Questions raised at hearing on UMC’s emergency room procedures
January 13, 2010 - 5:35 pm
Even if a hospital offers the best patient care in the world, it doesn’t make a difference if patients can’t get to the physicians.
That was the message delivered by Sen. Valerie Wiener, D-Las Vegas, chairwoman of the state legislative committee on health care, to physicians and administrators at University Medical Center in a fact-finding hearing today at the Sawyer Building.
The hearing came in the wake of outrage over how a pregnant Las Vegas woman was treated at the hospital on Nov. 30.
Roshunda Abney, 25, and her fiance, Raffinee Dewberry, waited for six hours in UMC's emergency room, despite Abney’s complaints about abdominal pain and repeated attempts by Dewberry and others in the waiting room to get UMC personnel to come to Abney’s aid.
The couple gave up hope of being seen at UMC and went to nearby Valley Hospital, where they say they were rebuffed.
Valley Hospital officials deny that personnel were unhelpful.
Abney went home and gave breech birth to a baby girl, who died. Abney said she did not know she was pregnant.
A state investigation confirmed the couple’s allegations about what happened at UMC. The hospital has suspended six employees.
Wiener directed most of the committee’s questions to UMC's chief executive officer, Kathy Silver, and several physicians accompanying her, including Dr. Dale Carrison, UMC’s chairman of emergency medicine.
The committee wanted to know how UMC practices triage, the system of sorting patients according to the urgency of their need for care.
“Do patients know what their rights are? Do they know what to expect when they come through the doors of the hospital?” Wiener asked.
Carrison told the committee that UMC’s triage system had added a “first physician” program, which requires a highly qualified member of the hospital staff to be present during the initial evaluation of patients.
A member of the staff, usually a registered nurse, is present from 9 a.m. to 3 a.m. each day to help evaluate the severity of a patient’s symptoms.
The hours had been 9 a.m. to 6 p.m. when the system was first implemented in September, but the hours were extended to 3 a.m. within the past two weeks.
Abney had arrived at the hospital shortly after 6 p.m., after first going to a UMC Quick Care.
“Our challenge, as an emergency department, is to devise the best system possible, so we can be sure no patient falls through the cracks,” Carrison said.
Previously, a patient would take a number and wait in line to be called before seeing the triage nurse.
Now, he said, a physician is out front evaluating patients immediately.
Wiener asked if the previous system was less professional than the newer system.
“No, ma’am, it means we had a different system,” Carrison said.
Carrison told the committee that UMC would not comment on the incident involving Abney and Dewberry directly, since a lawsuit has been filed.
Jacob Hafter, the couple’s attorney, said it seemed the hospital had made some changes since his clients’ story came out, but that there is a lack of accountability at UMC.
A Nevada law limits award for damages in civil lawsuits against state institutions, he said, and many Las Vegas lawyers won’t represent clients for what they deem a small payout.
Hafter, who filed a lawsuit on Abney’s behalf in federal court, said he has received dozens of phone calls from Las Vegans alleging harm by UMC.
Among other inquiries, Wiener also asked UMC officials to provide the committee records of complaints filed over the last three years, as well as data comparing the hospital against others nationwide.
Carrison said he would not make excuses for mistakes made within the hospital, but he pointed out that overcrowding plays a large factor in the speed doctors can see patients.
“I would love to say I could be there twenty-four/seven at the door to see you,” he said. “But that’s a lie. It won’t happen. And it’s the most difficult part of the job.”
Hafter said the “first physician” program in particular appeared to be a step in the right direction. But he said some hospitals have been doing that for the last 15 years.
“They’re celebrating that they’re doing it now, but I think it’s a little too late,” Hafter said.
Contact reporter Mike Blasky at mblasky@reviewjournal.com or 702-383-0283.