http://www.medicalpost.com/news/article.jsp?content=20061024_133936_5376

Waiting room death in Illinois ER ruled a homicide 
October 24, 2006 | Matt Borsellino 


While not a Canadian case, CMPA notes courts have not addressed how scarce 
health-care resources should affect standard of care

WAUKEGAN, ILL. | A coroner’s jury has declared the death of a heart attack 
victim who waited nearly two hours in a hospital emergency waiting room a 
homicide.

“Gross deviations from the standard of care that a reasonable person would have 
exercised in this situation” were the cause of the woman’s death, ruled panel 
members.

It’s not clear whether last month’s ruling will result in charges against any 
doctors, but according to published reports, the deputy coroner quickly 
subpoenaed documents after noticing what appeared to be discrepancies in the 
hospital’s record of events. The facility north of Chicago co-operated with the 
coroner’s investigation.

“Emergency physicians and nurses go into emergency medicine to save lives,” 
noted Dr. Rick Blum, president of the 24,000-member American College of 
Emergency Physicians. “To criminalize their efforts would be a terrible mistake 
and have a severe chilling effect on people going into the field.”

The Medical Post contacted the Canadian Medical Protective Association, this 
country’s pre-eminent provider of medical liability protection, but its 
officials would not speculate about the impact an incident in another country 
would have on this country’s emergency physicians.

Still, in a submission to the CMPA’s 2000 annual report, general counsel Marg 
Ross warned physicians that while their work environment may be under pressure, 
they cannot defend decisions that interject administrative concerns on a 
patient’s well-being.

“The courts have yet to fully address how the scarcity of health-care resources 
will affect the standard of care expected of physicians,” she noted. “To date, 
the courts appear unwilling to accept an ‘economic defence’ to justify 
withholding treatment or services from a patient for reasons of overall 
resource containment.”

Though written more than five years ago, the CMPA still stands by that 
assessment executive director and CEO Dr. John Gray told Medical Post West 
Coast freelance correspondent Ann Graham Walker for a story on health delivery 
services in British Columbia’s emergency rooms published early last year.

There have been no cases in Canada where a court cited resource issues or an 
inadequate work environment as mitigating factors in a medical error, he added.

“There’s no question there’s a tension between the duty of care you owe your 
individual patient and the duty you owe society to participate in the efforts 
to rationalize scarce health resources,” Dr. Gray said. “Most physicians are 
trained to direct all our efforts to our individual patients while increasingly 
doctors are pressured from administrators and governments to look toward the 
societal ability to deliver ideal health care for everyone.

“It is a terrible place to be. Unfortunately, the judiciary is not helpful in 
this regard because they tend to fall on the side of the doctor’s duty to take 
in the interests of their individual patient. . . . Eventually, the law is 
going to have to come to grips with the environment and either recognize that 
the environment has changed and hold physicians to a different standard or else 
I think these tensions will continue.”

The CMPA urges its more than 60,000 members to document their concerns about 
resources since those notes may carry weight in any future case.

The woman’s death also raises questions about what emergency patients should do 
if their medical condition worsens while they’re waiting.

“Physicians have been sounding an alarm for years about the growing crisis in 
our nation’s emergency departments,” Dr. Blum said. “All emergency departments 
use a triage process. . . . However, sometimes a patient will come in with mild 
symptoms and while they are waiting, their condition worsens. It’s very 
important for emergency patients in waiting rooms to notify the triage nurse if 
they are in pain or if they start to feel worse. If they are still concerned, 
they should ask to speak to an emergency physician or a patient advocate. 
People should not leave the emergency department without being seen.”

(About 3% of patients leave this country’s emergency rooms without being seen, 
according to the Canadian Association of Emergency Physicians.)

Dr. Blum also reminded the U.S. media that federal law requires all emergency 
patients to be seen according to the severity of their condition whether or not 
they have health insurance.

“People with less urgent medical conditions must wait until all critical 
patients have been stabilized and admitted to the hospital,” he noted.

Emergency room “gridlock” stems from the recent closure of nearly 200,000 
inpatient hospital beds across the U.S. as well as shortages of on-call 
specialists and nurses, he added.

--- URG-L
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