whole Rossi Family together (Time 2 hours)

Leo: My wife was fine until Tuesday morning when she woke up early, about 5:00 with pain in her abdomen that she did not have when she went to bed Monday. I think she took some medication Tylenol or something and tried to go back to sleep she was really in a lot of pain by the time I woke up at about 6:30.

She asked Angelo to take her to the medical centre that we have been going to. This medical centre is new, and I am not sure how good they are. Our own family doctor, who was able to talk to my wife in Italian moved across the city to join a bigger group of doctors about a year or a year and a half ago, and it was too far for my wife to go by bus, so she goes to the medical clinic to get her heart medication. She doesn't really like going there much doesn't feel as comfortable as with our old doctor.

They told her she had an inflammation or something and took some blood I think and gave her a prescription for some medicine. When I got home from work on Tuesday, she didn't look good and she was still in pain, so I called Tony.

Tony: Yes, Mom and Dad called me Tuesday night after Mom had been to the clinic and told me she was in pain and the doctor had told her she had some sort of inflammation she had a low grade fever, but she said Tylenol was working to take the pain away.

I guess I should have asked more questions I probably should have called the doctor at the clinic to find out what the blood work results were, and to find out exactly what he thought given that he gave my Mom the prescription for Cipro and Metronidazole, I assumed she had diverticulitis and that was what he was treating I really didn't get the impression from my Mom that she was that sick, I should have known that they wouldn't tell me the whole story, even Carmen didn't know how bad it was my Mom never wants to bother anyone, she is usually the one taking care of everyone else.

Carmen: I actually didn't know anything about my Mom being sick until Wednesday afternoon because I had been on night shift and my Mom never bothers me when I am working nights.

Anyway, Mom called me Wednesday afternoon and told me she was sick and that she had gone to the doctor the day before. She said she was uncomfortable most of the time and she had these bouts of really, really bad abdominal pain, but they came and went. She said she felt sick to her stomach, but that she wasn't vomiting. I went right over to my Mom's house to see her.

She was a bit flushed and breathing a bit fast, and her temperature was elevated again, I couldn't talk her into going to the hospital, so I called Tony and we both agreed that I should take Mom into the ED and have someone look at her. My Mom refused to go she is really stubborn, and never wants anyone to fuss over her. I feel so bad, I should have just dragged her to the hospital maybe then none of this would have happened and she wouldn't have gotten so sick. I made Mom promise that she would go to the doctor in the morning if she wasn't better.

I guess Mom was up most of the night and was in quite a bit of pain, but she wouldn't let my Dad phone me, She finally phoned me at 8 in the morning on Thursday and I was at her house in about 15 minutes flat again she was refusing to go to the ED but I did manage to get her to agree to come to the medical clinic the doctor there saw her quickly and knew that she was a lot sicker than she had been on Tuesday. He even called an ambulance to take her to the hospital. That didn't seem to matter to the doctors and nurses at the hospital though I thought she would be seen right away since she arrived in an ambulance, and it was the doctor that insisted that she be transported in an ambulance because of her blood pressure!

Well, she wasn't seen quickly at all, in fact when I got to the ED at about 9:35 I went in my own car my Mom was in the hallway with the EMT from the ambulance with her. I asked the triage nurse to get one of the doctors so that I could speak to them as I was starting to get really concerned about her and couldn't believe she wasn't triaged right in to the department. The triage nurse didn't seem to care and just told me that my Mom would be given the next bed and that the ED docs were too busy to talk to me she did at least start an IV and gave Mom a bolus of fluids.

Mom got to an ED bed about 11:45 and a resident came to see her about 10 minutes later and he got some blood work and xrays. When the ED doctor finally came to see my Mom I think it was about 12:30 or so, she said they had called in a consult to surgical services. I was really worried then, I told her how worried I was and that I couldn't believe how long it was taking for something to be done for my mother Dr. Jordan told me that she and her colleagues have been telling the hospital administration for many years how unsafe it is for patients with serious medical problems to be waiting as long as they have to for a bed in the ED, but nothing seems to change and there is nothing the ED Docs can do about it. I couldn't believe that is what she said to me!

I decided I should call Tony, so I went outside of the ED to call him. I got back to the ED about 15 minutes later and my Mom was gone. I didn't know where they had taken her I didn't know they had ordered a CT scan, so I had no idea where she was. My Mom came back from the CT scan, and she couldn't really tell me what they had done she said she had signed something for a test they did, but she didn't know what it was. My Mom doesn't speak English very well, so I can't believe they got her to sign a consent form when she didn't even understand what it was she was signing. She was feeling so awful that I didn't ask her any more questions.

About 2:10 or so what I thought was a doctor came in to examine her and I asked him what the CT scan showed and if they were going to do surgery, because my Mom was looking very sick by that time way worse than she did when she arrived at the ED. That was when I found out he was just a clinical clerk a clinical clerk! After 4 hours in the ED she was being seen by a clinical clerk from surgery what was he going to do

I was almost distraught by the time Dr. Chan came in sometime between 4:00 and 4:15 Dr. Chan said that she was going to do emergency surgery on Mom, but even then Mom didn't end up going to the OR for over an hour at about twenty after 5. I can't believe everything was so screwed up I wish I would have taken my Mom to the ED the night before, but I can't help wondering if they would have sat around and not done anything for her until she was really, really sick anyway.

So once they finally got her to surgery, I was a little bit relieved, until I saw her after surgery and things still were awful. But then it kept going downhill, maybe the worst part is the run around and lies I got once my Mom was in the ICU, after her surgery. I had to ask the nurses to have a meeting with the doctor from the ICU, Dr. Witmans, to talk about what was going on with my Mom. I asked him why it took so long for my mother to be diagnosed and treated for a life threatening condition and also why her kidneys had failed. He tried to explain what might have happened to cause the delays, but also kind of passed the buck by saying he wasn't involved with that part of her care. As far as the renal failure goes, he said he thinks that it was most likely caused by her sepsis and low blood pressure. He was at least honest with me about how my Mom was doing and was very clear that she was extremely ill and her prognosis should be considered quite guarded.

The next day, Tony arrived and started reading the chart and discovered my Mom's high creatinine level that showed up way back on Tuesday and was really quite elevated before they did the CT scan on her on Thursday. Tony explained to me that you don't give someone with a high creatinine contrast for a CT scan because it could cause them to go into renal failure I went to Dr. Witman's about this and asked him why he never said anything about it to me when I asked about the renal failure he said he didn't say anything because it wasn't his place. So, Tony and I had a meeting with Dr. Chan.

Tony: Carmen called me on Thursday right around noon to say how sick my Mom was, and how no one seemed to be taking her concerns seriously in the ED. I was working that day, so I booked a flight to come home as soon as possible the next day and went straight to the hospital to see my Mom.

She was intubated in the ICU and they had started her on dialysis. My sister told me about all the delays and how long it took for her surgery, so I demanded to see my Mom's chart to get to the bottom of things. The first thing that jumped out at me was that she had an elevated creatinine that showed up in her blood work from the clinic and that it was even higher when it was taken in the hospital and that no one seemed to even notice and they went ahead and gave her IV contrast for her CT scan which I don't really understand why they didn't just take her up to do surgery instead of wasting time with more tests when if anyone had actually looked at her, they would have realized that she needed surgery anyway, everyone knows that you shouldn't give IV contrast to a patient with a high creatinine, because of the risk of renal failure. I asked that Dr. Witmans about it in the ICU and that is when the whole runaround about who actually ordered the abdominal CT scan got started and when my sister and I really felt like the staff wasn't being honest with us and that there were lots of things they weren't telling us.

My sister was really mad when we had that conversation because she had talked with Dr. Witmans before I got there and he never said anything about the fact that the IV contrast could have been a major factor that lead to Mom's renal failure. The ICU doctor said that he didn't order the scan and it wasn't his place to bring it up. He told me to talk with the surgical service as they were taking care of my Mom at that time the test was ordered.

So we talked with Dr. Chan about the decision to order a CT scan when Mom's creatinine was already high. Dr. Chan passed the buck and explained the test had been ordered by the ED physician and told us to talk to the Department of Emergency Medicine to find out how to contact Dr. Jordan who was the ED doc on that day.

Finally Dr. Jordan came and talked with us face to face at least, and said it was the emergency resident, I think his name was Fitzgerald or something, who ordered the test. Then she left for a bit and came back only to tell us that it was Dr. Fraser a surgical resident who recommended to the ED Resident that the CT with contrast be done. So in the end, it feels like absolutely no one is going to accept responsibility for ordering a test that has caused my Mom to be on dialysis or accept responsibility for all the delays in getting my Mom to the OR, and ultimately causing her to be close to death in the ICU.

Who do you want to talk to now