The Adams Family
A 12-year-old boy attacked by a pit bull was taken to the University of Chicago Medical Center emergency room for treatment of the extensive injuries to his face. Instead of being rushed to surgery, hospital staff gave him a painkiller and a tetanus shot and then refused to admit him for surgery. His mother, beside herself with panic and fear for her son’s life, was forced to take her son, Dontae Adams, on an hour-long bus ride to another hospital that immediately admitted him and performed the surgery that saved his face – and his life.
The University of Chicago Medical Center defended their actions by citing its Urban Health Initiative, which is aimed at clearing its ER of patients with non-urgent injuries and illnesses by redirecting them to community hospitals and clinics. The medical center maintains that their initiative is about getting patients the right treatment at the appropriate location amid a tough economic climate.
The American College of Emergency Physicians (ACEP) has publically condemned the University of Chicago Medical Center’s actions, stating that they are dangerously close to “patient dumping,” a practice made illegal by the Emergency Medical Labor and Treatment Act (EMTALA), and reflected an effort to “cherry pick” wealthy patients over poor. ACEP has also called on a congressional investigation.
“The medical center is reducing emergency care access to its local community, while at the same time, opening a ‘side door’ to a ‘specialty intake area’ to provide emergency care to medical center private patients,” said Dr. Nick Jouriles, president of ACEP. “This is a dangerous precedent that could have catastrophic effects in poor neighborhoods across the country. Congress needs to hold hearings about the problems facing emergency patients.
“If other community, non-profit hospitals follow this example and shift the lion’s share of resources to its high-revenue elective patients and procedures, it will leave many emergency patients virtually out in the cold,” he continued. “The University of Chicago Medical Center is located in a poor neighborhood whose residents have few, if any, other options for emergency care.”
Dr. Jouriles took issue with a statement made by medical center spokesperson John Easton that “sending Dontae into surgery too quickly would have created a risk for infection.”
“As a physician who has treated hundreds of animal injuries, I know of no reason why early surgical intervention would increase infection risk,” said Dr. Jouriles.
In addition, Dr. Jouriles took issue with statements made by the hospital that the Urban Health Initiative is helping patients with non-urgent care find medical homes and that the issue was about patients with non-urgent medical conditions.
“There simply are no other health care providers willing to care for most of these patients,” said Dr. Jouriles. “Many primary care providers are simply not taking Medicare patients, let alone the uninsured or the underinsured. Most clinics don’t have same-day laboratory or X-ray resources needed to determine whether patients have emergency medical conditions. This is an abdication of the hospital’s obligation to provide care to its community and a fundamental assault on the safety net that emergency departments are intended to provide. The University of Chicago Medical Center is receiving considerable tax benefits as a non-profit hospital, with the expectation that it will provide care to its community. If other community hospitals follow suit, it will be catastrophic for the growing ranks of the poor, uninsured and underinsured, especially during this financial crisis. Access to lifesaving emergency care for all Americans is threatened.”
According to reliable sources at the University of Chicago Medical Center, the emergency department has one of the highest rates of emergency patients leaving without being seen [10 – 15 percent with prolonged waits of more than 14 hours up to three days for an inpatient bed] and one of the highest ambulance diversion rates in Illinois. The plans being made are another step in making sure people in the local community have no access to emergency care. Only 12.1 percent of emergency patients are categorized as “non-urgent” according to the Centers for Disease Control and Prevention.
“While we recognize that tough economic times demand sacrifices by everyone, the latest moves by the university unfairly distribute the burden to the poorest members of the community it serves,” said Dr. Jouriles. “If anything, these are times that demand the most from our hospitals and our emergency departments, because these are the times when our patients need more care, not less. My heart breaks for Ms. Adams and Dontae and the night of hell they surely endured just to get Dontae the care he needed and deserved. This should not happen to another family in America ever again. And Dontae Adams had medical insurance! Imagine this story playing out with patients in other communities who have no health insurance, a segment of the population that grows every day as more and more people lose their jobs.”