'No on-site doctor': Dental student died in ICU overseen by remote 'tele-health' physician who pronounced him dead on a video screen, lawsuit says

https://lawandcrime.com/lawsuit/no-on-site-doctor-dental-student-died-in-icu-overseen-by-remote-tele-health-physician-who-pronounced-him-dead-on-a-video-screen-lawsuit-says/

678 points · 101 comments · view on lemmy.world

101 Comments

jimonthony@lemmy.zip · 247 pts · 149d (29 replies)

How is it legal to have an ICU that isn’t staffed by a single doctor?

null@lemmy.org · 88 pts · 148d (1 reply)

This would never happen to people who write the laws so it's not a priority.

FosterMolasses@leminal.space · 7 pts · 148d

Literally the anime Monster lol

faythofdragons@slrpnk.net · 75 pts · 148d (20 replies)

It's probably staffed by Nurse Practitioners. They do a lot of stuff that used to be handled by doctors, even my primary care provider is a NP and not a Dr.

MonkderVierte@lemmy.zip · 40 pts · 148d (2 replies)

For 1/5 of the pay.

StaticFalconar@lemmy.world · 21 pts · 148d (1 reply)

More like dr make twice the pay than np because dr requires 10x more hours to be certified over a np. Also the family will be sueing the dr not the np for medical malpractice here.

MonkderVierte@lemmy.zip · 26 pts · 148d

Oh, not that a doctors pay isn't justified (and still too less, for the requirements). But this here seems a saving money on the cost of quality, only the patient suffers from case.

ColeSloth@discuss.tchncs.de · 12 pts · 148d (15 replies)

You consider that you may be getting fucked, then?

Waraugh@lemmy.dbzer0.com · 4 pts · 148d (14 replies)

The best experience I’ve had with a family practice doctor was the few years that I had a nurse practitioner, much more thorough and attentive.

faythofdragons@slrpnk.net · 12 pts · 148d (13 replies)

I am getting fucked tho, but it's not the NP's fault. It's the goddamn admins that decided patients should only get fifteen minutes for a yearly physical, including pap smear.

They've turned primary care into a referral machine, but there's nobody to coordinate care or collate results. I've got a stack of diagnoses from multiple specialists, but they give out conflicting advice. Like, I've got an EDS diagnosis from a rheumatologist who told me to take ibuprofen for my joint pain because tylenol doesn't help with inflammation, but I've also got intestinal ulcers that my gastroenterologist says comes from taking NSAIDs, and I should take tylenol instead. Fucking kill me.

Waraugh@lemmy.dbzer0.com · 5 pts · 148d

That’s insane, a fifteen minute visit is a joke.

ColeSloth@discuss.tchncs.de · -2 pts · 148d (11 replies)

Neither of them was wrong, really. The best option was ibuprofen, since it's pain relief and anti-inflammatory. But because you developed ulcers that ibuprofen can irritate, the best option is just pain management with something like Tylenol.

roguetrick@lemmy.world · 2 pts · 148d

I mean the answers are out there but they include ridiculously expensive biologics that no insurance wants to cover.

HeyThisIsntTheYMCA@lemmy.world · -1 pts · 148d (9 replies)

No, the rheumatologist should have known that nsaids cause gastro ulcers and not to prescribe them. They committed malpractice.

ColeSloth@discuss.tchncs.de · 1 pts · 148d

Lol. You fucking idiot, it doesn't do that to everyone. "Malpractice for prescribing ibuprofen" hahaha

NotSteve_@lemmy.ca · 2 pts · 147d

Not American nor am I lacking my own doctor but I generally choose to see a specific NP at my clinic over my doctor since she's able to do everything I'd need my doctor for as well as actually caring to look into my health issues. I went over a decade with crippling digestive issues that I complained about constantly to my doctor but it was always dismissed as anxiety related. It was only the NP who actually cared to get me checked for celiac disease

Not exactly that related of a tangent but just wanted to say bless nurse practitioners 🫡

RosaLuxemburgsGhost@lemmy.ml · 41 pts · 148d

The bourgeoisie does not care if the working class dies so long as they are maximizing profits and continuing to expand their ownership.

Tollana1234567@lemmy.today · 23 pts · 148d (2 replies)

teledocs, and equity firms have been snatching up doctors all over the place, this hospital is likely part of a firm that does this, they can just staff 1 or few doctors in a hospital, and use teledoc soley.

TwilitSky@lemmy.world · 4 pts · 148d (1 reply)

The end result is people getting terrible care as this young man did.

Tollana1234567@lemmy.today · 3 pts · 147d

i first read this complaint on one of the medical subs once, the poster said wtf she cant find any private doctors, and it was explained that private equity was buying them all up, and teledocs too.

youcantreadthis@quokk.au · 7 pts · 148d

Why would it not be? Why would that law be enforced if it existed?

VitoRobles@lemmy.today · 6 pts · 148d

And have the yacht-class pay doctors to help the non yacht class?

plz1@lemmy.world · 147 pts · 149d (4 replies)

....wow

That timeline reads to me like he was in withdrawal, vomited, and likely aspirated on his own vomit. All due to lack of actual human care in a supposed ICU. I say "supposed", because that shit shouldn't even be legal for tele-health in the first place.

Marketing be like "this service pairs expert remote monitoring with skilled bedside care" and I translate that bullshit as "we farm monitoring jobs to cheaper labor markets and they watch people die, on Zoom".

arrow74@lemmy.zip · 13 pts · 148d (3 replies)

I'm willing to bet his family can likely win their lawsuit . Hopefully that will be costly enough to reverse this bullshit.

plz1@lemmy.world · 14 pts · 148d

Unlikely, without regulation against this. Fines are just a cost of business, since they are never, ever costly enough. Either a true penalty fine, or executives in prison, or both, are the only response to ensure change, here.

p03locke@lemmy.dbzer0.com · 11 pts · 148d (1 reply)

You mean five percent of the money they make when they decide these immoral choices? Which then gets appealed to a high court and reduced to one-tenth of one percent?

arrow74@lemmy.zip · 5 pts · 148d

Totally depends. Usually in medical cases like this the margins for a hospital are thinner than you think. Healthcare gets so expensive thanks to all the middlemen.

It's a bit different than a company pollutes river and it costs 10 million in fines but they save 30 million.

In this case if the family wins the suit it can open up even more until it becomes unsustainable. It all depends on what is established in this case, the precedent alone could be effective in banning it.

I'd prefer legislation of course

SaharaMaleikuhm@feddit.org · 89 pts · 148d (2 replies)

The US is such a dumb fucking nation, I just cannot believe half this shit

AceOnTrack@lemmy.blahaj.zone · 27 pts · 148d (1 reply)

It's like an ongoing slow motion trainwreck and I can't help but stare

Pman@lemmy.org · 4 pts · 148d

It would be funny and entertaining if it didn't affect peoples lives the way it does instead of being a voluntary opt in option (and not some small TOS you agreed to this because we gave you no other choice)

Fmstrat@lemmy.world · 83 pts · 148d (3 replies)

Fun story:

I once got blocked from a flight by TSA because the inspector said my portable hard drive was an explosive device by looking at it via Facetime over an iPad while they were at an Arnold Schwarzenegger's body building conference instead of at work in the airport.

Gates9@sh.itjust.works · 20 pts · 148d (1 reply)

It’s a body building and strong man contest.

Fmstrat@lemmy.world · 3 pts · 148d

Fair fair. Gotta be able to lug around the iPad.

Stalinwolf@lemmy.ca · 4 pts · 148d

I almost got detained for bringing Exploding Kittens in my luggage. The game meows when you open the lid, so the device looked really suspicious. And the name on the front didn't help.

Shit fucking game, by the way.

RememberTheApollo_@lemmy.world · 81 pts · 148d (3 replies)

Great. We pay into health care that doesn’t offer physical care anymore.

Tollana1234567@lemmy.today · 31 pts · 148d

taxes are mostly subsidizing the companies too, and patients never see it being used for them.

FosterMolasses@leminal.space · 7 pts · 148d (1 reply)

It makes me wonder how much can actually be taken from the American people before they'll do something.

Before, it was a necessary cost that could bankrupt someone's livelihood. Now it's pretty much just a Kubla Kraus tax.

MML@sh.itjust.works · 1 pts · 148d

They be able to take everything as long as someone else is worse off.

phoenixz@lemmy.ca · 55 pts · 148d

People need to be jailed over this

As in the CEO, leadership, management, all involved in setting up and authorizing these procedures, should be jailed

If not, this will just become the norm

And of course it will just become the norm because again, somebody died needlessly and we're not doing shit about it because all the other CEO's still need a gold plated bathtub

Mulligrubs@lemmy.world · 52 pts · 148d (16 replies)

I've been waiting for this since the 1990s, surprised it took so long.

Starting in the 90s, much of the administrative duties of a hospital are now done overseas, including chart notes.

The doctors being overseas? Worst case scenario is just starting.

Why would a hospital pay a US physician 200K a year when they can get a doctor from Pakistan to do the same work for 50K a year? They even have surgical robots that can be remotely piloted from anywhere.

It's not prevalent yet, but it will be.

AcidiclyBasicGlitch@sh.itjust.works · 25 pts · 148d (3 replies)

This should have been such a straightforward case too.

Mr. Hylton's condition deteriorated in the ICU, and despite orders, there are no CIWA assessments, no intake/output monitoring, and no MD assessments for pain and/or change in mental status despite the RN's non-contemporaneous note indicating mental status change in a patient diagnosed with alcohol withdrawal and a history of alcohol withdrawal seizures for which he had "previously been given Keppra."

Hylton, who was admitted around 11 a.m., became unresponsive early the next morning around 4:30 a.m., the complaint says.

"Mr. Hylton slid down in bed, his eyes rolled back and he … exhibited seizure-like activity, vomited, became bradycardic and code was called," the complaint alleges. "He was intubated, but he could not be resuscitated, and he was pronounced dead."

What the fuck were they even trying to do? Some kind of tough love/cold turkey approach? Honestly wouldn't be surprised bc I've heard a lot of ignorant pieces of shit suggest that should be standard protocol for opiate withdrawal.

Aside from that being intentionally and unnecessarily cruel, there's this tricky thing about alcohol withdrawal vs withdrawal from other "more serious" substances, where you can literally fucking die. That's exactly what happened.

BygoneNeutrino@lemmy.world · 4 pts · 147d

...the designer benzodiazapines are taking the symptoms your describing to a whole new level.

The equivalent of thousands of alprazolam tablets can be acquired for a few hundred bucks. Addicts think they hit the jackpot when they get access to them, but they can be outright killed by the withdrawal. There is no ceiling for GABA A tolerance, so there is no ceiling for the withdrawal.

Washedupcynic@lemmy.ca · 1 pts · 146d

He wasn't going through opioid withdraw, he was going through alcohol withdrawl, which can be just as dangerous cold turkey quitting. Alcohol has non specific effects in the brain, inhibiting excitatory neurotransmission by acting on NMDA receptors, and accentuating inhibitory transmission by acting on GABA receptors. Stopping cold turkey causes hallucinations and seizures due to the jump in excitatory neurotransmission. Keppra is an anticonvulsant that blocks high voltage gated calcium channels, which I sort of feel is an inappropriate medication on it's own, might have been better to pair it with a low does of memantine/ketamine or a benzodiazapine class drug.

AA5B@lemmy.world · 1 pts · 147d

It’s simpler to believe he just got lost in the system - no treatment is similar to intentionally not treat

captain_aggravated@sh.itjust.works · 21 pts · 148d (6 replies)
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deathbird@mander.xyz · 10 pts · 148d (3 replies)

See you're just thinking of pro-social applications for tech. Nothing wrong with that. One day the world will be better and we'll need creativity and positivity rather than nihilism. In the meantime, some cynicism is warranted.

captain_aggravated@sh.itjust.works · 9 pts · 148d (2 replies)
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captcha_incorrect@lemmy.world · 5 pts · 148d (1 reply)

I'd wager a guess that the designer had what you described in mind, but someone else did not.

BygoneNeutrino@lemmy.world · 3 pts · 147d

Based on what I'm reading, the problem was he wasn't administered benzodiazapines for the withdrawal symptoms. This combined with alcohol induced organ damage were contributing factors.

I feel as though most doctors would have been reluctant to prescribe a sedative. The more liberal they are with prescribing sedatives, the more likely their practice is to be overwhelmed with drug addicts.

...it will be interesting to see how this plays out in court.

SuspciousCarrot78@lemmy.world · 6 pts · 147d (1 reply)
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Mirshe@lemmy.world · 2 pts · 147d

The issue is that these surgical robots are a goldmine for companies specializing in medical devices. I work for one. They look fancy, they're available to buy on loan if you can't afford the several million dollars, and they sound modern.

Meanwhile, the instruments are not cross-compatible (meaning you can't run Medtronic instruments on a US Medtech robot, for instance), so while they're reusable and sterilizable (unlike most other handheld devices which are designed to be one-case-only), you have to buy a whole suite of endocutters, staplers, and whatever else you want that robot to be able to do in order to make it do that. PLUS there's a proprietary computer system, an imaging system, the software to run those, often a televisual rig at the other end for the surgeon to run...you can get really pricey for these, real quick, and that's not to mention the staple cartridges, the trocars, all sorts of stuff that can be proprietary.

Crozekiel@lemmy.zip · 5 pts · 147d

I shudder to think about my surgeon having to deal with a 400ms ping to the fucking robot cutting me open and how badly that could go...

UnderpantsWeevil@lemmy.world · 2 pts · 147d

Why would a hospital pay a US physician 200K a year when they can get a doctor from Pakistan to do the same work for 50K a year?

Liability to the hospital if a remote doctor fucks up? Just for starters.

It's also very difficult to manage remote workers. As a result, that $50k Pakistani doctor needs another $50k Pakistani contract manager and a Pakistani HR manager and a nurse who can communicate fluently with both patient and doctor and software that an IT firm needs to maintain and a lawyer to sort out all the messy details of licensing and practice.

At the end of the day, it isn't nearly the cost savings you're promised.

Every outsourcing gambit plays out this way. Which makes it more of a negotiating ploy against local workers. Threatening to outsource is far more profitable than actual outsourcing.

normalentrance@lemmy.zip · 2 pts · 147d (2 replies)

I think now as things advance with AI and the US government is completely corrupt/dysfunctional some company is going to make a med bed with an array of sensors and AI.

One of the oligarchs will bless us with this technology and they will get a shit ton of money from the government, so long as the big guy gets his cut.

Crozekiel@lemmy.zip · 2 pts · 147d (1 reply)

Didn't he already put out a fluff video with ai generated images of basically that, like almost a year ago?

normalentrance@lemmy.zip · 2 pts · 145d

Yes that's exactly what I was thinking about!

roofuskit@lemmy.world · 48 pts · 148d (8 replies)

"But people fly here from other countries for healthcare."

krashmo@lemmy.world · 18 pts · 148d

If tele-healthcare was the same as in person then no one would need to go to a doctor, much less fly anywhere

Fedizen@lemmy.world · 16 pts · 148d

People get travel warnings about american "healthcare".

HerbalGamer@sh.itjust.works · 4 pts · 148d (4 replies)

They do?

roofuskit@lemmy.world · 6 pts · 148d (3 replies)

Extremely wealthy people do come here for unparalleled healthcare no normal American can afford.

The fact that they fly here for healthcare is often touted by conservatives as evidence of the quality of our healthcare system.

LifeInMultipleChoice@lemmy.world · 6 pts · 148d (2 replies)

The opposite happens as well, I have a family member with MS that left the U.S. twice for treatments. The first one he flew to Russia to get a stem cell treatment where even though they use the stem cells from his own body, was still considered illegal in the U.S. at the time. (May still be). That slowed/paused his MS and he didn't have any large degredations for 15 years after that. The second time he flew to South America, can't remember where for a different experimental surgery. That was about 5 years ago. All in all it took about 30 years post diagnosis to finally put him in a wheelchair, though I believe he still can stand up for short stints.

roofuskit@lemmy.world · 5 pts · 148d

MS varies widely. My mother has MS but it was caught extremely early due to a freak accident. She's had very little degradation since diagnosis because it was caught early. No need for experimental treatments.

Mirshe@lemmy.world · 1 pts · 147d

Trans people all over the US still go to Thailand and similar markets because to literally fly to another country, get bottom surgery, spend the 3-6 month recovery period there, and THEN fly back to the US is STILL cheaper and faster than trying to get it done here.

HubertManne@piefed.social · 2 pts · 148d

The rich fly here to get the good stuff that not for plebys.

TwilitSky@lemmy.world · 46 pts · 148d (5 replies)

How is is legal to pronounce death without directly checking their pulse in person?

roguetrick@lemmy.world · 38 pts · 148d

RNs can get the vitals that allows a pronouncement. I do it regularly for hospice folks and it certainly ain't my name on the death certificate. Having an RN verify vitals for an active code is a bit weird though. But so is running a code through telehealth.

Dozzi92@lemmy.world · 14 pts · 148d (2 replies)

Paramedics (at least in NJ) aren't allowed to pronounce, but they're what's called online care (maybe, it's online something), and so they feed vitals to a doc over the phone, and the doc says okay call it.

BarrelAgedBoredom@lemmy.zip · 1 pts · 147d (1 reply)

Medics can pronounce in the field in Florida for "injuries incompatible with life", think rigor mortis, decapatations, already rotting corpses, etc

Dozzi92@lemmy.world · 1 pts · 147d

That's fair and we can do that in Jersey as well (and I'm just an EMT). Obvious signs of mortality it was referred to as back in 2003 or 2004 when I first got my EMT.

Buffalobuffalo@lemmy.dbzer0.com · 4 pts · 148d

Just look at the guy over zoom, i guess we have set the bar pretty low.

kylie_kraft@lemmy.world · 35 pts · 148d (5 replies)
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TwilitSky@lemmy.world · 14 pts · 148d (4 replies)

So you got the platinum special. I got injected with some unknown disease and tagged for scientific research at a later date for $1,000 after insurance.

Plurrbear@lemmy.world · 8 pts · 148d

Same it ;was Gardasil the HPV vaccine given to me in my teens but NEVER told my mom I was a guinea pig and we were the first to test.

I got PSOS and my other friends either got that or endometriosis!

The American healthcare system is fucked! Never got any compensation or anything for it just a lifetime of health issues. Also, found out the drug I need is $500 a month and takes $3 to make! Fuck the pharmaceutical companies they’re just as bad as the government. They are basically legal drug cartel!!!

kylie_kraft@lemmy.world · 6 pts · 148d
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WorldsDumbestMan@lemmy.today · 4 pts · 148d (1 reply)

Now that's a whole differenr tier of fucked.

Tollana1234567@lemmy.today · 2 pts · 147d

thats not even the half of it, some insurance put different drugs on tiers, generics are usually the cheapest one, then brand name of those generics. and then expensive generics, and specialty like biologic, cancer drugs,,,etc. drastically increase in cost. they can unilaterally not cover certain ones too.

like alot of drugs, topicals are made from INDIA manufactured there, but a 200$ wholesale cost for a 30g tube for a topical immunosuppresant that is GENERIC, with insurance its either no cost or a small copay. probably look for online coupons if your insurance wont cover it, and you need it.

CaptDust@sh.itjust.works · 31 pts · 149d

That is fucking horrifying.

Gates9@sh.itjust.works · 30 pts · 148d (8 replies)

Boomers will die this way en masse in nursing homes and even the regular hospital system. They are about to learn first hand the correlation between their precious tax cuts and nursing ratios/turnover.

daannii@lemmy.world · 6 pts · 148d (1 reply)

We already pay enough taxes to cover universal healthcare.

It's just not spent on that.

Tollana1234567@lemmy.today · 2 pts · 147d

its going to defense budget.

Pman@lemmy.org · 5 pts · 148d

Their insurance is better than yours they won't suffer this until it doesn't matter much and their vote doesn't really count anymore.

VitoRobles@lemmy.today · 4 pts · 148d (2 replies)

This is Boring Dystopia. What will instead happen is everyone will shrug, just like when we let a bunch of boomers die from COVID, and then blame the Democrats somehow.

7101334@lemmy.world · 4 pts · 148d (1 reply)

and then blame the Democrats somehow.

Yes, how could anyone possibly blame the guy who prematurely declared the end of the pandemic, resulting in the discontinuation of preventative measures and robust data tracking, for the consequences of that decision?

Only those crazy tankies!

NauticalNoodle@lemmy.ml · 2 pts · 148d

The lesser evil strikes again!

OctopusNemeses@lemmy.world · 1 pts · 148d (1 reply)

Boomers no longer have the majority voting power. You can stop this any time.

Tollana1234567@lemmy.today · 1 pts · 147d

they dont, but they are benefiting under the current system.

roguetrick@lemmy.world · 21 pts · 149d (2 replies)

Non contemporus notes don't really matter (ICU nurse isn't going to write a note while they're peeling this guy off the ceiling) and I'm not familiar with ICU level withdrawal care but I doubt CIWA is helpful in someone like this who's in full blown withdrawal already and going brady with current interventions. CIWA is good for preventing him from getting where he already obviously was.

catbum@lemmy.world · 15 pts · 149d (1 reply)

What does "peeling this guy off the ceiling" mean in this context?

roguetrick@lemmy.world · 18 pts · 148d

Before he started precedex he would've been essentially highly anxious and fighting everybody. When he wasn't having seizures that is.

SnarkoPolo@lemmy.world · 17 pts · 148d

Once again the Bigly Beautiful Bill encourages survival of the fittest, puh-raise JEE-zuz-ah!

redlemace@lemmy.world · 14 pts · 148d

First thought: "Must be USA". opened the link just to check and was not dissapointed wrong

Phil_in_here@lemmy.ca · 11 pts · 147d

Meanwhile in in the rest of the world we've got conservatives telling us how much more efficient it would be and how much quicker you'd see a doctor if we adopted America's for-profit healthcare system.

MushroomsEverywhere@lemmy.world · 11 pts · 147d (3 replies)

I know this is fucked up in general, but am I the only one who's slightly bothered by the description of him as a "dental student"? Maybe I'm overthinking things, but I worry that reporting would look different if it didn't happen to a person of high status.

AnUnusualRelic@lemmy.world · 5 pts · 147d (2 replies)

While you were dicking around, he was studying the tooth!

Omgpwnies@lemmy.world · 1 pts · 147d (1 reply)

How would one phrase that if the victim were a urology student?

AnUnusualRelic@lemmy.world · 1 pts · 147d

Studying the nephron? Or the waste management?

Washedupcynic@lemmy.ca · 7 pts · 148d
sploder@lemmy.world · 0 pts · 148d
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