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Thu May 24 06:09:08 BST 2007

Ken

Please note: item 6 on my response is related to the fact that I'm in South Africa and our laws are different. We also have ONLY one health regulation authority, so for me it would be easy: Lodge a negligence report with the HPCSA, who are mandated to respond and investigate; it is up to them from there on!

Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
ATLS  instructor and DSTC Cape Town Course Director
Intern program Coordinator: Surgery
M.Med (Emergency Medicine) Executive Committee member
Clinical Head (Director): Diana Princess of Wales Trauma Unit
Division of Surgery (General) Room 4064
Department of Surgical Sciences
Tygerberg Hospital / University of Stellenbosch
PO Box 19063
Tygerberg 7505
Western Cape
South Africa
e-mail: tch at sun.ac.za
Cell: +27824681615
Office: +27219389281 or 4911 pager 0302

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]On Behalf Of KMATTOX at aol.com
Sent: Thursday, May 24, 2007 4:05 AM
To: trauma-list at trauma.org
Cc: ccm-l at ccm-l.org
Subject: EC - Unrecognized severe Peanut Alergy by triage clerk in MAJOR
EC

In a message dated 5/23/2007 12:07:34 P.M. Central Daylight Time,  
tch at sun.ac.za writes:

6)  As to the DUTY to the persons involved: none unless the law of the USA 
allows  otherwise or unless you are the patient's usual treating physician. The 
most  you can do is forward this information to the patient or their lawyer.  
However, I would suggest they get a local Emergency Physician and an  
Allergologist as expert witness rather than (an esteemed) trauma surgeon.  :)

I am not sure that the solution should be a legal one, although there are  
some JCAHO and regulatory system issues here.    One reason that  I choose to 
air this publicly is that this hospital is one known to everyone on  this list 
server, and may be one that is a major hospital for members of this  list 
server.   A patient who had come to this hospital before with  peanut allergy, who 
was in severe trouble was brought by an appropriately  identified health care 
worker with an in-route phone call made to the  registration desk of the 
emergency department of a hospital with a trauma center  designation.   When the 
patient arrived they were put into a long  line, put through a long interview 
and eligibility screen and made to wait,  while having strider and looking bad.  
 When questioned the  hospital (administration and registration) tried to 
cover up, tried to change  the story, and tried to indemnify the hospital and its 
staff.   We  each have a responsibility to assure that such system problems 
are  addressed.    Who knows, this might be my own hospital or your  own 
hospital.   I do have its name.   I did some calling  around and this kind of 
activity is more common than most of us would not like  to admit.   DESPITE EMTALA.  

I am almost ashamed that I gave my impassioned post about access to health  
care last week.   Now I am embarrassed to find that we have met the  enemy and 
it is us.  

k

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EC - Unrecognized severe Peanut Alergy by triage clerk in MAJOR EC