Patient Dies Awaiting Care in Hospital ER

By Walter F. Roche Jr.

Staffers at a York,PA hospital concluded that an emergency room patient left without treatment when in fact the patient lay dying in their midst.
An investigation by state surveyors on the Aug. 16 incident at the York Hospital showed staffers passed the dying patient at least a dozen times without checking for vitals. Some passed within 1 to 2 feet of the wheelchair where the patient was seated.
The patient was brought by ambulance to the Wellspan facility at 9:59 a.m. and was discovered unresponsive hours later. The death pronouncement came at 1:31 p.m.
The hospital also was cited for failing to report the incident within 24 hours as required by state law.
Despite a hospital policy requiring periodic rounding, the state investigators review of the patient's record "failed to reveal evidence that anyone had completed rounding, while the patient was in the waiting room."
The nurse who was charged with assessing the patients waiting in the ER never even spoke to or even approached the patient, according to the report.
A review of surveillance footage showed the patient showed no movement from 11:09 a.m. to 12:20 p.m.
The patient, identified as MR1, failed to respond to three calls of his or her name.
The surveyors from the state Health Department noted that two other patients, considered in a less critical status, were treated and released in the interim.
"None of the critical protocols were initiated on the patient," the report states.
The patient had been placed in front of a triage room that was not in use at the time, according to the report.
In a response to the report, the hospital said,"The event has been taken extremely seriously at all levels of the organization."
Wellspan officials called the incident a "rare event," but acknowledged the facility failed to properly care for the patient.
A plan of correction filed by the hospital calls for a series of retraining programs and additional staffing in the emergency room.
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