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October 31, 2014

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State records suggest UMC had pattern of refusing care

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Sam Morris

State records show University Medical Center has at least twice since 2005 violated the law requiring it to provide minimal emergency care.

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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The high-profile case of a pregnant woman who was refused treatment at the University Medical Center emergency room in November is just the latest in a handful of cases over the past five years in which the public hospital has refused to treat patients, according to records of state investigations obtained by the Sun.

UMC has at least twice since 2005 violated federal law that requires it to provide at least minimal emergency care, according to the state health division, and had several other cases consistent with violations of the law in which UMC staff turned away suffering patients.

These previously unreported cases ring similar to the plight of Roshunda Abney, who, not realizing she was pregnant, waited more than five hours in labor in the UMC emergency room without receiving care. Abney eventually went to Valley Hospital Medical Center, where she claims she was told that if she waited so long at UMC, there was no reason to think she’d receive care sooner at Valley. Her baby was born premature and died.

Abney’s lawsuit against UMC has been bolstered by state investigators who found that UMC’s refusal to treat her apparently violated the Emergency Medical Treatment and Labor Act, better known as EMTALA. Federal officials will make a final determination on the case.

Brian Brannman, UMC’s chief operating officer, said the hospital treats about 100,000 emergency cases a year, so the number of violations, while unacceptable, is certainly minuscule compared with the total. The mistakes made were all corrected and the hospital did not have to pay any fines.

Brannman said he does not know what happened five years ago, before he came to UMC, but said there’s never a situation where it’s acceptable for emergency room staff to be rude to patients.

“We want to ensure this is a welcoming place for patients here,” Brannman said. “That’s the standard. There’s no tolerance for people giving patients a hard time. If it happened in 2005 it’s unacceptable. If it happens today it’s unacceptable.”

In comparison, Desert Springs Hospital Medical Center twice has violated emergency room-treatment laws, and Sunrise Hospital & Medical Center and Valley Hospital Medical Center each had one such violation, state records show.

Attorney Jacob Hafter, who is representing clients in the Abney case and another EMTALA lawsuit against UMC, said he is not surprised to learn about the past violations.

“What’s unfortunate is that for as many complaints as there are, how many people are not complaining to the right authorities or getting attorneys to hold UMC accountable?” Hafter said.

The investigations expose a variety of problems with the care at UMC.

On the night of July 2, 2005, a man took his girlfriend to UMC, bleeding profusely from her face after a trampoline accident that caused seven fractures to her cheek and eye socket, according to the state report. The boyfriend ran into the emergency room and asked how long it would take to get care.

“I told the guy at the front desk that she was bleeding all over,” the boyfriend told investigators. “He told me to sign in and wait my turn like all the rest. I kept pleading and asking him ‘Can someone come out and see her?’ ”

The man was told it would be a three-hour wait, at least. The man asked for a triage nurse and complained, “I’m a taxpayer.”

“So am I,” the UMC employee said, according to the state report.

The man brought his girlfriend into the emergency room, in pain and staunching her bloody face with a towel.

The man said he continued complaining about needing care, resulting in the employee calling security and escorting the couple out of the hospital. The security guard pointed them to nearby Valley Hospital Medical Center.

The boyfriend told investigators he was “very impressed” with Valley.

“They came out and checked her right away ... The nurse got her a new ice pack, took her vitals and asked what happened.”

Valley tried transferring her back to UMC, but she was denied, the state report said. A UMC emergency room physician told state investigators that he remembers Valley trying to transfer the patient, but UMC administrators took more than two hours to reply to Valley, causing frustration.

A UMC administrator told state investigators that the case didn’t sound like an emergency and the Valley doctor “got fussy” when UMC asked so many questions.

The woman was eventually sent to Sunrise Hospital, where she had outpatient surgery on her face.

State officials said UMC’s treatment failed to meet the standards set by Medicare.

In a separate case, on July 5, 2005, a 22-year-old Cuban pregnant woman who had received her prenatal care at UMC was in labor when she arrived with her sister at the hospital to give birth. At the check-in desk she was told there were no beds. As they were talking to the desk clerk, another pregnant woman entered and was assigned a bed for medical care. They asked why the other woman went first and were told: “Some people have priorities,” the state’s report said.

The UMC employee told the woman to get her pregnant sister to another hospital, where she gave birth, investigators said.

The case was a violation of the federal EMTALA law, though UMC officials say the only problem was that they did not keep appropriate records in the case.

On June 28, 2008, a UMC administrator refused to accept the transfer of a 45-year-old man from Centennial Hills Hospital Medical Center. Doctors treating the man said he needed a consultation with a spine specialist, and one was not available at Centennial Hills. The patient had previously been a patient at UMC, and a UMC administrator called Centennial Hills to refuse the transfer. She said she had “reviewed his old records and she did not see a need for him to be admitted at this time,” the state investigator wrote.

The Centennial Hills doctor tried to explain that those were old records, and that the patient had a fever, elevated white blood cell count and a possible abscess.

“Yeah, well we are really busy and we won’t accept the patient,” the administrator reportedly replied.

The administrator told investigators she thought the situation was not an emergency and that the patient was seeking drugs. The patient was sent to a different hospital for a spinal consultation.

The state investigation found the case was a violation of federal law, but Medicare concluded it was not because the case was not an emergency.

Dr. Dale Carrison, UMC’s chief of staff and head of emergency services, did not return a call for comment.

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