Harris Health Ben Taub Refusal to Triage

This week I went to the Harris Health Ben Taub ED because I was passing a kidney stone. I was refused triage and told that I would have to wait 7 hours for treatment, behind a waiting room full of people who were obviously in the ED for urgent issues that were not as acute as a kidney stone.

As a e-patient advocate, I am aware of the options available for patients who are denied emergency care. Harris Health is not a Joint Commission accredited hospital. It is instead accredited by the DVN GL Corporation. I am sharing my experience with them using their patient compliant process. I choose not to be anonymous while submitting this form (obviously).

Description – please describe your compliant

In the early morning hours of 07-11-2017 I realized that I was passing my second kidney stone. I arranged for a ride to the ED quickly, knowing that crushing pain would soon begin. Indeed, by the time I arrived at the ER, I was unable to stand up straight and I was experiencing waves of nausea.

I walked into the ED told them I was passing a kidney stone and asked for help. Two security guards waved me around the corner where a woman told me to sit. As soon as I sat down, I began vomiting. After vomiting, I told the woman that I was passing a kidney stone and that I was in terrible pain. She never asked what level of pain I was experiencing, or asked what I was experiencing. I made it clear that I had a kidney stone and that I was in pain. I told her that I had not been previously treated at Ben Taub and that I went to Memorial Hermann ED for treatment that last time.

She took my information and told me to proceed through the double doors, and that I would find a trash can in the next room to deposit my pan of vomit away in. I went through the double doors to find the waiting room, threw away my vomit and immediately approached 4 people about what I was supposed to do next. All of the people who were clearly staff in the waiting room said the same thing. They were not the person I needed to talk to and they did not know who I should talk to. I spoke to at least 4 different people in at least 4 groups. Confused as to what I should do next, I returned through the double doors to the original woman and asked what I was supposed to do.

I was then informed that I was to wait in the waiting room for my name to be called and that the wait was going to be 7 hours.  I said that I was passing a kidney stone and made it clear that this was not acceptable. I was given a “sorry”. I asked if I could leave and seek treatment elsewhere, I was told that I could.

I left and went to an urgent care center. The urgent care center promptly treated my pain and confirmed a kidney stone with a CT scan. They also informed me that my blood sugar test qualified me for “first onset diabetes”. I was given insulin to immediately lower my blood sugar. I am a healthcare data scientist, and I am fully aware of what a Diabetes diagnosis means for me long term. However, I still do not understand what it means in the short term and what steps I need to take. I remain confused and frightened.

I know that drug seeking is a difficult problem. I am sympathetic to the pressures that the ED clinicians are under and I know that there were dozens of people seeking primary care in the ED. I was not one of them. I was having an acute event, for which opioid treatment is the only reasonable cure. The Harris Health Ben Taub ED department simply did not triage me.

Despite vomiting multiple times in front of the only clinical person that I engaged with, I was never asked how I felt, what my symptoms were. I was asked “when this started”, and not much else.

After leaving Harris Health without having my symptoms considered and without treatment, I went to an Methodist Urgent Care center were I received prompt treatment. I did not instantly receive opioids there either, but the delay was commensurate with the time it takes to verify that I am not a frequent opioid user (i.e. not an addict, and not an abuser of opioids) then they treated my pain quickly and with compassion. They also performed a CT scan which confirmed the presence of a kidney stone, the results of which I am attaching to this submission.

Desired Outcome of the Compliant

I expect patients to be properly triaged by competent staff in the ED. There are digital mechanisms to determine scripts for opioid usage. I know this, because I designed and implemented at least a few of them.

My personal opioid usage history is a perfect example of someone who suffers from kidney stones. I have never sought opioid prescriptions outside of acute events. These events always correspond with follow up visits to my primary care physician, who then prescribes appropriate, non-pain related medications to treat kidney stones. Using only the SureScripts medication reconciliation process (which is required to a part of any Meaningful Use Certified EHR). Clinicians at Harris Health could have verified that I was not a “drug seeker” (which is BTW, an insulting and pejorative term)

In short, the data shows clearly that I am exactly what I claim to be: A person with a history if kidney stones, passing a kidney stone.

Presumably, Harris Health and Ben Taub are very willing to use prescribing history against patients in their ED. They use this information to deny access to opioids to patients they suspect of being recreational opioid users or opioid addicts.

The desired outcome of my compliant is that Harris Health will actually perform triage on patients, ensuring that patients who are in pain receive timely pain treatment.

The reason that my drug history is available to Harris Health is so that they can better treat me when I arrive. If Harris Health has access to this data, but either ignores it, or merely uses it to deny care, then they have betrayed the intent of the information system. In my opinion, that makes them guilty of defrauding the public of the more than $2 million dollars they received to install the Epic brand EHR system.

I am posting this to my personal website at http://fredtrotter.com


I will update this article with any information I receive back.