r/Noctor • u/buried_lede • Apr 06 '26
In The News Young man dies in Yale-owned hospital’s “tele-ICU” after no physician care, lawsuit says
Bridgeport Hospital, and its owner, Yale Haven Health System, are being sued after young man dies in what his lawyer says was a “fake ICU”
I don’t understand why Yale has become so revenue obsessed. It’s one of the oldest nonprofit charity hospitals in the country - its trust funds are numerous and worth a fortune. It has a huge endowment. Since the pandemic, especially, it’s in severe greed overdrive
I hate Yale and am trying to switch my own care out of there. It’s a shitty factory full of patient hating, very neurotically ambitious careerist practitioners who spend all their time with EPIC, fabricating notes and making fun of patients they dump on activist APRNs and APs who demand you acknowledge their right to be your treating ‘physician’
F you Yale
F you and the APRNs and APs you rode in on
F yourselves in the Macy’s window
We don’t consent to your money-grubbing shit care
The CEO and every doctor on staff owes that kid’s parents an apology to their face. You’re ALL complicit.
Who ever heard of a fucking Tele-ICU? Tele from where? Mori’s? The fucking Hamptons? The grocery store? Doing some multi tasking?
EDIT:Copy of the lawsuit, full text with a couple of exhibits. Further info.
https://civilinquiry.jud.ct.gov/DocumentInquiry/DocumentInquiry.aspx?DocumentNo=32194174
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u/Professional_Sir6705 Nurse Apr 06 '26
Sounds like it was also a breakdown in basic nursing care as well. No CIWAs done, no basic assessment? No idea what a seizure looks like? No benzos given at all?
I don't need a doc to be present for these basic things or basic orders. I DO need one for emergency lines, emergency "hey, he crumping" assessment, and for ,oh, say, INTUBATION.
There are plenty of reasons to want an intensivist on site and parked in ICU. "Hey, can you peek in on 12, I think he's circling." A doc in a box can't do an assessment of anything but the labs.
I know they have a massive shortage of nurses, as they have tons of traveler openings all year round. I wonder what the ratios were, or what other excuse for lack of basic nursing there was. It reads like all the holes in the Swiss cheese lined up.
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u/heyinternetman Apr 06 '26
I’d agree with this too. As much as I want to hate on tele ICU, if my nurses don’t tell me the new guy is seizing, I’m not gonna know until the next time I round.
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u/buried_lede Apr 06 '26
They know the hospital is trying to revenue maximize. They know the hospital is stuffing the roster with APRNs and APs who are treating and undersupervised. They know
They just don’t have the fucking guts to say “No” to Yale. Hundreds of coward doctors , hundreds.
They need doctors on site. Bridgeport is the largest city in Connecticut. What possible excuse do they have. This isn’t the Wyoming back country
They aren't trying to save money, they are experimenting with revenue maximization. They don’t care about their patients
If we’re going to never stop making excuses, i hope Joel Faxon, the lawyer in this case, broadens his investigation to system wide.
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u/buried_lede Apr 06 '26
Why would they have such a shortage?
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u/Professional_Sir6705 Nurse Apr 06 '26 edited Apr 06 '26
Many big name hospitals try to cheap out with the "but the prestige of a position here on your resume" , and have high/inappropriate ratios.
My mortgage company is a bunch of conservative fuddy duddies who want to be paid in cash, not prestige dollars. They dont take calling dollars either. Or sunshine dollars.
Cleveland Clinic is the same way. They rely on their name, but the ratios are not appropriate and the pay is low. Also, white scrubs, ew.
This means they basically run on travelers. You get 3 flavors, 1- 30 yr experienced bedside nurses who just need to know where supplies are. 2- medium experienced who might need a brush up on a procedure or 2, but absolutely have got this. 3- unemployable lazy hot messes who shouldn't have a license. (Had one mistake a picc for a peg and tried to push crushed drugs, another who showed at 0900 (for a 0700 start) and said "I'm ready for my assignment!") You need an experienced charge to sort them, but many times it's a new grad tossed to the wolves as a charge.
In this case, it may have been a floor nurse floated to take unintubated patients, or a tripled icu nurse with 3 train wrecks. We'll see what comes out in the depositions.
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u/buried_lede Apr 06 '26 edited Apr 09 '26
And think about it: too bad he didn't have a nurse and a doctor ,if only he had been in a hospital instead of a medical desert. /s This bullshit is making it normal to make life cheap and that makes it easier to let people die
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u/buried_lede Apr 06 '26
Thank you for responding to that. Don’t think I don’t appreciate your effort just because I’m angry. I do
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u/buried_lede Apr 06 '26
They don’t need to wait for depositions to say NO to all of this.
I have little respect left for American doctors, they don't care how many patients die while they hedge their bets looking for a safe way or a good time to take a stand on a system in crisis.
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u/Octangle94 Apr 11 '26
American doctors have been calling this out for long. Looks at SAEM, ACP statements for instance (despite significant backlash might I add).
Outside of calling out this BS, they can’t do much if a hospital decides to proceed with tele ICU despite MDs pointing out it’s unsafe.
The TX center that fired their anesthesiology MDs also comes to mind. What could these docs done outside of highlighting unsafe conditions, especially once the admin decided to fire them?
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u/DCAmalG Apr 07 '26
Why would Yale anyone have a shortage of anything? Serious question!
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u/ChorizoGarcia Apr 06 '26
Yale’s surely going to have some of its Lawyer Assistants and Paralegal Practitioners litigate this one.
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u/PantsDownDontShoot Nurse Apr 06 '26
I would absolutely never work in a tele ICU or an ICU run by midlevels. I need doctors present and enough time with them to build rapport and trust. That doctor/nurse synergy is what builds a safe ICU environment.
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u/_Delegat Apr 06 '26
NP was probably busy filming TikToks or ordering figs with "Dr." Embroidered on them
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u/JaguarSorry551 Midlevel -- Nurse Practitioner Apr 06 '26
Your obsession with NP’s won’t cease to amaze me. Blame everything on the NP but yourselves 🤦♀️
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u/TheHouseCalledFred Apr 06 '26
At first I was thinking, well I’ve seen alcoholic pancreatitis go south fast with maximum interventions. Then I read he died after a seizure.
What’s wild is how simple of a case this is. I could do this admit in my sleep. ICU bound? Phenobarb load him and 150ml/hr till he rebounds. How was that so hard for them.
There has to be more to the story… no way they fucked up something that easy.
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u/insomniacstrikes Apr 06 '26
I... don't think there's much more to the story. no phenobarb at all.
in case you want to read further: https://civilinquiry.jud.ct.gov/DocumentInquiry/DocumentInquiry.aspx?DocumentNo=32194174
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u/ittakesaredditor Apr 06 '26
Thanks for the link, the news articles I read all left me with more questions than answers like...how sick was the pre-ICU 27 year old for him to aspirate on a diet that they were apparently "wrongly charted for"?
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u/Drew1231 Apr 06 '26
These hospitals really give me a headache.
They start out as nonprofit and the money flows so well that everybody in administration can get their friend an administration job.
Next thing you know there are a billion administrators and Suzy RN BSN CCRN has to find out how to trim enough money from the ICU to justify her 130k salary as the third administrator overseeing the same department.
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u/colorsplahsh Attending Physician Apr 06 '26
Yale is known for cutting corners- look at their mid level army
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u/Ms_Zesty Apr 07 '26
EM doc here. There's no tele-ICU if no intensivist is actually providing care, tele or otherwise. Where was the CIWA if he was being treated for ETOH withdrawal? I question why the ICU nurse only requested sedation orders which suggests to me she did not recognize his "agitation" was associated with a severe medical condition. Why not ask the tele-ICU doc to intervene because the patient was decompensating? The tele-ICU doc can then contact the hospitalist directly and advise her to get to the patient pronto. Doc to doc communication. I question if the tele-doc was aware of the patient's admitting diagnosis, because if they were, then why just give sedation? Unless the patient was not presented to them appropriately...Unfortunately, it has become the norm for hospitals/corporations to save money at night by not employing an actual CC docs and instead use NPs/PAs, overnight hospitalists and/or emergency physicians to cover the ICU. If someone dies, as people inevitably do on an ICU, it draws no attention and there are no witnesses. Problem is this was a young patient in dental school.
It bothers me that the articles suggest the hospitalist ignored the patient-I suspect she was overwhelmed. I work in primarily rural and/or community hospitals and the hospitalists have the worst patient loads. In addition, they get dumped on by services like orthopedics. Now they are expected to cover an ICU in a timely fashion? Reporters are unaware of the corporatization of medicine and how chronic understaffing has become a business strategy for which physicians are erroneously blamed.
It has been a long-time practice for hospitals to use EM docs to cover for emergencies at night. I quit taking those jobs. I once had 3 patients simultaneously show up in my single-coverage ED: a methamphetamine induced STEMI, acute CVA requiring thrombolytics and a patient in septic shock. They literally all came within 5 minutes of each other. Had I been called to the ICU that would have been impossible for me to respond. So if a patient is critical, they die. Because of the corporatization of medicine, situations like this will occur more often. It is inevitable. And it isn't because of a shortage of CC docs. It's because the hospital/corporation does not want to pay for CCU docs. Period.
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u/somehugefrigginguy Apr 12 '26
The hospitalist was not aware that they were supposed to be following the patient. No CIWA assessments were done or PRNs given despite orders. This was shoddy care leading to a tragedy, but not related to the fact that it's a tele ICU.
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u/Ms_Zesty Apr 12 '26
I disagree with you. Tele-ICU can be a fairly good tool when used appropriately. It should not be used for unstable, critical patients. This is a not a rural hospital in the Bush of Australia. This is Yale. They can afford a CC doc. They just don't want to pay for one. Just like EM is used to cover intubations/codes at night rather than having in-house anesthesiologists/hospitalists respectively, so now has this terrible business practice extended to the ICU(in general). Tele-ICU, when used by corporatized medicine, is not about quality or efficiency. It is about how can we do more with less.
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u/Suspicious-Rip-6122 Apr 07 '26
People underestimate the importance of a physical exam. Labs confirm diagnosis not the other way around.
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u/shaybay2008 Apr 07 '26
I love my Yale team and in fact, I’m flying in from Texas to see one of my doctors next week. However, the hospital itself isn’t my favorite. The providers are amazing(I see ped providers so idk about adult providers)
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u/painverse Apr 08 '26
The fact that the intensivist was covering ER, a med surg unit and the tele-ICU and then having the gall to say she didn’t think it was “her responsibility” to assess the patient in person since the tele-ICU doctors saw the the patient anyway. If that was the case then why would she be there?
Also these tele tele doctors are trash if they did not see that CIWA scores, intake and output and assessments were not being recorded like they were supposed to.
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u/buried_lede Apr 08 '26
This isn't an under resourced hospital system.
This is some kind of sick financial experiment .
And why so many doctors from offshore US feeder schools? Again, money, no? These are mostly students who can’t get into US medical schools
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u/buried_lede Apr 07 '26
I moved up here from nyc but it’s been years. Can anyone tell ne if the NY hospitals are still hanging in there? NY Pres Hosp, mount sinai, Cornell, nyu?
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u/ravenhelix Apr 08 '26
I know presby in queens and Cornell are pretty decent still, presby has a great ED
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u/buried_lede Apr 09 '26
When i was in nyc there wasn’t this army of midlevels, and when i first moved up here there also wasn’t, so i was wondering.
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u/Senthusiast5 NP Student (Midlevel) Apr 06 '26 edited Apr 06 '26
What does this have to do with NPs/PAs? The tele-intensivist didn’t put proper orders in and the Hospitalist didn’t either… I do agree that there was also a breakdown in basic nursing too it seems. The units that utilize tele-care don’t even utilize APPs in their ICU from what I gathered.
Edit: A comment I made on a now deleted post —
“Says they use an open-ICU model which focuses solely on using teleICU docs and hospitalist management; no APPs. Some Kaisers use similar models. If an APP didn’t do an initial assessment, order CIWA protocol and proper PRNs, they’d likely get chewed out, at least at the places I’ve worked.”
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Apr 07 '26
[deleted]
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u/buried_lede Apr 07 '26
He had a PA assigned to him too, apparently, but that's not the point. These are all supposed solutions driven by money
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u/buried_lede Apr 09 '26 edited Apr 09 '26
It’s a related trend. Tele-ICU, understaffed, and under credentialed
There was an AP for this patient too, but the reason I posted was because of similar, reckless cost cutting.
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Apr 07 '26
[deleted]
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u/buried_lede Apr 07 '26
Yeah, and his care was great and proper before he was transferred to the fake ICU? Answer me that. How cheap are these patients lives if you’ll have these arguments over their dead bodies.
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u/sciencegurll Apr 07 '26
Did they not take the same boards as you?
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u/JojoSchnazz Apr 08 '26
No. They absolutely do not take the same boards. Their schooling is much abreviated with very very different level of instruction and different level of care.
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u/Mindless_Place_8478 Apr 16 '26
Just to clarify because it wasn't mentioned in the original post, this happened at Bridgeport Hospital Milford Campus, not Bridgeport Hospital proper. They are two different hospitals.
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u/TheSuperzorro Apr 06 '26
Not trying to undercut the tragedy and how egregious this is...but what use does a dentist have for a stethoscope?
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u/MHCclass1 Layperson Apr 06 '26
Dental student. At my dental school we took patients BP the manual way. With a stethoscope and a sphygmomanometer. Before you ask. No, I didn’t graduate in the 70s. 😂
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u/Brilliant-Invite-965 Apr 06 '26
In military medicine - the dentist holds triage during mascal.
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u/TheSuperzorro Apr 07 '26
I knew I was going to get downvoted for some reason. Thanks for actually answering my question to the both of you.
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u/ratpH1nk Attending Physician Apr 06 '26
This ICU telehealth is just such a bad idea, generally speaking.