fannie-holmes_web.jpgLAUDERDALE LAKES — The state Agency for Health Care Administration (AHCA), which regulates hospitals and medical facilities, is investigating the circumstances surrounding the death of a woman who went to the emergency room at North Shore Medical Center FMC Campus.

Family members of Fannie Ruth Holmes, a 70-year-old retiree from Tamarac, allege that she did not receive the proper emergency treatment, even though she was rushed to the hospital complaining of stomach pain and vomiting.

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After emergency room staff examined her and administered tests, they finally admitted her to the hospital and assigned her to a room, where she died hours later. Family members question why she wasn’t taken in for emergency surgery or more tests.

Doctors did not immediately communicate to them the cause of death or provide any explanation about the circumstances surrounding the care she received, the family alleges.

The hospital rushed the body to the funeral home without an autopsy and without providing any explanation about why Holmes died, family members said.

Holmes died on Nov. 28. Her death certificate was not signed until the next week, on Dec. 3. The doctor who signed it listed the cause of death as acute pancreatitis and aspiration, a conclusion that was not based on an autopsy. Family members say they believe the hospital mishandled the situation.

Hospital officials have not responded to questions about the incident, or about the state regulating agency’s scrutiny.

“They watched her suffer, and just let her lay there and die,” said the woman’s husband, Willie Holmes, who accompanied her to the emergency room. “She went in complaining about her stomach, but they said she had a virus, or the flu, and never did anything to help her, even while she was vomiting up green stuff.”

State officials have not indicated when they expect to complete their investigation, but among other items, they conducted on-site inspections of the hospital on Jan. 4, and have begun interviewing hospital staff and the woman’s family, according to AHCA spokesperson Shelisha Durden.

The results of the investigation will be posted on the agency’s website within 45 days after the findings are made, Durden said.  If any violations are found, there could be  consequences.

“The Agency can impose fines or revocation of a facility’s license,” Durden explained in an email sent to the newspaper on Jan. 5. “Should the facility also be certified under Medicare/Medicaid we could also recommend to the Centers for Medicare & Medicaid Services (CMS) termination from the Medicare/Medicaid programs.”

Sue Conte, director of communications for the AHCA, said in an email, “…a complaint has been opened on this issue and we will be investigating it further. We will also be attempting to reach out to the family as a part of the investigation.”

RUSHED TO THE EMERGENCY ROOM

The incident unfolded at the former Florida Medical Center at 5000 West Oakland Park Boulevard in Lauderdale Lakes. The facility merged with North Shore Medical Center on June 1, 2009 and is now called the North Shore Medical Center FMC Campus.

On Friday, Nov. 27, Fannie Holmes called 911 after she began having stomach pains in her Tamarac home. Paramedics rushed her to the emergency room.

Willie Holmes said his wife was checked in and then sat, all the while groaning in pain. She was taken in for tests and then returned to a room in the emergency area, where she lay on a bed. He said hospital personnel came in and out of the room several times.

At one point, while comforting her alone in the room, Willie Holmes said her vomiting worsened, prompting him to run into the hallway and yell for help.

“They told me she had a stomach virus, but they still were not doing anything to help her,” he said.

Fannie Holmes died hours later on Saturday, Nov. 28. The hospital arranged for her body to be transported to a funeral home designated by the family.  The body was embalmed the next day.

Days after Holmes’ death, family members said, they could not reach the emergency room treating physician, and no death certificate had been signed. At that point, hospital officials still had not informed the family of the cause of death.

Further complicating the situation, the woman’s primary care physician refused repeated requests from officials at the hospital to sign her death certificate.

“I wasn’t there and have no idea what happened,” said Dr. Sharad Mabourahk of Tamarac, the woman’s doctor.

Citing confidentiality laws, Mabourahk would not discuss specifics, or provide any details about the woman’s health or other conditions. But family members say Mabourahk informed them privately that before the incident she was in good health, with no serious conditions or health concerns, and he provided them with copies of her medical records.

DELAYED BURIAL

When family members realized that no autopsy had been requested by the hospital or performed, they canceled the interment portion of the services scheduled for Dec. 5. Their request for the Broward Medical Examiner’s Office to conduct an autopsy was declined, due to the lack of suspicious circumstances, Medical Examiner Dr. Joshua A. Perper said.

Members of the family say they believe that Holmes, a wife of 40 years and mother, may have actually suffered from a ruptured pancreas or some other condition that emergency room personnel could have misdiagnosed.

According to eMedicalHealth.com, a website that focuses on emergency health conditions, acute pancreatitis usually begins after damage to the pancreas, a gland behind the stomach that releases insulin and substances that help with digestion.
Pancreatitis is an inflammation or infection of the pancreas.

Attacks are typically mild, but about 20 percent are severe. An attack can last for a short time, and attacks usually resolve completely as the pancreas returns to its normal state.

The website also describes aspiration as the accidental sucking in of food particles and/or fluids into the lungs.

The family has hired a lawyer and a private pathologist who performed a post-embalmed autopsy. The results are not yet available.

Funeral services took place on Saturday, Dec 5, but the burial was delayed until Dec. 22, after the autopsy was completed.
The woman’s daughters, Gina Holmes, 44, of Deerfield Beach, and Lisa Wiggins, 39, of Pompano Beach, say doctors and nurses refuse to provide them with any information. They say this raises suspicions about what happened.

“When I got to the hospital I was just so upset. They wouldn’t tell me anything, and got nasty when I asked them what happened, because she was in good health,” Gina Holmes said. “When I asked them about an autopsy, they kept telling me they had to send the body to a funeral home immediately, so I just gave them the information.”

Hospital officials said shortly after the incident that they were gathering facts in order to provide a response to the newspaper about the family’s concerns, explained Linda Jean-Long, the hospital’s director of marketing, when contacted on Dec. 2. As of this week, despite repeated calls, no response has been provided, and hospital CEO Bob Haley could not be reached for comment.

“Something is going on, because it seemed like they wanted us to complete the burial quickly without telling us anything,” Gina Holmes said. “That’s why we want the police to investigate this, too.”

Family members contacted the Broward Sheriff’s Office, which provides police services in that area, but BSO declined to investigate the matter.

North Shore Medical is a 459-bed, acute medical care and surgical hospital. On its website is a list of numerous accreditations and recognitions the hospital has received for  quality care and areas of practice.

Family members say there are too many unanswered questions surrounding the death that require explanations.

“We need to know why she was admitted to a room instead of going into emergency surgery, or intensive care,” Wiggins said.

“Why won’t they tell us anything, or what killed her? I just have so many questions, and it seems like they just walked around while she suffered, and let her die.”

EJones@SFLTimes.com

Photo: Fannie Holmes