this post was submitted on 27 Dec 2023
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Per the laws involved here, "permanent disability" means something like paralysis from a spinal injury, or loss of organ function due to acute critical illness like a necrotic bowel or something. Unfortunately, according to the medical and legal literature on the topic, disability from pain or chronic disease is beyond the required services of an ER. Arguments can be made for acute-on-chronic situations like splenic damage or rupture in sickle cell crisis, but those areas can get pretty fuzzy.
That's a shame. Under disability law, permanent disability is legally defined as a loss of mental or physical function to the point of significantly reducing one's ability to work or perform daily activities for an indefinite period.
It's ironic that medical disability considers the loss of a limb as a permanent disability but not permanent pain and suffering, because I'd gladly trade my leg to know what it's like not to be in pain again and to be treated like a person with a visible disability.
I think you misunderstood. EMTALA defines disability in relation to an emergent condition, injury, or acute illness. The degradation of a chronic condition into a disability is not something that an ER can or should be trying to treat. Disability as a whole can include things like chronic pain in addition to other neuropathies, parasthesias, or paralysis, but the definition of "disability" in terms of emergency medical care is entirely related to the disability being caused by an emergency medical problem, not a chronic one.
I think you are the one misunderstanding here. The medical neglect during my ER visit is what caused my disability. I'm not asking to be treated for chronic pain at the ER, I'm asking to be treated so that I would not have become disabled.
Unless you are obfuscating something, or there were some very unusual mistakes involved, I would think that medical neglect that caused a disability in an acute timeframe would warrant a consultation with a malpractice lawyer.
Medical neglect causing disabilities is much harder to prove than you would think. There is always the benefit of the doubt that doctors are assumed to have tried their best to treat you and that it was a 'coincidence' that you happen to have acquired a chronic condition.
There's nothing unusual about women with abdominal pain being sent home from the ER untreated and berated for coming here 'for no reason'. Women are systemically denied treatment from the ER because every form of abdominal pain is downplayed to being 'just female abdominal pain'. I had severe abdominal pain and spotting when I went to the ER on a Friday evening. I had to wait 4 excruciating hours after an initial screening. Andoctor was finally available and I tried to explain that this wasn't just a normal period and begged to have it checked out, but he doctor wouldn't hear it. He sent me home with ibuprofen and Tylenol and told me not to come back unless it was an emergency.
The OTC meds did jack shit and I already told the doctor I tried ibuprofen before coming. I was left to stew for 3 days, crying, in excruciating pain, and vomiting until I was able to see urgent care on Monday. Those 3 days were the most painful days of my life at the time. At which point I was diagnosed with a hemorrhagic ruptured ovarian cyst through ultrasound that was 3.5 inches in diameter. I was sent in for laparoscopic surgery to remove the cyst. I though that would be the end of it, but that was just the beginning.
I have spoken to my PCP, rheumatologist, and pain therapist about this, and it was universally agreed that the 3 days of neglect and severe pain was a significant contributor to fibromyalgia. Had I been immediately treated, there was a good chance that I may not have ended up permanently in pain. But there is no way to prove it. Any doctor could just say that I would have gotten it anyway.
The ER experience and the pain was beyond traumatizing, but the best part is that this is just the first one. You see, once you have fibromyalgia nothing you ever say in the ER will be believed anymore. The next two times I went to the ER, once for vomiting 24 hours straight and not keeping any fluids down, and once for severe full body pain and a 105F fever, I would be met when even more disdain and disbelief than before. Both times I was told by the advice nurse to go to the ER, and both times I would be eye rolled or reprimanded by at least one person. Keep in mind that I have already had fibromyalgia at this point, and each time I visited the ER it was under severe pain. And each time I regret mentioning fibromyalgia at all because I could immediately tell the change in tone and the insinuations of how I was 'one of those' implying that I am a drug seeker. I had to beg everytime to be treated and to be taken seriously which was immensely difficult to do when I was already delirious from pain.
These people don't know what pain is like with this condition or that how many of us want to kill ourselves because we can't handle the pain and stigma anymore. I'm not telling people about this because I have some personal vendetta, I'm trying to warn people to take everything ER staff say with a grain of salt because ER doctors are human and humans are not immune to implicit biases, and medical misjudgments are often made at the expense of patients who don't fit their preferred demographic.