Notes : Abused In Tufts Med Ctr ED Outline (Raw and Draft)

MACD

Case for Racial Discrimination
Assumption that I was drunk  -despite me telling the doctor I  was very tired so I stayed in Boston, I had a glass of wine with dinner and took my Klonopin.  They did not inquire how much klonopin or investigate or consider that the klonopin was kicking in and was responsible for me not being able to open my eyes or keep my head up
If I was under the influence the standard of care is that I cannot sign our AMA but ER physician was willing to allow it.
It was the security guards that convinced me and showed concern for the back that I was spitting up blood
In addition, a full evaluation is required before that determination can be made.  They never did a head CT despite the obvious trauma to my head.  How could they then allow me to sign out AMA.
In not doing a head ct, again they deviated from usual protocol
Pain medication was unduly and unjustiable delayed consider the obvious fractures, which after x-ray were considered severe requiring surgery.
Standard of care dictates relief of pain
No one performed a pain scale to determine the severity of my pain
Despite my repeated request for medication. I even asked for Tylenol and was told I may be going to surgery that night
Again documenting they knew my injuries were severe yet denied me immediate relief of my pain
My elevated Blood pressure was another sign they ignored
They all stood and looked at me discussing my BP but never treated
Entertain it was due to the intense pain I was experiencing
That this pain was driving me crazy
Standard of care dedicates
At my age, presenting with facial trauma after a fall a Head CT is mandatory that was not performed
An EKG to evaluate for stroke given my elevated bp and evidence of chest contusion
Instead they berated me
I told them I was a physician, trying to make them understand I knew my rights and I knew what was standard of care
One of the staff, said they were tired of hearing about my credentials
Another stated they were not impressed
They left me alone in the room until I was evaluated by ENT and much later given pain medication
They asked if I could sit in a wheel chair for some xray and I said no, my head was about to explode and I was tired.
They ignored my remark, placed me in a wheel chair, the nurse yelled at me because I put my head down while in the wheel chair; she even yelled when I tried to lie my head on the arm rest.
I could not hold my head up for 30 sec yet and so the scan was not performed
On returning I noticed the bed sheets were covered in  blood stain
I commented on this and when I noticed they did not care and were going to have me lie on that blood stained sheet. I asked for another sheet.
And they watched as my friend and I changed the linen.
When finally I was given pain medication which was hours into my stay
I commented on the rudeness of the nurse and she said okay I will not give you any pain medication
My friends husband had to beg her to return and he asked me not to say anything to her
She would have let me continue in pain
I requested some water:
They said I may go to the OR
They knew I was not going to the OR
If I was not aware of wipes to moisten your lips in situations like this I would have continued bare another discomfort  with my pain, the shock of the trauma,
the of facial deformity, the fear of my teeth, and questions regarding the fall
My friend left at 3:30am, he was told I would be going to the floor shortly.
I feel asleep and woke up at ~7am in the ER covered in vomit and surrounded by2  basins with blood and my handbag above my head.  The sheet barely covering the gurney
Of note on leaving the hospital I was bitten by bed bugs and had bites on my arms
That nurse never checked on me:
A pt with elevated blood pressure
Signs of head trauma

Change of shift – no one could tell me why I was still in the ER
I noted the adjacent  the patient had left and a new patient who received considerable more attention than I did
That patient wanted to be admitted to the hospital and he received attention.
At one pt there were 4 people in the room from different service- they were not residents
He was went up to the floor and I was still in the ER
No one provided any justification
My High School  son’s advisor drove him to the hospital.
At one oclock when he arrived I had asked the nurse for pain med an hour early
He was upset that I was in pain and everyone was ignoring me
He went out to the nursing station to request medication
30-45 minutes later I received pain med (took almost 2 hours after my request)
That morning I called to speak with the hospital administrator regarding my care and left a detailed message
No one returned my call
I called again at mid morning and heard the message that the person was not in the office that day
I called my insurance co to complain while my son went to the nurses states to inquire as to when I would get a bed on the floor
Less than 20 minutes later they have a bed for me.
Almost simultaneously the OR is ready for me
Prior to the surgery- the  OR nurses were upset that a consent form was not signed
A consent form is  standard of care
The resident informed her that it was okay, she spoke with her supervisor and the resident came and got the consent form
I realized I was going to the OR without seen an actual attending I had grave concerns about them doing surgery on my face
I requested to see the attending
That resulted in a delay
He stated he would be present throughout the surgery

On the floor the nurses changed my linen
Helped me to the bathroom
Asked me if I was in pain, assessed my level of pain
Helped me
They were kind and caring
I was given my d/c instructions by the nurse
I never saw the attending again
I was treated as if I was non-paying patient, a clinic patient
Constrast that with the care and attention received by my room mates in the ER who were white
I was not provided any information about the details of the surgery
No one mentioned the nerve that was causing my numbness
One day later as I was having severe facial spasm, I began to cut the sutures that wired my upper and lower teeth
The surgeon on call stated it was normal and not to cut anymore
They had not provided enough pain medication
No one from the administrative staff returned my call
I requested medical records , was told I had to call on weekdays a
Was told by medical records I had to complete the form which was available on line
I completed the form and when I did not receive the records after 2 weeks I called and was told I had to pay for the records
I spoke with someone in medical records who did not inform me of this
no where on the form is this information stated.
If I had not called I would still be waiting for this
I followed up at MGH and Dr Dobson required the records as I continue to has numbness in rt lower lip chin and teeth
As a request of poor quality care and discrimination I suffered in the ER, I continue to have problems
There outward and bold mockery of me (at a time when I was in pain and they knew of my trauma) displayed discrimination on the basis on race and socio-economic status
The ER nurse and accompany staff were racist and took advantage of my need for help by inflicting emotional and physical trauma
Their discriminatory behavior resulted in me not being thoroughly evaluated and therefore have to undergo further evaluation which should have been done in the ER
They ignored the IV and did not start fluids immediately.  In the 14-18 hours I was in the ER I urinated twice without any help from the nurses.  Only the security guards helped.
My roommate who did not require admission received help on going to the bathroom
He yelled and a nurse immediately came
I pressed the call button and waited and had to have my friend go to the nurses station

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Author: Angela Grant

Angela Grant is a medical doctor. For 22 years, she practiced emergency medicine and internal medicine. She studied for one year at Harvard T. H Chan School Of Public Health. She writes about culture, race, and health.

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