15 September 2006

This is why we move the meat

Our waiting room is always full, or at least it seems like it. Sometimes the nurses and hospital docs get a little miffed at me when I am pushing hard to get patients out of the ED as fast as possible. I don't look for a diagnosis quite so much as a disposition, and once there, I try to move the patient and get the next one back.

And this is why. Bad things happen in the waiting room. Apparently a runaway jury has decided to upgrade it from malpractice to homicide. Great. It won't stand, but it does usefully reinforce the point that I like to make: Quality ER care is of necessity Timely ER care.

Patient's Heart Attack In Hospital Waiting Room Is a Homicide
Coroner's Inquest Followed Death Afer 2-Hour Wait in ER
September 14, 2006

The official ruling by a coroner's jury in Lake County, Illinois that the cause of death for a 49 year-old patient who died in a nearby medical center was the "result of gross deviations from the standard of care that a reasonable person would have exercised in this situation." The jury determined that the patient's 2-hour wait in the hospital's emergency room was a homicide.


  1. Hey! What are you doing. This story begins with:

    A coroner's jury has declared the death of a heart attack victim who spent almost two hours in a hospital waiting room to be a homicide.

    You wrote:

    Apparently a runaway jury has decided to upgrade it from malpractice to homicide.

    By "runaway jury" do you mean appointed state scientists sitting in a panel? Because "runaway jury" is usually tied with "activist judges" and other fictious characters. The article says they don't know whether a runaway prosecutor will bring charges.

    It also didn't say whether anyone had brought a wrongful death action against the hospital--although they obviously will. But the story from the link is about a decision by your fellow scientists, bro.

  2. I presumed that a "coroner's jury" was a lay jury empaneled to decide a question posed by a coroner. To be quite honest, I have never even heard of the concept, anywhere, before this article. In my limited experience, the coroner or medical examiner makes an independent determination of the cause of death on their own medical judgement.

    Regardless, I think the coroner (or jury) overstepped their bounds by calling this death a homicide. The cause of death is coronary thrombosis and myocardial infarction. That is a natural cause of death. If the circumstances surrounding the death constituted medical malpractice and possibility criminal negligence, IMHO that determination should be made by a prosecutor and jury, not the coroner.

  3. I think the differences between cause and manner of death needs some definition (at least for me).

    "Cause of death" is usually a medical definition -- in this case an "Acute Coronary Thrombosis". I'm guessing this is the proximate cause while the dependant cause was "Myocardial Infarction", but the medical distinction of a heart attack is fuzzy to me. In an AIDS death, for instance, the dependant cause of death is AIDS, and the proximate cause is usually something like hypoxia due to pneumonia. So that's 'cause' as I understand it.

    Then there's "manner of death" which is usually a legal distinction like "natural", "homocide", "accidental", "suicide", and perhaps there's an unknown or misc. category as well.

    What these jurors have decided based on the verdict form I read seems to be a medical determination of cause of death of heart attack and manner of death as homocide. It seems strange to me that they didn't write in "negligence" since I can't imagine a more textbook example of what most people would consider a negligence case.

    I know this might seem a pedantic recitation, but it doesn't serve to get caught up in her heart attack when it's the neglect in the waiting room that is the real issue.

  4. First off: I was totally wrong about what a coroner's jury is. It evidently involves lay people recieving testimony from a coroner.

    Regarding criminal negligence: If criminal negligence causes a death, it is a homicide. (That is an unlawful killing of a person.) It is not murder, which varies from state to state on the exact identification. Homicide is unlawfully causing the death of another person. Murder usually adds intentional, or with malice, or with premeditation. And some codes talk about degrees of murder and manslaughter.

    Labeling it homicide may be less of a big deal than you think.

  5. I'm curious about who was charged with the homicide, was it the Triage nurse? The Charge nurse? The Ed physician? The Hospital?

  6. Who was charged with the homicide? The triage nurse? The charge nurse? The physicians working that day? The hospital?

  7. I don't believe a coroner's inquest would charge anybody. They just determine whether the death was natural, accidental, homicide, or whatever.

    "Who dunnit" comes from the prosecution.


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