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Hospitals: The Rosenbaum Case

By JOHN IRVINE

Three months ago retired New York Times reporter David Rosenbaum was mortally wounded
by a  mugger armed with a lead pipe in an encounter on a street near his home in Northwest Washington. Believing the injured journalist was drunk,
emergency services workers who found him lying sprawled in the street
drove him to Howard University Hospital. He would lie on a gurney for nearly an hour before the mistake was discovered and
trauma specialists were called in.

Two days later Rosenbaum died of
his injuries. The killing is focusing media attention on "amazing
levels of complancy and indifference in emergency care in the nation’s
capital," as the reporter’s old paper writes here.

DC’s Office of the Inspector General released the official report on the incident on Friday. Investigators concluded that circumstances surrounding the death, "have generated concerns . . . about the systemic nature of problems
related to the delivery of basic emergency medical services citywide." Critics want major reforms, including tougher certification requirements for EMTs and firefighters and termination policies for EMS personnel accused of substandard performance.

Washington
Post columnist Colbert King sees the case as symbolic of the kind
of substandard care that many DC residents get from emergency services. He followed the story aggressively in his column over the last few months. King tells Editor &
Publisher
that the report isn’t enough:

"Now the question is,
‘what will happen?’ What will the mayor do? Who will be held
accountable for this?" he said Friday, just hours after reading the
report from the D.C. Inspector General’s Office. "There are specific
things in the report that cry out for personnel changes."

King
said one of the first who should be held accountable is D.C. Fire Chief
Adrian Thompson. He scolded Thompson for declaring just days after the
attack that Fire and EMS crews responded properly to Rosenbaum’s
injuries, which eventually led to his death. "That is absolutely
false," King said. "Should the city have confidence in the fire chief
if he makes that statement? The I.G. report refutes that statement in
every way."

On Saturday, the Post reported that Thompson has fired the EMT involved in the incident.  Two supervisors have been suspended. The two cops involved face vague administrative sanctions. Is this an appropriate official response or politics as usual in the District?

As of this morning, it’s beginning to look at though Chief Thompson may lose his job.

Oddly, few of the media reports surrounding this story mention the important Institute of Medicine report released last week that finds that emergency care system in this county is in critical condition. The IOM inquiry, which fills three volumes, found serious problems in the emergency care system at nearly every level.  Over the last decade, demand for emergency room services has risen 26 percent. On average, an ambulance goes on diversion once every minute.

ERs nationwide are flooded with cases they shouldn’t have to deal with and are often ill-prepared for the most serious cases as a result. If the Rosenbaum case is symbolic of anything, it is the problems facing the critical care system as a whole.

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Don’t worry, consumer driven health reforms and competition will clear this up. Give the free market a chance to work will yea. I wonder if Mr. Rosenbaum had a chance to negotiate his hospital charges, maybe he didn’t do enough research on the proper EMT unit to call.