Malcom Randall VA Medical Center in Florida denied emergency care for a veteran in heart distress because they couldn’t identify him as a veteran. He had been found unconscious by a neighbor at his home. Yet he had been treated at that facility before. Emergency responders said they found the staff at the hospital “belligerent.” After 10 minutes of the staff refusing to treat him, they gave up and took the patient to another hospital. The patient died of heart failure 10 hours later.
Malcom Randall VA – violating procedure
Procedures for hospitals with emergency departments have one thing in common whether it’s VA or another: they are “obligated to provide medical screening examinations and stabilizing treatment to patients with emergency medical conditions.” The Malcom Randall VA totally disregarded that procedure in favor of demanding identification. The patient was later identified as a veteran, which if they had bothered to double check, they would have been able to establish. Instead, they placed the blame on first responders whose job it is to treat and transport, not interrogate an unconscious man.
During transport, EMS personnel conveyed the patient’s initials and a contact number for a family member, and informed facility staff that they did not have any other patient identifying information. Facility staff, including
four nurses, met the EMS responders at the Emergency Department ambulance bay and again requested the patient’s identification information. Later, at the request of one of the nurses, an Administrative Officer of the Day joined the nurses to request identifying information to verify the patient was an eligible veteran. The EMS responders reiterated they were unable to provide additional identifying information.
After waiting for a period of time in the ambulance bay, without facility staff attending to the patient, EMS responders asked if they should take the patient to Shands and facility staff responded “yes.” EMS then reloaded the patient into the ambulance and transported the patient to Shands where the patient died later that day. An Administrative Investigation Board (AIB) reviewed the patient incident and determined the event to be a Veterans Health Administration (VHA) Emergency Medical Treatment and Labor Act (EMTALA)-related policy violation, substantiated an inappropriate delay of care, and partially substantiated an inappropriate denial of care of the patient seeking treatment in the facility’s Emergency Department.
The OIG team learned that similar patient incidents had occurred in 2019, resulting in Emergency Department staff being required to complete EMTALA-related training.OIG Report
Investigators said part of the problem in the 2020 incident may have been grudges held by VA staff against the ambulance crew after a similar incident a year earlier, where medical center nurses were also criticized for failing to put patient care ahead of eligibility questions.
VA staffers told investigators that the first responders created confusion by not communicating the patient’s health status and what personal information they had. But inspector general’s staff, after reviewing case files and radio dispatches, called the ambulance staff “professional” and placed blame for the situation on VA employees.Military Times
There have been hundreds of horror stories about VA failures over the years. Whether it was cockroaches in the kitchens, or mold in the showers, or emergency departments failing to treat veterans in distress, it’s unacceptable. The hospital was issued a proposal of removal for the stated personnel, but the hospital administrator simply gave them a letter of reprimand. If an employee can’t establish proper priorities for veterans, they shouldn’t work there anymore.
Feautred screenshot of the Malcom Randall VA in Gainesville, FL via Flickr
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