallinghawks wrote:
| My neighbor, who has bipolar mania, was in the hospital for a
| 72-hour hold. She wanted to leave, naturally, and a "patient
| advocate" made it happen "against the doctor's orders." So I'm
| trying to figure out how the choices of someone who cannot
| soundly judge their own condition take priority over that of the
| doctor in charge of them.
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