Lee S. Goldsmith, M.D. and Jordan Goldsmith
The public service announcements routinely advise the audience that if you are with someone who suddenly collapses, who might develop a slurring of speech, a weakness in an extremity, develops blurry vision — call 911. Get that person to the hospital -- and fast.
The public service announcements routinely advise you that the person may be having a stroke and, if that is the case, treatment rendered soon after the onset of symptoms can prevent permanant devastating injury.
That is what should occur. It often does not.
Where you go or are taken for care will decide whether you recover with minimal injury or are paralyzed for life.
Two stories: A good friend living in Midtown Manhattan started slurring his speech at the dinner table. His wife immediately called 911 and he was taken to his local hospital, which happened to be the New York University Medical Center, a primary research and teaching hospital in the heart of NYC. While lying on a gurney in the Emergency Room being worked up by a resident who was planning a number of tests, a neurologist walked by. He stuck his head in the door, told the resident to stop what he was doing and immediately ordered medication that stopped the progression of the stroke. Two days later, he was discharged and within months his speech returned fully, as did his muscle function
Another gentlemen got up from the lunch table and collapsed. His wife called 911. The ambulance came and the family requested that he be taken to the hospital. He was not taken to a community hospital that had the designation as a primary stroke center (PSC). He should have been fine. However, the hospital did not function as its designation implied. The patient’s stroke was not timely diagnosed, he was only seen by a physician’s assistant, his stroke was not timely treated and he was left partially paralyzed.
There is an organization called the Joint Commission that inspects and accredits hospitals. The Joint Commission sets standards for the minimum care that the hospital should provide. That accreditation is required by both Federal and State governments, and both entities rely on the inspection and accreditation to allow the hospital to bill for patient claims.
There are four different designations that hospitals can apply for and receive. Each level of care allows for or requires different resources for a patient. A rural hospital may not have an onsite neurologist or even one within commuting distance. A rural hospital may not have full time emergency physicians and it cannot be expected to have that availability. However, a hospital with the PSC designation must have an emergency room trained physician to do the evaluation of the patient.
Considering the rural hospitals that I have visited in the states of Maine, New Hampshire and Vermont, where they may have a medical staff with less than 20 physicians, most hospitals in New Jersey will have a staff in excess of 100. Rural hospitals are far from any medical center. In New Jersey, no individual is further than an hour's drive from the most comprehensive medical center, with all forms of treatment and the availability of every speciality on a 24/7 basis.
As a consumer, ask to be taken to a tertiary medical center.
As a consumer, make sure that you are seen by a physician.
As a consumer, if you get to the hospital and don’t get the immediate treatment you deserve, contact an attorney.