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May 12, 2008
Please be advised I wrote this letter back in April, 2006. I have been holding it and I am really not sure why, other than dealing with the stress of what happened to my Mother. I have been giving it much thought and have decided I must go ahead and let you know of my concerns.
First I would like to preference and acknowledge my Mother did receive excellent care both in Jan. 2006 as well as the Feb. 2006 in the Maui Memorial Emergency room. The Emergency room doctors and nurses were out standing in both cases. She also received good care for her hospital stay of Jan. 2006. During her hospital stay in Jan. several of the nursing staff did provide outstanding care and I truly appreciate this.
However, following is what I wish to share with you.
I am writing to you to with deep concern regarding the medical treatment at Maui Memorial Hospital which was given to my Mother, Mary Clark for the time period of Feb. 20 to March 13, 2006.
As you read the following which I observed at the hospital, I would hope you would consider your own Mother or loved one receiving this type of treatment:
My Mother was admitted on Feb. 20th with heart fibrillation. On a following
Wednesday, I visited and noticed her right arm appeared to be swollen and she was not moving it.
My Mother stated her arm was numb and thought perhaps she had slept on it. I located a nurse and asked if my Mother had had a stroke and explained my Mother‘s arm did not look right and her comments. I was told my Mother was “fine“, that the nurse had just checked her and not to be concerned. The following Friday an MRI was done and I was informed by Dr. Jacobsen, my Mother had a stroke, but it was unknown when the stroke had occurred. I told Dr. Jacobsen, it was obvious, it was on Weds! What if the stroke had been diagnosed immediately?
While under care at the hospital my Mother developed a bed sore. Numerous times it was necessary for me to find someone and request my Mother be turned. My Mother stated, unless I was there she was not turned.
Numerous times, I observed her food tray had been brought and the covers still on hours after meal time. The staff did not assist her with meals.
My Mother complained of stomach pain. I was told she was constipated, I asked why a laxative was not given. I believe this was on the 28th of Feb. she was then given a laxative. About 4 days later, I arrived to find my Mother in
excruciating pain and sobbing. I was told her bowels were now impacted. I was told no future laxatives had been given since the 28th! Should not have this not been monitored and the doctor advised? She should not have gotten to this condition.
On one occasion, a nurse came in for a urine sample. A bedpan was placed but the specimen could not be obtained, after the pan was removed she did urinate. The nurse refastened the diaper. When I complained the diaper was wet, I was told “It is only damp.” This when she had a bed sore!
The call button and phone were constantly placed on her right side. She was paralyzed on her right side and could not call for help.
On one occasion, I came to find her crying and in extreme pain. I found a nurse and was told “She refused her pain medication as she can not swallow.” I asked WHY DO YOU NOT GIVE HER AN INJECTION IF SHE CAN NOT SWALLOW!! I am by no means a medically trained person but to me this lacks basic common sense. I was told there was no doctor’s order for injection. I requested a Doctor on call be brought to the room immediately. My requests were ignored. Finally, the nurse located Dr. Jacobsen by phone and an injection was ordered. My Mother’s pain was not managed.
One day an obvious mentally disturbed man was in the room directly across from her. He was ranting and raving and shouting profanities for hours in the hall way. When I arrived my Mother was quite nervous and upset about the situation. She asked me not leave the room until something was done about this person. My Mother did not feel safe. I stayed with her until this man finally went back into his room and calmed down. This person did not belong on the regular medical floor, he should have been in a mental unit.
After her stroke her hand was in a fist. After a week or so, I became concerned that perhaps her nails may be digging into her hand. I asked for a wash cloth to roll up to put in her hand. When I opened her hand I was over whelmed with the smell of what I can only describe as putrid mold. I asked for something to clean her hand and was given the pink spray used for cleaning when changing the diaper. Evidently, her hand had not been cleaned since the stroke!
I observed at times no one at either the front desk or at the nurses station. One incident took me over 15 minutes to find some one.
On three separate occasions I arrived at the hospital to find my Mother’s oxygen was not working. After locating staff, the oxygen was fixed.
I believe there was insufficient staff to meet the needs of my Mother, which put her life in jeopardy.
My Mother was released from the hospital on March 13th and moved to Kalama Hgts where she received Hospice care. She died on March 24th.
I firmly believe the lack of basic care at Maui Memorial hastened her death. I feel the hospital failed my Mother and did not meet her medical needs. I feel she did not received any where near adequate basic medical care.
There needs to be an investigation into the quality of care provided for the care of patients in the Maui Memorial Hospital. After observing what happened to my Mother while under care in this hospital my husband and I have discussed leaving Maui. We do not feel safe to rely on the a quality of care at Maui Memorial. Perhaps, there is need for an additional number of trained staff or an added medical facility of choice on Maui. I have spoken to many people since my Mother’s case and found it is very common for residents to seek medical treatment on Oahu or the Mainland as they fear the quality of care provided at Maui Memorial Hospital.
I would be pleased if you would carry out a full investigation into my concerns and
provide a response.
I look forward to receiving your reply. Please do not hesitate to contact me if you
need any further information.
(Name
withheld and on file)
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April
13, 2008:
My
husband got Leukemia and we have Kaiser insurance.
We were told because we don't have a blood bank on this island he had to be
treated on Oahu.
This became a hardship for us, because I work on Maui.
I wanted to be with my husband knowing this was a deadly cancer and he most
likely would die.
I didn't want to have regrets that I didn't give him quality time in what
little time he had left.
I chose to stay with him at the hospital and borrow from the equity line.
I slept on a cot in his room for 3 months on Oahu and two months for the bone
marrow transplant in California.
I had friend care daily for our dogs.
I can't tell you the countless mistakes I caught.
My husband also lost his voice during a lot of it and I spoke for him.
Nurses had know idea what was going on with him when they weren't in the
room.
He was in the pattern where he get a high fever they bring his meal and he
would throw it up.
He wasn't getting food in his body for days.
Till I checked his temperature and requested Tylenol to bring down the fever
so that he could hold down his food.
Yes they came in and checked pretty regular, but I would catch the fever an
half hour after they left.
Which would brew till the next time they came around.
The nurses were loving and the doctors were caring.
They brought a lot of joy to my husband in his last days.
Regardless spouses need to work and they need to be there for their dying
love one.
How can this be done if you have to go to another island for treatment.
I'm also bothered that in 3 different hospitals we stayed at for his
treatment.
Three nurses gave him his Alertness medication for his Narcolepsy at night
time.
I asked the nurses at each hospitals why are they give an alertness
medication 9 pm at night.
All had the same answer.
We always give the patience once a day pills at the end of the day.
None cared that its a medication that must be taken in the morning and slow
released all day for day time alertness.
Name
held by request
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Received April 6, 2008
I think that all of us can relate to these stories. Three years ago, after several mammograms (every six months) I was told that I needed to have a
stereo tactic biopsy done. It was scheduled in January (a month later). However, when I was admitted, IV attached, and a mammogram to mark the location before surgery was done, they said they couldn't find it. They told me that my surgery would be cancelled (one month after they told me I needed it). I was taken back to the
surgi-center and left in my room, IV attached and running. I needed to go to the bathroom but had been told I should not get out of the bed by myself so I wanted to call for help. I finally got hold of the buzzer but leaning out of the bed as far as I could, and swinging another line until it hit the buzzer and got it to swing back and forth and eventually to me.
They were shocked to find that I was there. They didn't even know when I had been brought back. They checked with radiology and then the doctor. Dr. Rosales had never been told of the cancellation. He was furious. They sent me home.
He consequently sent me to Kapiolani Women's Center where they did the mammogram before and after the surgery to remove the spot. All was done in a very short span of time. Very efficiently, too. So after seeing the spot for two years in the mammograms, they should've known that it was still there a month later, when the surgery was to have been done. They didn't even check further to find it.
As you know. Dr. Rosales has left Maui. One more wonderful physician to leave. Thank God that there are some physicians who continue to stay, despite all of the frustrations with the hospital, so that we, the innocents, can continue to have good care, at least from them.
I can tell you many more horror stories. But it would take days to recount them.
Aloha,
(Name withheld)
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Received April 5, 2008
Subject: ct scan Maui erroneous 1107
My husband experienced a tragic event on 080207 in the Bay area of
California, when he was hit by a light rail train. The resulting numerous injuries were life threatening and included diagnoses of 2 aortic injuries verified on CT
scan; he has a traumatic aortic injury at the isthmus with pseudo aneurysm AND a traumatic aortic injury in the descending thoracic aorta with associated
pseudo aneurysm. The hematoma is no longer visible, but the other 2 aortic injuries and
pseudo aneurysms were clearly visible on CT scans he has had repeatedly since 08/07 to 10/31/07. The event has been life changing and a source of tremendous stress.
Due to his head injury status as well as other injuries, they did not do surgery and instead had to monitor the injuries quite closely. The injuries were continued to be verified by the on going CT scans as well as follow up MRI. Due to the severe trauma he incurred, stress, anxiety and unclear long term life expectancies, we went to Maui in 11/2007 to try and achieve some stress relief. We had to travel with physician advice to seek immediate medical care with any symptomology we had been clearly educated on, due to the life threatening state of limited time issues should either of the aortic injuries rupture. During our trip to
Maui, unfortunately Eric began experiencing significant pain of concern that caused him to double over and be unable to continue driving. After locating the hospital after much delay due to very unclear signage from Kihei Maui to the hospital, he was admitted to the ER. I IMMEDIATELY provided staff there the specific diagnoses as well as copies of the CT CD and scan we carry with us in case of an emergency -to counter any further potential delays or confusion about his injuries. Again, we are optimistic they will remain stable, but have been advised by multiple professionals in the field that there is no guarantee and they can rupture, invoking an immediate, time sensitive emergency to save his life.
The staff clearly understood what his diagnoses was and they talked Eric into having another CT scan. Much to our shock, they reported to us an hour later that there were no longer any visible tears or aortic injuries. Therefore, they stated it must have diminished and healed. We respectfully questioned them because he had only had a CT scan at Stanford Hospital 3 weeks prior confirming the same status of those injuries. However, they
adamantly stated they did not understand but that they could not locate them on their CT scanning machine. Therefore, they must be better and healed. By clear indication, the staff was
extraordinarily nice and professional there.
Therefore, they discharged Eric even though he was still having some problems including chest pain; this obviously caused us stress and concern. The following day , we read the article in the paper describing major diagnostic concerns with the CT scanning machine at
Maui Memorial. Due to my husband's level of injuries and feelings concerned about what he had experienced diagnostically in the ER , we had to cancel the remainder of our time, left the island before intended and returned home, continuing to monitor his condition. Testing since then has confirmed that his 2 aortic injuries are still clearly visible ( even on a MRI scan), present and an ongoing concern; they are to a level they must be checked on an on going basis. We have complete documentation of each scan if needed.
This experience placed my husband at significant risk and appears to be emblematic of a much greater risk to not only tourists coming to Maui, but to the permanent residents. Regardless of whether it is a cancer diagnoses, cardiac, acute appendix issues, trauma, or car accident victims, proper diagnostic CT scanning equipment is vital for any hospital. Arguably whether it is commonly seen acute appendicitis or aortic injuries, both conditions are vastly reliant on proper scanning equipment. In fact, the diagnoses is key in what emergency surgery must take place and how quickly. CT scanning is used due to its' ability to quickly, particulary in emergency situations, scan and accurately diagnose such vital emergencies. If a hospital does not even have updated CT scanning equipment, it means the difference between life and death for more than a few situations. How can tourists and residents alike live in peace knowing that Maui Hospital does not have the proper diagnostic equipment needed to save their life in an emergency, including common acute appendicitis emergencies diagnosed on CT scanning? Vehicle accidents and traumas are common on this island; how could Maui not have the proper equipment needed?
Further, Maui has a tremendous international attraction to tourism, sports, retirement and investment properties-not to mention a obligation to care for its' residents. Therefore, it appears that there are potentially large financial stakes at risk, not to mention the risk to a families well being. Just as this has a wide sweeping impact on other families, it has definitively, negatively impacted our family. Further, as we were actually in the process of looking at property there and had planned to return to
Maui on a regular basis during the year, we have had to change our plans. We cannot invest financially either in investment property there or in vacations, with the scary, firsthand realization that the Emergency room on Maui does not have even the most basic, essential diagnostic equipment-most specifically CT scanning machines so clearly vital in trauma case and many other treatment issues.
This is clearly not a physician/nursing quality issue, but rather a remarkably alarming lack of quality equipment present in the hospital, that is urgently needed by them to properly diagnose and treat patients.
This failure in medical care there is so glaring that it can mean the difference between life and death; a risk most of us are not willing to take.
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February
13, 2008
To Whom It May Concern:
I hope I'm not too late to add my defense for
the AIHM bill HB 2867. I’m not
only a Registered Nurse and past employee of Maui Memorial Medical Center,
but I've also been a patient there.
I quit the hospital in 2005 because of
bureaucratic stubbornness, poor employee moral, and lack of proper resources.
MMMC has a hard time finding nurses and staff whom are willing to endure a
second rate hospital. A private
hospital would attract new nurses and doctors to the island whom are
seeking a more sophisticated, state of the art facility.
I, for one, would be interested. In November of 2007, Kaiser
laid off 90 RN's and all of their nurse practitioners island wide, just after
SHPDA said there were not enough nurses in Hawaii to support a new hospital.
Since quitting the Maui Memorial, I have been a patient there twice,
and nothing has changed. The
staff at MMMC preformed as best it could with limited resources, but twice my
baby had to be flown to Oahu for better care.
In addition, the lack of a visitor’s cafeteria, the postpartum ward
being family un-friendly, and sharing a cramped room, made me hope for better
options in the future. Maui
Memorial should not overexert themselves on becoming larger until they better
what they have.
We have already seen the prospect
of another hospital’s competition force the MMMC to expand and upgrade its
facility. If built, a private
hospital will continue to bring the needed competition and private
investment to better our community.
Maui is developing at an astronomical rate. Please
think of our future, and our family’s future.
We must take advantage of this opportunity now.
Thank you for your support on bill HB2867.
Sincerely,
Janet M
King, RN
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Dr. Ron Kwon and Jan Shields are
honored on the "Heroes of
Hawaii" list:
more about the heroes of Hawaii list...
Aloha Team AIHM,
It is a sad day for Maui. Dr. Ron Kwon is leaving.
Letter
from Dr. Ron Kwon:
Dear friends: I shall be closing my Maui practice and relocating to
the Boston area where I shall serve as a clinician and medical director with
Harvard Vanguard starting in April, 2008.
more
about Dr. Kwon's letter and Jan's response...
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Dec.
12, 2007: Read Maui News Opinion article http://www.mauinews.com/page/content.detail/id/36785.html
AIHM
Response
to Maui News editorial of December
12, 2007:
AIHM agrees that the answer is a 350 bed state of the art hospital in on
Maui. What would really answer our needs is for that hospital to be a
PRIVATE, teaching hospital. A government hospital will never be able to offer
the quality of care and the services that the good people of Maui deserve. As
long as the government has control over our Maui hospitals, it will have its
hands in the cash register and stop us from taking profit and turning it into
capital improvements.
What this hospital should not be is “Maui Memorial” in a new building.
That would be completely counterproductive. Private hospitals run efficiently
because there is a bottom line. Government hospitals run sloppy because they
are bottomless money pits. Private hospitals, profit or non profit, must
answer to a board, and therefore, must run like a well oiled machine.
Government hospitals answer to the government with an open hand. When MMMC
does make a profit, the money goes to Oahu.
A private hospital is for all Maui County people. It is private only in that
it doesn’t get paid for by your tax dollars, instead, it pays taxes.
Maui Memorial should become a combination of PRIVATE hospital services
including mental health, long term rehabilitation and long term nursing care.
None of these services will be so hard on an aging structure.
Placing a
failed organization in a pretty new building leaves you with just that: a
dressed up failed organization.
Join AIHM.
Jan Shields L.V.T., B.S.N., R.N.C
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Excerpt in a letter from a Canadian friend of an AIHM member:
November 2007
"Found out this a.m. I have a cataract....how the hell did that happen? I am too young aren't I?
Dr. Didn't think that was funny when I asked him, guess I am...sad state of affairs. LOL
Nothing done 'til March 5th...I waited four months for this appointment....don't let anyone tell you our health plan works l00%, we don't get what the taxes are up here. I can hardly wait to deal with the green card and get my butt back down to PA.
Going there in mid to late March to deal with everything. Mark’s will is STILL not done, 13 months now...(Mark was her husband who passed away)
Again, Gov't has to get in on it and we are waiting for a clearance certificate...which can take a year or more....can you believe it?
By next year I will be bag lady selling peanuts or pencils...if you are visiting here and see someone like that, say hi... Hailey."
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11/21/07
Thank you for forwarding this email.
Great information! Keep up the good work. Just wondering how many lives are lost because of Maui's poor healthcare system. So sad, because most residents and visitors do not even know the jeopardy that they put themselves in while living on or
visiting Maui. Fly to Oahu (if a plane is available and weather allows a safe flight) while experiencing a cardiac arrest, MI, serious accident, or a myriad of health issues that require a speedy diagnosis and proper treatment. No, no, no! What
can we do to help to get a state-of-the-art hospital in South Maui? Get the hospital and we will move back and contribute. Until then we have no other option but to stay on the Mainland where superior healthcare is available to us. We found the
healthcare on Oahu certainly below standard, also; especially, a good ER Department and hospital that must to be available to the ever-increasing aging population. I smell a rat in the political arena.
Maureen Chesney-Brown, RN
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10/29/07:
Dear Jan,
A friend of ours went to the ER at MMH Saturday evening - he was having difficulty breathing.
They diagnosed it as
pneumonia. They could not admit him as there was not a hospital bed available. They treated him in a hallway, administrating intravenous antibiotics - there wasn't even room for him in the ER. After several hours they sent him
home. AND WE DON'T NEED ANOTHER HOSPITAL - THIS IS UNCONSCIONABLE!!!
Aloha,
Shirley
OlstenZ
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10/22/07:
Aloha:
Although I currently live on the Mainland (Seattle), I do have family residing on Maui. I am concerned that the senior managers of the State's hospital system are not listening to what the residents of Maui are saying about the need for at least
one more major hospital on that island. Because of the current composition of the commission, which happens to be very Honolulu-centric, the healthcare needs of people on the neighbor islands is being
severely compromised. and the current CON
process is old and antiquated and needs to have a major revision or be abolished completely. It is a process that has outlived its usefulness..
I have a Masters of Health
Administration and have worked in the healthcare industry (managed care) for many years. While I would love to move back to Maui, I have some serious concerns about the quality and quantity of medical care that would be available to me if I needed
it. MMH is a fine institution, but when there are critical emergencies on the West or South side, a lot of time is wasted by emergency personnel who have to deal with the vagaries of the traffic infrastructure.
Having
additional hospital resources available are only one part of an acute problem with access for Maui residents, but the saying, "build it and they will come" I think will encourage more specialists and medical personnel to consider
practicing on Maui. There is also a critical need for more long term care facilities for the aging population. It scares me to read that Hawai'i's senior population is growing faster than anywhere else in the country.
Knowing
that critical hospital beds might be occupied by seniors who have no place else to go is a double tragedy.
I hope your organization not only works toward the day when Maui has at
least one more hospital, but that you also address the staffing situation and access to healthcare for our kupuna.
Sincerely,
Suzanne Kaneda
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RECENT NEWS
ARTICLES:
If the links don't take you to the page, "copy" and "paste" them in your browser address window:
If you can't read all of the articles, please don't skip this one:
http://www.bizjournals.com/pacific/stories/2007/07/02/editorial1.html
To review letters and editorials in the Maui News:
http://mauinews.com/page/search.results/nav/-1.html?startIndex=1&keywords=malulani
http://mauinews.com/page/search.results/nav/-1.html?startIndex=1&keywords=west%20maui%20hospital
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