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July 31, 2014

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Inquiry backs horror story of pregnant woman neglected in UMC’s ER

In Their Own Words

Roshunda Abney and her fiance Raffinee Dewberry did not know she was pregnant when they went to University Medical Center November 30, 2009. She was in severe pain, but they could not convince anyone to give her care. After more than five hours of waiting, the couple left UMC. They went to Valley Hospital Medical Center where they claim they were also turned away. She gave birth later at home to a premature baby girl who later died. This is their story, in their own words.

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State health inspectors have verified that University Medical Center emergency room employees neglected to provide care to a pregnant woman who was in labor, which may have contributed to the death of her premature baby.

The finding is the first independent verification of what happened that night and will likely be used as evidence in a lawsuit against the hospital.

Roshunda Abney, 25, and her fiance, Raffinee Dewberry, waited for more than five hours Nov. 30 in the UMC emergency room. The uninsured couple pleaded for help as she writhed in pain, but she received no medical attention, the investigators found. They did not know at the time that she was pregnant.

The couple eventually gave up hope at UMC and went to Valley Hospital Medical Center, where they were allegedly told that she would not be seen in a timely manner. She went home and gave breech birth to a premature baby girl, who died.

UMC and Valley now face a federal lawsuit alleging that they violated the Emergency Medical Treatment and Labor Act, better known as EMTALA, which requires hospitals to care for emergency patients no matter their ability to pay.

UMC’s penalties could include fines and the loss of the ability to be reimbursed by Medicare.

The investigation’s findings by the Nevada State Health Division, released Monday, show that UMC did not screen Abney in a timely manner — violations of state laws that are similar to the EMTALA regulations. Attorney Jacob Hafter, who represents the couple in the case, said the state conclusions will be a key piece of evidence.

“It validates my client’s story yet again and shows she’s not making this up,” Hafter said. “She’s not being overly dramatic. She went to them seeking help and assistance and was turned down with every attempt.”

UMC officials did not respond to a request to comment for this story, but previously have declined to speak about the matter because of the lawsuit. Six hospital employees have been suspended as a result of the incident.

Health investigators interviewed Abney, her fiance and UMC employees as part of their investigation. The emergency room medical director said he saw several areas where “we failed,” the report said.

The uninsured couple were referred to the emergency room from one of the hospital’s Quick Care clinics, but the certified nursing assistant never asked for the Quick Care paperwork, the medical director said.

“She would have gone all the way through in ER if (Quick Care) documents (were obtained) ... they forgot customer service,” the medical director said of the patient intake staff.

Lab tests at 11:19 p.m. — before the couple left the hospital — showed that Abney was pregnant, but there was no evidence that doctors or the patient were notified of the result, the report said. Records documented that Abney was in severe pain, but she was given no option other than sitting in the waiting room, the report said.

“There was no documentation the nursing staff alerted any physician or higher nursing administration managers of the need to get the patient seen by a physician to complete the screening already started by Quick Care and to diagnose and treat the patient,” the report said.

A security guard interviewed by the state inspector disagreed with allegations by employees that Dewberry was disruptive, and said employees were rude to the couple. Abney had been waiting for care for more than three hours when Dewberry politely asked a nurse when she would be seen by a doctor, the security guard said in the report. A nurse replied: “If you keep interrupting I’ll call security,” the guard said.

About 30 minutes later, Dewberry again asked when his fiance would be seen by a doctor, and the nurse lifted her finger and said, “I am going to have security escort you out,” the security guard said in the report.

“I felt the fiance was asking legitimate questions,” the security guard said, adding that the couple’s behavior was no different from anybody else’s.

Another patient in the emergency room that night told health inspectors that a different employee told the couple: “If she was in pain for two days, she can wait another 45 minutes.”

The state also conducted the survey on behalf of the Centers for Medicare & Medicaid Services, which will review the report and determine if there is an EMTALA violation.

(Editor's note: This story has been amended to clarify that the couple did not know that the woman was pregnant.)

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