• Sweden edition

Ignored ambulance call fatality 'a tragedy'

Published: 21 Apr 11 16:13 CET | Double click on a word to get a translation
Online: http://www.thelocal.se/33350/20110421/

The nurse who refused to send an ambulance to a 23-year-old Stockholm man who later died had been reported several times prior to the incident.

"Help me," 23-year-old Emil Linnell can be heard saying repeatedly in recordings of his January 30th call to SOS Alarm, Sweden's emergency response service.

According to Sveriges Television (SVT), the nurse who took Linnell's call had several years of experience in the healthcare sector and had worked as an emergency call operator for more than a year.

During his time on the job, however, the nurse had been reported for a number of failings in his work, referred to as deviations from standard procedures.

"The majority of the mistake rests with one person," SOS Alarm spokesperson Fredrik Bergengård told the Dagens Nyheter (DN) newspaper.

Linnell made several calls to SOS Alarm complaining of breathing trouble, but the on-call nurse deemed his condition not to be life-threatening.

The transcript of the communication between the nurse and the man shows that he pleaded ‘help me’ repeatedly on the phone to SOS Alarm but was ignored.

According to the transcript the nurse said he couldn’t really understand what Linnell’s problem was. He said that Linnell was ‘running about the flat’ with no ‘apparent problem breathing or speaking’.

But Linnell persisted in saying he couldn’t breathe.

“I know, but I have been sitting here listening to you. You are breathing fine now,“ the nurse answered.

“No, I am fainting! I’m fainting,” he said.

“Take a deep breath now,” the nurse urged.

“I can’t! Please help me! Please! Help me,“ pleaded Linnell.

A little later he said, “I can’t breathe” again.

“You are breathing fine. I promise you,” the nurse then answered him.

The call then finished with a wheezing noise followed by a crash. Two hours later a neighbour found Linnell dead by the open door.

No ambulance was ever sent, and it was later determined Linnell died from a ruptured spleen.

“The whole incident is a tragedy and we are deeply grieved with what happened,” SOS Alarm CEO Johan Hedensjö said in a statement.

According to Hedensjö, SOS Alarm is assisting the police and the National Board of Health and Welfare (Socialstyrelsen) in their investigations. The nurse who took the call has since been dismissed from duty.

Filippa Reinfeldt, wife of Prime minister Fredrik Reinfeldt and county council chair, described the incident as a ‘great tragedy’, which must be investigated thoroughly by both the National Board of Health and Welfare and prosecutors.

TT/The Local/dl (news@thelocal.se)

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17:40 April 21, 2011 by Horace
This is sad......of the dental and clinical experiences I've had in Sweden, I really don't think the doctors and nurses are very professional for a developed nation.
17:46 April 21, 2011 by shaq
Wow, such a tragedy. Not surprised though, Sweden's health care system is of third world quality. Absolutely shameless how they treat their citizens...especially their elders. I've had multiple surgeries in Sweden and whenever I go on my check ups in the U.S., the physicians are amazed at the damage the Swedish surgeons did...one time, a doc even called in another doctor to look at the scars of my ACL surgery...
17:58 April 21, 2011 by Thompsuleme
This is really sad. I sincerely hope his surviving family members get through this tragedy. They dont have to listen to the deceaseds fina calls. Hearthbreaking this is... just reading extracts from the transcript.
18:37 April 21, 2011 by Nilspet
@ shaq

I disagree with you: some 3rd world countries have better healthcare than Sweden!

Go to e.g. Thailand and you will see what I mean. Thousands of Swedes go there each year not just for beach vacations but to get some treatments they cannot get at home or they will have to wait 9 months or so....
19:02 April 21, 2011 by NickM
911 centre workers in Sweden are on a bonus system to reduce the amount of call outs that ambulances are required to make. It sounds crazy but apparently its true and I wonder if this has something to do with case. It sounds like the health authorities are trying to make out she was simply a bit unstable and that's all there is to it.
19:36 April 21, 2011 by J. L. Belmar
I am not surprised at all, after the ordeal I just went through at the Karolinska "Hospital". It all started on August 25 of last year and just finished on the 25th of February of this year. I survived thanks to God. Four surgeries in my left leg and two in my right one, because they "discovered" that the 78 centimeters by-pass they performed in my left leg was 8 centimeter too long and later they also discovered that the one performed in my right leg was five centimeters too short. New operations in both legs, to cut the 8 centimeters in the left one and to add the five centimeters missing in my right one, but, the one performed in my left one caught a Streptococus B at the hospital. After tons of antibiotics, which produced a huge diarrhea, a real doctor decided that the wound was never going to heal and that I needed an third operation in my left leg to save it. Up to now, it looks like I am going to walk normally again. Every third day, a nurse comes to take care of my bandages. As far as the nurses, what can I say. One of them,of Finnish origen, grabbed my wheelchair, shooked me up and down, just because I wanted to dry my hands after using the alcohol they have for desinfecting them. Another one, just did not know what Nitromex was when I requested a pill because I was having pain in my chest (I have been through two successful tripleheart by-passes here in Sweden. Fortunately, I always carry a little bottle of Nitromex, so I went down my bed the way I could and took the bottle from my jacket. Just to make this story shorter than it really was, one of the times they sent me to the rehabilitation center Stockholmssjukhem, I was ther only 8 hours, because the "doctor" and the "nurse" who send me there, did it in spite that I was bleeding in my left leg and had 39 degrees fever. But, as Gloria Gaynor sung, I will survive, I will survive, but I do not wish any, and I mean any, to go through the ordeal I had with the expertise of many Swedish doctors and nurses.
20:13 April 21, 2011 by Keith #5083
But...the earlier report stated that this 'nurse' did refer the matter to a doctor who reportedly attempted to contact the deceased by phone - and got no reply. The doctor took no further action.

In other words, there was a 'failsafe' procedure, but it failed with very tragic results.

It is significant the the police are involved and I trust will discover all the pertinent facts and bring appropriate charges.
21:13 April 21, 2011 by tuerd1982
@shaq

Not really. It is true that there are full of problems with Swedish health care procedures, but it is not that bad as what you refereed. For your example about the doctor in US : it is quite common for medical doctors to despise each others specially in same sectors, so you should not very trust it.

@ J. L. Belmar

I am sorry about your incidents, it is painful to read it. Wish you will recover soon.
21:49 April 21, 2011 by hlmencken56
One death is a tragedy, one million deaths is a statistic.

Stalin
22:33 April 21, 2011 by SaraMx
Swedish healthcare has to improve a lot and it should not be denied. Until I got to Sweden, I swear I never saw so much disinterest and apathy in a medical crew. I have been in mexican, american and canadian hospitals before and I was stunned when I went to a hospital here. In Mexico they treat you friendly and not stone-faced, in USA they are very efficient, they send you exactly where you gotta go and they would never leave you waiting in a bad state. In Canada I was in the hospital 'cause of a friend and you see the doctors and nurses all over the place, running here and there and really into their work. Here in Sweden I felt I was in a library or a funeral: everyone so silent, slow and serious. I almost felt that if I moved someone would go "sshhh!"
22:42 April 21, 2011 by eddie123
a tragic story indeed. may the soul of the departed rest in peace. having said that, i must concur with others about the lopsided nature of the swedish healthcare system. they seem to treat people unjustly - perhaps for administrative purposes f.ex balancing their budgets. last year, i had reoccurring acute pain in my lower right jaw, headaches to the right side of my face and neck pain. i went to the clinic and the attending nurse dismissed my complains once i mentioned jaw and referred me to a dentist. i couldn't see a state dentist and the dental clinic within the state clinic referred me to a private dentist. so, i called the dentist and got there and was x-rayed and asked to de-floss and what not. dentist said me teeth were ok and that i had a physiological problem as it appeared locked my jaw tight whilst asleep. i didn't buy his crap but i listened all the same. left the clinic 2000kr poorer only to get home and experience worse pain. went back for a check. he did another procedure that set me back 1000kr and nothing worked. i requested for pain medication but the dude won't prescribe. he said i needed a bite pad to wear at night and that would cost me some more. i got frustrated and decided on not returning to the dentist. i turned to soft and warm water, constant brushing after meals and i stopped eating or drinking anything sweat or spicy. i knew i would be home for xmas and could get a dentist or doctor to look me up. so, in early january, i'm in Nigeria and i dash to see the dentist. it cost me 10kr by the way. i told me my ordeal with the swedish dentist and he smiled. he took a look at my teeth and said the wisdom teeth were both impacted. he ordered a scan and an hour later, the scan confirmed his position. the options to me were to either cut the gum around the wisdom teeth or remove the teeth as a permanent solution. i chose the latter and a tooth was removed on the lower right jaw. to my disbelieve, the tooth wasn't just impacted, it had half decayed. why the swedish dentist and hygienist with all their flashy computerized clinic could not diagnose what a Nigerian dentist diagnosed in a minute is beyond me. the entire procedure in Nigeria cost me 110kr whereas i had spent a little over 5000kr in sweden. the system here borders a lot on laziness, an over reliance on technology and incompetence to be honest. for 9 million people, swedish medical personnel are often under experienced as they do not work often. medics elsewhere work a lot and are exposed to a range of medical situations thereby broadening their skills and competence. people must now question the link between saving healthcare costs in sweden and the quality and availability of healthcare to the people. a young lad has lost his life because someone deemed it unnecessary to assist. most times, healthcare providers in sweden behave as though human life has got to value to them. this is worse off for immigrants.
22:42 April 21, 2011 by SaraMx
And for the way they attend you, well, I commented in the website before about my own experience... the Karolinska Hospital is a shame...

I'm deeply sorry for the death of this young man, I'm almost his age... it's horrible and awful such a thing happened... what's wrong with this people? 'cause something like this happens in all countries but in different areas. What's wrong with people not caring about a human life anymore? You can't play with something like that, if the guy said he needed help, send it for god's sake... There's more to lose than a tank of gas. Any human life worth the caution.

It pisses me off nowadays people are so unsensitive towards other persons.
00:31 April 22, 2011 by Great Scott
@NickM

Maybe the reason you are failing to understand, is that the emergency telephone number in Sweden is 112.
00:52 April 22, 2011 by Nilspet
@eddie123 and SaraMx

I do believe you totally. I myself experienced bad medical care (care or noncare...)

numerous times in Sweden. I hate it when I call vårdcentral and have to answer

dozens of questions before I could even tell my problems. A lot of times they told

me to call back the day after...it is simply horrible. But you have probably

experienced worse moments. It is ashamed..well it is totally UNacceptable in this

case when a young man was refused an ambulance he desperately asked for. In fact he

would not have been that ill should he been treated properly right from the

beginning (referral to the specialist before it all got worse).

Now I will be totally unpatriotic and state my claim loudly:

Sweden has the worst medical care in the EU, probably the worst in the western

world. It is not because of poor technologies deployed, too few doctors or too little

money. We have enough doctors, nurses...worse still...we HAVE some of the world best

medical equipment (like eddie123 has seen) but we just cannot use it to make people

healthier. Sweden export medical tools, medicines to the world but we have very UNFIT

medical staff (as SaraMx noticed the apathy...) and the worst is probably the

attitude of medical staff in Sweden from SOS to ordinary vårdcentral. Sweden

definitely need a medical care reform especially when it comes to staff. We need a

new kind of education and training. They government should look at how other

countries do it and then learn from them. They probably do not want to admit that it

is so so bad.

Many of my friends go to Poland and Germany for dental care which is cheaper

and better. For more complicated operations and health checkups they go to Thailand!

yes they go that far because and there they get what they need (want) and feel much

better than at any vårdcentral or hospital in Sweden. In this beautiful country if

you are over 50 and want to have EKG test (your heart waves) you can just walk in any

hospital in Thailand and have it done right away (or wait a few moments). Here

(unless you are dying in a heart attack) all you can get is a wait time of weeks if

not months! There is nowhere else in the world where the state thinks it is fine that

patients can wait up to 90 days to meet a specialist.
02:01 April 22, 2011 by NickM
@Great Scott

I know. I was using 911 as a universal reference to emergency numbers.

Its highly unethical that emergency call centers in Sweden work on a bonus system to keep ambulance call outs to a minimum - that's the important point I was making.
06:50 April 22, 2011 by dot114
In 2000 I was having a miscarriage and was bleeding.I was made to wait for more than 3 hrs before anyone saw me.I went to see the nurse to asked when can I see the doctor and do you know what she said to me!!!You don't have an appointment so you will have to wait for yr turn just like anyone else.Just moved there and my husband was out of the country I just sat there and cry and never ever felt so alone in my life.Eventually when I did see the doctor she immediately admitted me into hospital.
07:48 April 22, 2011 by animalr
This is a sad sad story and having health problems is terrible regardless. My sympathy to everyone here who has had difficulties.

However, my experience with Swedish healthcare has been really positive, Of course, unlike other "pay for play" healthcare systems you do sometimes need to wait which is never nice and you don't always get prioritised and treated and tested for every possible ailment at your demand.

The system functions to provide the broadest and most vital care to the most amount of people and this means that your issues don't always come first. Sweden has one of the world's most extensive medical databases to prove the effectiveness of the system for the whole society. This story is a failure of the system in my view, not a function thereof.

In all the treatments I have received (form the larger to the smaller) I have found medical personnel to be compassionate, professional and genuinely concerned about my personal wellbeing. That they have been, in addition, willing to provide me with treatment in another language and that the state even provides translators at state expense if I request, is an indication of the commitment to professional care.

Where I have experienced and worked in other "1st world" public healthcare systems, I have found it impersonal and highly bureaucratic, doctors and nurses never have time to attend to people personally (often not even physically examining patients, only filling in questionnaires) and many problems go undiagnosed and caught up in the red tape. "Files" (not patients) are handled by multiple personnel often resulting in persons making diagnoses and giving treatment never having actually met the patient. Carers are inflexible to offer treatment in other languages never mind offer free translation services. And if you are outside of the system, i.e. a non-citizen, forget it!

In contrast, my experience of the system here is fair, professional, personal and highly democratic.
08:25 April 22, 2011 by Great Scott
@NickM

I can hardly see how 911 is a universal reference to emergency numbers, when it is only for north america. I would have thought that 112 is more a universal reference to emergency numbers, as it is used by the European Union and on GSM mobile networks across the world.
09:18 April 22, 2011 by calebian22
This is just another sad example of why people need to be careful in Sweden. If there is an emergency before fikatid, you will be s.o.l. So be extra cautious at 0900 and 1500.
10:05 April 22, 2011 by J. L. Belmar
07:48 April 22, 2011 by animalr

You are the exception of the rule if you are not working at a hospital. For your information, not one of the doctors performing the wrong surgeries in my legs, came EVER TO SEE ME and just to say "hello José, how are we doing?" The whole situation was so weird and so badly handled that the Head of the medical department reconized to my wife and me that I had not been properly taken care of. The whole Kafkanian story is now in the hands of the "Socialstyrelsen" and let us see what they will answer. They already recognized that my cse is a horrible story of mistreating. I have to say that the doctor who operated my left leg for the third time is simply out of this world. She did what the rest never did.

Now, to all of those who hve been mistreated at the Swedish hospitals by doctors and nurses, what about organizing a massive pacific demonstration in front of the Karolinska in Solna with posters saying: "WAKE UP! WE NEED BETTER SERVICES.
15:46 April 22, 2011 by hunnysnowbee
You think it's bad in Sweden. Try liveing in the UK! My experiance of Swedish health care is a 100 times better than in that hell hole.
16:37 April 22, 2011 by animalr
@ J.L. Belmar

My heart goes out to you Belmar. Sure sounds like an ordeal.

You needn't take my comments personally if they represent a different perspective from your own. I don't work in healthcare in Sweden at all - I have merely interacted with the system and the personnel as patient and have had positive experiences, especially considering what I believe to be a generally high standard of care for a public system. Obviously cases like this, and your own, show the flaws and failures in the system and of the personnel at times.

I think organising your complaints in demonstration sounds like a good idea, and certainly holding the individuals accountable by reporting their negligence to the medical council.
22:22 April 22, 2011 by Lovelygirl
Thank God I am not the only one that believes there is a big failure with the health care practitioners here! I am not criticizing the system... I mean, free health care sounds fantastic, but the medical attention is lousy! Numerous bad experiences I have had and it's embarrassing! I thought that this country would do much better... I can't wait to visit my doctors for a full check up every time I go back to my country... and I am always praying that nothing bad happens to me while I'm here :(
02:14 April 23, 2011 by craigtaylor
Make a law that if an ambulance is sent to someone who is not in an emergency situation and/or does not need an ambulance then that person receives an on the spot fine of say 5000:- . So there is no reason budgets constraints should impact on the decision to send an ambulance. This will put a large degree of judgement on the ambulance drivers.
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