Young boy dies in hospital waiting room "because he had to wait"

[LannaGuy]

Lot of BS on here by people who have no idea about hospitals and, yes, I worked in them for 20 years. This was one incident, sad as it was, but to blame the staff is absurd UNLESS it can be proved there was negligence but I doubt it. There is a queuing system in all hospitals and judgements are made by TRAINED staff (i.e. not by TVF armchair doctors) and they are not perfect, the system is not perfect and medicine is not perfect. If he had been carried into A&E on a stretcher his chances would have been much higher but I assume he walked in (to A&E?) and he was that 0.1%. Sorry but that's the way it goes.

[petermik]

7 hours ago, LannaGuy said:

Lot of BS on here by people who have no idea about hospitals and, yes, I worked in them for 20 years. This was one incident, sad as it was, but to blame the staff is absurd UNLESS it can be proved there was negligence but I doubt it. There is a queuing system in all hospitals and judgements are made by TRAINED staff (i.e. not by TVF armchair doctors) and they are not perfect, the system is not perfect and medicine is not perfect. If he had been carried into A&E on a stretcher his chances would have been much higher but I assume he walked in (to A&E?) and he was that 0.1%. Sorry but that's the way it goes.

Has any of your 20 years been spent working in Thai government hospitals?

[mommysboy]

25 minutes ago, LannaGuy said:

Lot of BS on here by people who have no idea about hospitals and, yes, I worked in them for 20 years. This was one incident, sad as it was, but to blame the staff is absurd UNLESS it can be proved there was negligence but I doubt it. There is a queuing system in all hospitals and judgements are made by TRAINED staff (i.e. not by TVF armchair doctors) and they are not perfect, the system is not perfect and medicine is not perfect. If he had been carried into A&E on a stretcher his chances would have been much higher but I assume he walked in (to A&E?) and he was that 0.1%. Sorry but that's the way it goes.

 

Yes but an investigation is warranted, right?

 

In UK it would be a coroner's report.

 

 

[LannaGuy]

3 minutes ago, petermik said:

Has any of your 20 years been spent working in Thai government hospitals?

No but such things happen in all hospitals, it's rare, but it happens and relatives always complain as they need to lash out in their grief.

 

Look at those parents who want to send their son to USA for 'experimental treatment' when he's at one of the best children hospitals in the world. They can't let him slip away gracefully after all the money and treatment has been spent for his care. It's emotional reaction.

 

 

[petermik]

8 hours ago, colinneil said:

Yes i agree with you on certain points.

Not every hospital has fully trained qualified staff on duty all the time.

Reason being lack of finance, not training, also i as am in a position to notice, first thing you ar e told to do is take a seat, or in my case lie on the gurney and wait.

Nurses will not attend to you without your notes being present, so somebody has to go to the office and queue to get them.

Before anybody tells me i am wrong, wife takes me every 3 weeks for the catheter to be changed, every staff member knows me, knows why i am there, but will do nothing until my wife appears with my notes, so she goes park the pickup walks back to the hospital, goes gets the notes, meanwhile 15/20 minutes have past.

Crazy because i am on a gurney blocking part of the emergency room.

It,s the system over here sadly,crazy as it is and it cost a young fellow his life,in most other countries the family member(s) in attendance when it was becoming obvious his condition was deteriorating would have called out for urgent assistance and kept calling until someone who was competent enough to attend to him was on the scene,here sadly they don,t seem to want to create a disturbance until its too late...........sad case indeed

[LannaGuy]

2 minutes ago, mommysboy said:

 

Yes but an investigation is warranted, right?

 

In UK it would be a coroner's report.

 

 

Yes of course. If there was negligence that should be addressed but saying 'he could have lived' and blaming staff is nonsense.

[petermik]

7 hours ago, petermik said:

Has any of your 20 years been spent working in Thai government hospitals?

 

7 hours ago, LannaGuy said:

No but such things happen in all hospitals, it's rare, but it happens and relatives always complain as they need to lash out in their grief.

 

 

 

 

Thanks for answering my question

[LannaGuy]

1 minute ago, petermik said:

It,s the system over here sadly,crazy as it is and it cost a young fellow his life,in most other countries the family member(s) in attendance when it was becoming obvious his condition was deteriorating would have called out for urgent assistance and kept calling until someone who was competent enough to attend to him was on the scene,here sadly they don,t seem to want to create a disturbance until its too late...........sad case indeed

One lesson here is go in an ambulance don't just walk in.

[atyclb]

5 hours ago, Bill Miller said:

Symptoms of acute abdominal pain could have been appendicitis as well, also fatal if not properly treated.
Hospitals available to "The People" are chronically understaffed and underfunded. Not unique to Thailand at all.
In the US I was lingering in our version of a Provincial hospital for two days before being transferred to a hospital that could (would?) do an angiogram. It was a weekend.
Within an hour of the angiogram, I was air lifted to a heart hospital for an emergency by pass operation.
I was lucky to live, in the US which often ballyhoos it's superior medical capabilities.
I feel very sad for this young guy and his family. I do not pretend to know all the reasons this happened, nor have I the education and experience to remedy the Thai medical system.  

 

 

http://onlinelibrary.wiley.com/doi/10.1080/110241598750004922/abstract

Results:

38 Patients (43%) presented with symptoms of their aneurysm exceeding nine hours prior to admission (range 10 hours to 14 days, median 2 days). Fifty patients (60%) were initially misdiagnosed by the referring practitioner. Ultrasonography was consistent with rupture in only 36/70 (51%). 52 Patients died (54%), (operative mortality 45 (46%)), and was not affected by delay in diagnosis or treatment.

Conclusions:

Although delay in diagnosis or treatment did not seem to affect mortality, improved awareness of non-specific presentations of (imminent) rupture will result in fewer misdiagnoses and earlier treatment. A group of patients will undoubtedly benefit from this as they can be operated on at a stage when expected mortality is lower. Copyright © 1998 Taylor and Francis Ltd.

[metisdead]

Some more off topic posts and replies intended to hijack the topic into discussion of diabetes, triage in other countries have been removed. 

[Thongkorn]

How many have actually been in a Thai Government Hospital, Like most Hospitals in the world they are under pressure and usualy A&E is full, some genuine some not so, The Staff at the Hospital probably where doing their best, its unfair to criticise them , Only they know the real facts

[Here2008]

8 minutes ago, atyclb said:

Although delay in diagnosis or treatment did not seem to affect mortality,

 

And how many of the patients in that study were children ?   You only post an abstract but I am willing to bet there were no children involved.

Edited July 23, 2017 by Here2008
spelling

[mark131v]

18 minutes ago, Here2008 said:

 

And how many of the patients in that study were children ?   You only post an abstract but I am willing to bet there were no children involved.

You triage on symptoms that are evident during your assessment based on the report here this young lad presented with very obvious signs of acute abdo pain over a fairly protracted period of time, acute abdo is worrying and can be time sensitive and is treated as a medical emergency until proven otherwise

 

There are many reasons for these symptoms but what this case has highlighted is there has been a catastrophic failure in the triage system with tragic results especially for the family who have watched this culminate with him being treated on the floor of the ED in full view of anybody with a cell phone 

 

Not going to argue on whether this could have been treated or not as that is beside the point and we will probably never know what really happened  but I can categorically state that had this kid been dealt with in the UK he would certainly have been triaged as a high priority patient based on the limited report we have here

Edited July 23, 2017 by mark131v

[Here2008]

2 minutes ago, mark131v said:

presented with very obvious signs of acute abdo pain over a fairly protracted period of time,

It would seem you are reading more into a rather poor Tabloid 'report' than is actually there.

 

Your claims of there being a "catastrophic failure" are nothing other than speculation.  

 

Perhaps you have  privileged access to detail not available to others?

[mommysboy]

4 minutes ago, Here2008 said:

It would seem you are reading more into a rather poor Tabloid 'report' than is actually there.

 

Your claims of there being a "catastrophic failure" are nothing other than speculation.  

 

Perhaps you have  privileged access to detail not available to others?

 

The following is surely salient:

 

"The poster said that the boy had repeatedly been told to wait after arriving at the hospital with stomach pains.

Even though he couldn't even sit he was still told to wait his turn."

 

My take is that the poor lad arrived at hospital in acute pain and collapsed before he was even seen.  Doesn't that point to the possibility of something being very amiss?  Try to imagine being there, perhaps that will help in seeing things straight.
 

[Here2008]

Just now, mommysboy said:

Try to imagine being there,

Imagination coupled with Speculation breeds rumour in the absence of verifiable fact ..........

[mommysboy]

4 minutes ago, Here2008 said:

Imagination coupled with Speculation breeds rumour in the absence of verifiable fact ..........

 

5 minutes ago, Here2008 said:

Imagination coupled with Speculation breeds rumour in the absence of verifiable fact ..........

 

In effect then following this old trope nobody need make a single comment.

 

Poor posting imho

 

[Here2008]

20 minutes ago, mommysboy said:

Poor posting imho

I disagree -- Just an abhorrence

of speculation/rumour-mongering by those who love to gossip, find fault and attribute 'blame".

Edited July 23, 2017 by Here2008
Correction of "predictive" text !

[LannaGuy]

2 minutes ago, Here2008 said:

I disagree -- Just an abhorrence

of speculation/rumour-mongering by those who love to gossip, find fault and attribute 'blame".

and without facts to back it up!  it's extremely unlikely him being seen earlier would have helped but you would know better than me if it would or not but, as you know, hospitals visit life and death daily. This was bad luck. We don't know so many things like how busy they were, what cases they had, how long they waited, why they didn't call an ambulance, why the relatives did not make more fuss etc.

[tryasimight]

On ‎22‎/‎07‎/‎2017 at 4:52 PM, Pridilives said:

Universal healthcare?

you read story from Missouri above?

i believe elected government more responsive to needs of people. What you believe?

I believe elected governments have very little to do with the day to day running of a country. Governments decide policy.

The day to day running of a country, elected governments or not, is done by bureaucrats and the public service.

 

If you really think that a district hospital administration has changed by the installation of a non elected government has changed then you are delusional and away with the fairies.

[tryasimight]

On ‎22‎/‎07‎/‎2017 at 5:38 PM, dcnx said:

Probably because we're in Thailand and we're all posting on a forum called Thai Visa.

 

But don't let something so unbelievably obvious get in the way of your agenda.

 

Most posters are not in Thailand.....

Edited July 23, 2017 by tryasimight

[Pridilives]

8 minutes ago, tryasimight said:

I believe elected governments have very little to do with the day to day running of a country. Governments decide policy.

The day to day running of a country, elected governments or not, is done by bureaucrats and the public service.

 

If you really think that a district hospital administration has changed by the installation of a non elected government has changed then you are delusional and away with the fairies.

So introducing universal healthcare changed nothing at Thai hospitals? You may want double check your beliefs.

 

Edited July 23, 2017 by Pridilives

[Grubster]

1 hour ago, mommysboy said:

 

The following is surely salient:

 

"The poster said that the boy had repeatedly been told to wait after arriving at the hospital with stomach pains.

Even though he couldn't even sit he was still told to wait his turn."

 

My take is that the poor lad arrived at hospital in acute pain and collapsed before he was even seen.  Doesn't that point to the possibility of something being very amiss?  Try to imagine being there, perhaps that will help in seeing things straight.
 

There are many things that are not urgent that could cause this pain, you ever had a kidney stone. Until emergency nurses can do a cat scan with their eyes there will be those who fall through the cracks of a fair system. I have been in many emergency rooms where there were several in acute pain including me. Most times I was there I was working as I did a lot of work for hospitals. Maybe you should have the job of deciding when to send the next patient in and then you could see that that is not an easy call to make.

[Prbkk]

1 hour ago, Here2008 said:

Imagination coupled with Speculation breeds rumour in the absence of verifiable fact ..........

Absolutely nothing compared to what this thread would have been like had it been an elderly farang with chest pain or a bikie injured in a crash that had been made to wait. In those cases it would have been: a monumental scandal, further proof of Thailand's third world status, a conspiracy because foreigners are not wanted, plain racism, something to do with Thaksin, etc

But raise questions over a delay in having a very young child in acute pain seen by doctors rather than a triage nurse/clerk....don't be silly, no story here. Weird.

[tryasimight]

On ‎22‎/‎07‎/‎2017 at 7:53 PM, todlad said:

I go to the eye hospital every few months to check the pressure in my eye. I arrive and within minutes they take my blood pressure and weigh me. Basic practice.

 

In A&E they prioritise their patients, of course. However, I believe children are always somewhat prioritised. In this case, this boy's blood pressure would have been lower than normal: red flag. Move him up the list. Do they treat on a first come, first served basis here?

 

 

Why do you presume his blood pressure would have been lower than normal?  The cardio vascular system is a little bit more refined that basic plumbing. A leak doesn't mean a lowering of blood pressure.

[Grubster]

I think they need to open lots of small government clinics here to handle non emergency cases, keeping the hospital emergency rooms clear to handle emergencies. That likely would not have saved this boy though as his parents probably would have taken him the the clinic thinking he ate something bad.

[sweatalot]

On 7/22/2017 at 5:27 PM, colinneil said:

Please get your facts correct the boy was never admitted 

Why are you going on about training?

WHERE YOU THERE? did you witness the incident?n answer yes to both questions, your comments are valid.

If the answer is no, which it probably is. Please stop condemning the staff.

He came to ER - that means he had to be assessed asap

[Prbkk]

2 minutes ago, Grubster said:

There are many things that are not urgent that could cause this pain, you ever had a kidney stone. Until emergency nurses can do a cat scan with their eyes there will be those who fall through the cracks of a fair system. I have been in many emergency rooms where there were several in acute pain including me. Most times I was there I was working as I did a lot of work for hospitals. Maybe you should have the job of deciding when to send the next patient in and then you could see that that is not an easy call to make.

Really, that is nonsense. It is universally accepted that pain of the magnitude experienced by this boy, "unable to sit" , need to be evaluated and relieved as a high priority. USUALLY such pain has a serious cause and is ALWAYS considered URGENT. Read the triage guidelines.

[sweatalot]

9 minutes ago, tryasimight said:

Why do you presume his blood pressure would have been lower than normal?  The cardio vascular system is a little bit more refined that basic plumbing. A leak doesn't mean a lowering of blood pressure.

A leak doesn't mean a lowering of blood pressure.

 

Yes it does mean this - in particular when it can lead to death

There is something that is called shock index which is a reliable indicator 

Edited July 23, 2017 by sweatalot

[Grubster]

1 minute ago, Prbkk said:

Really, that is nonsense. It is universally accepted that pain of the magnitude experienced by this boy, "unable to sit" , need to be evaluated and relieved as a high priority. USUALLY such pain has a serious cause and is ALWAYS considered URGENT. Read the triage guidelines.

And you can tell how much paid a child is in? I have seen many act like they are in the process of having their head sawed off when they hurt their finger. And that is not nonsense, again you need that job so you could be the man who decides. Bad pain may be urgent every time in some western hospitals as they do not have people waiting for emergency care like they do here.