When you are in the throes of an emergency medical condition such as a heart attack or a stroke, you want an ambulance to arrive quickly, and take you to the nearest hospital for treatment. Thanks to the quietly-kept practice of ambulance diversion, you may not get the help you need in time.
Ambulance diversion seeks to manage the overcrowding of emergency departments by redirecting emergencies to another hospital. Health Data.gov explains that ambulance diversion occurs when a hospital’s ER is unable to care for more patients. The ER goes “on diversion,” and ambulances are re-directed to another hospital or medical facility.
The problem with this practice, of course, it that it doesn’t always work. The Journal Sentinel reports that several studies have found diversion fails to solve ER overcrowding, and it puts patients at risk by delaying care. Delaying treatment can be deadly, and the act of diverting an ambulance could be construed as medical negligence if the patients’ injuries or illnesses are exacerbated as a result.
An example of ambulance diversion turned deadly
USA Today reported the story of a Wisconsin woman who had a stroke while she was at work in the cafeteria of a medical center located 350 yards from Froedert Hospital, the area’s most advanced stroke center. For every moment blood flow is being choked off by a blood clot, as occurs during a stroke, the brain is losing vital oxygen. This damages cells and can cause brain damage, paralysis, and the loss of the ability to speak or see. It is critical to send a patient who is having a stroke to the nearest stroke center or hospital, so that the patient can receive clot-busting drugs or a surgical procedure to remove the clots offers the best chance of survival.
But Froedert Hospital’s ER turned the woman away. Instead, they sent her to a hospital three miles away which only offers limited stroke care.
Three and a half hours after her first stroke symptoms occurred, the patient arrived at another hospital. They performed a procedure to remove a clot, but the procedure failed. The woman died because she was refused admittance to a stroke specialist center which was steps away from where she fell ill.
Don’t Emergency Rooms have to admit patients?
Under federal law, hospitals must treat every patient who arrives in the emergency department, and make sure that those patients are stable before they can be transferred or released. This law does not apply to patients in an ambulance, however, which is banned from bringing the patient to the ER.
Has South Carolina found a solution for ambulance diversion practices?
In a study published in the Annals of Emergency Medicine, researchers studied the effects of the Massachusetts law (the only statewide law in the country) banning ER diversion and found a collaborative ambulance diversion policy that has been in effect in Charleston County for many years. With seven emergency departments, Charleston’s 911 response is provided solely by the Charleston County Emergency Medical Service, which is a division of county government. Prior to 1989, ERs diverted ambulances at will. Then the ER physicians realized that these practices were detrimental to ambulance patients.
The ER doctors from regional hospitals met and developed a diversion policy that was implemented in 1989: once an Emergency Department was contacted by an ambulance, that Department must provide care to the patient itself, or arrange for another hospital to do so. If the Department needed to divert an ambulance, it must arrange with a physician at another facility to accept the patient. If no other hospital will accept the patient, then the ambulance proceeds to the original hospital.
Charleston County’s emergency room physicians and administrators saw a problem and took steps to rectify it, but there are no laws in South Carolina mandating that all hospitals follow suit. Until there are, people may end up dying needlessly.
At McGowan, Hood & Felder, LLC, our South Carolina medical malpractice attorneys understand the devastating consequences of death or serious injury because of an act of negligence. To schedule a free consultation to discuss your case, please call 803-327-7800 or fill out our contact form today.