Richard Mabry - Medical Error

"Doctor, more than fifty patients come in here every day."Rhonda pointed to the open door to the waiting room. "Most mornings every one of those chairs is filled. As soon as somebody comes in here for us to draw blood, somebody standing along the wall takes the vacant seat. We check their paperwork, ask them to verify their name and birthday, take the sample and move on. So far as we're concerned, you are who your lab slip says you are."

"Well, can I ask the other technicians? Maybe they remember something."

Rhonda was already shaking her head before Anna finished."Dr. McIntyre, you ever heard of HIPAA?"

Of course, Anna had heard of the Health Insurance Portability and Accountability Act of 1996. Its most important provision, designed to protect patient privacy, had added another layer of paperwork for medical professionals already buried under reams of it. Before any medical information could be revealed, even to a patient's spouse or parent, the proper forms had to be signed. "You're telling me you can't help me because of HIPAA regulations," Anna said.

"I'm telling you that I could get in trouble just by talking to you about this. That patient-the one who told us she was Anna McIntyre-didn't list your name on the HIPAA form she signed."

"But I'm Anna McIntyre. So I can give you permission."

Rhonda shook her head and started to turn away. "Doctor, I've given you more time than I should already. Even if we went through all the legal hassling to get permission to talk about this, I'd still tell you the same thing. All the information we have about these patients is what they give us and what Lola out there at the desk copies offtheir insurance papers. We don't remember their faces or whether they have green hair or a big eye in the middle of their forehead. All I'm looking for is a good antecubital vein. Then, if the patient doesn't faint in the chair, we slap on a bandage, they're out and somebody else fills the spot before it gets cold." The last words were said over her shoulder and by the time Anna framed a reply, Rhonda was looking over a printer strip as it spewed from an automated analyzer.

It was obvious to Anna she'd gone as far as she could go here, with absolutely nothing to show for her efforts except the start of a massive headache. She thanked Rhonda, who acknowledged it with a wave. Anna turned and made her way back into the waiting room where the receptionist-presumably Lola-hardly gave her a glance before returning to her attack on the keyboard of her computer.

Anna spied a water fountain in the corner. She dug two Extra Strength Tylenols out of her purse, and washed them down with tepid water from the fountain. As soon as she got to a better neighborhood, she'd stop at a convenience store and get a Coke. Maybe the caffeine would help get rid of the headache.

In the parking lot, the collection of homeless men had dwindled to three, all leaning against the chain-link fence. The bag-in-a-bottle she'd seen earlier was no longer in evidence. Anna headed toward her car, fighting the urge to run. Easy now. Just like being in the jungle-don't show any fear. Halfway to her car, she pulled her keys from her purse and thumbed the remote.

"Hey, lady. You got any spare change?"

The largest of the trio, a stocky white man, eased offthe fence and began walking toward her. He hadn't shaved in days, and as he got closer, Anna decided he probably hadn't bathed recently either. The other two men didn't move, apparently content to watch the scene unfold.

"I asked if you got any spare change." He was directly between Anna and her car, standing easily with his hands on his hips. His breath smelled of cheap wine and dental decay.

"No. No, I haven't." She tried to move past him, but he moved with her, blocking her way.

"Well, maybe we should just see." He reached out for her purse and tried to wrestle it away from her, foiled for the moment by the strap across her chest.

"Help!" Her screams didn't produce any action from the two observers, who continued to watch with detachment. She tugged at her purse with her left hand, groping wildly for her pepper spray with her right.

The man dropped his hold on the purse and drew back his fist. Anna's hand closed around the spray canister and pulled it free. Her finger was on the button when she felt a jarring pain in the point of her jaw. She caught a glimpse of sky. A loud thud, like a football being punted, filled her head. Then nothing.

Her first thought was that she had to get up. It must be morning. She wasn't sure what she had to do, but she was certain she was late. She started to roll out of bed, only to find that she couldn't move. She was strapped down. And the room was moving-rocking from side to side, bumping up and down. What was going on?

"Just take it easy, miss. Lie back."

The unfamiliar voice didn't reassure her. Just the opposite. She was in some sort of narrow room, and the sound of a siren seemed to be all around her. Where was she? And why couldn't she move? She opened her eyes but the light was dim. Everything was fuzzy, with halos and colored spots making it almost impossible to see anything clearly.

She heard a man's voice, the words faint and echoing as though issuing from a tunnel. "Easy there."

She tried to turn her head but met resistance. A wave of pain drove her back against the bed. What was going on?

"Don't struggle. We have you secured to a stretcher. Your neck's in a collar, in case you hurt it when you fell back on the concrete. Just relax and we'll have you in the Emergency Room in just a few minutes."

She strained to move, but when she flexed her right wrist she felt a sharp prick.

"You have an IV in your arm. Just lie back. We'll be at the hospital soon."

Why was he saying that? What was going on? Another effort to turn her head intensified pain that she thought couldn't get any worse. Her stomach began to churn. She lay back, closed her eyes, and took a deep breath.

"Can you tell us what happened to you?"

The voice was nearer. She opened her eyes, squinted, saw a man bending over her. He was wearing blue coveralls with some type of emblem on the chest. The nameplate over his breast pocket read "Tom."

"Tom." Her voice was raspy. She swallowed and tried again."What happened? Where am I?"

"Hold on. Let me check your vital signs again."

She felt something squeeze her arm to the point of pain, heard a mechanical whir. She bit her lip from the discomfort before the pressure was released with a low hiss. Tom nodded and made a notation on a clipboard he pulled from somewhere behind him. "Okay. Here's what I know. You apparently fell in the parking lot of Metro Labs. Looks like you hit the back of your head. Lost consciousness. One of the technicians stepped outside for a smoke, saw you, and called it in. We just picked you up, and we're headed to the Emergency Room."

"Hey, Tom." A metallic voice came through a speaker above her head. "Baylor's ER says they're swamped. If she's stable, I'm detouring to Parkland."

"Affirmative," Tom replied. "Let's do it."

She squeezed her eyes shut and tried to concentrate. Her head felt as though an air hose was inflating it to three times its normal size. The pain increased with every beat of her heart. When the wail of the siren dipped, she was conscious of a constant roaring in her head. The ambulance-at least, she figured she was in an ambulance-rocked and swayed, bringing with it more nausea. She swallowed hard and willed her stomach to be calm.

Think. Why had she been at that lab-the name had already flown from her thoughts-and why did she fall? As her thoughts went around like a carnival ride, going in a circle with no progress, a more important question intruded. Who was she?

Ambulance coming in,Dr. Fell. Female, found unconscious in a parking lot. Vital signs are stable. The EMT says she's starting to wake up."