The paralyzing cramping in 25-year-old Roshunda Abney's abdomen, side and back wouldn't go away.
For two days, the part-time customer service representative for Quality Towing had taken over-the-counter painkillers. But what had started out as an intermittent dull ache had developed into a recurring, searing pain that made her stiffen and left her gasping every few minutes.
What she first thought was the beginning of a menstrual period, she decided Monday afternoon, must be something more significant.
"It was getting to be a sharper and sharper pain," she said Tuesday, closing her eyes as she rested in a hospital bed at University Medical Center.
Weary, she nervously pulled on her hospital gown to make sure she was covered as she remembered a day she will never forget. "It was a really, really strong cramp that I had never felt before."
How Abney finally rid herself of her physical distress, according to her attorney, Jacob Hafter, raises serious questions about the availability of competent emergency medical treatment at both UMC and nearby Valley Hospital Medical Center, where she also tried unsuccessfully to get help.
Rick Plummer, UMC director of marketing and communications, said hospital officials cannot speak about specifics of Abney's case because of "our concern for patient privacy" and because Abney has retained counsel "in anticipation of litigation."
"I can say that UMC takes any issue related to patient care very seriously, and we are reviewing all aspects of the care provided to Ms. Abney," Plummer said in an e-mail.
Gretchen Papez, director of marketing at Valley, said the hospital is unable to comment on Abney's assertions because of confidentiality laws and hospital policies.
"Notwithstanding," Papez wrote in an e-mail, "Valley Hospital Medical Center denies any claims or contentions that it failed to provide necessary medical care and treatment to Ms. Abney nor discouraged Ms. Abney from seeking treatment at Valley."
Hafter noted his client has formally waived the federal privacy law protecting a patient's health records from being publicly revealed.
"We have nothing to hide," he said.
Hafter said he has requested videotapes from both hospital emergency rooms.
Abney's quest to rid herself of pain began with a trip to the UMC Quick Care on Craig Road in North Las Vegas. She was driven there by her 24-year-old fiancé of four years, Raffinee Dewberry, a customer service representative for AT&T.
High school sweethearts in Mississippi, they migrated to Las Vegas about five years ago when jobs were plentiful. On Monday, Dewberry became increasingly concerned about Abney's condition.
"I had never seen her in such pain," he said as he sat next to her hospital bed. "And I saw her get four teeth pulled out."
Quick Care records show Abney arrived at the center at 5:25 p.m. Though she was uninsured and unable to pay up front for care, medical personnel performed a preliminary screening on her, as required under the Emergency Medical Treatment and Labor Act.
Abney's medical record states that at 5:35 p.m. she was placed in an evaluation room and a urine sample was obtained.
Five minutes later, records show, a physician performed a brief physical and then ordered a urinalysis and urine pregnancy test. A nursing note states that at 5:45 p.m. urine was unable to be obtained from Abney. After she was unable to urinate, Quick Care personnel decided to transfer her to UMC's emergency center for "higher care."
Abney said she was never told by Quick Care medical personnel that they suspected a possible pregnancy.
And if she was pregnant, she wasn't aware of it either.
Shortly after 6 p.m., Abney arrived at the UMC emergency room after a short ride in her fiancé's car. She signed in and unsuccessfully tried to give her transfer papers from Quick Care to personnel at the front desk.
"I was surprised they didn't want my papers," she said.
Within minutes of her arrival at UMC, Abney said she had her blood pressure taken. She described her pain to the UMC staffer administering the test, who said her description of distress sounded as though she had gallstones. She said she told the staffer that the pain was excruciating whether she was sitting, standing or lying down.
The blood pressure test was the last time any UMC staffer tried to evaluate her condition at the emergency room, Abney said.
"I was there for almost six hours and couldn't get any help," she said. "I couldn't believe it. I was moaning and pleading for help. ... I went up to the desk a couple of times and so did Raffinee. Other people tried to get me help, too."
At one point, Abney said she told the certified nursing assistant who was running the desk that she felt like she was dying.
"He asked me how long I had been in pain, and I told him two days," Abney said. "He told me that since I had been in pain that long, another 45 minutes wouldn't make any difference."
While at the UMC emergency room, Abney said she had her fiancé get her a cup to urinate in. She said she hoped the specimen would help doctors find out what was wrong with her.
After she urinated, she gave the bloody specimen to the nursing assistant at the front desk.
As the evening wore on, a woman who was sitting near Abney in the crowded waiting room became increasingly concerned.
"This woman who I didn't know kept moaning, 'Oh, Jesus, please help me,''' Victoria Taylor recalled Thursday from her Las Vegas home. "It gave me chills. She (Abney) would rock back and forth. 'Oh, Jesus. Oh, Jesus.' It got louder and louder. It got the whole waiting room real nervous. Three or four of us went up to the desk to tell this CNA who was running the waiting room to help her. We said everybody would let her go first. When I told the CNA to do something. He said I should close my mouth and stay out of other people's business, or I'd never get to see a doctor."
Taylor, a 48-year-old thyroid cancer patient who was waiting to get medicine for her condition, was stunned by what she described as the nursing assistant's "coldness."
"I'm Jewish," she said, weeping. "And all I could think of was this is the kind of coldness they had in concentration camps. I've read so much about the torture when people were sick. The Nazis wouldn't do anything."
On two different occasions, the nursing assistant called security as Dewberry spoke with him.
"I told him once that he might want to find another profession if he can't be friendly," Dewberry said. "I told him another time that if he looked around he'd see that Roshunda was the only one in so much pain, that she stuck out like a sore thumb. And I told him that other people were willing to let her go first."
Taylor said she was surprised at the mannerly way in which Dewberry spoke with the nursing assistant.
"He was much nicer than I was," Taylor said.
Both Dewberry and Taylor said no action was taken by security against Dewberry.
"I learned in customer relations with AT&T how to deal with people," Dewberry said.
Just before midnight, Abney and Dewberry decided to leave for nearby Valley Hospital. They said they were convinced UMC was not going to help them.
At the Valley emergency room, Abney said she was told she would have to fill out paperwork before she could be seen. She said she was in too much pain to do so, but that she did request to see a physician.
Dewberry said he told the Valley representative that they had been waiting for six hours at UMC and had not been seen. According to Dewberry, the Valley employee responded with this question: If they had waited that long at UMC and were not seen, what would make them think they would be seen any sooner at Valley?
The pair said they then decided to buy some pain medicine and go home. Dewberry said they were thinking at that point that Abney was suffering from gallstones.
About 20 minutes after she got home, she had to go to the bathroom.
She felt a rush of water from her insides. And then, she began giving birth.
"I didn't know I was pregnant," she said, shaking her head Tuesday.
His fiancée's screams brought Dewberry to the bathroom.
He said he saw a baby's legs hanging, with the arms alongside the head in the vagina.
After calling 911, he helped Abney lie on a mattress. Within minutes, paramedics showed up and made the breech birth delivery, where the legs come out first. Doctors say this is more painful and more dangerous than a normal birth for both the mother and the baby.
The infant and the mother went in separate ambulances to UMC. As Abney was brought through emergency, Taylor was still there, and she waved to the woman she had tried to help.
Not long afterward, Taylor saw Dewberry in the parking lot.
He told her what happened, and she said she broke down. Their baby girl was dead, Dewberry said.
The baby, called "Angel" by Abney, weighed 1 pound, 6 ounces.
Abney said nurses told her she was about six months into her pregnancy.
She said the nurses repeatedly suggested that she cremate the body.
"We decided not to take them up on that offer," attorney Hafter said.
Instead, he requested that the Clark County coroner's office perform an autopsy on Angel. Conducted last week, the results have not been made public.
Dr. Richard Chudacoff, a Las Vegas gynecologist and obstetrician, said there are times that women go into labor who aren't aware they're pregnant.
"It isn't common by any means, but it does happen."
The TLC cable channel recently aired a reality series on the phenomenon. Some women even continue to have light menstrual periods while pregnant.
"I miss a lot of periods and I never felt anything, so I never thought I was pregnant," Abney said.
Even though it is uncommon for a woman not to know she is pregnant when she is well along in a pregnancy, Hafter said that is no reason for emergency personnel not to suspect that condition when a woman complains of intermittent abdominal pain.
"A basic rule of emergency medicine is that any woman of childbearing age who complains of abdominal pain is considered pregnant until proven otherwise," said Hafter, who was a paramedic for 15 years. "The fact that Ms. Abney's complaints of intermittent severe pain, which comes and goes every three to five minutes, were disregarded by emergency rooms should create significant concerns for this community."
Abney no longer has the pain she had when she was in labor.
"But now my heart hurts," she said. "It hurts bad."
Contact reporter Paul Harasim at firstname.lastname@example.org or 702-387-2908.