For Profit “Medicine” just killed my brother

On New Year’s Eve, my brother (who I will call “Carl” in order to maintain privacy) had developed a terrible cough, and had to go to the Urgent Care in the rural community he lived in part time with his longtime girlfriend “Pam.” He was admitted to the hospital in the community (I will call it RR Hosptial) with pneumonia in both lungs.

My brother was legally blind, having lost an eye to glaucoma, and had been disabled for years. Despite the fact he had diabetes and heart disease, he still stayed as active as he could—when he would go down and stay with “Pam” he would help her with things around the house, like home repairs, and he would often go on camping trips with some of our cousins. He had just taken up caving as a hobby and wanted to explore some of the abandoned mines and caves in the area.

He spent a few days in the ICU on a bipap machine, receiving antibiotics. After 3 days, he was moved to a different unit because they said they needed the bed for another patient, and he was “doing better.” And maybe he was, for a short time. He came off the bipap machine for a day or two and was on just a regular nasal canula.  When I called the hospital during this time, the nurse told me his lungs were looking better, and they were thinking about discharging him to a rehab facility.

Then, the next day when I called, they told me he had to go back on the bipap machine because he was having anxiety that was affecting his breathing. The next day, the nurse told me he was having a great deal of swelling in his legs, so much so that he had blisters on is feet. I asked the nurse if he could be developing kidney failure and if sepsis was a concern, and she told me they thought the swelling was from the way he was sitting in his chair—he was trying to breathe a little easier. This went on for a few days. They told me then that his feet looked much better after a cream had been prescribed for him. She stated his lungs were looking better on the x-rays, and that the issues with his kidneys was probably due to one of the antibiotics he was on, so they switched his medications.

I was really starting to worry about “Carl” at this point. I suggested that perhaps he should be moved to one of the hospitals in Lexington since his condition was deteriorating and it did not seem like they were properly handling his situation. 

Then, last Saturday, he took a turn for the worst. He was no longer able to maintain an o2 sat above 90 on the bipap, and his blood pressure had dropped dangerously low. The had to put him on a ventilator and started him on medications that would help to support his blood pressure. I asked the nurse once again if he had sepsis, and her answer was “well maybe that’s what it could be, but said some of his labs did not reflect that.” His white blood cell count was 24, and he was only able to pass a little urine, yet nobody would simply tell me or “Pam” that he had sepsis and his kidneys were failing. They seemed like they were downplaying the severity of his condition. 

The next day, I called the nurse again. Now the doctor (who I was never able to meet with) had decided it was time for my brother to be transferred to a facility where he could receive inpatient dialysis—now, when his kidneys were completely shut down. They claimed they could not find a nearby facility that could accept him because they did not have any beds. He was on a “waiting list” at all the hospitals in Lexington, so they said.  I told them that if this was the case, it would be fine with me if he was sent to Cincinnati or Louisville—he needed to be on dialysis as soon as possible. I even called around myself to see if I could find a facility that could provide him with inpatient dialysis with open ICU beds (I work in the medical field myself). The nurse said the doctor was worried about their contract with one of the hospitals in Lexington—apparently, they were holding out for an ICU bed at that particular facility.  

I finally bluntly asked them why they were delaying sending him to a higher-level facility that could provide him with appropriate care, since they were unable to provide inpatient dialysis, and that he would die without it. I let them know I did not give two shits about their contract. I told them I worked in healthcare myself, and that I knew they were legally required to find him an appropriate transfer.

Early the next day, I received a call from the hospital saying they had finally arranged a transfer for him—and not the facility they were contracted with either. How convenient. They were unable to transport him by ambulance because there was only one paramedic on duty in the entire county, so they had to airlift him. He made it to the hospital around 9 am on Wednesday. They placed the shunt at the new facility, but they needed my signature in order to start the dialysis—and they were unable to contact me for several hours because RR Hospital did not give them the correct contact information for me. I called and the nurse on duty told me I needed to come sign it. I left work immediately and went over and signed it. He was finally able to start dialysis.

At first, it seemed to be helping him. They were able to back off on the amount of oxygen he was receiving in the ventilator, and I went home knowing the situation was grim, but hoping he had a chance and might make it. Interestingly, the head nurse at the ICU told me their hospital does not cap beds, meaning they accept any patient who needs treatment—they on fact had 4 beds. So my brother could have been there much sooner—and it seems as though somebody at RR Hospital was not being completely truthful about their ability to find him a transfer.

The next morning, about an hour after I clocked in at my job, I got a phone call from the new hospital in Lexington. They told me the line on his dialysis machine had clogged, and they were unable to continue dialysis because his condition had worsened overnight, and he was too unstable to continue. His o2 had dropped to the 70’s, even though he was in the maximum amount of oxygen. I met with the pulmonologist and his nephrologist. His lungs had gotten worse overnight, and they told me there was nothing more they could do for him. Then they told me that RR Hospital should have been working on getting him transferred days before—like when his legs started swelling and he had blisters on his feet—not days later after he was on a vent and his kidneys were completely shut down. The pulmonologist and the nephrologist both said he would have probably lived if they had transferred him sooner.

They wanted me to let them take him off life support then and there, but many members of the family are very religious, and they would not want this. I got them to agree to let “Carl” go when he went into cardiac arrest on his own. He held on throughout the day. Some family members were able to say goodbye to him at least. Then later his preacher came and visited him. His girlfriend and I were with him when he passed.

But my brother did not have to die! Wy did they wait so long to transfer him at RR Hospital? Was it because they were making money off him being in the ICU, and since he was just a poor, disabled guy on Medicaid his life did not matter to them? Or is their contract with another hospital more important than protecting the health of their patients?