He Refused the ER—and His Family Believed We Sent Him Home
This account was submitted by a healthcare provider and de-identified before publication. Details that could identify a patient or practice have been removed, and it is shared with the provider’s consent.
Had a patients family member comment that their loved one, who was seen for urinary retention at my urgent care, was sent home to die.
Pt with chief concern of urinary retention. He had obvious evidence of head trauma on exam (abrasions and a black eye if I recall correctly). Recognizing the red flags, immediate recommendation for transfer to the emergency room via ambulance was advised. The patient who presented to the urgent care by POV, was A&O, not showing any signs of confusion or inappropriate behavior unfortunately refused transfer by ambulance. He stated he would drive himself to the hospital per my recommendation to proceed to the emergency room. Regretfully, according to the posted comment, it seems he must have returned home instead and eventually passed from complications of his injuries. During the visit he showed evidence of possessing all cognitive abilities to maintain his patient autonomy and therefore had every right to make decisions regarding his own care. He assured me he was driving to the emergency room upon leaving and I had hoped for a good outcome for him.
The commenter likely has no knowledge of the discussions the patient and I had, that he was advised to report to the emergency room, or that I discussed the reasons for referral included progression of complications to severe morbidity and even mortality with the patient. While I am upset at the outcome of this case, I realize it is nothing compared to the despair loosing a loved one way too early in life. The patients family has likely lost faith in the care provided across all urgent care facilities and possibly that of all physician assistants across the profession, or even the entire medical system as a whole. Being unable to respond the the comment left by the patients family member leave no room for further discussion, anxiety regarding the case, and no room for expressing my condolences for their loss, or further informing them on the conditions surround the care of their loved ones.
For fear or legal consequence, I have not tried to resolve or address the case in any way.