US hospital told family their daughter had checked out when in fact she'd died
theguardian.com
theguardian.com
I had a cousin who voluntarily checked himself into the hospital related to severe withdrawal symptoms (and had bouts of psychosis related to said with withdrawal - meth addictions are nasty). His mother stayed for awhile but had to leave for work. She was repeatedly guaranteed by multiple doctors and nurses that he could not check himself out and would be there for several days at least. They told her to come back the next morning.
Late that night, he was discharged. Not even "he checked himself out". The hospital discharged him (and that's over an hour ride away from home, btw - no hospitals in rural areas these days).
He had no phone and no wallet. According to staff, he tried to call his mother to pick him up, but couldn't remember her cell phone number (it had changed recently). He called his sister and left a message, but she was traveling and didn't get it until much later. According to the hospital, he tried to call several different numbers trying to get a ride home and they made him stop and made him leave. In a quite rough downtown area he was not familiar with. While clearly not in his right mind. At 2am. With no wallet, no phone, no nothing.
The hospital had his mother's contact info. They did not give it to him even when he requested it. They did not attempt to contact her in any way.
We still don't know what happened afterwards. His body was found four days later in the river and it had been there for awhile.
Forcibly discharging someone under those circumstances and refusing to even contact their emergency contacts is beyond belief. I'm furious about it. Apparently it's common and not even something there's any recourse for.
I really don't know how long it took or how I made it, but many many hours later I made it back to my car. I had to beg for money and walk the last several miles once I recognized finally where I was. It really sucked, and ever since then I've had a great deal of sympathy for people that are churned through this terrible system and spit right back out with no dignity whatsoever, let alone empathy. This incident disrupted my life irreversibly (ended up missing tests and having to do a medical withdrawal from school, lost scholarships, etc) and derailed a lot of things I had wanted to do for many, many years. The hospital/medical care industrial complex doesn't optimize for empathy. They're just trying to get the bodies through as quickly as possible.
How could they do that without notifying your parents and telling them exactly where you've been sent to, and what they should do?!
How could they've done that without giving the hospital your parents' contact info? How could the hospital accept you without requesting it, given that you were sent from school, where you have limited rights because they have the responsibility for your well-being?
How could have they discharged without allowing you to contact your family yourself?
This should be grounds for a civil lawsuit, if not criminal prosecution. I am not a lawyer, but I really hope that anyone reading this would contact one if they end in a situation like that.
>They're just trying to get the bodies through as quickly as possible.
I don't think taking 30 seconds over those 20 hours to contact your family would've slowed them down any.
This is not about efficiency. They should not be allowed to operate.
I know for a fact the school never contacted my emergency contacts but there wasn’t really anyone to contact to begin with so I don’t fault them for that.
What should have happened was I referred to a school therapist or actual doctor.
To explain further what this place was like - it was the county mental facility at a large hospital. imagine a toned down version nurse ratchet kind of setting, people defecating on themselves, screaming, people in straight jackets. and then me, a slightly disheveled kid who was stressed about finals. they wanted me out of there immediately once they realized what was going on because they were already full. then when they process the paper work you get shuffled to a front desk behind a window who just wants you out of their sight ASAP. I remember I had to actually argue for the bus tokens and the woman seemed exasperated with even that.
That’s their problem, especially if they deal with proper mental issues, you can’t just dump these kind of people on the street.
Oftentimes it's not even that, or can go to the opposite extreme. It can be "or until evaluated by a psychiatrist or MHP".
I'm a paramedic in Washington. The biggest example of this I remember was a 14yo, intentional pharma overdose. We brought her in, "invol". Four and a half hours later, call goes out, same address, 14 year old girl, overdose. We checked with dispatch, was there a glitch?
Nope. Psychiatrist had spoken to her, determined she was "no threat to herself". Parents drove her home, and within fifteen minutes she'd locked herself in the bathroom again, and taken more of the same meds.
Was furious. Between the psychiatrist, parents not locking up the meds, hell, the ER, she probably still had drugs in her system.
"Maybe hold on to her for more than four hours this time."
Also, tangentially, if EMS wants to transport you involuntarily, we actually need Law Enforcement involvement - they don't even necessarily need to talk to the patient, but they do need to complete the paperwork that takes them into custody, which they then "assign" to us. EMS generally has no power to treat you against your will (however, if you are actively a threat to yourself, we can act on that, usually restraint and sedation. Or there is 'implied consent' where if you lose the ability to effectively consent, the law assumes that a rational person would want aid to be rendered).
now at this point I had zero ideation even, no plan, no intentions of killing myself, but being a pedantic dork studying philosophy I said I wasn’t sure about that, because I really wasn’t sure what to say. 10 minutes later a cop shows up, puts me in handcuffs, parades me off campus in them and people I knew saw it. I had absolutely no clue what was going on and had to sign papers I didn’t want to sign and when I protested the answer was basically “you can come voluntarily or with force, your choice.”
It ended up doing far more harm than good for me. I know physicians personally that will often throw people into 72 hour holds in the ER “just to be safe,” either not understanding or caring the long term consequences of being put in an involuntary hold. These same physicians have told me she did the “right” thing but anyone with common sense and experience could figure out very quickly I was not a danger to anyone. I was just trying to find some help because I was overwhelmed.
I'm the same as you, too, and pondering the deeper, thinking answers.
That whole process sounds messed up. I would say over 99% (and that's not an exaggeration, but literal) of our invol patients do not have police involved (other than to submit paperwork to the hospital), let alone cuffs. Our EMS protocols DO require soft restraints during transport, but we generally make a point of being apologetic about it, putting them on at the last moment and that we will take them off ASAP (essentially once the ambulance is in Park). Even this is only because, unfortunately, some of those patients have attempted to exit a moving ambulance, sometimes at freeway speeds.
I'm curious what papers were put in front of you, though, as the whole point of the involuntary custody process is that your acknowledgement is not necessary (at that point - after the mental health hold hearing, in front of a judge - you are asked to acknowledge/sign, but not required).
Looking back with a more historical lens I think at the time this happened for me was shortly after columbine and everyone was freaked out about mentally ill people shooting up a place because that had at that time been a shocking incident.
> I made it back to my car
and although no glasses or license, did you have keys? could you drive?
That must be why health care is so affordable (/s)
Got to experience that first-hand when my partner lost her pregnancy. We went in for the procedure to remove the nonviable fetus and were advised we had 14 days to arrange for a mortuary to take the remains if we wished to keep them, which we did. At 7 days when the mortuary tried to arrange for pick-up, we were informed that the hospital had disposed of the remains. It was "very uncommon" for people to want to take the remains, so they got lax in following their procedure and jumped the guns. Left us nothing to take home. It still sucks.
(sarcasm warning) But who can fault them, imagine they had to explain to each pair of parents from scratch what is happening behind the scenes, and how such decisions are being made with little to no public discussion let alone democratic oversight? The time it would take compared to the harvesting itself would be intolerable. Intolerable! Not to speak of having to invest in bulletproof panes from behind which they would quickly learn to explain all this.
It's a sad fact but hospitals have no one who is responsible for advocating for your care. I think it's a major ethical flaw in our entire healthcare model. People are not medical experts or legal experts and when they are suffering they're even less capable of handling that burden.
To expect the hospital with a financial incentive to do this is absolute folly. It just doesn't happen. They'll _absolutely_ get your insurance information, even when you're laying in the ER and doctors are still attending to you, but they'll provide you less than nothing when it comes to understanding your care and your options.
We afford people public defenders as disinterested third parties when they're accused of the most petty of crimes, yet, you're absolutely on your own when it comes to the hospital. This is a complete social moral failure.
Those who don’t have kids will learn quickly how hospitals treat those without children. It’s not pretty.
The nurse then recognized the woman, for it was the very nurse who had rolled her out for fresh air some time ago.
It was a cold night, as well. I think there was some snow, or it was about to snow.
There is definitely an over-reliance on schematics in emergency medicine. The moment a slightly more complicated patient is involved or one falls outside the schematic otherwise, their risk of serious health injury or death goes up a lot.
This was always interesting to me. I went to medschool, and I remember my peers as people who genuinely wanted to help others. Few would have refused to help someone collapsed outside in the cold. But our medical system has changed a lot, many more people do it for the pay slip. Most probably still care about the patients but I suppose some portion genuinely don’t. If it’s not on the schematic, they won’t care for it.
It’s like asking a software engineer to write a hundred new features in a given sprint while the rest of the application is in flames. Eventually you stop aspiring to build good software and just hope enough of your code works that it’s good enough for some people.
Unfortunately medical services are literal life and death services. So we have it much easier as software engineers.
The hospital is directly responsible for your cousin's death.
The fact that they assured the mother that they'll keep him, specifically told her to come the next day, and then forcibly discharged him at 2am without either calling his mother or even providing mother's contact to him should be grounds for criminal prosecution.
This is beyond negligence. They lied to the mother and knowingly forced him out when they were responsible for his well-being.
It would've cost them $0.00 to dial his mom's number. The fact that he asked for his mom's phone and they refused means they did it on purpose. This sounds very much like and indication of malicious intent to me.
I hope your family sues the bejeesus out of the hospital, and that someone will get a felony charge over this.
This hospital mot merely betrayed the trust of your family. It is literally a public health hazard. It should not continue existing.
I don’t know what it is legally but morally that is negligent manslaughter.
I regularly have to aggressively bully medical care teams for myself and others to get them to do the right, obvious things.
I do not trust doctors, they do not care to figure out problems, ignore so many people's problems, and make wildly stupid mistakes all of the time.
Did you try clicking the link? They are. 5 million dollars. I expect they will win, and that still won't make them whole.
I want this to be a lie, but I don't treat HN comments that way. This is horrible, absolutely appalling.
When my kids were born, the hospital had this incredibly elaborate, incredibly detailed checklists of things that needed to be in order before they would let you leave. Did you have a carseat? Did you have a ride home? Did the doctor come by and give you discharge instructions? Do you have all the belongings you came with? Did you fill out the birth certificate application? Have all your discharge papers been signed?
They actually wouldn't let my wife walk herself down - they had to call Transport, and she had to be wheeled down in a wheelchair with the baby's carseat on her lap, and I had to be waiting at the designated curbside to pick her up. She was perfectly capable of walking herself down, and we were both capable of putting the carseat into the car in a normal parking spot, but everything had to be done in the presence of an orderly.
This is the same health care company mentioned in the article, but at a pretty affluent suburb of Silicon Valley.
The only reason is people love to sue for anything in this country. This is unrelated to best practices.
People "love to sue" in this country because the court system was designed to be THE place where problems are solved. Can't have a federal agency who's job it is to make sure hospitals don't kill people, that would be tyranny, better make everyone sue them instead.
This affects everything in the US. It only affects hospitals worse because the US cost of healthcare is so stupidly artificially inflated that you have to sue for very minor things so you can pay the $40k it takes for some basic physical therapy.
Do you really believe that everyone working in maternity wards in hospitals cares absolutely nothing about babies?
The "won't let mom walk to the door" thing is a great microcosm of that—it's a blanket policy applied to all mothers regardless of need.
My wife had our youngest at home but we had to take her to the hospital afterward because her lungs were a little sticky and she needed a respirator for ~4 hours. I took our daughter in and my wife followed a few hours later, walking all the way into the hospital.
The NICU wouldn't discharge us for two days (which is a whole liability > care story of its own), but when they finally did they insisted that my wife—who had had the baby at home and driven to and walked into the hospital while mere hours postpartum—needed to be in a wheelchair to the curb.
We liked that shift of nurses, they clearly cared, but no one in that room looked at my wife standing by the warmer and thought "she needs a wheelchair". They had a checklist and they were going to be darn sure they followed it.
I've definitely been in hospital situations with my children where I was honestly afraid (perceived or real threat, I still don't know) that they were going to report me for child abuse if I took my kids home and refused care. People with authority are kinda scary, and while I love for us to all choose rights over security, sometimes I just don't want to have to fight for everything.
And this is where police states evolve from.
Holding someone for longer than the traffic stop requires to wait for a drug dog is illegal in the USA. That's not to say it never happens, but it's grounds to exclude any evidence found, and for a lawsuit.
The judge won't be amused if the police say it took them 45 minutes to write a speeding ticket.
I've definitely been detained for what seemed to me an acceptable amount of time for a traffic stop, but who's to say the cop can't come up with myriad reasons it had to take that long? Is 35 minutes too long? Is 38 minutes? Who's keeping time, and who's word is taken as truth?
The increased use of car and body cameras makes this particular abuse harder to get away with. A request to search denied followed by a call for a dog, followed by unusual delays recorded on dashcam leads to a challenge even the most overworked public defender would raise.
If its a black man in a poor part of town driving a cheap car your success rate in getting away with it will be 100%.
I'm not saying it never happens, but the legal risk is too high for most cops to do it often. They may try to get you to think they will, but it's usually a bluff.
I can see an argument that it's about increasing average wellness across all people ever taken care of by that NICU, but from the perspective of an individual patient there's no difference between the two motivations—the point is that your own care is not the important thing to the hospital at that time, what's important is the rules and regulations.
In our case, we both felt that our care was actually actively hampered by NICU discharge rules that were designed for premature babies and were completely inappropriate for our late-term baby. The wheelchair was just the last hurrah of the situationally-inappropriate hospital regulations.
I suspect this is one such case.
Is the risk sufficiently on a per-step basis to make that worth it?
For them to be so soulless when it concerns infants, you can be sure they aren't any better when they're just dealing with adults. Greedy psychopaths are overrepresented in the medical industry.
The interesting point here is about how so many institutions become so much sloppier when the legal system becomes unaffordable for a majority of residents. Unsurprising, but it has pretty far-flung consequences if you're trying to root-cause why so much of America seems like a 3rd-world country today.
And as far as safety, it's not always legal liability. I'm sure a good portion is, but we're talking about newborn babies right now. Most people don't want to have any part in a newborn being harmed, so it's trivially easy to get employees to take that stuff seriously.
And nobody is ever the bad guy in their own story. During my sister's birth, she got stuck, and the doctor, instead of doing the normal and accepted and standard fix of breaking one bone, broke a different one instead. This damaged nerves in her arm and permanently disabled her. Turns out, he did the exact same thing to another kid in town a few years later. ALSO turns out, he had to stop practicing medicine in a different state because he kept doing that to a bunch of babies, so instead of retiring or retraining because he obviously did not know what he was doing, he moved to bumb-fuck nowhere so he could keep doing it. I bet he even thought he was a good doctor.
It is never trivially easy to get someone to do something they don't want to do, like admitting they fuck up, or that they are careless about something they don't think is important.
We only got $10k in the malpractice suit, which doesn't even cover like a year of physical therapy, for a lifelong and entirely avoidable disability of her dominant arm. She had to learn to be left handed. If our family didn't have state employee insurance, we would have never seen a doctor, like most people in poverty.
They kept giving her an oxy in the morning, then after it set in, asking her to rate her pain level, and recording it. Which is backwards.
Then they blamed her for not asking for more pain meds, which she had.
Then they told her to just ask for more pain meds, which we did.
Then the nurse told her that shes not allowed to have any more pain meds. At which point I went full Karen, got our stay extended by 2 nights.
Apparently the midwives expected her to be walking up and down the corridor, which was not a requirement and not part of the treatment, just to demonstrate her pain levels.
When I was a university student, my tonsils suddenly swelled up so much that I was unable to speak and I was having difficulty just breathing.
I went to the university urgent care, and the nurse showed me a pain scale and asked me what my pain level was. I pointed at the '7', and she told me I needed to actually say the number to her. I kept trying (it was extremely painful to try, more like a 9!) but I physically could not make the sound — which just pissed her off even more. At long last, she got so frustrated that she stormed out and finally got the doctor.
When the doctor examined me, he told me that I had the biggest tonsils he had ever seen in his career.
He diagnosed me with mono and put me on steroid treatment, and my tonsils were back to normal by that evening.
A classical example of this is in Norway. There's nothing that gives you access to more resources than being pregnant or being in care of a newborn. You can suffer from all kinds of mental health issues for your entire life, struggle to be a productive member of society and be in and out of temporary treatment and be on social benefits. But the moment someone is pregnant they get will be top priority for anything that is even remotely connected with child mortality, almost regardless of how benign something is.
I personally know several people that finally got the help they had been so desperately been begging for, just because they got pregnant. We could have saved them from literal decades of suffering by just providing good treatment early. I'm willing to bet that we'd even be in a position to spend even more money on reducing child mortality, because when you start doing the math of how much they ended up costing society it really adds up.
I have tonic-clonic seizures; at least 4 hospitals have wheeled me out that way, suffering no argument otherwise. I guess it is common.
If they know you won't be paying, they will try to kick you out as fast as they can and consequences be damned, if you don't have insurance you likely don't know/understand your rights and wouldn't sue them.
should be
> You'd be amazed how bad hospitals in the States can be at keeping track of fairly critical things.
This crosses into criminal liability.
A lot of hospital care is done by residents with surgeons overseeing and stepping in for the most difficult parts.
Our healthcare system would literally collapse without residents doing the heavy lifting. It won’t change until we stop artificially limiting the supply of doctors or give mid level practitioners more power.
This is despite health in general, and the HNS in particular, being a major source of interest for the electorate.
Salaries are also much more compressed than in North America - UK junior doctors generally earn more than NA residents, but then not that much more (maybe 4-5x from lowest to highest, not >10x to reach hundreds of thousands) as consultants (attendings). Locum pay & additional private work can make up for some of that, but probably not all, and I assume similar could be done in NA if you wanted to earn more (or open their own practice, pharma sponsorship, etc.)
It's probably true in general (relatively compressed salary ranges) actually, not just in medicine.
Why could that be? Does that factor into your assertion?
The UK government has no power to keep people in (though my own departure shows they could do a better job of not making people want to leave in the first place), but it does have power over the other two.
Until then I guess we all just have to make sure we never need to use the healthcare system we all pay so much for.
In Texas, three hospitals (Baylor St. Luke’s Medical Center (BSLMC), Baylor College of Medicine (BCM) and Surgical Associates of Texas P.A. (SAT)) agreed to pay $15m as part of a settlement with the DOJ. These doctors/surgeons were booked for multiple simultaneous procedures that they could not have possibly conducted, even though they recorded things to make it look like they conducted all the surgeries. In reality many procedures were performed by unqualified residents and other caretakers and not who the patient was told would be performing the procedure.
> To make it seem as if the teaching physicians were present during the "entire" operation, they would lie on medical records, the court filings say. The medical staff also would not tell patients that the surgeon planned on leaving the room to perform another operation, the documents continued.
This only came out because of a whistleblower, and because the DOJ pursued it. It is nearly impossible for a patient to know if they are wronged or harmed this way because they are put under for these procedures, and because friends/family are typically not allowed to observe or record anything (likely to prevent accountability). And then there’s the cost of lawsuits, the stress, and limitations under law (like tort reform in Texas) - it’s just lucky that this was pursued by a government agency (DOJ).
> Under the False Claims Act, the private whistleblower who reported the allegations will receive over $3 million from the settlement, the Justice Department said.
We need more incentives like this, but we also need greater penalties and jail time for the practitioners and literally everyone who knew. They should be investigating who was in the room, what was recorded in logs, and who accessed records, and go after all of them. Right now, this settlement achieves nothing. Some articles claimed that these hospitals made more than $150 million off these procedures for which they are settling the lawsuit for just $15 million.
https://www.seattletimes.com/nation-world/texas-heart-surgeo...
https://www.justice.gov/usao-sdtx/pr/texas-medical-center-in...
Before tort reform punitive damages were already capped in Texas at a value twice the amount of economic damages plus the amount of non-economic damages, so tort reform does also have a effect of sometimes reducing punitive damages.
On average, a medical malpractice case might require anywhere from 500 to 1,000 hours of legal work, with more complex cases potentially requiring over 2,000 hours.
Average lawyer cost in 2022 was $313/hr.
So we're basically looking at, generously, 750 hrs x $300, or $225k to the lawyer.
And that's just one side - the hospital presumably pays near the same.
... Huh.
Once again, I am stunned at the American legal system being so obviously and cartoonishly evil.
The end result is that doctors are essentially lawsuit-proof (as the minimum cost of a suit exceeds the maximum possible recovery) in Texas, and you have no recourse if yours was at fault.
It's a beautiful system.
Texas medical costs are lock-step with the lest of the country.
Texas malpractice rates are leading the country.
https://www.howellslegal.co.uk/news/post/The-5-Largest-Perso...
Basically they had to cut into someone’s skull as part of a surgery. They did not label and catalog skull parts properly. Because they lost the skull part they had to use a synthetic skull flap, and they charged the patient for it. The synthetic flap caused an infection. The patient was on the hook for something like $150K for all of this (the synthetic part, the procedure of placing it, the infection) which was due to the hospital’s own criminal negligence. An investigated showed that the hospital was not properly labeling and cataloging parts for many patients and basically had a mess of random skull parts that would not make their way back to all those patients, so it is a systemic issue and not just an unfortunate one off mistake. All of this is alleged and there is a lawsuit pending, but it seems to me like the part about a systemic issue of mishandled parts is confirmed.
Obligatory.
Lawyer: "Doctor, before you performed the autopsy, did you check for a pulse?"
Witness: "No."
Lawyer: "Did you check for blood pressure?"
Witness: "No."
Lawyer: "Did you check for breathing?"
Witness: "No."
Lawyer: "So, then it is possible that the patient was alive when you began the autopsy?"
Witness: "No."
Lawyer: "How can you be so sure, Doctor?"
Witness: "Because his brain was sitting on my desk in a jar."
Lawyer: "But could the patient have still been alive nevertheless?"
Witness: "Yes, it is possible that he could have been alive and practicing law somewhere."
A couple of years ago I climbed Mt Whitney in California. One of the climbers that day was from the east coast and failed to show up for work a few days later. The family became concerned and called the car rental agency in Las Vegas where he flew to and rented his car. The agency said the car had been returned. After another day of him missing they called the car rental agency again to confirm and once again the agency said the car was in the lot. The next day the rangers found the car was still parked in the Mt Whitney parking lot and search and rescue was finally dispatched.
In this case I believe it didn't make a difference because the climber appeared to die from acute injury on the mountain the day of his climb but in another scenario maybe those 2 days would've been the difference between being rescued or dying from exposure.
I’m not mad about it. I’m mad there’s no apology because the company insists they did nothing wrong.
Another company, the one reading the form, is responsible for services rendered in regards to the form. Clearly not the form-fillers fault.
The only thing that has changed is my HMO; the kids still have the same pediatrician with the same office staff for which referrals were never a problem in the past. However, the insurance company made sure to tell me that they are not the ones delaying it, because it's technically the administrative department of my pediatrician that has to do the referral review. The fact that insurance company mandates that the referral review must be performed by a licensed nurse and follow a byzantine process, of course, has nothing to do with the delay.
The article is so much worse and the headline buries the lede. I would be horrified. My condolences to the family.
- it's not just that the hospital told her family totally the wrong thing for a day or a year...
- or even negligently cremated or buried her in a pauper's grave...
- but they also mishandled the corpse, which IIUC is a misdemeanor (corpse desecration, which is a felony, might not apply), by shipping her decomposing body to an off-site warehouse morgue.
- and failing to timely issue a death certificate or do an autopsy prevents determining whether there had been medical malpractice associated with her death.
Covering up a case of medical malpractice by surreptitiously filling out discharge paperwork is certainly possible. A surprisingly large component of healthcare processes is to blindly trust that doctors are manually entering information truthfully and accurately. The fact that they couldn't locate her body for an entire year strongly suggests a criminal conspiracy to hide the body.
It would seem that the actual care you receive is only remotely related to that.
(Not your fault not to notice though, sarcasm can be very subtle)
Two days before “checking out”, the daughter called the mom to say she was better and was about to leave. Soon after that, something bad happens (possibly malpractice) and she dies. An autopsy would reveal the true cause of death, so the hospital quietly ships her to an off-site morgue, doesn’t even fill a death certificate, and fabricates her checking out.
Now the body is beyond decomposed and an autopsy is impossible. The hospital claims it was a simple mix-up and gets away with a bit of bad press and a negligence charge.
It appears they need a name change after this lawsuit
We had oysters and dry lancers
And the check when it arrived we went dutch, dutch, dutch, dutch
A redder shade of neck on a whiter shade of trash
And this emory board is giving me a rash
I'm flat out
You're so beautiful to look at when you cry
Freeze, don't move
You've been chosen as an extra in the movie adaptation of the sequel to your life
I find that really unlikely.
I mean, for starters, they had her body and knew it was her body in storage. That doesn't happen if they don't have IDs attached to the corpse. I find it unlikely that the hospital wouldn't be ringing the family like crazy because of a body they want to unload. Especially if they have the paperwork showing that she'd checked out. There'd be no reason not to almost immediately say "Hey, actually, we found her right outside the hospital dead, sorry for your loss".
I'm guessing an obvious fuck up killed her like 10xing her insulin dosage by mistake. Or administering something other than insulin.
And it wouldn't surprise me if, conveniently, 17 or 24 months just happens to be the retention policy for medical records.
This was in California, where the law [0] is 7 years minimum, potentially more if the patient was a minor.
AFAICT every state wants at least ~5 years of retention.
[0] https://www.law.cornell.edu/regulations/california/22-CCR-72...
Front-desk has a signed waiver? Good luck proving that it was the person on shift at the time who forged it, she doesn't remember what happened a year ago, and the existence of the fraudulent waiver isn't proof that she authored it.
Nobody's responsible, and nobody's accountable. There's a legal requirement that someone at the hospital should have done their jobs, but there's no legal requirement that forces someone particular to do them.
She checks herself out (given that she called about leaving I find it reasonable to think she might have), goes to the bathroom and arrests in a stall but is not discovered for a while.
The family is looking for her, the hospital correctly notes that she had checked herself out. Eventually her body is found. She's not a patient since she checked herself out. Somehow it fell through the cracks about notifying her family, or perhaps she didn't have ID on her and the body was sent as a Jane Doe.
Despite the misconduct, I think saving people's lives is the most fundamental duty of a hospital.
Fundamental is also defined as “so basic as to be hard to alter, resolve, or overcome.”
I would argue that ‘saving lives’ is not a ‘basic’ process; it is complex. However, informing someone’s next-of-kin of their passing, is a basic (ie fundamental) role of a healthcare facility.
Isn't "a Maximal Element need not be Unique" a more elegant and much more succinct way of saying the same thing?
But to your original question: As you are hanging around these website, I notice (and you too maybe), that even the most educated Americans have an "only American" world view. They consider it is the best country in the world anyway and don't care about other parts of the world.
In German news on German problems (e.g. Digitalisation) journalist sometimes point other countries as a positive example or role model (here Estonia or rarely Ukraine). On American problems it does not happen and we (as a I assume you live on my site of the Atlantic) just nodding our head why it does not change. It would need to change a deeply entrenced attitude. On this discussion page here they dont discuss how other countries do it. Not a single example how to make it better. Because the US is on the top of the hill anyway.
My experience is that Americans are very insular and do not know much about other countries because American-owned new media focuses on US stories, most major social media sites are American-owned and overwhelmingly populated with other Americans, etc.
Americans are insulated simply because the information sectors they have access to are dominated by American businesses. Hell, even the Internet itself is American. (This is the same reason that non-American countries are also overwhelmed by American issues/news/culture.)
It is not because Americans think they are superior, and it does not cause Americans to think they are superior. Degree of insulation and sense of superiority are independent variables, and Americans (especially middle-aged and younger) are actually quite low on the sense-of-superiority scale — certainly way, way lower than most Europeans in my experience. (This is not intended as a slight against Europeans; you have very good reasons to prefer Europe to the US.)
Every American I know has serious complaints about the US and is acutely aware that other countries leave the US in the dust in several of areas, including (though certainly not limited to) healthcare. There are of course some nationalist extremists out there who will argue otherwise, and they can be especially noisy on the internet because that is the nature of extremists, but these are not the average people you meet walking down an American street.
Most Americans may not know the ins and outs of other countries' healthcare systems, and therefore may not speak in any detail about those systems on American media sites like this one, but that isn't because they think theirs is the best. They may not ponder the ways that Estonia or Germany has the better healthcare system, but that's because they would be over the moon for anything half as good as either of them.
The USA's political flaws unfortunately run very deep and are in no way the fault of the modern American people. The US Constitution is a very old, very hard-to-change document that was designed primarily to make the US government as stable as possible — at the cost of responsiveness to democratic will.
Basically all of the genuine democracies (I am not talking about dictatorships that larp as democracies) created after American democracy were designed to correct the flaws of the US Constitution: the first-past-the-post voting system, the extreme difficulty of adding amendments, etc. That's why they have nice things.
To put it another way, clearly the outcome in this story was unacceptable, but what was the correct outcome?
HIPAA does specifically allow for the sharing of PHI with family and friends of a with substantial leeway given to medical professionals to document their reasoning for sharing information if it is "in the patient's best interest". In the hypothetical scenario where concerned family/friends are inquiring about a discharge, it would be perfectly acceptable to share certain details of the discharge if the healthcare provider is willing to document and possibly defend their decision.
In this case, not reporting to next of kin was certainly not in the patient's best interest and a prima facie case of misconduct. As someone who sat at the intersection of health and law for several years, I can't see any possible legal justification or loophole for the hospital to avoid a hefty settlement. As some of the other comments on this thread suggest, this shocking oversight may not be an isolated case, so a hefty monetary penalty is the only realistic way to force the other for-profit health systems of America to implement better processes for this.
So, after the patient died, what is the mechanism by which the family should have been contacted?
Later, if that failed and the family came to ask the hospital, the correct answer was "they're dead", not "we can't tell you" (and especially not "they were discharged against medical advice"!). How does the hospital authenticate and authorize the inquiry party?
Edit: also, is being dead PHI?
You can't just truck the body off to storage and then forget about it.
Obviously the death certificate here was quite delayed, but this shows that generally the fact of death is something that can be shared with those suing.
While your web dev has a very good idea about infrastructure and code maintenance these guys are usually clueless about CI, git, secrets management etc. but still they now all want to migrate their stuff to azure, because it’s cool… to say the truth I didn’t understand the reason why they want to. People that are basically relying on Microsoft wizard based development.
Shocking was that this was not only some bureaucracy software, but systems that are used for actual operations and patient management.
I guess that many people died already because windows developers but nobody did a systematic investigation so we don’t know.
Shouldn't this be a criminal case?
Odds are the hospital will settle this out of court for an undisclosed sum because they can't realistically have their records on the matter brought to light. Was it medical malpractice?! We'll never know.
IMO it should not be legally possible to settle something this dire out of court. You shouldn't be able to bury anything simply by paying a large sum.
Obviously a lot of crap happened here but there's not a legal obligation to be helpful to next-of-kin. Suing for vague "damages" is going to be far more productive.
What on earth is that? Hypo/hyperglycaemia? You'd have to have extremely poorly managed type 1 diabetes for that to become fatal without a massive screwup at that age.
this event is just one more reason i’m terrified to be diabetic in this country.
honestly the way you posed this question is awful and I invite you to reconsider your intent. hopefully the benefit of my doubt is not misplaced.