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12-year-old is now an amputee after a 10-hour wait in the ER, New Mexico lawsuit says
- Thread starter allantois
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Can’t get past the paywall.
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No paywall on my end. Article copied here.
A 12-year-old girl had her leg amputated after she waited 10 hours in an emergency room for her fracture to be treated, according to a lawsuit filed against a New Mexico hospital.
Meiah Tafoya fell while rushing to class at her middle school on Oct. 14, 2022, according to the complaint and a GoFundMe page organized by her mother.
She went to the emergency room at Presbyterian Hospital in Albuquerque where she waited for 10 hours before staff told her that she could not be adequately treated there and would need to transfer to a different hospital, according to the complaint, which names Presbyterian Healthcare Services, the company that owns the hospital, as a defendant.
She was then taken to the University of New Mexico Hospital, where she underwent four surgeries, including having her injured leg amputated, according to the lawsuit. “Had (she) been promptly treated at Presbyterian her leg would not have needed to be amputated,” the lawsuit says. “One or more of the surgeries she has undergone would also not have been necessary.”
A spokesperson for Presbyterian Healthcare Services said in a statement that the hospital had recently been served with the complaint. “ … we will reserve comment on pending litigation for the appropriate venue,” the statement says.
The hospital wait
When Tafoya went to the hospital on Oct. 14, 2022, she was given an initial assessment, including a leg X-ray, when she arrived, the complaint says. She was then told to wait, even though she was crying and “visibly in pain,” the complaint says.
Her mother asked staff multiple times when her daughter would be seen, and they replied each time that they were busy seeing patients in more serious condition, according to the lawsuit. At some point during the 10-hour wait, the Tafoya’s leg started to go cold. Her mother told an emergency room staff person, who said that they were still waiting on the results of her daughter’s X-ray, the complaint says. “... ER staff either did not read the X-ray or read the X-ray and did not promptly act upon the report,” the complaint says. At no point during the wait did a doctor or nurse immobilize her leg, the lawsuit says. This contributed to “internal blood loss and circulation issues,” according to the complaint.
A life changed
Tafoya is now in a wheelchair and has not returned to school, Todd J. Bullion, a lawyer representing her and her mother, told McClatchy News. “She is inspiring with her optimism and her bravery,” he said. “It’s truly an inspiration talking with her and seeing her approach her therapy and everything, taking her best shot at living a happy and normal life.” But the 12-year-old, who played trombone in the school band and enjoyed many activities, is now limited in what she can do and will eventually need to get a prosthetic leg. Her mother, Stephanie Sedillo, who is a single mom of four, has had to take a leave of absence from her job so that she can take care of her daughter full-time, according to a GoFundMe page. Bullion said the family is seeking damages to help cover the cost of Tafoya’s medical expenses, as well as punitive damages. The family also hopes to prevent another incident like this from happening again. “You’ve got to push and advocate for yourself, but that’s exactly what Meiah’s mom did here,” he said. “She told the staff what was going on, what was wrong and it was just ignored. Our hope with this case is that we’re going to drive change here in New Mexico and make sure that this doesn’t happen to anyone here again.”
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This is heart breaking. I hope they win a lot of money. Completely preventable if appropriate staffing had occurred or someone in triage had checked the neurovascular status. Poor kid - her entire life is changed .
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Agreed, this will settle for many millions, especially in a state like New Mexico.
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Really? What about New Mexico makes you say that?
Sympathetic plaintiff with a long life ahead + disability to pay for will likely result in a high dollar amount, but I wasn't aware of NM being a bad med-mal environment.
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Agree completely with your second paragraph, that’s a no brainer.
But as far as state med mal ratings go, I believe New Mexico is up there as one of the worst, if I can remember from ACEP rankings. If I’m not mistaken, there’s no caps on damages for ‘pain and suffering’, don’t have to demonstrate gross negligence to win etc.
I could be wrong.
The suit is against the hospital.
Nice!!!!!
My previous health system, which used to be moral and ethical and truly non profit, determined it was cheaper to understaff and deal with the lawsuits, penalties etc.
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Technically the article just said the hospital was named as a defendant. It didn't say that the hospital was the ONLY defendant...
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Guaranteed the docs are named.
As a general rule malpractice attorneys are starting to not name physicians as defendants when they can also name the hospital or the corporate physician group. Juries are sympathetic to physicians, they aren't to hospitals or corporations. It is also easier to deal with the corporation who writes one big check.
Interestingly, this case does not show up as filed under the New Mexico courts which should contain every court in the state (according to the website), and it also doesn't show up as a federal suit. (It would be difficult to figure out how it could be federal, and trial lawyers try to avoid federal judges like the plague.)
But since I am now retired and have nothing to do, I will check back on that in a day or two.
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I'm sure the docs are named, but the hospital has a much bigger malpractice cap than the docs. No lawyer in their right mind would ignore the systemic issues going on right now leading to massive delays in care when filing a suit. Hospitals insurer carriers are going to be paying up. And then when they find out what hospitals are doing to compensate for terrible staffing, there's going to be some hell to pay.
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Totally agree--they have a de facto qualified immunity but should absolutely be held responsible as part of the "team"
Especially since they "round" with staff nowadays
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Absolutely. Not sure why people celebrating. A doc or more are absolutely going down with this even though they likely had no idea this patient was even out there. Probably will just throw whatever doc the triage nurse used for orders under the bus
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I throw the hospital under the bus in my note whenever there is an egregious delay in care secondary to long waiting room times, radiology delays, consultant delays, etc.
Why should I suffer the consequences of a bad outcome or a patient complaint because of system issues beyond my control?
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"Patient in the ER for 12 hours waiting for xyz; care delayed secondary to abc [whatever it is, maybe the hospital decided to run one CT scanner today]. Patient very displeased with experience here today."
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One can only hope.
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I would be incredibly surprised if no (innocent) doctors are named in this. Incredibly surprised. Lawyers just add up the total potential policy limits and name everyone. Innocence is not part of the equation, in their eyes. It’s all about the total potential recovered amount. With a child amputee, they’re going to maximize that, wherever you’re liable or not. “Let the jury decide,” is what they hide behind.
Just playing devils advocate…
Doctor, can you tell us what exact steps you took to rectify this situation?
Based on what you charted it appears you knew that you were offering substandard care?
Doctor, did your inattenttion to all those problems you documented, that delayed my clients care, contribute to their injuries?
If you just payed attention to the problems doctor, they would not be injured today.
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"ER operations are not in the purview of my position. Those responsibilities lie with the department chair, and nursing manager."
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Probably filed in the US District Court of New Mexico. They're probably alleging an EMTALA violation, which the federal courts deal with. Can't say with certainty. Haven't used my PACER account to log in to search for US Courts records, and they have to mail my reset password by USPS (7-10 days).
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Is a PACER account free? Can anyone sign up?
I believe anyone can sign up, but they charge by the search up to $3 per search, depending on how many results are found with the search
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"No I do not staff the department and I do not hire nurses, PAs, techs, lab technicians, CT techs, xray techs, I don't also have any control and EMS coming in especially when we are listed as being on diversion."
"Are you saying that I shouldn't chart facts."
I checked PACER and it wasn't on that - as of yesterday.
Sort of.
PACER is a scam. There is talk about making the searches completely free, but Congress doesn't want to pony up the money to actually fund the operation of federal courts.
The cost is 10 cents per page, up to a $3 maximum for documents with some rare exceptions. HOWEVER, if you don't rack up $30 in a quarter (3 months), then you don't pay. So if you use it a lot for entertainment purposes, you need to keep an eye for your usage, because if it is up to $29.90 in a quarter, then your bill is $0, but if it is $30.10, then you pay that amount. That last search cost you $30.
But anyone can sign up for PACER. There is something similar called ECF that lawyers use to actually file documents, that obviously we can't get, but signing up for PACER is relatively easy.
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At one of my hospitals, there is a really bad habit of the charge nurse assigning doctors to patients in the waiting room who they think will be roomed next (soon could imply maybe an hour), many of them who have already eloped. It's cases like this that make me really concerned (and I was already pretty annoyed before) because you have a doctors named on record to patients they have no control over or saw. And if you get assigned a patient like this in the WR, you're even more ****ed than normal.
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There is also a chance that the filing was sealed because of the patient's age. Apparently the news outlets have access to court documents or they were forwarded to them.
Good point.
This is definitely the type of case they like to try in the "court of public opinion" first.
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Why would they do that and why has your medical director either stopped this or gotten themselves fired fighting it?
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I'm with you. People love to put disclaimers in their notes about dictation software, pandemics, staffing, etc. I've never seen them as anything that would protect you in court while definitely being things that can make you look less sympathetic to a jury. The above are just examples supporting that pitfall to me. Like I want to be talking on record strengthening arguments against the tasty, deep pockets of the hospital tied to my neck while explaining how Susie got crippled because "well, that's not my job".
My pandemic disclaimer specifically cited and used language from the 2014 Chest consensus statement for critical care in pandemics and disasters. If citing a national professional organization guideline doesn't provide any protection, then all guidelines for care are worthless.
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For me, it's moreso about fending off patient complaints, which are much more common and threatening to one's career than a malpractice suit.
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Yes.
Bad outcome + sympathetic plaintiff = $$$$$$$$
You didn’t really think a macro would save us, did you?
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But the guidelines exist period. I dont know why we need to post guidelines. Like do I need to post a guideline on why I'm not giving antibiotics to a viral URI? Guidelines help guide they are not the end all be all. People only post them for legal protection not to help other doctors who may read the note.
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The more you show you thought about the patient, the more sympathetic you'll be. If you can specifically cite evidence that what you're doing is "standard of care", the better plaintiff's lawyers will either pass or have to come at you from a different direction. Guidelines existing doesn't show you are aware of them and a plaintiff can always claim that you're retrospectively fabricating your MDM if it's not prospectively documented. That being said, I don't think spamming multiple obviously macro'd paragraphs is going to play as well with the jury even if it may make the lawyer's work harder.
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O
We are insured by the hospital where we work, I am not sure what the truth is, obviously “our” (also the hospitals ) legal has mixed motives.
Our legal has asked that we not use disclaimers like that, as they claim this would cause a lawyer to zero in on a case - something was definitely done wrong, here they are admitting they are doing something wrong - and doesn’t offer us any protection in return.
We are insured by the hospital where we work, I am not sure what the truth is, obviously “our” (also the hospitals ) legal has mixed motives.
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Please explain this to me. How is an obvious macro going to fend off patient complaints?
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When defendants (or potential defendants) start pointing fingers, that is is a telltale sign to an attorney, that they've got a good case. Usually, they hope you'll start doing it during depositions or at trial. But when you've already done it in writing in the chart, they know not only that they have a case, but that they've already won.
I don’t know. People still are hell bent on starting anaerobic coverage for friggin aspiration.
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Bring me this guideline.
“
Question 10: In the Inpatient Setting, Should Patients with Suspected Aspiration Pneumonia Receive Additional Anaerobic Coverage beyond Standard Empiric Treatment for CAP?
Recommendation
We suggest not routinely adding anaerobic coverage for suspected aspiration pneumonia unless lung abscess or empyema is suspected (conditional recommendation, very low quality of evidence).
Summary of the evidence
Aspiration is a common event, and as many as half of all adults aspirate during sleep (113). As a result, the true rate of aspiration pneumonia is difficult to quantify, and there is no definition that separates patients with aspiration pneumonia from all others diagnosed with pneumonia. Some have estimated that 5% to 15% of pneumonia hospitalizations are associated with aspiration (114). Rates are higher in populations admitted from nursing homes or extended care facilities (115).
Patients who aspirate gastric contents are considered to have aspiration pneumonitis. Many of these patients have resolution of symptoms within 24 to 48 hours and require only supportive treatment, without antibiotics (116).
Studies evaluating the microbiology of patients with aspiration pneumonia in the 1970s showed high rates of isolation of anaerobic organisms (117, 118); however, these studies often used trans-tracheal sampling and evaluated patients late in their disease course, two factors that may have contributed to a higher likelihood of identifying anaerobic organisms (114). Several studies of acute aspiration events in hospitalized patients have suggested that anaerobic bacteria do not play a major role in etiology (119–121).
With increasing rates of C. difficile infections (frequently associated with use of clindamycin), the question of adding empiric anaerobic coverage (clindamycin or β-lactam/β-lactamase inhibitors) in addition to routine CAP treatment in patients with suspected aspiration is an important one. However, there are no clinical trials comparing treatment regimens with and without anaerobic coverage for patients hospitalized with suspected aspiration. Most recent studies are small, retrospective, and provide only observational data on microbiologic patterns and treatment regimens for patients hospitalized with suspected aspiration pneumonia.
Rationale for the recommendation
Although older studies of patients with aspiration pneumonia showed high isolation rates of anaerobic organisms, more recent studies have shown that anaerobes are uncommon in patients hospitalized with suspected aspiration (119, 120). Increasing prevalence of antibiotic-resistant pathogens and complications of antibiotic use highlight the need for a treatment approach that avoids unnecessary use of antibiotics.
”
Joint Chest and IDSA guideline for community acquired pneumonia.
TL/DR:
You don’t need anaerobic coverage unless you have cavitation or an empyema. You likely don’t need any antibiotic coverage as it’s most commonly pneumonitis. Which, as inflammation, will still give you a leukocytosis and infiltrates.
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Sounds a lot like diverticulitis. Tough to get people to change practice in a world where everyone can envision getting smoked in a courtroom if there is a bad outcome associated with withholding of antibiotics (and where there is likely a long line of "experts" who will testify that GI/ID guidelines are meaningless compared some some imaginary "standard of care").
Sigh.
Admitted a young patient with a creatinine of 6, 3+ protein on the UA, single kidney (accident years ago). It looks either intrensic AKI or CKD. Patient also tested positive for HIV.
Talked to nephro and started lisinopril. I wonder how long that’s going to last because “ZOMG AcEi iS gOiNg To KiLl ThE kIdNeYs.”
