Mr. Rosenbaum at Howard
THE LAST 46 hours of New York Times reporter David E. Rosenbaum's life can be segmented into three stages: his robbery and beating on Gramercy Street NW; the response of the D.C. Fire and Emergency Medical Services Department (FEMS); and his treatment at Howard University Hospital, where he died from a massive head injury. Mr. Rosenbaum's alleged assailants are in custody and awaiting trial. Possible missteps by FEMS have been reported. Now, thanks to an in-depth investigation by the D.C. Health Department, we learn what happened to Mr. Rosenbaum after he arrived at the emergency room of Howard University Hospital on the night of Jan. 6. It is a distressing account of across-the-board failures.
The Health Department found that:
· "Once Mr. Rosenbaum was transported to the Emergency Dept., the triage nurse failed to properly assess, evaluate and manage his clinical presentation" as required by protocols and patient care standards. "The triage nurse also failed to perform a neurological assessment to determine Mr. Rosenbaum's level of consciousness and the possibility of a brain injury, based on the low GCS scorings [suggestive of a severe brain injury] obtained by the EMS unit while on the scene."
· "The evening charge nurse then failed to assess and evaluate Mr. Rosenbaum's condition prior to assigning him to the hallway. Furthermore, she failed to alert and specifically assign his care to one of the ED nurses overseeing patients in that hallway."
· "Mr. Rosenbaum was . . . left unattended in the hallway for approximately one hour and 20 minutes after his arrival to the ED . . . after which time he was discovered to have a life-threatening brain injury which required emergency neurosurgical intervention."
· "There was no documented evidence that Mr. Rosenbaum's initial evaluation by the physician included a comprehensive head-to-toe assessment . . . that would have revealed any trauma to his head. . . . Concurrently, there was no evidence that [his] initial level of consciousness (documented as lethargy), along with his limited response to painful stimuli, was investigated by the physician to determine a possible cause."
The Health Department has notified Howard of several deficiencies in its patient treatment and has demanded an "acceptable plan of corrective action," D.C. Health Director Gregg A. Pane said yesterday. The Health Department has also notified the federal Centers for Medicare and Medicaid Services of its findings and is weighing other options for holding the hospital accountable.
And to think: Howard University is asking that the city spend $200 million and that the federal government guarantee an additional $200 million so the university and the city can build a $400 million medical complex that Howard medical professionals will control and operate.