Left paralyzed after a 2-hour ER delay

ON A COOL SEPTEMBER evening in 2014, 54-year-old Anthony Medlin arrived by ambulance at Lincoln Hospital and was deemed mobile and low risk, so the staff told him to wait.

Then came the two-hour delay in the busy Bronx emergency room.

By the time a doctor got around to examining Medlin, he was paralyzed from the waist down. He was rushed to surgery, but it was too late.

ER staff had labeled Medlin’s case a lower priority because they believed he’d arrived with only a minor facial injury. There was, they decided, no need to rush.

But the staff at Lincoln had failed to read a report filed by the ambulance crew stating clearly that Medlin had been hit by a car. Trauma like that requires an immediate head-to-toe exam by a doctor, experts say.

A Lincoln nurse acknowledged later that the hospital has no protocol requiring triage staff to review the “pre-hospital care report summary” all ambulance crews must file when they bring in a patient.

“They didn’t kill me, but they took my life away,” Medlin, sitting in his wheelchair, said last week. “Just to leave me on the side like I’m just a nobody, that really hurt.”

Medlin’s fateful two-hour wait is hardly unusual at Lincoln Hospital, where an ongoing Daily News investigation makes clear that the Bronx’s biggest public hospital has one of the worst records in the city for ER waits.

On average, federal data show, a Lincoln ER patient waits 93 minutes before he or she sees a doctor. By comparison, the average wait in New York City hospitals is 46 minutes; nationally, it averages 29 minutes.

Lincoln also has the highest rate in the city of patients who simply give up and walk out of the ER before seeing a doctor — 15%. That compares with 3% citywide and 2% nationwide.

In 2015, the last year data were available, that meant 26,020 of the 173,470 patients who visited Lincoln’s ER gave up before they got care.

A spokesman for city Health and Hospitals, Robert de Luna, said that Lincoln was recently recertified by the American College of Surgeons, and that Lincoln “is certified as a Level 1 trauma center, at the ready around the clock to save patient lives and provide the highest-quality care.” Citing patient confidentiality, he declined to discuss Medlin’s case.

Medlin’s experience came just two months after a July 2014 incident in which the Lincoln ER staff lost track of patient Angel Rivera. He arrived with a head injury and wound up in an irreversible and ultimately fatal coma.

Rivera’s disturbing treatment, detailed last month by The News, triggered an examination of Lincoln by the state Health Department and the city Department of Investigation. Both reviews are pending.

In Rivera’s case, he languished in the ER for nine hours before a doctor found him. In Medlin’s case, he sat there for two hours before a physician checked him out.

Rivera’s family and Medlin have sued the city over these delays. Medlin’s attorney, Alan Fuchsberg, has obtained medical records and questioned doctors, nurses and emergency medical technicians on duty the night of Sept. 15, 2014, to get to the bottom of what happened.

Medlin had been drinking that night and spending money a few blocks north of Yankee Stadium when he was mugged. To escape his attackers, he ran into E. 167th St.

There he was hit by a car. Somebody called 911, and the ambulance arrived at 11:13 p.m. He was found lying flat on his back in the street.

Questioned by Medlin’s lawyer, EMT Shawn Healy said that discovering Medlin lying in the street like that clearly indicated he was hurt.

“Not too many people want to lay on a New York City street, so I don’t know — he just couldn’t get up, didn’t want to get up,” Healy said. “Usually when someone gets hit by a car and they’re still on the ground, they’re hurt.”

Healy and his partner strapped Medlin to a long board used to stabilize patients during transport, and clapped a cervical brace around Medlin’s neck.

The ambulance arrived at Lincoln at 11:29 p.m., records show, but it wasn’t until 11:48 p.m. that the triage team first spoke with Medlin. By then, the EMT team had filed their report with Lincoln clearly stating that Medlin had been hit by a car.

But that report was filed electronically, not handed to the nurses in triage as a note. Lindsay Diaz, the registered nurse on duty that night, conceded later during questioning by Medlin's attorney, “When they changed it to computerized, you’re not able to view it. So I did not see their note.”

When she was asked if her “level of concern” would have risen if she’d known Medlin had been hit by a car, she said yes, but she added that “there is no protocol” at Lincoln requiring that triage read staff ambulance notes.

Notes of Diaz’s triage report show the staff wrote “No” next to “High Risk,” and described “Facial trauma” that included “Periorbital swelling with abrasions s/p assault. Head trauma. No pain present.”

The record also noted that during the triage query, the patient at one point took off his collar and got off the board. The report than added the acronym “MAEX4,” which means the team had determined Medlin “moves all four extremities.” The record said Medlin “denies numbness or tingling.”

At that time no doctor physically examined Medlin, so he lay back down and waited. And waited.

More than 90 minutes later, at 1:30 a.m., a nurse asked a doctor on duty, Dr. Jason Greenman, to look at Medlin because “somebody said he was acting strangely and just was requesting that a doctor see him,” Greenman later recalled.

At that point, it had been more than two hours since Medlin had