Northside Hospital FL problems

Moving forward

2009-11-18T14:00:00.001-08:00

At the moment, the trial (The Estate of P___ Lastname v. Northside Hospital) is slated for next summer. When the time is closer, I'll see about posting about.

In the meantime, I keep hearing that we have to keep things legal. This is how it should be. If we start talking in mistruths, then nothing good can come of this. We also have to keep things within the confines of the law. Again, this is how it should be.

The only problem I have is that sometimes we can't get into ethics. We can only litigate against a medical person or facility when they legally or medically have screwed up. We technically can't go after them when their ethics harm or kill someone.

At USFSP, if a student majors in journalism, they must take a semester of Ethics. How about for medicine? Are there no ethics classes for doctors, nurses or hospital/nursing home administrators? If not, why not? And if so, how many who took the class forgot what they learned? If there aren't classes in ethics, shame on medical and business schools. If there are and people have forgotten their ethics, shame on those who forgot.

Karma's a boil on the butt of those who forget the Golden Rule.

Three years and counting...But not down for the count

2009-10-18T13:25:00.000-07:00

I have been in a funk for the better part of the week: I haven't slept as well as I usually do (which really hasn't been great of late, but now it's more disrupted), I've felt somewhat unmotivated, I'm having trouble concentrating. But I know what's happening: today is the third anniversary of when P__ went into the hospital. Saturday, the 24th, will be the third anniversary of his death.

Last year, I met someone who had lost her husband. Not in that hospital, mind you, but she did mention that while it had been several years since she'd lost her husband, she still found herself withdrawing a little at the anniversary time. (She also said that she started dating about two years after her husband died.) I'm not sure how long it had been that she'd been widowed, except that it was only a few years longer than I've been there.

In some ways, I envy her. She has gotten on with her life. But I feel like my life is in a holding pattern. Why? Because of the lawsuit.

Do I regret bringing on the lawsuit? No. I'd file it again in a heart beat if the circumstances re-presented themselves. What I am angry about is why I had to file: because of blatent disregard for human life by those in the medical field. If others--enough others--had fought when their loved ones had been harmed at this particular facility, then maybe P__ would still be alive.

Which is why, after three years, I'm still fighting, so that others might have a fighting chance.

Slowly moving along

2009-10-04T15:11:00.000-07:00

For those who have wondered about what is up with this blog, this punchline is this: the lawsuit against N.side is slowly moving forward.

The weird thing is that since P__ died--in fact, since before his death--I've run into numberous people with their own horror stories. (Note: This month, will be the third anniversary of his death.) Between those who have posted here on the blog, those who have contacted me through channels and those I've spoken to in person, we're talking anywhere between 50-100 people, easily. One person said that she had nothing bad to say about the place, that she'd go there again. The rest have had mostly horror stories, frequently ending with, "Is it any wonder they're so close to that cemetary?"

I realize that hospitals, like most businesses and people, have detractors, as well as those who speak in glowing terms of the place. But even if it were a mere 50 I had had contact with, one person who says that the hospital is good to go with 49 detractors is still only a 2% approval rate. Not good.

Contrast

2008-01-20T12:14:00.000-08:00

Talk about a difference in care. I spent the weekend at Bayfront Medical Center (1/11-14), then for a "pit-stop" in their ER this past Friday. I figured I had the option of going early enough to have a friend drive me there or wait until later, call 911, and end up at N.side.

Okay, here's the deal. First off, Bayfront's ER seems to have a grasp on what triage means. Yes, people are seen on a first-come,-first-serve basis, with a definite change: If someone has been sitting in the ER with, say, a probable sprain, broken toe, etc., and someone comes in with chest pain, altered neuros, etc. before the sprain is seen, the chest pain is seen first. This is how is should be.

While spending the weekend there, from what I observed, whenever a call light is pulled, if a nurse or Patient Care Tech is nearby, they'll pop in and ask what is needed. Otherwise, within a matter of seconds, the room's intercom will come on and whoever is manning the nursing station full-time will ask what's needed. If no response, or if a response that is urgent, someone is in the room STAT. Flip side is that if it's not an immediate emergency, it may take a minute or two, especially if there is an emergency elsewhere on the floor. However, I never saw anyone, even in a non-emergency, have to wait long. Certainly not ten minutes, and definitely not ten minutes without checking on the patient, which is one of the complaints I had with P__'s stay at N.side.

Another issue at Bayfront: Everyone seemed to know what he or she was doing. The only time it looked like someone might have a problem was when my IV had to be changed. I've got veins that like to roll, move, and otherwise do "the funky chicken" when they see a needle. This is on good days. After several days of being stuck, they were even funkier. The nurse assigned to my room told me that she'd get the charge nurse, who was a pro at hitting hard-to-get veins. When in deep, call for help. This is different from the nurse at N.side who told P__ and me, "I'll figure it out," when she had to use an inhaler she was unfamiliar with. I have more respect for someone who knows they have a problem and asks for help, especially on something as important as someone's health.

Finally, when I was discharged, I had K__ (my cab driving friend who was going to help pick P__ up) waiting downstairs for me. The nurse had a wheelchair waiting and said that, no matter what, they always insist on having someone discharged from the hospital in a wheelchair with a nurse wheeling them down. This, of course, is another difference with N.side's treatment of P__.

Which begs the question: Why can't N.side take a few lessons from a hospital? They sure need it!

Wednesday's meeting

2007-12-21T05:34:00.001-08:00

This past Wednesday, my attorney and I met with an attorney from N.side, along with someone from risk management for unsworn depositions. Of course, I can't go into detail on what happened. But I will state: N.side's people did not seem happy.

Which is fine with me.

Now comes the wait-and-see.

First Meeting

2007-12-15T13:39:00.001-08:00

My attorney and I are scheduled to meet with N.side's attorneys on Wednesday, December 19, 2007. It won't be sworn depositions--not yet, anyway. But this is where N.side's attorneys hear our side of the case.

Should be interesting.

I wish I could write more. But those of you who have followed this blog thus far can understand why I can't, at this point in time.

Let's just say, things are heating up.

Another recap of the hospital stay

2007-11-07T20:02:00.000-08:00

For anyone new here who doesn't want to go looking for what happened to my husband at Northside, I'm going to repost what happened here:

Wedneday, Oct. 18, 2006

P__ requested that I call 911, as he was having trouble breathing. We wanted him to go to Bayfront Medical Center as P__ had received good care there in the past, as well as the fact that Bayfront has the only Trauma Center in Pinellas County. Instead, P__ was taken by ambulance to Northside Hospital, an HCA hospital.

Once at Northside’s Emergency Room, the staff responded quickly, within minutes. Dr. T___ was on-call at the time. (I’m not sure if he is a resident, intern, or if he has completed residency.) Dr. T___ attempted to use a facemask to assist P__ with his breathing, but when it became apparent that this was not helping, P__ was intubated. P__ was placed on Diprivan to keep him sedated. The RN assigned to P__ (A.) mentioned that, since many people are sensitive to Diprivan, he would keep a close watch on how it affected P__, which he did. As soon as P__’s blood pressure started to bottom out (at one point, down to 52/35), A. backed off the Diprivan to bring P__’s B.P. back, saying that once the BP came up, he’d try to find a happy medium.

Meanwhile, P__ started to regain consciousness, becoming combative. Dr. T___ came in and, with his face literally inches from P__’s, started screaming at P__ to calm down. At that point, A. came in and physically had to move Dr. T___ out of the way to administer medication. Later, when I asked, Dr. T___ said that he yelled at P__ because “P__ is deaf.” When I asked how he figured that, he stated that he “knew” this because “he has white hair and he’s 71, therefore, he’s deaf.” He never bothered to ask if P__ was deaf (he wasn’t), just assumed. This assumption was not a big deal, but it begs the questions: What else does he assume about his patients? How does this affect their treatment?

P__ was brought up to the CCU later the same day.

I requested both in the Emergency Room and the CCU that P__ be transferred to Bayfront Medical as soon as possible for two reasons: (1) it was our preference (due to better care), and (2) our insurance, United Health Care (Medicare Complete) didn’t have a contract with HCA hospitals at that time.

Thursday, Friday October 19, 20

Both days are unremarkable. P__ slowly got better, to the point where he was allowed to regain consciousness by Friday morning; the tube was removed several hours later. Nursing care in the CCY was as good as it should be.

Saturday October 21

I visited for 1 ½ - 2 hours in the early afternoon, then went home for 1 ½- 2 hours. During this time, the hospital called and said that P__ had been transferred—NOT to Bayfront Medical, but to room 243, bed 2 (B?).

When I came back to visit him, the nurse assigned to P__ seemed very unsure of herself about giving him some medication by inhaler. It was a type of inhaler that we were unfamiliar with. P__ has used what is referred to as “rescue inhalers”, as well as a nebulizer in the past, and had received breathing treatments in the CCU as well as when he’d been in Bayfront. We were not familiar with the kind that the nurse was getting ready to use. According to the nurse, it was supposed to crush a pill so that P__ could inhale it. The nurse kept asking me, “Do you know how to use this?” When I told her I didn’t, she said that she would figure it out. I suggested she find someone on the floor who knew how to use the inhaler; she stated that she didn’t think anyone on the floor knew how to use it. I then mentioned that maybe she should contact Respiratory Therapy and get a Respiratory Technician up to the room either to administer the medication or to show her how to do it. At that point, the nurse stated, “No, that’s alright. I’ll figure this out." After having P__ breath twice into the inhaler, the nurse opened the inhaler, looked inside, and stated, “The pill is gone. I guess it worked." While this nurse was in the room, I discovered through small talk that (1) she’d been an RN for 20 years, and that (2) she was nearing the end of a 12-hour shift.

My point is that if she was unsure of how to use this inhaler—or how to do any procedure—she should have asked for help. The pill in the inhaler may have been inhaled properly—or it could have lodged in any part of P__’s air passages.

Sunday October 22

Before I left home to visit, P__ called and asked if I would call the nurses’ station. When I asked why, he stated that he had gotten up to use the portable commode and that when he got up, her nasal canula had become disconnected from the oxygen supply. He stated that he had pulled the cord for the call-light and waited for 10 minutes for a nurse to arrive while trying to reconnect the tube.

I immediately called the nurses’ station and told the person who answered that someone needed to check P__ and why. That person told P__’s nurse, “You need to check room 243. He needs help reconnecting to his oxygen,” to which I heard the male nurse reply, “I was wondering why the light was on for the past ten minutes!” Ten minutes—and the nurse hadn’t checked? P__ could have been having chest pains, a possible heart attack, stroke—any number of problems.

Monday October 23

I received a call in the morning from P__ that he was to be discharged that day. He also mentioned that his hip was hurting. When I inquired if he had fallen, he denied falling. (He had broken his shoulder after a fall in May, so I was concerned about possible osteoporosis.)I arrived around noon and was informed (by P__) that he had had nothing to eat that day. There was a food cart in the hallway, and other patients were observed to have lunch trays. I asked P__’s nurse why he had not received any meals that day, as he was diabetic and required both food and medication to keep his blood sugar levels in check. The nurse told me that since he was scheduled to be released, no meals had been ordered. I had to ask several times to have a meal brought up before one was finally ordered.

During this time, P__ continued to complain that his hip was bothering him. When I inquired about the possibility of having an X-Ray done, I was informed that one wasn’t necessary. “After all,” I was told, “we can’t X-Ray everyone for every little ache and pain.” This was said after I mentioned my concern over possible osteoporosis, both because of his age and the broken shoulder several months before.

Between 2:45 and 3:00 p.m., P__ said he needed to use the bathroom. He stated that he had used the bathroom earlier (with the help of a walker), that his hip had hurt when he had walked to the bathroom, so I asked his nurse if it was okay for him to attempt to get up and go to the bathroom and was told it was okay.

However, when P__ attempted to get out of bed, he fell. I pulled the cord for the call-light. When no one came, the family of another patient in the room ran out and got the nurse. She came in and stated, “Somebody put the bed too high. That’s why he fell.” After she helped me get P__ back into bed, she took his blood pressure, which was elevated. She then reiterated that there had been several tests run on P__ that day and that “one of the technicians must have raised the bed and forgot to lower it.”

Note: The other patient in the room was only there for part of one day and signed himself out of the hospital AMA after P__’s fall. I overheard him tell his family that he didn’t trust Northside.

Around 3:30, the nurse came back into the room with a syringe. When I asked her what it was and what it was for, she told me that it was for the high blood pressure and that I didn’t need to worry about what it was. I told her that she really needed to take another blood pressure, as it had been 30-45 minutes since the one elevated one, and that that one had been taken immediately after a fall, that there was a good probability that the BP had come down enough to either not need the medication at all or, at the very least, a lesser dose of the medication. However, she informed me, “I don’t have time to take another blood pressure right now” as she injected the medication into P__'s arm.

At 4:30, the nurse stated she was almost done writing the incident report on the fall and that as soon as she was done, she’d give us the discharge papers. She also told me, "His doctor is on the floor. Please don’t tell him about the fall, as then he might want to keep P__ in the hospital longer.” At that point, I simply wanted to get P__ out of Northside so that I could bring him to Bayfront Medical.Around 5:00, the brought me the discharge papers and a wheelchair. She informed me that since they were extremely understaffed, would it be possible for me to please bring P__ down to the main entrance and help him to leave? Again, I simply wanted him out of there. (By now, she still had not taken another blood pressure--even after giving the still unknown blood pressure medication!)

I got in touch with a friend of ours who drives for cab. K. arrived at approximately 5:30. I wheeled P__ out to the cab. K. stated, "I thought the hospital was supposed to have someone here to help him out!"

At this point, P__ stood up and immediately collapsed onto the ground. K. came around to help me pick P__ up but we were unable to do so. I ran inside and told the girl who was working the front desk what had happened and asked that she call for help, STAT. She assured me she’d get help right away. Five minutes later, when no help had arrived, I went back inside and asked where our help was.

“I’ll call Security back and see what’s taking them so long,” she informed me. Security. For a medical problem. Of course.

I then ran around to the Emergency Room and told the Triage Nurse what had happened and that we needed help. She informed me that if I would simply put P__ back into the cab and drive around to the Emergency Room door, they’d help us. At that point, I picked up the nearest phone and dialed 911 to get help. After being assured that help was on the way, I hung up. The Triage Nurse asked who I’d called; when I told her, she asked me if I didn’t think that was “overkill” (her words).

By the time I got back to the front of the hospital, where K. was still trying to keep P__ as comfortable as possible, a nurse and a woman from Security were out front. The nurse never once made an effort to help, but kept asking why we had P__ on the ground. She then heard the sirens in the distance and said something about someone coming to the ER. I told the nurse I’d called 911. Her response was to ask if I could call them off; the woman Security Officer told the nurse that once 911 is activated, they couldn’t be called off, to which the nurse made a comment about my calling 911 “ridiculous”.

When the paramedics arrived, they were able to bring P__ around to the ER, where he was readmitted. It wasn’t until after the paramedics arrived that the nurse who had come out made a show of helping; before then, she wouldn’t call for help or make any attempt at helping.

After P__ was readmitted to the ER, one nurse worked on him for several hours. Periodically, the nurse mentioned P__’s blood pressure being very erratic.

Tuesday October 24

Shortly after 2 a.m., while still in the ER, P__ suffered a heart attack...After being moved to the CCU, P__ was hooked up to seven or eight bags of medicine. I was told that four of the bags were for medication to bring P__’s blood pressure back up, and that the medications were being pushed to the limit. He was also in the Trendelenburg position to help bring the blood flow to his brain and heart.

When P__ finally died at 10:44 p.m., the nurse working on him said that when he died, his blood pressure suddenly went haywire.

My problem with Northside Hospital is that: 1) P__ wasn’t transferred to Bayfront Medical once he was stabilized, 2) the care (or lack thereof) contributed to P__’s death. Yes, he was in his early 70s and had had two previous heart attacks... However, while P__ was in N.side, several doctors wrote that his heart sounds were good. The heart attack that figured into the death happened after the administration of the medication to drastically bring his blood pressure down—and this was for a one-time BP reading taken immediately after a fall and not monitored thereafter.

And the clock is ticking...

2007-11-07T19:48:00.000-08:00

I received a letter from the attorney today; it was a copy of the letter sent to N.side, putting them on notice. The hospital now has 90 days in which to either respond to the attorney. If they don't respond, it looks like we'll then request a court date.

I would love to share every little detail in the letter from the lawyer. However, at this point, it would be better for me to remain silent. The truth will come out soon enough, without my jeopardizing the case.

I did, however, want everyone who has followed this saga thus far to know what is happening, that, indeed, things are now really progressing. When I can reveal more, I will.

Sometime in the next few days, I may repost the timeline of P__'s hospital stay. Anyone wishing to read (or reread) it, please be advised it was originally posted in December.

One last thought: Those who've had problems similar to what has been revealed on this blog, be assured that, if one follows through legally, you have a chance of making a difference for those around you. You may not bring your loved one back, but you can make a difference for others. Please keep that in mind.

First Anniversary

2007-10-23T19:31:00.000-07:00

Tomorrow is the first anniversary of P__'s death. He died at 10:44 p.m., Eastern time. I contacted the St. Petersburg Times's obit department; there'll be a short "In Loving Memory" for him.

If only...if only...

Does the term "for-profit hospital" seem like a conflict of interest when it comes to treating a patient?

AHCA reports

2007-09-11T13:10:00.000-07:00

Friday, I recieved the last of the AHCA reports from my attorney. She had forwarded the main batch earlier. With the last batch, though, was a note saying we needed to talk. The appointment is set for tomorrow. Wow, do we have a lot to talk about.

At this point, it's probably not the best thing to release all the notes I've written in response to N.side's version that they gave AHCA. Suffice it to say that I found error after outrigtht indications that N.side was practicing more than their share of CYA.

For anyone else who has had problems with N.side who hasn't contacted an attorney, please be advised that it's my understanding that, in most cases, you have two years to file suit. There may be a loop-hole, time-wise, but don't count on it. Try finding an attorney. If the first one turns you down, contact another. And another. But you have to be the one who decides whether or not it's a problem which needs to be brought to the attention of a lawyer. Did the ER give you one bandaid rather than two? A nurse took 45 seconds to respond to a call light rather than 30 seconds? I wouldn't bother. But a medical screwup? That's another thing.

Will keep everyone posted...

In Response

2007-08-19T10:39:00.002-07:00

There is a recent comment posted to my August 7th entry ("Well, it's about time...") from a nurse who worked at Northside. I wanted to respond.

First of all, thank you for your condolences.

Now, for the nitty-gritty here: FOR-PROFIT HOSPITALS!!! Nurse, you hit the nail square on the head. I want to thank you for telling it from a nursing stand-point. My sister was a nurse for a number of years in one of the local HCA hospitals (no, not Northside, but that's as much as I'm saying, unless I have her permission to state which one). I knew that there were other HCA hospitals in the area.

From what I have read/studied/discovered, when a hospital is a for-profit facility, the profit-margin (or bottom-line) becomes the Most Important Part of any decision. Why? Profits. (No brainer here.)

For example: Let's say you have a ward with 30 rooms, 2 beds each, for a possible 60 patients. Well, if the hospital can get by with 2-3 nurses for that ward (rather than 6-8), then have them work 12-hour shifts (rather than 8), look at the savings. Now, say we're paying the RNs an average of $25/hour. Three nurses per twelve hour shift times two shifts per day comes to $1,800 (3 X 12 X 2), while having eight nurses for each of three-eight hour shifts comes to $4,800 a day. There's a salary savings of $3,000/day/ward--and that isn't even figuring in the benefits, such as health and life insurance, worker's comp, etc. (Therefore, better for profits if you have two-12 hour shifts, rather than three-8 hour shifts per day.)

What does this mean for the nursings staff? Rapid burn-out. Why? It's simple: if a person is over-worked in a facility that is understaffed, expected by doctors, management, etc. to do the majority of the hands-on patient care, while trying to keep up with the demands of the patients, you're going to find yourself chronically exhausted and, in the end, burned-out.

True, we need hospitals, but to put profits above patient care is inexcusable.

Then, there's the toll that it takes on the patients. If the theoretical 30-room-2-bed-per-room ward is full and there are only three nurses working the floor for a 12-hour shift, what kind of care can a patient expect at the end of that shift?

That said, there were definite screw-ups on my husband's care. How much was from exhaustion, how much from burn-out, how much from a simple "I don't care" attitude, I don't know.

According to a paper I did this past spring for an expository writing class, if you have two hospitals across the street from each other, identical in every way--same services, same types of wards, same out-patient services, etc--except that one hospital is a For-Profit facility, the other is a Not-For-Profit facility, your chances of dying in the For-Profit is between 5-25% higher than the Not-For-Profit (depending on whose statistics you look at). We're not looking at critical-care-patients vs. patients in for a simple X-ray; we're comparing similar patients. And while 5% may not seem like a big deal, that's still 5 people out of 100; 50 out of 1,000.

Nurse, while your hot-button issues are taken from the front-lines of the hospital and mine (at least here) are from the patient/patient's family's point-of-view, it sounds like we have the same complaint here: FOR-PROFITS are a death waiting to happen.

Well, it's about time...

2007-08-07T14:42:00.000-07:00

Shock and surprise. Northside finally sent the records to the attorney. They arrived in yesterday's mail. The attorney is even keeping the envelope that the records came in so that they have proof as to when they were mailed out.

I could have hand-delivered something from Northside's front door to the lawyer's office sooner by walking!

The thing is, if anyone was thinking I was going to simply go away by using stalling tactics, forget it. We can calmly discuss politics or any number of things, but don't expect me to quietly go away after causing the death of someone I care about.

I've maintained all along--and will continue to maintain-- that if P__ had died after getting great medical care, I could have accepted it. Since P__ died, both my brother and dad have died. I'm not filing any lawsuits there, even if I were considered the appropriate person to do it. There was no medical malpractice in either case, even though there were medical problems going on.

Everyone who is born dies, some sooner than others. But to have that death caused by another person--including by lack of decent medical care--is as wrong as it gets.

I can't say much at the moment...

2007-07-22T17:05:00.000-07:00

Things are heating up to the point where I've got to start watching what I post. Why? For the simple reason that I don't want to jeopardize the case. Anything that I post on here is, of course, open to anyone and everyone to read...including anyone from N.side.

However, I have read part of the ACHA file on the case...The only thing I can say is it's enough to knock anyone's socks off.

If that sounds cryptic, I'm sorry. But be assured that things are moving forward as planned. Maybe better than planned...

One last thought for the evening: Over the past few months, I have heard time and again, "But what can I do? I'm only one person." So was Rosa Parks. So is Erin Brockovich. I could go on. My point is that maybe one person (you, me, or any other "one person") might not be able to change the world (or our corner of it) in the positive way we'd like to.

But if that one person doesn't, who will?

So, what are they hiding?

2007-07-12T15:24:00.000-07:00

I talked with the main attorney's office this afternoon (after reviewing some paperwork that they had sent me). I found out that N.side still hasn't sent out P__'s records. Apparently, N.side has been stalling...and stalling...and stalling about the records.

I won't go into details at the moment, as I'm really not sure how much I can say at this stage of the game, what with lawyers, etc. However, my question is this: If N.side has done nothing wrong, what the heck is their problem with sending out the records? To my way of thinking, the only reason that they'd have to not hand over the records (which are, if I remember correctly, legal documents) is that they know they're in the wrong and/or they're doctoring the records.

By the way, I found a way to see the story that WFLA did on the missing insulin pump and N.side hospital. Click on: http://tbo.com/membercenter/contactus/8oys.htm , then click on the tab at the top of the page that says, "Video Reports." After a short (maybe 15 second) video, you should see a grey/white box immediately to the right of the video screen. Click on "Insulin Pump" (you may have to scroll down a little to find that). Viola!

Yup, you can't make this stuff up...

Repost for newbies...

2007-07-10T08:49:00.000-07:00

This will be a repost for anyone new to the blog. It is basically a repost of April 9's post:

For anyone new here who doesn't want to go looking for what happened to my husband at Northside, I'm going to repost what happened here:

Wedneday, Oct. 18, 2006

P__ requested that I call 911, as he was having trouble breathing. We wanted him to go to Bayfront Medical Center as P__ had received good care there in the past, as well as the fact that Bayfront has the only Trauma Center in Pinellas County. Instead, P__ was taken by ambulance to Northside Hospital, an HCA hospital.

Once at Northside’s Emergency Room, the staff responded quickly, within minutes. Dr. T___ was on-call at the time. (I’m not sure if he is a resident, intern, or if he has completed residency.) Dr. T___ attempted to use a facemask to assist P__ with his breathing, but when it became apparent that this was not helping, P__ was intubated. P__ was placed on Diprivan to keep him sedated. The RN assigned to P__ (A.) mentioned that, since many people are sensitive to Diprivan, he would keep a close watch on how it affected P__, which he did. As soon as P__’s blood pressure started to bottom out (at one point, down to 52/35), A. backed off the Diprivan to bring P__’s B.P. back, saying that once the BP came up, he’d try to find a happy medium.

Meanwhile, P__ started to regain consciousness, becoming combative. Dr. T___ came in and, with his face literally inches from P__’s, started screaming at P__ to calm down. At that point, A. came in and physically had to move Dr. T___ out of the way to administer medication. Later, when I asked, Dr. T___ said that he yelled at P__ because “P__ is deaf.” When I asked how he figured that, he stated that he “knew” this because “he has white hair and he’s 71, therefore, he’s deaf.” He never bothered to ask if P__ was deaf (he wasn’t), just assumed. This assumption was not a big deal, but it begs the questions: What else does he assume about his patients? How does this affect their treatment?

P__ was brought up to the CCU later the same day.

I requested both in the Emergency Room and the CCU that P__ be transferred to Bayfront Medical as soon as possible for two reasons: (1) it was our preference (due to better care), and (2) our insurance, United Health Care (Medicare Complete) didn’t have a contract with HCA hospitals at that time.

Thursday, Friday October 19, 20

Both days are unremarkable. P__ slowly got better, to the point where he was allowed to regain consciousness by Friday morning; the tube was removed several hours later. Nursing care in the CCY was as good as it should be: caring, competent, good nurse-to-patient ratio.

Saturday October 21

I visited for 1 ½ - 2 hours in the early afternoon, then went home for 1 ½- 2 hours. During this time, the hospital called and said that P__ had been transferred—NOT to Bayfront Medical, but to room 243, bed 2 (B?).

When I came back to visit him, the nurse assigned to P__ seemed very unsure of herself about giving him some medication by inhaler. It was a type of inhaler that we were unfamiliar with. P__ has used what is referred to as “rescue inhalers”, as well as a nebulizer in the past, and had received breathing treatments in the CCU as well as when he’d been in Bayfront. We were not familiar with the kind that the nurse was getting ready to use. According to the nurse, it was supposed to crush a pill so that P__ could inhale it. The nurse kept asking me, “Do you know how to use this?” When I told her I didn’t, she said that she would figure it out. I suggested she find someone on the floor who knew how to use the inhaler; she stated that she didn’t think anyone on the floor knew how to use it. I then mentioned that maybe she should contact Respiratory Therapy and get a Respiratory Technician up to the room either to administer the medication or to show her how to do it. At that point, the nurse stated, “No, that’s alright. I’ll figure this out." After having P__ breath twice into the inhaler, the nurse opened the inhaler, looked inside, and stated, “The pill is gone. I guess it worked."

While this nurse was in the room, I discovered through small talk that (1) she’d been an RN for 20 years, and that (2) she was nearing the end of a 12-hour shift.

My point is that if she was unsure of how to use this inhaler—or how to do any procedure—she should have asked for help. The pill in the inhaler may have been inhaled properly—or it could have lodged in any part of P__’s air passages.

Sunday October 22

Before I left home to visit, P__ called and asked if I would call the nurses’ station. When I asked why, he stated that he had gotten up to use the portable commode and that when he got up, his nasal canula had become disconnected from the oxygen supply. He stated that he had pulled the cord for the call-light and waited for 10 minutes for a nurse to arrive while trying to reconnect the tube.

I immediately called the nurses’ station and told the person who answered that someone needed to check P__ and why. That person told P__’s nurse, “You need to check room 243. He needs help reconnecting to his oxygen,” to which I heard the male nurse reply, “I was wondering why the light was on for the past ten minutes!” Ten minutes—and the nurse hadn’t checked? P__ could have been having chest pains, a possible heart attack, stroke—any number of problems.

Thing is, P__ was always fairly accurate about time; I kidded him about this over the years. I had watched him keep an eye on the clock on numerous occasions, to the point that if he told me he had waited 10 minutes, it was (fairly reliably) somewhere between 9 1/2 and 10 1/2 minutes. Also, I had overheard the nurse reply about the light being on "...for the past ten minutes."

Monday October 23

I received a call in the morning from P__ that he was to be discharged that day. He also mentioned that his hip was hurting. When I inquired if he had fallen, he denied falling. (He had broken his shoulder after a fall in May, so I was concerned about possible osteoporosis.)

I arrived around noon and was informed (by P__) that he had had nothing to eat that day. There was a food cart in the hallway, and other patients were observed to have lunch trays. I asked P__’s nurse why he had not received any meals that day, as he was diabetic and required both food and medication to keep his blood sugar levels in check. The nurse told me that since he was scheduled to be released, no meals had been ordered. I had to ask several times to have a meal brought up before one was finally ordered.

During this time, P__ continued to complain that his hip was bothering him. When I inquired about the possibility of having an X-Ray done, I was informed that one wasn’t necessary. “After all,” I was told, “we can’t X-Ray everyone for every little ache and pain.” This was said after I mentioned my concern over possible osteoporosis, both because of his age and the broken shoulder several months before.Between 2:45 and 3:00 p.m., P__ said he needed to use the bathroom. He stated that he had used the bathroom earlier (with the help of a walker), that his hip had hurt when he had walked to the bathroom, so I asked his nurse if it was okay for him to attempt to get up and go to the bathroom and was told it was okay.

However, when P__ attempted to get out of bed, he fell. I pulled the cord for the call-light. When no one came, the family of another patient in the room ran out and got the nurse. She came in and stated, “Somebody put the bed too high. That’s why he fell.” After helping me get P__ back into bed, she took his blood pressure, which was elevated. She then reiterated that there had been several tests run on P__ that day and that “one of the technicians must have raised the bed and forgot to lower it.”

Note: The other patient in the room was only there for part of one day and signed himself out of the hospital AMA after P__’s fall. I overheard him tell his family that he didn’t trust Northside.

Around 3:30, the nurse came back into the room with a syringe. When I asked her what it was and what it was for, she told me that it was for the high blood pressure and that I didn’t need to worry about what it was. I told her that she really needed to take another blood pressure, as it had been 30-45 minutes since the one elevated one, and that that one had been taken immediately after a fall, that there was a good probability that the BP had come down enough to either not need the medication at all or, at the very least, a lesser dose of the medication. However, she informed me, “I don’t have time to take another blood pressure right now” as she injected the medication into P__'s arm.At 4:30, the nurse stated she was almost done writing the incident report on the fall and that as soon as she was done, she’d give us the discharge papers. She also told me, "His doctor is on the floor. Please don’t tell him about the fall, as then he might want to keep P__ in the hospital longer.” At that point, I simply wanted to get P__ out of Northside so that I could bring him to Bayfront Medical.

Around 5:00, the nurse brought me the discharge papers and a wheelchair. She asked that, since they were extremely understaffed, would it be possible for me to please bring P__ down to the main entrance and help him leave? Again, I simply wanted him out of there. (At this point, she still had not taken another blood pressure--or any other vitals--even after giving the still unknown blood pressure medication!)

I got in touch with a friend of ours who drives for cab. K. arrived at approximately 5:30. I wheeled P__ out to the cab. K. stated, "I thought the hospital was supposed to have someone here to help him out!"

At this point, P__ stood up and immediately collapsed onto the ground. K. came around to help me pick P__ up but we were unable to do so. I ran inside and told the girl who was working the front desk what had happened and asked that she call for help, STAT. She assured me she’d get help right away. Five minutes later, when no help had arrived, I went back inside and asked where our help was.“I’ll call Security back and see what’s taking them so long,” she informed me. Security. For a medical problem. Of course.

I then ran around to the Emergency Room and told the Triage Nurse what had happened and that we needed help. She informed me that if I would simply put P__ back into the cab and drive around to the Emergency Room door, they’d help us. At that point, I picked up the nearest phone and dialed 911 to get help. After being assured that help was on the way, I hung up. The Triage Nurse asked who I’d called; when I told her, she asked me if I didn’t think that was “overkill” (her words).

By the time I got back to the front of the hospital, where K. was still trying to keep P__ as comfortable as possible, a nurse and a woman from Security were out front. The nurse never once made an effort to help, but kept asking why we had P__ on the ground. She then heard the sirens in the distance and said something about someone coming to the ER. I told the nurse I’d called 911. Her response was to ask if I could call them off; the woman Security Officer told the nurse that once 911 is activated, they couldn’t be called off, to which the nurse made a comment about my calling 911 “ridiculous”.

When the paramedics arrived, they were able to bring P__ around to the ER, where he was readmitted. It wasn’t until after the paramedics arrived that the nurse who had come out made a show of helping; before then, she wouldn’t call for help or make any attempt at helping.

After P__ was readmitted to the ER, one nurse worked on him for several hours. Periodically, the nurse mentioned P__’s blood pressure being very erratic.

Tuesday October 24

Shortly after 2 a.m., while still in the ER, P__ suffered a heart attack...After being moved to the CCU, P__ was hooked up to seven or eight bags of medicine. I was told that four of the bags were for medication to bring P__’s blood pressure back up, and that the medications were being pushed to the limit. He was also in the Trendelenburg position to help bring the blood flow to his brain and heart.

That same afternoon, his primary care physician came in to check on him and to talk with me about P__'s prognosis. The last time I talked with Dr. ___ face-to-face was shortly before 6:00 p.m. on the 24th. I was getting ready to head home. The visiting hours in the CCU ran until 6:00 p.m., then resumed from 8:00-10:00. This way, the staff could finish charts, do end-of-shift care while the new shift came on and everyone could get a complete run-down on the patients. Very necessary, somewhat time-consuming (I imagine), very hectic. Also, I had only gotten an hour's worth of sleep the night before, so I figured I'd forgo coming back in that evening, opting for seeing P__ the next morning.

Dr. ___ arrived shortly before visiting hours were over. Around this time, a technician came in to run an EEG on P__ which a neurologist had ordered. The technician told me that he would run the EEG after I left, then immediately get the results to the neurologist. The tech was kind, asking me if I had any questions, giving me a brief run-down on the procedure. Meanwhile, Dr. ___ proceeded to tell me, "We need to pull the plug on your husband."

"Why?" I wanted to know.

"He has no chance at all of any kind of recovery or meaningful life. He is brain-dead. We need to pull the plug now."

Hey, wait a minute. Who let him into this nightmare?

"Excuse me," I told him. "You're expecting what from me?"

"We can't pull the plug without your permission. And we need to pull the plug on him now. Tonight."

I informed him that, first off, I wanted to see what the EEG showed.

"That won't change anything. He's brain-dead."

"I want to check with the neurologist."

"That won't change anything. We need to pull the plug. You need to give me permission to pull the plug." Meanwhile the two or three others (I really don't know who they were) pulled closer around him. There's strength in numbers, they seemed to be stating.

I pointed out that I needed to sleep on this and to talk with P__'s sister. Also, I was going to talk with the neurologist first. Also, if Dr. ___ couldn't pull the plug without my permission, he was not going to get it that night. End of discussion.

Sometime between 7:30 and 8:00, I called the CCU and talked with P__'s night nurse, C__. C__ mentioned that Dr. ___ had made more noise about pulling the plug. "However, the neurologist did look at your husband's EEG. If you'd like, I can page her for you so you can talk with her." I thanked C__ and told her that I wanted to talk with the neurologist.

"Good," she told me. "I promise, we won't do anything except to continue our care for P__ until after you talk with Dr. (neurologist)."

I only had to wait a few minutes for the neurologist to call back. While she said that the EEG showed little, if any, activity, she did offer me this much hope: four (4) days. As she relayed to me, "After an incident like your husband experienced, it's not uncommon to see very little brain activity." However, in her experience, the first four days after such an incident held the key: either the patient would expire on his or her own (frequently within the first 24 hours), or they would stabilize, after which it would become clear that the patient was being kept alive by machines (in which case, letting the patient go was probably the kindest thing to do), or there would be some sign of improvement. She likened it to stories most of us hear on the news during the winter months: a person will fall through the ice, remain submerged for half an hour before being pulled out, and walk out of the hospital a week later, missing only the memory of that week. "Personally, if it were my loved one," she stated, "I'd give him the four days."

After being assured that she would call the CCU immediately, I thanked her. Five minutes later, I talked to C__ in the CCU; she had just hung up with Dr. (neurologist) and agreed that I had done what she felt was best for P__: given him a chance.

When P__ finally died at 10:44 p.m., the nurse working on him said that when he died, his blood pressure suddenly went haywire.My problem with Northside Hospital is that: 1) P__ wasn’t transferred to Bayfront Medical once he was stabilized, 2) the care (or lack thereof) contributed to P__’s death. Yes, he was in his early 70s and had had two previous heart attacks... However, while P__ was in N.side, several doctors wrote that his heart sounds were good. The heart attack that figured into the death happened after the administration of the medication to drastically bring his blood pressure down—and this was for a one-time BP reading taken immediately after a fall and not monitored thereafter.

Another (dis)satisfied patient...

2007-07-09T15:31:00.001-07:00

Did anyone watch Channel 8's (WFLA, Tampa, FL) 6:00 news this evening? A woman, Gina Bernard, went into Northside Hospital back in (if I remember correctly) April. When she left a month later, it was without her $6,000 insulin pump that she had gone in with.

After numerous calls to Northside, Ms. Bernard finally contacted 8 On Your Side's Stacie Schaible. When Ms. Schaible first contacted Northside, she was told that there was no insulin pump with Ms. Bernard when she entered the hospital. Long story short, after much prodding and insistance, the hospital finally found the "non-existent" pump.

As soon as I am able to get a link from WFLA's site, I'll post it here. (And if anyone else runs across the link, please feel free to post it and let me know.)

I'm not the world's biggest Tom Clancey fan, but I don't dislike him. I am a big fan of one of his quotes, though, which is: "The difference between fiction and reality? Fiction has to make sense." (From http://www.brainyquote.com/quotes/authors/t/tom_clancy.html) About the amount of problems at N.side Hospital, all I can add is, You can't make this stuff up.

For-Profit Hospitals vs. Patient Care...

2007-07-06T21:05:00.000-07:00

This is the term paper I put together for an Expository Writing class last semester...

FOR-PROFIT HOSPITALS VS. PATIENT CARE:
HOW THE BOTTOM LINE AFFECTS PATIENT CARE

ABSTRACT
This paper examines For-Profit hospitals and how having a profit margin can, and often does, adversely affect patient care. I will begin by discussing the role of For-Profit health care providers, including hospitals, clinics and labs, and their place in the health care field. From there, I will touch on the larger for-profit health care providers in the United States, with a brief run-down on how they came into existence. Finally, I will explore how for-profit health care affects patient care, along with possible long-term ramifications and solutions.

INTRODUCTION
Aunt Sarah is the epitome of health; at seventy-something, she hasn’t been sick a day in her lively life. Meanwhile, Grandma June, Sarah’s older sister, has been in and out of the hospital all her life: pneumonia, TB, heart attacks, the flu…Not a year goes by without a trip or two to the emergency room. Thank goodness for Medicare; that helps with a good portion of the bills. Not all of them, mind you, but between that, her Medicare supplement, and her drug plan, she’s getting along. Too bad she lives near that For-Profit hospital, since that’s where the ambulance takes her. The last time she went in with a heart attack, she nearly died after waiting an hour to be seen in the emergency room. If only she lived closer to that city-owned non-profit hospital…

Most of us give little thought about the medical facilities in our area, figuring that most hospitals, clinics or labs are the same, that one is as good as the next. True, we may realize that there are facilities that cater to one group of people: a Children’s Hospital is better suited for treating children than geriatric patients; a hospital set up for OB/GYN problems is not set up to deal with general trauma. However, many people are unaware that there are differences in care between for-profit and not-for-profit hospitals. I plan to explore why the average non-profit may very well be a safer place than the average for-profit facility.

DISCUSSION
The main topic for discussion is how for-profit medical facilities’ quest for the best profit margin has the ability to cost patients and their families, in higher medical bills, in poor-quality care, and in lives lost. While there is be a place for for-profits, everything else being equal, the non-profits are a better choice.

Is There a Place for For-Profit Hospitals?
It is simplistic to state that medical care in the United States would be better if all for-profit facilities closed, for while not-for-profit hospitals tend to be safer than for-profit ones (everything else being comparable), there are times when for-profit facilities provide a much needed service.

In many instances, for-profit chains have either brought hospitals to communities that didn’t have medical facilities or bought out facilities which were about to close, up-grading them and turning them around, thereby keeping valuable medical care in places that would otherwise have little more than one or two overworked doctors (Inlander 225).

Given the choice between no medical care or for-profit facilities, there is no contest.
Small community hospitals in rural areas tend to have fewer resources; fewer people mean less revenue for the facility, making it necessary to ration resources: Do we spend money on one piece of equipment that may be used possibly once or twice a year, or spend the same money on what will be utilized on a daily basis? In this case, having a for-profit group take over the hospital can be a blessing; with their additional resources, they can obtain equipment and care that might otherwise not be available.

The Rise of the For-Profits
During the 1960s, Dr. Thomas Frist, Sr. of Nashville, Tennessee, along with a group of doctors, created Park View Hospital. By the end of the decade, along with Dr. Thomas Frist, Jr., and Jack C. Massey, formed Hospital Corporation of America (now HCA) and began building a chain of for-profit hospitals.

The 1970s saw a rapid industry growth, spawning numerous for-profit hospital chains. As HCA grew, it began buying up smaller for-profit chains, until it finally merged with Columbia in 1994. (Prior to the merger, Columbia had bought out the Humana chain.) HCA is now the largest for-profit chain in the United States, though Tenet Healthcare is also growing with 63 hospitals (http://www.tenethealth.com/Tenet-Health/OurCompany), as well as Universal Health Services (UHS) and Iasis, among others.

Realistically, one can expect the growth of for-profit hospital chains to continue, fulfilling a need in underserved areas, buying out not-for-profits where they can.

The Pain of Dealing With For-Profits
On the surface, it can be incomprehensible why anyone would object to for-profit
hospitals, especially in the United States. Since its founding, the United States has thrived as a capitalistic country, with all its strengths and weaknesses; profits are part of this system.

As for hospitals, most of us acknowledge the fact that we will most likely need their services at one time or another during our lives. Add the two together—for-profit and hospitals—and theoretically, you have a win-win situation.

However, there is the problem of the profit margin. According to the University of Buffalo (NY) Reporter (Thursday, June 27, 2002), “A study…from more than 26,000 hospitals…has shown that people treated in private for-profit hospitals in the U.S. have a greater risk of dying than those cared for in private not-for-profit hospitals (Baker).” The report goes on to state that this study appeared in the Canadian Medical Association Journal (CMAJ).

According to the Canadian Health Coalition press release titled, “Higher death rates in for-profit hospitals: Study,” two thousand (2000) more Canadians would die each year if Canada switched over to for-profit hospitals (CHC Press release, May 27, 2002).

In addition, a commentary in the May 28, 2002 issue of the Canadian Medical Association Journal (CMAJ), titled “Your money and/or your life?” states that “the authors have…reviewed…the results of 14 US studies that compared short-term mortality outcomes for elderly patients admitted to private, for-profit hospitals with those for elderly patients admitted to private, not-for-profit hospitals.” After careful study, the authors concluded that there was a “statistically significant increase in 30-90-day mortality among patients admitted to private, for-profit hospitals (Naylor).”

Dr. Naylor, who was the Dean of Medicine and is now the President of the University of Toronto, ends his commentary by asking, “Does anyone still want to contract out large segments of our publicly financed health care system to for-profit US hospital chains after reading this article (commentary)? I hope not (Naylor).”

In addition, according to the American Hospital Association (AHA), when looking into hospitals, a person is strongly advised to find out if a hospital is nonprofit of for-profit. While the AHA admits that “the quality of care varies widely within each of these categories (for-profit or nonprofit),” they report that “a study in the Journal of General In-ternal Medical found that patients at for-profit hospitals are two to four times more likely than patients at not-for-profit hospitals to suffer complications from surgery or delays in diagnosing and treating illness. Previous research found death rates 25 percent higher at for-profit hospitals than at teaching hospitals and six to seven percent higher than at non-profit, non-teaching hospitals (“All Hospitals Are Not Created Equal”).”

Why the problems? Simple bottom-line: it’s cheaper—on the surface, anyway—to pay for two RNs per shift per floor than four. When Medicare and other insurance companies pay a flat rate for a procedure, it makes sense from a financial standpoint to get the patient out of the hospital as quickly as possible to reduce cost.

On a personal note, I experienced this first-hand with my husband. He had been hospitalized on several occasions since we’d been together: twice at a city-owned not-for-profit hospital, once at a for-profit, chain-owned hospital. While at the not-for-profit facility, he received consistently good care. Even when moved to a non-critical floor, his care remained good: the nurse-to-patient ratio remained low, giving the staff the ability to care for their assigned patients; call lights were acknowledged and answered in a timely manor; patients were cared for as though their lives depended on it!

However, during his last hospital stay, the ambulance was forced to bring him to the closest hospital, a for-profit facility. While the care he received in the CCU was extraordinarily—good, caring staff, a 1-to-1 nurse-to-patient ratio—once on the floor, the profit-margin took over: on a wing where 4-6 nurses may have comfortably handled the work load, there were never more than half that number to be found on the ward. These over-worked souls were then put on 12-hour shifts as opposed to 8-hour shifts. Simple math shows us that this gives us 4-6 nurses on a ward for every 24-hour period, as opposed to 12-18 for the same period. Multiply that number through the non-critical wards and you see not just a smaller staff but a much higher profit-level.

Did this figure into my husband’s death, as well as in the other horror stories I’ve discovered about this and other for-profits, due to under-staffing and higher profits? True, a for-profit hospital is better than no hospital, as mentioned earlier in this article. But when a profit-margin is more important than caring for the patient, we need to ask ourselves the hard question of, “What is more important? A life or a dollar?”
Finally, as Jeffrey Kaye states, “The for-profit industry adamantly maintains its
goal is to combine efficiency with high standards of patient care. But as an increasing number of hospitals have been converted nationally, critics have repeatedly questioned whether profits come before quality care.”

CONCLUSION
While for-profit hospitals may be a positive approach in areas where no other medical facilities would otherwise be available, if given a choice between a for-profit or not-for-profit hospital, with everything else being equal, the not-for-profit would be a healthier choice.

Works Cited
_____, “All Hospitals Are Not Created Equal,” Health Pages: The voice of the Health
Care Consumer, http://www.thehealthpages.com/artricles/ar-hosps.html.
Baker, Lois, Hospital Mortality Rates Analyzed, University of Buffalo Reporter, Vol. 33,
Number 29, June 27, 2002.
_____, “Higher Death Rates in For-Profit Hospitals: Study,” Canadian Health Coalition
(CHC) Press Release, May 27, 2002, http://healthcoalition.ca/for-profit-death.
html.
Inlander, Charles B. et al, The People’s Medical Society Health Desk Reference,
Hyperion, 1995
Kaye, Jeffrey, Community Care-Part 2, The NewsHour with Jim Lehrer Transcript,
KCET
McCabe, Justine and John Battisa, “Warning: For-Profit Hospitals Can Endanger Your
Health And Finances,” The Litchfield (CT) County Times, January 26, 2001.
Naylor, C. David, “Your Money And/or Your Life?” Canadian Medical Association Jour-
nal (CMAJ), May 27, 2002.
Schiff, Gordon, MD, “Fatal Distraction: Finance vs. Vigilance in Our Nation’s Hospi-
tals,” Journal of General Internal Medicine, April, 2000.

Conference...and other notes of interest

2007-06-20T15:29:00.000-07:00

First off, the phone conference with the new attorney went well. I should have the paperwork from him within a couple of weeks to look over and sign. Things are looking up...

There's a funny little glitch which was brought to my attention. When the main attorney signed on--for sake of ease, since this attorney's in Tampa, for this blog, I'll name him/her Pat Tampa--Pat informed me that a cursory look at the few records I had showed a DNR on file.

(For anyone unfamiliar with the terminology, a DNR is a "Do Not Resuscitate." This is a document signed by the patient or his/her spouse, guardian, or next of kin that says if the patient stops breathing, etc, nothing will be done to bring the patient back: no CPR, no mouth-to-mouth, nothing.)

I stated that: (1) I didn't recall signing a DNR for P__, (2) if one was signed, it was most likely slipped in amongst the paperwork signed when he was readmitted (after he'd been lying on the pavement for 30-45 minutes and I was stressed on beyond Pluto), (3) no one mentioned signing a DNR, (4) if one had been signed, would I really have been confronted by a group of three people between 1:00-1:30 a.m. the morning of October 24th who wanted to know, "If he Codes, do you want us to work on him by doing CPR, etc. to try to bring him back?" (to which I answered, "Definitely. Work on him."), and (5) would Dr. ____ (see blog post from May 4) have had to keep asking my permission to pull the plug?

And yet the cursory records stated there was a DNR in place.

I'm sure that there might be people who wonder if I'm telling the truth to everything written in this blog.

My answer is this: At 53, this is the first lawsuit I've filed (other than filing for divorce from my first husband years ago, well before I knew P__). There have been times I could have filed, but didn't.

On top of that, while grieving over the loss of the love of my life, it would simply be easier to let it go and go on. I'm sure that I could heal a lot faster if I didn't have to think about this lawsuit. And, on top of that, I do know, beyond the shadow of a doubt, that most medical people are good, decent, hard-working people who care for others at great personal costs to themselves. Anyone who doubts this should talk to someone whose marriage and personal life are taking a hit while they go through the rigors of medical school (or nursing school, paramedic/EMT training, any kind of technician training, etc.) Ask them as they put birthdays and holidays on hold while going through residency and internship. Look at the ambulances and fire departments still on call as you and I celebrate our major holidays. One word, folks: Dedication.

For most of these people, Dedication is part of the job. Pride in a job well done is another. I know that these words frequently sound almost goofy these days. But it's really there. Why? Because when you hang up your hat at the end of the shift and can say, "I made a difference today; that man/woman/child would be dead right now if I hadn't been there, doing my job. Now they have a chance."

And if the patient dies? I've seen grown men and women in the medical field in tears when they've worked hard against all odds and a patient dies. I've seen this (and experienced) both as an outsider, as well as when I worked as an EMT.

But when incident after incident of negligence and malpractice kill someone, I tend to get angry. Make that someone I care for...well, you get the picture.

On top of that, look at the people who've commented here; consider those who've contacted me through the reporter from the St. Petersburg Times. For the most part, they are people I've never heard of before starting this blog. They've all told and/or written the same thing: they have horror stories about N.side, too. I've also talked with people I know personally who've had problems with N.side before P__'s death. I'm not a rich, famous person who could get this many people to come forward with horror stories just to try to get close to me. These are real people, real lives, real horror stories about a hospital that is understaffed, about personnel who do things that maim and cause death.

That, my friends, is why I'm fighting mad. Will I give up?

If you've guessed that the answer is "No," you've guessed right.

Gettin' good, folks...

2007-06-18T16:42:00.000-07:00

Well, I've got a phone conference tomorrow with another lawyer. What, exactly, does this mean? There are now three--count 'em, three--lawyers on the case. Fine by me. This is one of those times when I love decent lawyers, especially when they're just a little bit outraged at a hospital's horrible mistreatment.

In response to Loretta's comment (in Un-flippin'-believable), I have yet to hear from the hospital directly. They've been trying to stall the main attorney(s) on the case by not wanting to give up his records.

As far as your husband's stay in N.side: Best care, huh? I guess next the woman who contacted you from the hospital will try telling you that both the Pope and the Dali Lama are Jewish...

My sarcasm is not directed at you; I've seen the way that hospital treats its patients. When my husband was lying on the pavement right outside the front door (after discharge and while we were waiting for EMS to come help him), the charge nurse informed us that she didn't need to help; as she put it, "Everyone is where they're supposed to be." (I wonder if that included my husband...lying on the pavement because of their screw-ups!)

I, too, have often wondered where the CEO and other big-wigs from Deathside send their loved ones when they're sick; if it's to that very same hospital, do they make sure, loud and clear, who their loved ones are related to so that they get decent care?

Not to worry, Loretta: I'm still going after them...me and my THREE LAWYERS!!!

Un-flippin'-believable

2007-06-01T17:43:00.000-07:00

After being out most of the day, I just got around to checking my email about half an hour ago. One of the emails was from the attorney. Turns out N.side hasn't sent them the requested medical records.

"Why?" you might ask.

Turns out they need a copy of P__'s death certificate!!! The man died in their hospital at their hands, and they need proof that he's dead!!!

Now, there are those who will rightfully say that a sense of humor is not needed to live, at least not the way breathing and a viable heartbeat are. But it sure helps. That, and a true appreciation of warped irony.

Lawyer has signed on...

2007-05-13T15:51:00.000-07:00

As of Tuesday afternoon, I have an attorney who has signed on. I'm not naming names at this point. I figure that if anyone from Northside is reading this, I don't need them contacting the attorney just yet. After gathering more information and deciding how best to proceed, I know s/he'll contact Northside. I will say this, though: The Jacksonville lawyer is still on the case, but at this time, he is taking a backseat and letting the Tampa lawyer run with the case.

At one point, after I had signed papers so that the Jacksonville lawyer could get P__'s complete medical records, Northside refused to send the records, stating that Jax was the lawyer for P__'s estate. Apparently, this is highly unusual; the usual scenario is that the patient (or next of kin--me--if the patient is deceased) signs a release form (actually several), sends them to the lawyer, who then requests the records, which are then collected and sent. That is the way it is supposed to be done. Except, of course, Northside didn't want to turn loose of the records. (What were they trying to hide?)

Well, the records finally arrived. Jax also contacted me to let me know that the Tampa attorney wanted to sign on; did I find this acceptable? In many ways, it would be advantageous to the case: when things start picking up steam (if N.side not won't turn loose of any more records; depositions being made; etc), it would be much easier to commute from Tampa than Jacksonville. Add to the fact that the Tampa lawyer is a medical malpractice attorney, highly recommended, etc., I told Jax that I accepted. Jax assured me that he's still in the picture, so that made me feel more comfortable.

During the meeting with the Tampa attorney, I signed the paperwork to get the whole ball rolling. S/he was impressed with the letter that the Agency for Health Care Administration (AHCA) sent. It stated that it was able to confirm most of my accusations. The two accusations that it could not confirm (or deny) were the two most inconsequential ones, at least to this particular case. However, I do have several witnesses who can back up my claim on one of those claims, bringing us down to one unconfirmed accusation.

I feel very good about the direction this has taken. I had hoped for an attorney who was totally excited about taking the case; to have two (one doing the steering, the other as back-up) is indeed wonderful.

One more thing: anyone who missed the article in the St. Petersburg (FL) Times last month, here's a link to it: http://www.sptimes.com/2007/03/18/Neighborhoodtimes/Widow_warns_others_in.shtml . Feel free to read.

One last thing for this evening: If you have a loved one going into the hospital, keep watch. Ask questions. Expect answers. (However, use common sense. If your loved one is in the ER and 10 people are frantically working on your loved one, it might be difficult for someone to break away and give you a play-by-play report. But someone from the hospital should be able to talk with you and let you know what's what.) Be vigilant. Write things down, even if it seems insignificant. Keep in mind that most medical personnel are decent, caring people who will try to help you and/or your loved one. As with many professions, it is the bad ones who give the good/great majority a bad name.

I hope this helps someone out there...

Another little tidbit

2007-05-04T09:08:00.000-07:00

There is always something to be said about telling one's story. Especially important is when, in the telling, we are able to put our thoughts in order.

Sometimes, when we tell our story often enough, as has happened with P__'s death, someone will mention, "You forgot to put this down," or "But what about that?", as in "I'm not quite following this, can you clarify this point?"

Several relatives and friends (in some cases, these are one and the same) have pointed out that I neglected to add one point in the diary of what happened to P__. I intend to add that here.

On the afternoon of P__'s death, his primary care physician came in to check on him and to talk with me about P__'s prognosis. The last time I talked with Dr. ___ face-to-face was shortly before 6:00 p.m. on the 24th. I was getting ready to head home. The visiting hours in the CCU ran until 6:00 p.m., then resumed from 8:00-10:00. This way, the staff could finish charts, do end-of-shift care while the new shift came on and everyone could get a complete run-down on the patients. Very necessary, somewhat time-consuming (I imagine), very hectic. Also, I had only gotten an hour's worth of sleep the night before, so I figured I'd forgo coming back in that evening, opting for seeing P__ the next morning.

Dr. ___ arrived shortly before visiting hours were over. Around this time, a technician came in to run an EEG on P__ which a neurologist had ordered. The technician told me that he would run the EEG after I left, then immediately get the results to the neurologist. The tech was kind, asking me if I had any questions, giving me a brief run-down on the procedure.

Meanwhile, Dr. ___ proceeded to tell me, "We need to pull the plug on your husband."

"Why?" I wanted to know.

"He has no chance at all of any kind of recovery or meaningful life. He is brain-dead. We need to pull the plug now."

Hey, wait a minute. Who let him into this nightmare?

"Excuse me," I told him. "You're expecting what from me?"

"Well, we can't pull the plug without your permission. And we need to pull the plug on him now. Tonight."

I informed him that, first off, I wanted to see what the EEG showed.

"That won't change anything. He's brain-dead."

"I want to check with the neurologist."

"That won't change anything. We need to pull the plug. You need to give me permission to pull the plug." Meanwhile the two or three others (I really don't know who they were) pulled closer around him. There's strength in numbers, they seemed to be stating.

I pointed out that I needed to sleep on this and to talk with P__'s sister. Also, I was going to talk with the neurologist first. Also, if Dr. ___ couldn't pull the plug without my permission, he was not going to get it that night. End of discussion.

Sometime between 7:30 and 8:00, I called the CCU and talked with P__'s night nurse, C__. C__ mentioned that Dr. ___ had made more noise about pulling the plug. "However, the neurologist did look at your husband's EEG. If you'd like, I can page her for you so you can talk with her." I thanked C__ and told her that I wanted to talk with the neurologist.

"Good," she told me. "I promise, we won't do anything except to continue our care for P__ until after you talk with Dr. (neurologist)."

I only had to wait a few minutes for the neurologist to call back. While she said that the EEG showed little, if any, activity, she did offer me this much hope: four (4) days. As she relayed to me, "After an incident like your husband experienced, it's not uncommon to see very little brain activity." However, in her experience, the first four days after such an incident held the key: either the patient would expire on his or her own (frequently within the first 24 hours), or they would stabilize, after which it would become clear that the patient was being kept alive by machines (in which case, letting the patient go was probably the kindest thing to do), or there would be some sign of improvement. She likened it to stories most of us hear on the news during the winter months: a person will fall through the ice, remain submerged for half an hour before being pulled out, and walk out of the hospital a week later, missing only the memory of that week. "Personally, if it were my loved one," she stated, "I'd give him the four days."

After being assured that she would call the CCU immediately, I thanked her. Five minutes later, I talked to C__ in the CCU; she had just hung up with Dr. (neurologist) and agreed that I had done what she felt was best for P__: given him a chance.

Of course, he passed away at 10:44 that evening. But what really makes me angry about this is that Dr. ___ wanted to pull the plug immediately several hours earlier without hearing from the neurologist, and kept pressuring me to give him permission to do so.

And while it didn't affect the end result--P__ still died that evening--I'm still angry that Dr. ___ didn't want to at least discuss options or talk with Dr. (neuro) first.

lawyers and papers and blogs (oh, my)

2007-04-25T17:07:00.000-07:00

Well, looks like there are 2 more lawyers interested in working with the lawyer in Jacksonville on the case against N.side; one of them is in Tampa. I'd write more about this, but on the off-chance that anyone from the hospital is reading this, that's all I'll say at this point.

Will add more here in the next week or so...

For anyone new here...

2007-04-09T06:20:00.000-07:00

For anyone new here who doesn't want to go looking for what happened to my husband at Northside, I'm going to repost what happened here:

Wedneday, Oct. 18, 2006
P__ requested that I call 911, as he was having trouble breathing. We wanted him to go to Bayfront Medical Center as P__ had received good care there in the past, as well as the fact that Bayfront has the only Trauma Center in Pinellas County. Instead, P__ was taken by ambulance to Northside Hospital, an HCA hospital.

Once at Northside’s Emergency Room, the staff responded quickly, within minutes. Dr. T___ was on-call at the time. (I’m not sure if he is a resident, intern, or if he has completed residency.) Dr. T___ attempted to use a facemask to assist P__ with his breathing, but when it became apparent that this was not helping, P__ was intubated. P__ was placed on Diprivan to keep him sedated. The RN assigned to P__ (A.) mentioned that, since many people are sensitive to Diprivan, he would keep a close watch on how it affected P__, which he did. As soon as P__’s blood pressure started to bottom out (at one point, down to 52/35), A. backed off the Diprivan to bring P__’s B.P. back, saying that once the BP came up, he’d try to find a happy medium.

Meanwhile, P__ started to regain consciousness, becoming combative. Dr. T___ came in and, with his face literally inches from P__’s, started screaming at P__ to calm down. At that point, A. came in and physically had to move Dr. T___ out of the way to administer medication. Later, when I asked, Dr. T___ said that he yelled at P__ because “P__ is deaf.” When I asked how he figured that, he stated that he “knew” this because “he has white hair and he’s 71, therefore, he’s deaf.” He never bothered to ask if P__ was deaf (he wasn’t), just assumed. This assumption was not a big deal, but it begs the questions: What else does he assume about his patients? How does this affect their treatment?

P__ was brought up to the CCU later the same day.

I requested both in the Emergency Room and the CCU that P__ be transferred to Bayfront Medical as soon as possible for two reasons: (1) it was our preference (due to better care), and (2) our insurance, United Health Care (Medicare Complete) didn’t have a contract with HCA hospitals at that time.

Thursday, Friday October 19, 20
Both days are unremarkable. P__ slowly got better, to the point where he was allowed to regain consciousness by Friday morning; the tube was removed several hours later. Nursing care in the CCY was as good as it should be.

Saturday October 21
I visited for 1 ½ - 2 hours in the early afternoon, then went home for 1 ½- 2 hours. During this time, the hospital called and said that P__ had been transferred—NOT to Bayfront Medical, but to room 243, bed 2 (B?).

When I came back to visit him, the nurse assigned to P__ seemed very unsure of herself about giving him some medication by inhaler. It was a type of inhaler that we were unfamiliar with. P__ has used what is referred to as “rescue inhalers”, as well as a nebulizer in the past, and had received breathing treatments in the CCU as well as when he’d been in Bayfront. We were not familiar with the kind that the nurse was getting ready to use. According to the nurse, it was supposed to crush a pill so that P__ could inhale it. The nurse kept asking me, “Do you know how to use this?” When I told her I didn’t, she said that she would figure it out. I suggested she find someone on the floor who knew how to use the inhaler; she stated that she didn’t think anyone on the floor knew how to use it. I then mentioned that maybe she should contact Respiratory Therapy and get a Respiratory Technician up to the room either to administer the medication or to show her how to do it. At that point, the nurse stated, “No, that’s alright. I’ll figure this out." After having P__ breath twice into the inhaler, the nurse opened the inhaler, looked inside, and stated, “The pill is gone. I guess it worked." While this nurse was in the room, I discovered through small talk that (1) she’d been an RN for 20 years, and that (2) she was nearing the end of a 12-hour shift.

My point is that if she was unsure of how to use this inhaler—or how to do any procedure—she should have asked for help. The pill in the inhaler may have been inhaled properly—or it could have lodged in any part of P__’s air passages.

Sunday October 22
Before I left home to visit, P__ called and asked if I would call the nurses’ station. When I asked why, he stated that he had gotten up to use the portable commode and that when he got up, her nasal canula had become disconnected from the oxygen supply. He stated that he had pulled the cord for the call-light and waited for 10 minutes for a nurse to arrive while trying to reconnect the tube.

I immediately called the nurses’ station and told the person who answered that someone needed to check P__ and why. That person told P__’s nurse, “You need to check room 243. He needs help reconnecting to his oxygen,” to which I heard the male nurse reply, “I was wondering why the light was on for the past ten minutes!” Ten minutes—and the nurse hadn’t checked? P__ could have been having chest pains, a possible heart attack, stroke—any number of problems.

Monday October 23
I received a call in the morning from P__ that he was to be discharged that day. He also mentioned that his hip was hurting. When I inquired if he had fallen, he denied falling. (He had broken his shoulder after a fall in May, so I was concerned about possible osteoporosis.)

I arrived around noon and was informed (by P__) that he had had nothing to eat that day. There was a food cart in the hallway, and other patients were observed to have lunch trays. I asked P__’s nurse why he had not received any meals that day, as he was diabetic and required both food and medication to keep his blood sugar levels in check. The nurse told me that since he was scheduled to be released, no meals had been ordered. I had to ask several times to have a meal brought up before one was finally ordered.

During this time, P__ continued to complain that his hip was bothering him. When I inquired about the possibility of having an X-Ray done, I was informed that one wasn’t necessary. “After all,” I was told, “we can’t X-Ray everyone for every little ache and pain.” This was said after I mentioned my concern over possible osteoporosis, both because of his age and the broken shoulder several months before.

Between 2:45 and 3:00 p.m., P__ said he needed to use the bathroom. He stated that he had used the bathroom earlier (with the help of a walker), that his hip had hurt when he had walked to the bathroom, so I asked his nurse if it was okay for him to attempt to get up and go to the bathroom and was told it was okay.

However, when P__ attempted to get out of bed, he fell. I pulled the cord for the call-light. When no one came, the family of another patient in the room ran out and got the nurse. She came in and stated, “Somebody put the bed too high. That’s why he fell.” After she helped me get P__ back into bed, she took his blood pressure, which was elevated. She then reiterated that there had been several tests run on P__ that day and that “one of the technicians must have raised the bed and forgot to lower it.”

Note: The other patient in the room was only there for part of one day and signed himself out of the hospital AMA after P__’s fall. I overheard him tell his family that he didn’t trust Northside.

Around 3:30, the nurse came back into the room with a syringe. When I asked her what it was and what it was for, she told me that it was for the high blood pressure and that I didn’t need to worry about what it was. I told her that she really needed to take another blood pressure, as it had been 30-45 minutes since the one elevated one, and that that one had been taken immediately after a fall, that there was a good probability that the BP had come down enough to either not need the medication at all or, at the very least, a lesser dose of the medication. However, she informed me, “I don’t have time to take another blood pressure right now” as she injected the medication into P__'s arm.

At 4:30, the nurse stated she was almost done writing the incident report on the fall and that as soon as she was done, she’d give us the discharge papers. She also told me, "His doctor is on the floor. Please don’t tell him about the fall, as then he might want to keep P__ in the hospital longer.” At that point, I simply wanted to get P__ out of Northside so that I could bring him to Bayfront Medical.

Around 5:00, the brought me the discharge papers and a wheelchair. She informed me that since they were extremely understaffed, would it be possible for me to please bring P__ down to the main entrance and help him to leave? Again, I simply wanted him out of there. (By now, she still had not taken another blood pressure--even after giving the still unknown blood pressure medication!)

I got in touch with a friend of ours who drives for cab. K. arrived at approximately 5:30. I wheeled P__ out to the cab. K. stated, "I thought the hospital was supposed to have someone here to help him out!"

At this point, P__ stood up and immediately collapsed onto the ground. K. came around to help me pick P__ up but we were unable to do so. I ran inside and told the girl who was working the front desk what had happened and asked that she call for help, STAT. She assured me she’d get help right away. Five minutes later, when no help had arrived, I went back inside and asked where our help was.

“I’ll call Security back and see what’s taking them so long,” she informed me. Security. For a medical problem. Of course.

I then ran around to the Emergency Room and told the Triage Nurse what had happened and that we needed help. She informed me that if I would simply put P__ back into the cab and drive around to the Emergency Room door, they’d help us. At that point, I picked up the nearest phone and dialed 911 to get help. After being assured that help was on the way, I hung up. The Triage Nurse asked who I’d called; when I told her, she asked me if I didn’t think that was “overkill” (her words).

By the time I got back to the front of the hospital, where K. was still trying to keep P__ as comfortable as possible, a nurse and a woman from Security were out front. The nurse never once made an effort to help, but kept asking why we had P__ on the ground. She then heard the sirens in the distance and said something about someone coming to the ER. I told the nurse I’d called 911. Her response was to ask if I could call them off; the woman Security Officer told the nurse that once 911 is activated, they couldn’t be called off, to which the nurse made a comment about my calling 911 “ridiculous”.

When the paramedics arrived, they were able to bring P__ around to the ER, where he was readmitted. It wasn’t until after the paramedics arrived that the nurse who had come out made a show of helping; before then, she wouldn’t call for help or make any attempt at helping.

After P__ was readmitted to the ER, one nurse worked on him for several hours. Periodically, the nurse mentioned P__’s blood pressure being very erratic.

Tuesday October 24
Shortly after 2 a.m., while still in the ER, P__ suffered a heart attack...After being moved to the CCU, P__ was hooked up to seven or eight bags of medicine. I was told that four of the bags were for medication to bring P__’s blood pressure back up, and that the medications were being pushed to the limit. He was also in the Trendelenburg position to help bring the blood flow to his brain and heart.

When P__ finally died at 10:44 p.m., the nurse working on him said that when he died, his blood pressure suddenly went haywire.

My problem with Northside Hospital is that: 1) P__ wasn’t transferred to Bayfront Medical once he was stabilized, 2) the care (or lack thereof) contributed to P__’s death. Yes, he was in his early 70s and had had two previous heart attacks... However, while P__ was in N.side, several doctors wrote that his heart sounds were good. The heart attack that figured into the death happened after the administration of the medication to drastically bring his blood pressure down—and this was for a one-time BP reading taken immediately after a fall and not monitored thereafter.

A couple of more contacts...

2007-04-07T11:55:00.000-07:00

Well, I have a few more contacts on Northside...By contacts, I don't mean people working there, but more dissatisfied people with complaints about them.

Now, granted, it seems that I have heard from one or two complaints about most hospitals in the area...At this point, it's not unheard of.

But what I've been hearing runs along the line of car stories: Ever notice how, if you mention "I just bought a used (fill in the blank with whatever type of car you own)..." you may hear, "Well, I'm a Ford (Chevy, Toyota) person, myself..." Occasionally, though, you'll hear, "I would never buy one of those; worst car I ever owned," or "I had one of those; great cars; you just can't kill them!" Soon, a pattern develops. And while you may hear an occasional dissenting voice, you'll soon discover that the vast majority of a certain car's owners (past and present) either would never buy another one or can't say enough good about that car.

Well, that's what I have been hearing about Northside--and I'm not hearing too many buyers! This includes the recent contacts. Granted, the staff I observed in the CCU were exceptional; I feel that I could reliably put my life in their hands and stand a fighting chance. (If any of you who work in the CCU and cared for my husband, you know who you are. Thank you. Honestly.) The rest of the hospital, especially the regular floors/wards, those of us from NY have a phrase: Fahgedaboudit!

How long will it take before this changes? How many more unnecessary deaths will it take before something changes?

Where do those in charge of N.side (and other HCA hospitals) take their loved ones when they're sick? If it's at an HCA hospital, do they get better treatment?

Anyone in charge have the guts to respond?