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Wednesday, November 21, 2007

Hospital Cited In Death At Jail

Denver Health Medical Center has been cited for failing to diagnose and treat Emily Rae Rice's abdominal injuries before sending her to the Denver jail where she bled to death, U.S. District Court records show.

Rice, 24, died in her cell Feb. 19, 2006, after a drunken-driving crash in which her spleen was ruptured and her liver slashed.

She was first taken by ambulance to Denver Health, where a paramedic student and a graduate nurse indicated to the primary-care nurse and physician that Rice complained of pain to her shoulder and abdomen, the records show.

But the primary-care nurse and physician did not follow up with a physical examination of Rice's abdomen before she was transferred to the jail, the records say.

Three federal citations, issued in August 2006, were contained in a court motion filed Monday by Rice family attorney Darold Killmer.

Killmer says he and the family were unaware of the citations or the federal probe for 16 months because Denver Health officials did not inform them even though they were engaged in discussions with the hospital on resolving the family's federal lawsuit.

"Denver Health has effectively squashed that investigation because it's so damning towards them," Killmer said Tuesday.

Denver Health spokesman Tony Encinias said the medical center has not been fined, and he declined to comment on whether a fine could be pending or other elements of the Rice case because of the litigation.

Rice's parents have sued the hospital and the jail because they say her complaints of abdominal and side pain were ignored, causing her death 20 hours after she was seen by doctors at the medical center.

An internal-affairs investigation at the jail determined that two deputies had failed to make required visits to check on Rice, possibly contributing to the cascading events that led to her death. The jail has denied that the failure to check on Rice played a role in her death from internal bleeding.

In the filing, Killmer is responding to a motion to dismiss the case against Dr. Jason Haukoos, one of many medical personnel who came in contact with Rice the day she was taken to Denver Health.

Killmer contends Haukoos should not be dismissed from the lawsuit because his negligence caused Rice's death and that the citations support the allegations.

"Defendant Haukoos affirmatively decided to perform no diagnostic tests or labs which could explain the cause or causes of her shoulder or abdominal/side pain," the filing says. "Instead, the only lab work those detaining Ms. Rice found to be important enough to perform was a Breathalyzer that would determine Ms. Rice's criminal culpability instead of any tests whatsoever to determine the severity of her medical condition."

Rice had a 0.12 percent blood-alcohol level at the time of the crash. The legal limit for drivers in Colorado is 0.08 percent.

The investigation of Denver Health's actions in the Rice case was conducted by the state on behalf of the federal government. Authorities found Denver Health failed to provide Rice adequate medical screening; failed to ensure that Rice received adequate assessment and treatment to stabilize her medical condition; and failed to ensure that her medical condition was stabilized before she was transferred to the jail.

Such deficiencies violate the federal Emergency Medical Treatment and Active Labor Act, designed to guard against hospitals dumping patients.

Neither Howard Roitman of the state Department of Public Health and Environment nor Killmer knows what the citations mean for the hospital.

Officials with the federal Centers for Medicare and Medicaid Services, the agency that oversees the citations, could not be reached Tuesday for information about the investigation.

The Denver Post

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