The entrance to University Medical Center’s trauma unit and emergency room is shown in 2009.
Thursday, Feb. 4, 2010 | 2 a.m.
In Their Own Words
Roshunda Abney and her fiance Raffinee Dewberry did not know she was pregnant when they went to University Medical Center November 30, 2009. She was in severe pain, but they could not convince anyone to give her care. After more than five hours of waiting, the couple left UMC. They went to Valley Hospital Medical Center where they claim they were also turned away. She gave birth later at home to a premature baby girl who later died. This is their story, in their own words.
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The federal government is threatening to halt Medicare payments to University Medical Center — a sanction that could devastate the financially stricken hospital — because of its failure to care for an uninsured pregnant woman in its emergency room.
About half of the hospital’s operating revenue through the first three quarters of 2009 came from Medicare reimbursements, totaling about $180 million.
UMC can avoid the Medicare termination by correcting the deficiencies by Feb. 11, and the hospital says it has taken the steps to do so. If those fixes are confirmed by Medicare officials, the termination notice would be rescinded.
Brian Brannman, UMC’s chief operating officer, said Wednesday he is confident the solutions will satisfy the federal government. The Nevada Health Division, which licenses UMC, has accepted the hospital’s correction plan for the same violation, he said.
Brannman said UMC has replaced certified nurse assistants with registered nurses and doctors to do primary patient assessments, streamlined and standardized the process for transferring patients from Quick Cares to the emergency department and trained all staff in federal law, so they understand the need to screen and treat all patients.
Although UMC was implementing reforms, the Medicare termination notice is the kind of letter that “gets everybody’s attention,” he said.
“That’s the hammer they use, appropriately,” Brannman said.
At issue is how the hospital treated 25-year-old Roshunda Abney, who waited to be treated for more than five hours in UMC’s emergency room Nov. 30, complaining of severe pain, without realizing she was pregnant and in labor.
Records indicate Abney was given a blood test, which showed she was pregnant, but there is no evidence that she was informed of the results or given any medical care.
After leaving UMC’s waiting room and going to Valley Hospital Medical Center — where she says she was turned away — she went home and gave birth to a premature baby girl, who died.
The Nevada Health Division investigated the case on behalf of Medicare, and concluded that UMC failed to medically screen the patient and provide emergency care, as federal law requires.
“Consequently, we plan to terminate University Medical Center of Southern Nevada’s participation in the Medicare program,” the Jan. 29 letter from Medicare says.
Six staff members were suspended, and other measures have been taken to improve how patients are seen and prioritized in the emergency room, UMC officials said.
Jacob Hafter, the attorney representing Abney and her fiance, Raffinee Dewberry, said the couple are relieved that the federal government has validated their story.
“It’s a positive to know that UMC is being held accountable for its actions,” Hafter said.
He said he hopes UMC does not lose its Medicare funding, but is prompted by the tragedy to conduct a systematic evaluation and fix any problems that result in poor care. The couple’s reason for publicizing their experience was to bring about change, he said.
The state’s inspection showed that even though one of the hospital’s Quick Care clinics referred Abney to the emergency room, she only got as far as the waiting room.
The emergency room medical director told state inspectors he saw several areas where “we failed,” their report said.
Among them: When Abney complained she had been in pain for two days, a UMC employee told her that if she had been hurting that long then she could wait another 45 minutes.
And when her fiance urged UMC staff to take care of Abney, an employee threatened to call security to have him removed.
A security guard interviewed by the state inspector disagreed with allegations by employees that Dewberry was disruptive, and said employees were rude to the couple. Abney had been waiting for more than three hours when Dewberry politely asked a nurse when Abney would be seen by a doctor, the security guard said in the report. A nurse replied: “If you keep interrupting I’ll call security,” the guard said.
About 30 minutes later, Dewberry again asked when his fiancee would be seen by a doctor, and the nurse lifted her finger and said, “I am going to have security escort you out,” the security guard said in the report.
“I felt the fiance was asking legitimate questions,” the security guard said, adding that the couple’s behavior was no different from anybody else’s.
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