Wednesday, Aug. 20, 2008

Family questions diagnosis, care by Mercy ER doctors

Physicians sent woman home, then she died in the hospital the next day.

By CAROL REITER
creiter@mercedsun-star.com

A Merced woman who came to Mercy Medical Center Merced with chest and abdominal pains on Friday was sent home by physicians.

She died early the next morning.

Charlotte Brown, 47, came to the emergency room at about 10:30 a.m. after she had gotten sick at home. She was brought in by ambulance, then told the emergency room physicians that she had pain in her chest and belly.

"I was talking to her on the phone, and she said she was sick and had to call an ambulance," said her daughter, Jana Bridges of Modesto.

Brown's boyfriend, George Warren, was with Brown at the hospital. He told Bridges by phone that the doctors were running tests on Brown.

Among the tests done Friday was a computed tomography (CT) scan. After it was done, Warren said a nurse came into the room and told Brown that "'she was a very sick woman and had to be medi-flighted to a hospital that could take of her.'"

Then a doctor came in and told Brown and Warren that they had thought that Brown had an aortic aneurysm, but that it had only been "a glitch in the machine."

According to the Mayo Clinic, an aortic aneurysm is a weakened and bulging area in the aorta, the major blood vessel that feeds blood to the body. The aorta is about the thickness of a garden hose and runs through the center of the body. If the aneurysm bursts, a person can bleed to death in minutes.

Mercy is a part of Catholic Healthcare West, a California not-for-profit public benefit corporation that operates 43 hospitals in California, Arizona and Nevada. Because it is not-for-profit, it's exempt from federal and state income taxes. CHW is the eighth-largest hospital system in the nation and the largest not-for-profit hospital provider in California.

Mercy San Juan Medical Center, a CHW hospital in Sacramento, had a similar experience happen last Friday. A 51-year-old Bay Area man came to the emergency room with chest pains, sat and waited to be seen for two hours and died on the emergency room floor of an aneurysm.

Friday afternoon, Brown was told by doctors that when her high blood pressure came down, she could go home.

"They called my aunt to pick her up at 10:30 p.m. -- she was there about 12 hours," said Bridges.

When Brown went home, she went to bed. Warren said she moaned all night long. When he went in the next morning to check her, she wasn't breathing.

"They called me and said they couldn't get a heartbeat," Bridges said. Despite both Warren and the paramedics doing CPR, Brown had no heartbeat when she got to the hospital.

Bridges' aunt, Becky Johnson, went to the hospital when Brown was returned on Saturday morning. "They got a heartbeat back, then they moved her up to an intensive care room," Johnson said. Once Brown was in intensive care, she "coded" again (no heartbeat, no respiration), and Bridges was told to go in the room to say goodbye to her mother.

"I was in there with her, and then the doctors came in and told me they were going to do blood transfusions and get her to Modesto," Bridges said. "One minute they were telling me to say goodbye to her, and then they give me that little bit of hope."

But Brown coded again, and this time Bridges tearfully told the doctors to stop.

Johnson said that while Brown was in the intensive care unit, three doctors came in and told her and Warren that Brown had an aortic aneurysm, that she was bleeding into her abdomen. They explained to Johnson why Brown probably wouldn't make it. Another CT scan had been done Saturday morning, and the aneurysm was confirmed, Johnson said.

Mercy contracts with an emergency physicians' group to do emergency care at the hospital. Valley Emergency Physicians Medical Group has been in Mercy's ER for the past three years, and they claim to have brought patient satisfaction up during that time.

Robert McLaughlin, spokesman for Mercy, said, "Our preliminary review of the case shows the patient was treated promptly and provided care and diagnostic testing by several members of our medical staff."

Because of patient confidentiality, McLaughlin said he couldn't discuss the case further.

Bridges and Johnson both said Brown had many illnesses, including lupus and rheumatoid arthritis.

"It wasn't her sicknesses that took her -- it was the ignorance of the doctor," Johnson said. "He decided to send her home and hoped she would be OK."

Both Johnson and Bridges said Brown was a frequent visitor to the emergency room because of her illnesses and because she had no medical insurance. They both believe that those facts made a difference in how Brown was treated.

"They get to the point they don't care anymore," Johnson said. "No matter how many times people go to the ER, they can't just push them under the rug. It seems like they thought, 'Here we go again, let's get her something and get her out of here.'"

"I just don't want my mom's death to be in vain," Bridges said. "She was a very giving person, she wouldn't have let this happen to someone else."

McClaughlin said the hospital's thoughts and prayers are with Brown's family.

Reporter Carol Reiter can be reached (209) 385-2486 or creiter@mercedsun-star.com.