HEALTH CARE:

Patient’s paperwork came first

Witnesses say they were shocked; hospital’s experts say staff did what they could

COURTESY OF SCHEINBAUM FAMILY

Linda Scheinbaum has sued over the death of her ex-husband, Morton. She says she doesn’t care that she may not be able to collect any money because they had divorced.

By Marshall Allen (contact)

Sunday, Aug. 24, 2008 | 2 a.m.

National Public Radio: In The ER, Unhealthy Premium On Insurance Data (8-21-2008)
The Associated Press: Average ER waiting time nears 1 hour, CDC says (8-6-2008)

Morton Scheinbaum was moaning, his head resting on a desk, as he strained to answer the emergency room nurse’s questions.

He was in the throes of a fatal heart attack.

But even as Linda Scheinbaum — Morton’s wife of 24 years — was screaming for medical attention to save his life, the MountainView Hospital nurse was insisting on getting his Social Security number, emergency contact and insurance information.

“I’ll give you all the information later!” Linda Scheinbaum yelled at the clerk.

In fact, the northwest Las Vegas hospital had his records because Morton, 59, had been treated there for a heart attack a week before.

It would be Scheinbaum’s tragic misfortune to return to the emergency room on the night of Nov. 4, 2005, when it was busy and hospital officials said there were no open rooms. The Scheinbaums were told to take a seat and wait — even though a delay of just minutes can make the difference between life and death during a heart attack.

Dr. John MacGregor, a cardiologist at San Francisco General Hospital, would say later that Scheinbaum should have been rushed immediately into the emergency room for treatment. And emergency room bystanders would testify to their shock that the hospital staff failed to take his condition seriously.

The precise timeline of the events of that desperate night is in dispute, but hospital records show that it was at least 41 minutes from the time Morton Scheinbaum arrived to the time he collapsed, blue in the face and foaming at the mouth. Only then was he rushed into the emergency room for treatment.

And that’s where he died, his admission paperwork completed.

Linda Scheinbaum claims nearly an hour had passed from the time her husband arrived at the hospital in serious distress — sure that he was having a heart attack — to the time he received treatment.

She and Wendy Cannon, Morton’s daughter from a previous relationship, are suing the hospital for malpractice. Scheinbaum said she may never see a penny from the lawsuit because she and Morton divorced in 2002 to insulate her from his debt. She doesn’t care about money, she says.

“I want justice,” she said, her voice shaking. “He was left to die on the floor of the emergency room and just didn’t have a chance.”

The lawsuit is scheduled for trial in January. The evidence unearthed so far highlights the direct connection between hospital staffing and patient care. It also shows how MountainView responds — or doesn’t — to unexpected deaths. Hospital administrators concluded Scheinbaum’s death did not reach the level of a “sentinel event” — a classification that requires notification of the state and corrective action to ensure such incidents are not repeated.

An attorney representing MountainView, which is owned by the Tennessee-based Hospital Corporation of America, said neither he, hospital officials nor the nurse would comment for this story.

Morton Scheinbaum’s heart problems were genetic. He had his first heart attack when he was 31. He had the first of two five-vessel bypass surgeries in 1986, two years before he moved from Northern California to Las Vegas, where he worked in the moving business.

The couple had been in and out of emergency rooms over the years because of Morton’s heart condition. They had no complaints about the care they received for a heart attack on Oct. 25, 2005, when he was treated at MountainView for the same symptoms that led to his death a week later. When he was released, he was told to return immediately if he noticed any other problems.

A week later, on the night of the fatal heart attack, Linda went to bed early. When Morton roused her to go to the hospital she looked at the clock. It was 10 p.m.

They didn’t call an ambulance because the situation didn’t seem that dire. His heart was fluttering irregularly, just as it had the week before when they went to MountainView. She grabbed the already packed bag and quickly drove the 2.6 miles to MountainView.

Linda says they walked into the emergency room at 10:15 p.m., though there is no record of their exact time of arrival. Lanny Waite, her attorney, said security cameras in the emergency room have since been reused, destroying any possible time-stamped video evidence of their arrival.

In her deposition, Linda said that when she called her stepdaughter Wendy from the hospital, she looked at the clock and it read 10:20 p.m.

Linda said she told a woman who she thought was an admitting clerk that Morton was a heart patient suffering from chest pains, and that they needed to see a triage nurse. They were told to take a seat and wait their turn, she said.

Waite says the admitting clerk was actually a nurse, May Taylor, who was alone in the admitting and triage area and busy with another patient when the Scheinbaums sat at the other side of her cubicle. It’s unclear why a nurse would be doing admissions, Waite said.

Hospital records note that the Scheinbaums arrived about 10:30 p.m. and that Taylor started the triage process at 10:42 p.m.

While Scheinbaum waited to be administered an electrocardiogram, a test that measures heart function, Taylor took down information. That’s when Linda recalls Morton’s leaning over the desk, moaning, while they repeated the information they had given on their previous visit.

By now hysterical, Linda was pointing to a sign that says patients with chest pain should notify hospital officials so they can be attended to immediately.

Indeed, there seems to be no dispute that the nurse was putting paperwork ahead of treating Morton Scheinbaum. In her deposition, Taylor recalled Linda Scheinbaum “screaming and yelling saying that her husband is having chest pain” and that she had to “calm this screaming wife before she can settle down and give us the information.”

The doctor read the EKG results at 10:50 p.m., and signed it with an instruction: “Bring back now,” underlining the word “now.”

But that did not happen. After his EKG, Scheinbaum continued waiting in the admitting area, because hospital officials said there were no beds available.

By now, the crisis was reaching a crescendo. Sitting in the chair, Scheinbaum grabbed his chest and said, “Oh my God, here it comes!”

Witnesses told Linda afterward they would never forget her bloodcurdling screams. “Someone get me some help! He’s having a heart attack!” she remembers shouting.

A nurse ran from the back with a wheelchair, and they put him, slumping, into it. But when she pulled him back, he fell to the floor and landed on his face. Hospital staff loaded Scheinbaum onto a gurney and got him into the emergency room. Hospital records show they started lifesaving efforts at 11:12 p.m. — 22 minutes after the doctor wrote “Bring back now” on the EKG record and 42 minutes after hospital officials estimate he arrived.

With efforts to save him with drugs and CPR failing, Linda — now joined by Wendy Cannon — was called to Morton’s bedside to say goodbye. She said he turned his head toward her.

“You can let go, it’s OK,” Linda recalls saying. “You’re tired of the struggle. You held on as long as you could.”

He was pronounced dead at midnight.

As Linda Scheinbaum and her daughter staggered in shock from the facility, they were approached by a woman who said she had witnessed how they were treated. The woman was joined by others who said they also would be witnesses in case there was ever a lawsuit against MountainView.

Margo Williams, one of the witnesses, wrote in her affidavit: “After being in the emergency room area for approximately an hour to an hour and 15 minutes, Mr. Scheinbaum collapsed, and Mrs. Scheinbaum was screaming for help. I, along with many others in the waiting room, was shocked by the apparent lack of concern by hospital staff for Mr. Scheinbaum’s insistent complaints about chest pain and a possible heart attack.”

Another witness, Anita Troy, said she was “shocked by the nasty, nonchalant and uncaring attitude of the hospital staff. Mrs. Scheinbaum repeatedly told them of her husband’s heart problems, and pleaded for help. However, it appeared that the staff did not care.”

MacGregor, the cardiologist serving as an expert witness for the family, said in a deposition that hospital employees should have skipped the EKG and immediately taken Scheinbaum into the emergency room. The patient had a history of heart problems and a recent heart attack, and was suffering from “classic symptoms of cardiac instability,” MacGregor said.

“So I think it would have to be extraordinary — you know, like a bomb going off in the emergency room — to mitigate not bringing such a patient back right away and getting them medically seen and stabilized,” MacGregor said.

Physicians who reviewed the case for the defense say the hospital employees did everything they could to save Scheinbaum’s life.

The Scheinbaum family learned later that four of the emergency room’s 22 beds were free that night, but the hospital had chosen not to use them.

“Based on the anticipated census it was predicted that 18 rooms would be sufficient to handle the anticipated load that evening,” the hospital’s attorneys wrote.

In addition, hospital records show that some of the 18 beds might have been occupied by patients whose conditions were not as critical as Morton Scheinbaum’s. One patient, for example, was suffering from acute abdominal pain caused by constipation.

Discussion: 22 comments so far…

By VegasMD

8/24/08 at 2:16 a.m.

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Wow. Anyone who has ever seen the inside of a hospital knows that chest pain patients get fast-tracked into a monitor bed. The saying is "time is myocardium"..
By neiman1

8/24/08 at 3:05 a.m.

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This needs a criminal investigation, not a civil or administrative one.
By Lenny_V

8/24/08 at 5:36 a.m.

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This is BS. What the f is wrong with these hospital employees? I can tell you right now, if that was my dad who was left to die, I would be sending the idiots responsible to the after-life.
By teacher

8/24/08 at 9:24 a.m.

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There seems to be an increasing sense among employees who work with the public that there is NEVER, EVER a reason to raise your voice, and that if you do, you must be a whack job who may be treated with disdain -in this case, disdain that killed.

This is certainly not the first case of something like this happening in an emergency room. Obviously there is something enormously wrong with a medical system where the profit motive is the driving force. Americans need to wake up and take a clue from other systems. That requires paying attention, educating yourself about candidates before you vote, becoming aware of what goes on in other places, etc., rather than listening to politicians who will simply carry on the status quo. And that's a problem. It is a whole society whirling out of whack - take it from a teacher! - and people need to wake up, stop shouting blame (as people will at this nurse- which she deserves, but she's got a huge, broken system behind her), and actually start working at trying to effect change, rather than looking for somebody to provide an easy way out.
By gmag39

8/24/08 at 9:26 a.m.

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By GOD, we're sure glad your God because you are quite the judger. Now; how's about making ONE post that doesn't include derogatory political commentary. This was not political, it was criminal.
By hilda

8/24/08 at 10 a.m.

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By GOD you are sooo right!! Been there-done that!!

It does not matter to hospital staff what your medical emergency is....all they want is proof of payment.... it is the hospitals policy since so many come in for treatment that do not/cannot/will not pay for services received. It is 'show me the money' before any service is rendered or any admitting is done.
By PEG

8/24/08 at 10:10 a.m.

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I agree with what the teacher said 100%
This problem is not a new problem, it has gone on for years,everywhere, even the best of the best.
However, there is a triage nurse for a reason, to triage the patient that is sicker than others and/or that requires immediate attention. There is NO excuse that a person with chest pain has to wait, under any circumstances. It is a known priority for any medical facility, especially an emergency room to take chest pain very seriously.
After all, it is the #1 killer...
By NevadaFive

8/24/08 at 10:59 a.m.

Comment removed by staff.
By lasvegan2008

8/24/08 at 12:12 p.m.

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Wake up, people of Las Vegas

It is important that the people in Las Vegas demand of their prominent members of the community to take health care provision seriously. It is these prominent members of the community who come to you when they need you help i.e., vote. At that time they promise you health care, the sun and the moon. Go to the prominent members of this society and ask them to put right, the wrong which has been going on for many years in Las Vegas

Let me also advice, you the readers, that the health care situation in Las Vegas is so dire, that until and unless we as citizens of Las Vegas stand up and demand the care we deserve, of which we pay through our tax dollars, we will not get this care.

The article, ‘Patient’s paper work came first’, was a tragedy waiting to happen. The medical care in Las Vegas is full of complacent and irresponsible nurses, doctors and other medical staffing. The CEO’s, administrative staff and insurance companies sole purpose is to make money by cutting corners. Their day to day decisions, does not and never did, take in to account patient care. It is money that is counted at the end of the day.

Nurses do not provide the care they are trained for, doctors provide, looks good from the door, (more commonly called LGFD in medical community in Las Vegas) consultations. This associated with complacent, irresponsible medical staff, money making schemes of the CEO’s and insurance companies, at the expense of patient care, is a time bomb waiting to explode. There are many such time bombs exploding, if not frequently, it is also not infrequent. It is just that 90% of such incidences are not reported in the news.

To the people of Las Vegas, medical care is your right. Get up there and demand it. The experience of Schienbaum’s is not the first of it’s kind, neither is it the last. We need to stop such injustices.

I have many examples of the way hospitals, doctors, nurses etc., conduct their business, that without exaggeration I could write a book on this topic. Believe me that if I write such a book, the powerful medical mafia in Las Vegas will see to it that I be put down, as many will be exposed.
Good Luck
By lswaaley

8/24/08 at 1:04 p.m.

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Any licenses of the hospital employees involved need to be revoked and there needs to be criminal charges filed. Most hospitals understand that they are going to be paid or reimbursed or have a tax write-off etc. If this based on the corporate or administrators guidelines, then criminal charges also need to be filed against them. What would happen if they (employees, corporate or administrators) were the patient in the hospital dying in the Emergency Room.
By Sjohnson

8/24/08 at 2:10 p.m.

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In response to lswaaley’s writing, and I quote, ‘If this based on the corporate or administrators guidelines, then criminal charges also need to be filed against them. What would happen if they (employees, corporate or administrators) were the patient in the hospital dying in the Emergency Room’, unquote.

The written guidelines are in most cases correct and 99% foolproof. Following such guidelines will provide very good care but requires well trained medical staffing and expenses. While one can get well trained medical staffing within the country (and there are many at present, working in Las Vegas), and from outside USA, what is not available is the will of hospital CEO’s, administrators, and people who make policies for the community, like health legislative council etc, to do what is right.

By not fully implementing guidelines, the hospital saves money and so makes money. The priority of hospitals and insurance companies in our country, the USA, is making money, and to do that, compromises are made. Obviously, instruction’s which compromises patient care on a day to day basis are not done in writing, hence it is hard to prove, should one think of taking these people to justice. Having said that, where there is a will there is a way.

The agencies which monitor health care are rife with corruption. Examples of such are the recent expose in this newspaper of blatant and open abuse of foreign doctors, in Las Vegas. There is proof that the monitoring agencies were more than aware but corrupt officials looked away. Hepatitis scare: This situation arose with the knowledge of medical personnel all over Las Vegas, not only that, but Dr. Death and other doctors who worked with him were members of monitoring agencies, agencies who are supposed to monitor such matters. It is free for all in Las Vegas, with the blessing of corruption.

To what would happen if they (employees, corporate or administrators) were the patient in the hospital dying in the Emergency Room.
What would happen is this. The nursing administration will go on red alert, so nursing care will be provided. The doctors will be making frequent rounds. Other medical personnel, inclusive of nurses and doctors, would be wagging their tails in front of CEO’s, Politicians etc. Let me assure you that, most of the people you talk about, do not get their medical care in Las Vegas. For example, if a politician were to need medical care, the Federal Government pays for their choice of medical facility and all who serve Las Vegas, go elsewhere. If the government were to say, you serve Las Vegas, get your medical care in Las Vegas, you will see how quickly changes would be made.

So this is how the situation is. We the population of Las Vegas have power. We unfortunately accept such treatment of us, without even raising an eyebrow.
By lasvegan2008

8/24/08 at 2:17 p.m.

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Trust me, ‘If we do not take care of ourselves, nobody will take care of us’. I say this, as I have learn't from experiences of life.
By will

8/24/08 at 3:10 p.m.

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Linda divorced Morton in 2002 to insulate her from his debt.

The nurse used his Social Security Number for identity verification.

MountainView had his information (read: insurance and credit history) from a week earlier.

Heart attacks are deadly and treating them (successfully or not) is very expensive.

Morton couldn't pay...

Linda wasn't obligated (see above).

Unprofitable hospitals close their emergency rooms.

Doctors siphon profitable procedures off to private clinics.

Insurance companies and credit bureaus have an effect on patient outcomes.

There will be no satisfactory outcome.

May Mr. Scheinbaum rest in peace.
By mikeg

8/24/08 at 9:14 p.m.

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Will, I don't think the problem was really money here. Hospitals bring in plenty of money, and they could have treated this man without going broke.

Honestly, have you ever met a doctor who worked full time who made less than $200,000 a year? Didn't think so, so stop apologizing for their greed.
By Planetearthcalling

8/25/08 at 1:02 a.m.

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Medical care in las vegas really is atrocious and something should be done about it.

Seriously.
By lindascheinbaum

8/25/08 at 6:38 a.m.

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On behalf of Wendy Cannon and myself, We would like to thank Marshall Allen for telling our story. I have looked over the comments, I thank all you good people in Las Vegas for your concern and interest in our nightmare story. No matter the outcome of our DAY IN COURT, Mort Scheinbaum was given a chance for his story to be heard. He is smilling, that is for sure. I do
hope the attention from Morts tragedy brings attention to everyone, anywhere, be alert and demand your loved ones are taken care of in the manor we all deserve. And pay our health benifits for this service, or lack of in Morts sutition.
Last comment, I beleive only God has the right to take a life. Mt. View Hospital took his life
from him and our family. SOMEONE must be held accountable !!
From the bottom of my heart, thank you all.
By Iliacus

8/25/08 at 7:12 a.m.

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It seems as if this was a tragedy that could have been avoided if there were an extra bed for this gentleman. Inebriated illegal Mexican immigrants, who don't pay taxes, surely occupied the majority of these beds. Don't believe me? Why do you think most of these construction workers (aka illegals) keep falling off these construction sites? Drinking on the job, that's why. This immigrant segment is prone to criminal activity, and are flooding our schools with their uneducated children. These people, who are blatantly disrespectful to the country that gladly harbors them, have no positive social significance, and should be treated accordingly. US flag burning. Refusing to speak English. Putting a negative economic burden on our society by not paying taxes and at the same time abusing the welfare system. This can no longer continue. Today's feature article about the majority of Nevadans wanting to prosecute places that harbor these parasites is a step in the right direction.
By littlerosecon

8/25/08 at 5:33 p.m.

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I agree that someone, or many, should be held accountable and face criminal malpractice. A nurse should certainly have known better than to do what she did. Next time, it might be you or I, or your husband, or father.... Think about it! It's time for an attitude adjustment!
By lasvegan2008

8/26/08 at 11:21 a.m.

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First thing which went wrong, unfortunately, whatever be the reason was that ambulance was not used.
Advantages for using ambulance: 1. Patient is quickly assessed by emergency trained personnel and made comfortable 2. Information about the condition of the patient is conveyed to the nurses and doctors of the receiving hospital. This gives a head start to the medical personnel in the receiving hospital and as soon as the patient arrives at the hospital, medical personnel, with background information, quickly start the process of taking care of the patient. Quick and immediate resuscitation greatly increases recovery and survival rate.

Second issue is of the triage nurse. A triage nurse is a person who is placed in this service because of his/her knowledge, skill and experience. The knowledge, skill and experience renders him/her the ability to quickly and urgently assess a patient’s clinical status and send the patient to the appropriate area of care.

Assuming that the triage nurse fulfilled the above criteria, than the question arises, what was the reason that the nurse did not send this patient to the resuscitation area, rather take the patient to triage area. Was the patient taken to the triage area as a matter of hospital policy or the nurse failed to assess the urgency of the patient’s clinical status or nurse could not transfer the patient to a bed, as non emergency patient beds or resuscitation area beds were not available. For all of the above, hospital must be held responsible.

Nurse doing the work of a receptionist: Nurses and other medical staff, including at times doctors, are placed in an awkward situation by the nursing administration, of taking on work of others. If cooperation is not provided than the nursing administration/ hospital administration personnel start talking about how uncooperative this or that nurse / personnel is or was. This kind of pressure brought on by the nursing administration and hospital administration is particularly hard on the nurses. Cooperation to perform non nursing jobs is taken as somebody who is a nice person, a nice cooperative nurse will go a long way than somebody who would rightfully refuse to do such non nursing jobs. So most nurses, thinking of future gains and preventing immediate and future wrath of nursing administration and for the sake of peace compromise and comply. In other words, nurse is distracted.
By chopsuey

8/26/08 at 2:24 p.m.

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Take a look at WHICH hospital this occured at. Mountain View is owned by HCA, one of the largest FOR PROFIT hospital chains in the country. As a former HCA employee I can tell you that HCA does not care about patient safety, they only care about profit. Thats why their CEO took home an $11 billion bonus in 2006. Have people already forgotten that HCA was involved in the biggest Medicare/Medicaid fraud in history? Isn't it amazing they are still allowed to accept Medicaid payments? Any other corporation convicted of Medicaid fraud would no longer be eligible for reimbursement, but HCA can. Don't let the name fool you, HCA and Columbia are one in the same. They just put a new dress on after the scandal and pretended to hire a new CEO to clean up the organization. Funny thing is, the "new" CEO had been there all along and was aware of the Medicaid fraud. Now for another thing you may not know, Mr. Frist from HCA has a brother, you may have heard of him, former US senator Bill Frist? It helps to have relatives in high places. Bill Frist was in office during the time period that HCA was allowed by the federal govt. to accept Medicare fraud charges under a different corporate name so that HCA hospitals would still be eligible for Medicaid reimbursement. Make no mistake, HCA is a corporate model. Other businesses look up to them, when asked how they made their bottom line so pretty they proudly exclaimed "by cutting employee salaries and benefits!" Before I left that wretched organization, we were asked to no longer refer to people as patients, but instead "customers". Thats fine for a business model, but these are HUMAN BEINGS LIVES!!! What I found most despicable was that on nurses annual performance evaluation they were rated on taking a higher load of patients consistently. If you have ever read any published studies on hospital outcomes you will know that the more patients a nurse is responsible for, the greater the risk of death/morbidity for the patient. HCA knows this and yet they still try to get by with as few nurses as possible, all under a "money saving" guise. The truth is that the nurses consistently work short so that the CEO's can maintain their lifestyles. And beware going to HCA on a weekend or in the middle of the night because in an effort to save (earn) more money the staffing cuts are most deep at those times. I do not doubt that other hospital chains are as money hungry as HCA, but HCA in my opinion is the most shady. Most people don't even know that a hospital is owned by them because they don't put HCA in the facility name. They don't want people to know they are the same HCA who defrauded Medicaid.
My heart goes out to the Scheinbaum family. I hope they will find justice. Hopefully this case will bring to light the unethical business practices of HCA, but I am sure they will try to offer a settlement to sweep everything under the rug. Maybe another name change is in store for HCA.