EMTALA Scam
This ought to be illegal. From the Houston Chronicle:
"Zee Klein wasn't about to just let her (91 year old septic demented) mother die, no matter what some hospital committee decided. But instead of waging a high-profile fight against the hospital, she decided to get her mother out on her own.
It wasn't going to be easy. For one, Medicare wouldn't cover (her mother's) care if she were transferred to Christus St. Joseph, the downtown hospital where a doctor had agreed to take the case. Her coverage for her particular diagnosis already had been exhausted at Memorial Hermann.
Further complicating matters, (her mother's) condition was deteriorating fast — by the time the hospital's futility committee ruled, she was in respiratory distress and her kidneys were failing. Doctors wrote in her chart that the discharge was against their advice.
"The patient was unstable," Castriotta said. "Given how sick she was, doctors felt her release would be dangerous."
The moment wasn't lost on Klein.
"She looked like she was in the throes of dying," said Klein, 68, who had previously cared for her late husband when he suffered a stroke and numerous heart attacks. "We didn't know how long she had."
Still, Klein had a plan. She would have her mother transferred back to St. Dominic nursing home for several hours, then taken to St. Joseph's emergency room, where federal law would require she be admitted.
But would she make it? (Her mother's) condition was so precarious that paramedics gave her oxygen through a respirator and stood ready to take her to a closer emergency room if it looked like she wouldn't survive the drive to St. Joseph.
On the afternoon of June 26, (her mother) was discharged from Memorial Hermann and started the journey..."
read the rest
"Zee Klein wasn't about to just let her (91 year old septic demented) mother die, no matter what some hospital committee decided. But instead of waging a high-profile fight against the hospital, she decided to get her mother out on her own.
It wasn't going to be easy. For one, Medicare wouldn't cover (her mother's) care if she were transferred to Christus St. Joseph, the downtown hospital where a doctor had agreed to take the case. Her coverage for her particular diagnosis already had been exhausted at Memorial Hermann.
Further complicating matters, (her mother's) condition was deteriorating fast — by the time the hospital's futility committee ruled, she was in respiratory distress and her kidneys were failing. Doctors wrote in her chart that the discharge was against their advice.
"The patient was unstable," Castriotta said. "Given how sick she was, doctors felt her release would be dangerous."
The moment wasn't lost on Klein.
"She looked like she was in the throes of dying," said Klein, 68, who had previously cared for her late husband when he suffered a stroke and numerous heart attacks. "We didn't know how long she had."
Still, Klein had a plan. She would have her mother transferred back to St. Dominic nursing home for several hours, then taken to St. Joseph's emergency room, where federal law would require she be admitted.
But would she make it? (Her mother's) condition was so precarious that paramedics gave her oxygen through a respirator and stood ready to take her to a closer emergency room if it looked like she wouldn't survive the drive to St. Joseph.
On the afternoon of June 26, (her mother) was discharged from Memorial Hermann and started the journey..."
read the rest
posted by scalpel at 5:50 PM
16 Comments:
The daughter should be prosecuted for elder abuse, and reimburse the taxpayers for the whole futile ordeal.
This is one of many reasons why I, and everyone I'm related to/care about that I can convince has at least an advance directive. Regardless of whether anyone thinks the daughter did the right thing or not, I definitely do not want to die slowly and dementedly. brrr.
Well, whenever I get depressed about the seeming inevitability of socialized healthcare one of these comes along. It's safe to say that hundreds of thousands of dollars won't be pointlessly dropped on assauging boomer consciences then.
Of course the elderly will probably be encouraged to hurry up and croak so that they quit wasting taxpayer dollars, but it's all tradeoffs I suppose...
AHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH!
fuck this, i'm not going to medical school. unbelievable.
great find on this story doc. i can't believe anyone would take advantage of EMTALA like this. stunning (not). i feel badly for the patient.
I told my kids that if they ever do something like this to me, I'll come back to haunt them after I die. Great story, Scalpel.
MJ
This is disgusting. They should never have approved the transfer.
It is easy to say do whatever you can when you aren't the one paying. But even without looking at money, why would anyone want to live in such a sad sad state. When my mind is gone (or my body), my spirit will be trapped inside a worldly body, and my family knows it will be time to let me go. I did think it was very strange that she said her mother would go when it was her time and that she didn't need doctors hastening death, but why was she perfectly happy to let doctors prod her mother and delay that God was obviously calling her home. I would really like to at least understand how anyone can think that zero quality of life can possibly be better than passing, surrounded by your loved ones. I just can't wrap my mind around it. I wish I could because then I could find some empathy for the people, that as of now, I regard as selfish, selfish people who cause their loved ones to suffer so that they can delay the emotional pain of death. Thanks for sharing this.
yes that must be, or at least should at least be illegal...
I can't even understand why the daughter wanted all of that to be done... They way it sounds it would make her mother feel worse.
The most tenacious malpractice lawsuit we have ever faced at our facility was for a 92 year old who died from mesenteric ishemia. He had been bedridden and VEGETATIVE for a decade, but was well cared for by his son... the attorney.
I've never heard of a nursing home that would accept an unstable patient. Hell, they usually don't even want the relatively healthy ones and they send them to the ER for the most insignificant complaints.
As a Hospitalist we see these patients all the time. It is one of the most emotionally painful parts of the job. As a physician, at some level, you feel like you are participating in torture of this poor shell of a human being. In spite of your attempts to explain to the family concerning prognosis, futility, quality of life, etc., many of them just don't get it. You feel helpless, with no control, completely at the mercy of the delusional family members. So you do the best you can for the patient, try to " patch them up", get them back to the Nursing Home, knowing full well they will be back within the month for the same thing. If you can get a DNR from the family you feel like you have achieved a small victory, at least you don't have to hear/feel the ribs and sternum crack during a futile attemt at CPR when they code. You sometimes wonder, what is the motive behind their decisions? Many are distrustful of the medical profession, others are simply in denial, others have an emotional dependency that raises its ugly and hysterical head when the patient dies, and God Forbid, some have some financial motives ( Grandma lives at home and her SS check helps pay the rent). We all get a little jaded/ cynical doing this job, and I just have to tell myself, just keep at it, your bound to comfort/help at least one patient today. Part of me says, " How f--ked up as a Society/Culture are we that we can't stomach the inevitability of death?" How much of our and our grandchildren's collective treasure are we going to commit to the care of " living corpses" ?. Rant Off.
And on the other end of the spectrum we have anencephalic babies, delivered prematurely to alchoholic, crack mothers (the 3rd or 4th), who are seen by every medical and surgical specialist in the hospital- and for WHAT?
Random story Re: anencephalic babies
We had the BodyWorlds exhibit in the Twin Cities, and I begged my boyfriend to go with me even though he gets creeped out by anything medicine-related. They had an anencephalic baby (along with miscarried fetuses of various ages and a pregnant mother who'd died), and after he saw that baby, he started to cry.
They actually try to 'save' those babies in hospitals? How sick.
At the start of the story the septic, demented old patient with renal failure and "respiratory distress" is portrayed as being abandoned for no good reason.
At the end, she is stable but "it was clear the end was near".
Nothing like a little hindsight, ignorance, and rationalization to clear up the situation.
Thanks for the story, it's not surprising to see it happening. But here's my 2 cents.
"We believe that when it's someone's time, it will happen," Klein said. "Without doctors pulling plugs or stopping food and water."
It is facinating for me to see that Klein believes that God is the one who determines who lives or who dies, BUT she makes pains to take her mother to the doctors. So it's ok for the doctors to heal her mother when God is striking her down with illness but it's not ok for the doctors to say, "we're beat". It seems to me she's having her cake and eating it too.
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