Tuesday, November 13, 2007

Follow-up on LA Heart-Attack

This is my blog and I run it the way I want.

You can call me a jackass and an idiot and any other choice words you choose. Creativity is a bonus, but stooping to profanity will get you deleted. You cannot call any readers or commenter stupid or offend them in any way, especially if they are grieving. You do not blame the victim.

I deleted an anonymous poster's comment this morning, but (s)he made some good points. I offer the comments below with edits where I thought they were appropriate. This whole thing is emotionally draining and a strain on the family of the deceased and I am aware that family and friends are reading. I am still trying to view this as a policy discussion with a really dramatic human impact, the nature of which has to be respected by everyone.

Remember, the following is from an anonymous poster responding to Missing a Heart Attack in LA:

Living in the LA area I have followed this in the news AND being a senior I am quite interested in LA County health facilities as I use them myself. I did a little investigation into this particular matter. It would seem from your post that you yourself are a medical professional since you claim your friend died of a heart attack.... well, after calling the county coroner they stated they would not have the autopsy results for another two weeks.

At this point we do not even know why he died. The Times reported he died of heart failure, however anyone who dies has heart failure. All that means is that the heart stopped. That happens when a person dies.

[...] Why did you stop at a county hospital? Verdugo Hospital is private and Olive View is county, which means it is free, obviously then the man did not have health insurance therefore Verdugo would have refused him treatment altogether. Don't you know that a private hospital can refuse treatment to those without insurance, like myself, with no repercussions? [Ed: This is untrue because of a rule known as EMTALA, but if a person perceives an obstacle to accessing care, they may not seek the care they need; the consequences of which are plain to see. This is an argument for universal health coverage.]

Also, the Daily News and LA Times reported that you and your friend had just come back from a "wild" weekend in Las Vegas. [...] Could that have been a contributing factor[?]

The Times [also] reported that your friend told the nurses at Olive View that he had been drinking and that he was currently intoxicated. [Could that have contributed to the nurse's judgment?]

[...]

Having used County Health Facilities myself I know there are at least 4 to 6 persons involved with every patients. When I visit the ER at a county facility I have to sign up with one person, wait to be triaged by another, sit in the waiting room with at least 40 other people; after triage I go to the financial person, then I wait to be called back to the ER and another RN checks me out, takes my vitals etc., then I wait to see the doctor.

It will be very interesting to find out what the autopsy and toxicology report from the coroner's office has to say.
While Anonymous adopted an abrasive tone, the post highlights that health outcomes such as this unexplained death in LA can have multiple contributing causes. This whole thing started when I posted on GruntDoc that an EKG would not necessarily have saved his life. As more details come out, it seems that an entire health system is under indictment and yes, patients are an integral player in the system and yes, they sometimes make mistakes too (Anonymous included). we still don't know enough of the details and they are contentious, to say the least. I think the purpose here is to understand what happened and with as little rancor and blame, try to come up with a way to minimize the frequency of system failures such as this.

7 comments:

Anonymous said...

Yes the family must be grieving at their loss. EMTALA does allow a non insured person to receive stabilizing care in the ER, but then they are transfered to a county hospital.
I find it very difficult to believe that one nurse at Olive View can run the whole hospital and be responsible for what happens on a daily basis. According to media reports the fired nurse only wrote on a piece of paper? What about all other care givers. Being a frequent patient at Olive View I know that the chart goes from the front line triage nurse to many other professionals in the ER. Where was the charge nurse? The charge nurse is directly responsible to review each and every chart and assign an order in which the patients are called back to be seen by a doctor. Is any one considering what the fired nurse is going through? The nurse and his/her family must also be grieving. This is clearly a failure of the system and not just one person. From all indications it would seem that Hospital Administrators and The Department of Health Services of LA County and Supervisor Mike Antonovich are using this nurse as a scapegoat. Instead they should re-evaluate the entire system.
Another good point was brought up. I too wonder what the autopsy will reveal. It is true that at this point nobody knows why this young man died.

Bob said...

My name is Bob and I would like to respond to Mr Carlsons comments relating to the events at Olive View. I saw his ranting on gruntdoc.com. I am very sorry for the loss of your friend. I can only guess at the grief you and his family are trying to deal with. However lying about the events will not help but hinder the truth. You can not blame one hard working nurse who works understaffed and with substandard resources and no help from the agency that governs Los Angeles County. I know that most of what you said is not true. How do I know this? I was there. It was I who was standing in line behind your friend and he was alone. I can describe what he was wearing. Shorts, tennis shoes and a tshirt with large text on the front. Can you describe the nurse you bashed. I can I even know what they were wearing. The nurse was kind caring and professional. The nurse took your friend directly into the triage are. I had to wait over 45 minutes to see a different triage nurse. And still I did not see you. I sat outside the ER at times with your friend who introduced him self as Chris. At one point he asked me to listen for his name and let him know when he came back from his car. You were not there then also. I was there when an african american woman stepped inside the ER and said that a person was having a seizure. The whole waiting room got up from their seats to gawk, me too im affraid. There were medical staff at his side, but no friend. Again I am sorry for your loss, my god he was only 33 yrs old. But lying will not help change things. I can only guess at your motives for doing so. Possibly guilt that you were not there by his side? Blame the system not the staff. I have been an Olive view pt for many years as I lost my insurance. From my experiences the staff has always worked with the pt in mind and the conditions are chalenging to say the least

Anonymous said...

Dear Bob,
Thank you for coming forward with the truth. In these times of political corruption many people are afraid of our elected representatives. It is wonderful to know that you are not afraid. May I suggest that you write or phone supervisor Mike Antonovich's office and tell them the truth also as his office railroaded this sham of an investigation. I have been following this situation closely and felt that Mr. Carlson was not telling the truth. Yes, maybe he feels guilty and is not thinking straight. His behaviour is not helping the grieving family at all.
You are correct Bob.... the problem lies directly in the laps of the County Board of supervisors and the LA Health Dept. as they are the governing bodies for health care in LA County. It is quite obvious after reading the papers that they are using this nurse to cover up a failed system. Our front line nurses and doctors are dedicated to patient care. They are underpaid, overworked and must practice medicine without the sufficient resources they need.
Again, Bob, please come forward if you can and let the citizens of LA know the truth. If there is any way we can come in contact I will stand by your side.

BIG ART's little sis... said...

First I would like to say that the County Health System has been screwed up for years Any person needing to go to Olive View does so out of desparation. I, personally, have had to make a decision as to whether to take my chances at Olive View or become finacially bankrupt (almost) by going to Verdugo Hills Hospital instead. I chose the latter because i value my life, but this is not why I am truley responding.
My late brother experienced the same lack of concern and mistreatment by Olive View Medical Center, not only the day of his death but two years prior. My brother passed June, 2006 of Heart Failure. We became aware of his heart problem two years prior when he was diagnosed and operated on by a Dr. Lee, practicing at another local hospital in the Glendale area. We were introduced to Dr. Lee after my mother had to pick my brother up from Olive View Medical Center and take him to the Glendale hospital. She had to do this because the ER department at Olive View was not treating my brother and making him wait, although he was complaining of massive chest pains, just like with Chris Jones. In fact, my mother, at one point, had to threaten to call 911 from the ER lobby if someone did not do something to help my brother. She was told by an ER nurse "oh no you won't" and my mother responded with a phrase I would rather not repeat.
She took my brother to the Glendale hospital where Dr. Lee found my brother needed bypass surgery. A shunt inserted into his aorta in 2004.
Now this story doesn't end there. My brother, two years later, wasn't feeling good, once again. He was fully aware of the symptoms of his heart failing, obviously, and he went to Olive View Medical Center again. It was four hours later that he called a friend to pick him up because they were not treating him, despite the fact he had a documented serious heart condition. My brother new his plight and stated to his friend on the phone that if he were to die it wasn't going to be at Olive View because they weren't doing anything to help him.
My brother passed away that evening in his apartment.
So, Bob, I think you should think before you speak. You are in no position to make accusations or judge the character or Chris' friend until you can honestly say you have walked the same road in his shoes. It has been instilled in us to trust everyone in the medical field. How could we not? They are the trained professionals. If you were told by a medical proffesional that you should go and your friend will be FINE, what would you do?
Thanks for your time.

Anonymous said...

Sorry to hear about your brother, however Bob was there at the ER and disclaimed what Mr. Carlson wrote. Bob described the situation to a tee. Mr. Carlson was never there with his friend. Mr. Carlson cannot describe the ER nurses. Bob can. Bob even talked to the patient several times. I tend to believe Bob. Mr. Carlson was ranting in his post and offered no viable proof that he was there. Bob however can provide viable facts, and the fact is that Mr. Carlson was not there and is making up a story. I can think of many reasons he would do this but the one that sticks out most in my opinion is that he and the family are pursuing litigious actions. I see no other reasons for Mr. Carlson's lies. I am also fairly certain that any video surveillance would show that Bob is telling the truth.

BIG ART's little sis... said...

Let me get this straight. You and Bob are trying to blame Mr. Carlson for Chris' death? Why, because he wasn't there when he passed away? give me a break. You both are baing your opinions from an internet blog. Have you taken ten minutes to read any one of the articles written by the LA Times? I think not because if you had, you would know that Mr. Carlson dropped Chris off at the ER, parked the car, came back to see if all was well and then was told by Chris to just take off because he would be fine. Of course, that was a bad judgement call on Chris' part because he trusted the hospital personel to do their due diligence.
Pinting fingers at laymen is ignorance. It is the nurses, the doctors, the hospitals responisibility to give the public the best medical care possible. They did not do this in this case, I assure you.
Why don't you ask the hospital or it's staff, how many times they are told by someone who doesn't want to wait that he or she has chest pains so they can get seen faster. After the 100th time, I'm sure they begin to pass judgement because they THINK someone is faking just to get in faster. Well, it is not their job to pick and choose who gets to recieve proper medical treatment.
An EKG is a 15 minute test that requires no supervision if necessary. how hard would have been for them to hook him up and then leave him sit for up to three hours? Not hard at all. It isn't like the test will do any harm the longer the patient stays hooked up. CHRIS MIGHT BE HERE TODAY IF SOMEONE TOOK TEN MINUTES TO JUST HOOK HIM UP TO THAT STUPID TEST!!!!!

Anonymous said...

i think the fact that they are firing this nurse and not looking at the way things are run at olive view is a huge slap in the face to us as citizens. does it take something so out of the ordinary like this for the city to look at the way things are run and still choose not to correct a problem. most of the comments ive read in these articles show that most people are agreeing that this nurse is being made out to be the entire reason this person died and she certainly isnt. what about overbooking? what about the charge nurse? why did she not take the patient back after reviewing a chart that showed signs of a heart attack so instead he gets sent to the waiting room? its obvious la county could care less about us in our most needy. i would like to see a 24 er that patients can be seen so our few county hospitals have room and beds for its patients. the nurse should be reassigned or at least given the option to resign for taking all the blame for the way things are run. i spent a few minutes to write to the county like commenters suggest and i recommend anyone reading this that lives in la do the same. after this blows over these suits are still gonna make money off us and nothing will be done until something far worse than patients being burned or heart cases being made to wait happen and when it does well just see other hospital get closed and then what?