Frontiers in Hospital Management: Letting Patients Die of Neglect

As we noted last week, some “safety net” hospitals are working to shed that label by building out expensive high-tech facilities in order to attract well-heeled — and fully insured — patients. Others, meanwhile, appear to be making do by ratcheting back services to the point that patients are simply dropping dead, often before they’re even admitted:

• In May 2007, Edith Rodriguez began vomiting blood at the Martin Luther King Jr.-Harbor Hospital emergency room in Los Angeles, then collapsed and died hours later of a perforated bowel. The hospital let her writhe in the emergency room for 45 minutes while a janitor apparently mopped up her blood. (See first video, below.) The case helped force the closure of King-Harbor, which already had a reputation for shoddy management that had led to patient deaths.
• Then on June 19 of this year, 49-year-old Esmin Green suffered a seizure and fell to the floor in the waiting room of Kings County Hospital in Brooklyn, N.Y., where she had been waiting almost 24 hours for treatment. She laid there for more than an hour before hospital staff finally approached to find her already dead. (See the second video below.)
• Now comes news that 50-year-old psychiatric patient Steven Sabock died in April after staffers at Cherry Hospital in Goldsboro, N.C., left him sitting in a chair without food or bathroom assistance for almost a full day. Surveillance videos haven’t yet been made public, but they do apparently exist, so at this point it’s probably only a matter of time.

Richard Fogoros of the Covert Rationing Blog has long argued that the U.S. healthcare system effectively rewards insurers and medical providers who figure out how to withhold care from those least able to pay. Although “DrRich” usually seems to be writing tongue-in-cheek, cases like these are enough to make me wonder. At the very least, they suggest how dehumanizing many of the nation’s overcrowded and understaffed emergency and psychiatric wards have become — which isn’t exactly the sort of managment problem that can be solved with a few workshops. (It doesn’t help that apparently the insured are also starting to turn to the ER in large numbers, often because they can’t get a quick appointment with a family doctor.)

Of course, these are only the cases that happen to have gotten some national attention, not least because they were all caught on tape. (It certainly doesn’t help to learn that in two of the three cases, hospital workers apparently falsified medical records to cover up their neglect.) So for a cheerful thought, just reflect on how many other similar cases might lie out there untaped and undiscovered as you check out the videos in question.

The Edith Rodriguez video:

The Esmin Green video: