Emergency room procedure

Not sure if this is sop or my friend thinks she has a legal case. She has been throwing up for a while, she does find blood in it. She also fractured her collarbone last week and went to the e.r.
They gave her pain meds for the bone, and just gave her a bag for when she throws up. Her neighbor thinks of contacting his lawyer for a case. Is the hospital supposed to just disregard this or even check? They did not check her stomach at all, just x rayed her chest.

What is the damage to your friend that she thinks she needs to sue for?

She thinks they should’ve checked her stomach, throwing up blood is supposed to be serious, I think.

I’m thinking there’s more going on then we are aware of. Either they did more then just an x-ray or your friend gave them enough details that made the ER docs comfortable in sending her home (ie she’s been taking massive amounts of Advil or has the flu/cold). If she’s that worried, I’d be less concerned about finding a lawyer and more concerned about A)why she thinks the collarbone and the vomiting are related and B) getting to another ER or urgent care.

Is she still throwing up blood? Does she have a serious medical condition that was missed because they didn’t check her stomach?

ETA: What I’m saying is, if you go in for two complaints, yeah, they should check both of them, but if the stomach problems cleared up with no further problems, I don’t she’d have much of a legal leg to stand on.

Shes been doing it for a while, at least a month. She did tell them that, from what she said. She does drink a lot, and thinks she might have cirrosis.

If she’s seen her GP since the collarbone break, I’d call his/her answering service and have him paged at home. She’s likely to get the most calm, level headed, informed answer that way. If he/she says to go to the ER, explain what happened and ask for advice. Perhaps he can suggest somewhere where he has privileges and meet her there or call ahead and give them a heads up.

See. I knew we didn’t have all the details. Those are some pretty freakin important details to leave out.

The thinking of the ER might be that if she’s been throwing up blood for a month, it’s not an emergency. The ER’s job is to stabilize the patient, and either admit them to the hospital for Big Important Surgery (or something similar) or send them home and tell them to see their regular doctor for followup. They are not a substitute for regular doctors.

I broke my wrist and was X-rayed, then given a splint, a prescription for pain meds, and told to see an orthopedist for a cast and followup.

I’m pretty sure there isn’t much to be done for a broken collarbone other than pain meds, as long as the bone is in place. Vomiting blood on and off for a month and it’s not frighteningly worse? Not an emergency; see your regular doctor.

She doesn’t have a doctor, and has no coverage.

It’s time to get one. Can she get some sort of help from the state/welfare? You can’t treat cirrhosis via ER visits.

That’s unfortunate, but an ER visit costs far more than a doctor’s appointment. ERs must see people regardless of their ability to pay, but they will definitely also charge for their services after the fact.

Many physicians will cut their costs for someone who doesn’t have any insurance; the hospital I work for cuts their rate at least in half for the uninsured, and will refer to their social workers for advice on any kind of assistance plans they might be able to get on, or work out a payment plan.

She has no income but lives with her guy, who does work, but she isn’t covered on his medical, though shes trying to become his dependant.

I’m sure the ED did blood work (CBS, LFTs) and determined she was not in any imminent danger. I’m equally certain they discharged her with instructions to follow up with her physician to have the levels re-checked.

I find it amusing that her main concern seems to be whether she should retain an attorney.
mmm

If you’re friend truly has liver disease related to alcohol use and is vomiting blood, her absolute first priority in life needs to get that worked up by a competent specialist (overwhelmingly likely to be a gastroenterologist based on what is written here). There are several things that can cause people to vomit blood (from ulcers [perhaps “less serious” but still something that should be worked up properly and treated by a trained professional] to bleeding esophageal varices [something that would be a much more serious prognostic marker about the health of her liver]), but she’s not going to find out what it is second hand over the internet. Either way, making a serious attempt to stop her alcohol use probably can’t hurt. There’s AA, there are medical professionals like psychiatrists that can help, but stopping heavy alcohol use “cold turkey” should also be done in a medically supervised setting.

I’m not going to ponder all of the hypotheticals about a “legal case”, but no, just because someone has upper GI bleeding doesn’t mean that they must be admitted to the hospital and that your friend will win some huge settlement after locating the appropriate pond-scum sucking lawyer. As other posters have stated, ED’s in particular are not responsible for providing definitive treatment for all medical problems. As an example, if your friend had a breast lump due to a breast cancer, she might desperately need to get plugged in with a surgical and medical oncologist to have that cancer treated, but an ED may not have a legal responsibility to admit the patient to do all of that. It’s enough for them so say, “you’re stable, get thee to a real doctor.”

I know it might not be easy to find health insurance, but if she has any financial resources at all she should consider going to a GI doctor out of pocket. Also, she should comprehensively research public assistance programs. For instance, if she has no income, does she qualify for Medicaid in her state?

To recap, her focus should not be on suing doctors but finding one to work with her. What you have described could be a very serious problem and she needs to be an adult that takes a serious stab at getting it taken care of. Regressing to some childish, “oh, I went to an ER once and it didn’t get taken care of, that’s all I need to do for my own health outside of file stupid lawsuits against the ER,” will probably not be to her benefit.

Christ, this thread gave me a headache

That seems like a very “nothing that’s wrong in my life is my fault” attitude (External Locus Of Control).

BB, I could be totally, wrong. Obviously, I don’t know her. But as I said above and MMM re-iterated. If she’s that concerned. Go to another ER or urgent care, don’t worry about seeing a lawyer. More then likely the ER docs didn’t do anything wrong and a lawyer isn’t going to take the case.

Your friend sounds like a lot of my patients. Who generally got to be my patients by not taking responsibility for themselves.

From what you posted here, she has no legitimate case. As has been already noted. threemae gives good orderly direction.

It might be worth calling the social work department at the local hospitals to ask for information on if they have any assistance for patients without insurance, particularly for any help finding substance abuse treatment. As threemae pointed out, it can be dangerous for an alcoholic to just stop drinking cold turkey without medical supervision, so the best thing for her would be to try to get into detox.
If she can get in to see a GI doc, the GI doc might want to do an endoscopic exam to see if she has esophageal varices and band them if they are present since esophageal varices can occur in people with cirrhosis and are very, very dangerous (many alcoholics die from ruptured varices causing them to suddenly bleed to death). However, if she does have cirrhosis, I think any GI doc would tell her that the biggest thing that will extend her life is getting off alcohol. There isn’t much a GI doc can do to save an alcoholic who won’t stop drinking.

Frankly, the bleeding may also just be due to alcoholic gastritis. In that case, abstinence and the use of some acid blockers like omeprazole will take care of it, a whole lot more cheaply than endoscopy. I’d only push for endoscopy first if there was a history of large bleeds, frank melena, and/or significant signs of cirrhosis on exam/labs.

Not all reported histories of vomiting blood require upper endoscopy as a first, or even second step.

I’m confused. Is the OP asking for medical advice about a friend with a potential bleeding stomach problem, or is the OP asking for legal advice about not receiving proper emergency treatment at an ER?

If the former, the friend should go see a general practitioner. As stated above, vomiting up blood for a prolonged time doesn’t sound like an emergent need. One doesn’t need insurance to see a doctor. Just need to be able to discuss how they are going to pay or workout payment arrangements.

If the latter (legal matter), friend should consult an attorney. But as stated above, the ER is responsible for providing emergent care. Your friend has known she has had this problem for a month. Also, how was she damaged by the ER? Did she die? Has her problem gotten worse? Instead of focusing on the potential legal action as a means to get compensated for some mystery illness, most likely attributable to her alcohol abuse, maybe your friend should stop drinking and find a doctor that can adviser her.