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Man died after calls for ambulance ignored

TT/The Local/dl · 13 Apr 2011, 07:23

Published: 13 Apr 2011 07:23 GMT+02:00

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The man first called SOS Alarm, Sweden's emergency response service, in the early hours of January 30th, telling operators he was having trouble breathing, the Dagens Nyheter (DN) newspaper reports.

The nurse who took the call nevertheless judged the man's condition to not be life threatening.

A short time later, the 23-year-old called again, explaining that he had fainted as soon as he had tried stand up, but again, no ambulance was sent.

"They talked for a total of 12 minutes. Our son repeated time and again that he needed an ambulance and wondered if one was on its way. He even opened the door so that it would get inside. But help never arrived," the 23-year-old's stepfather told DN.

The on-duty nurse instead referred the case to an on-call doctor, who called the 23-year-old several times, but never received an answer.

However, no other emergency personnel were sent to the man's residence to check on his condition.

Several hours later the 23-year-old was found dead by a neighbour. The cause of death was a ruptured spleen.

The man's stepfather told the newspaper that his son had been suffering from periodic fevers and abdominal pain for months prior to the incident. Despite several health clinic visits, no relevant tests were taken to get to the bottom of the 23-year-old's ailment.

SOS Alarm has now referred the case to the National Board of Health and Welfare (Socialstyrelsen) according to Sweden's Lex Maria, the informal name used to refer to regulations governing the reporting of injuries or incidents in the Swedish health care system.

The 23-year-old's parents have also reported those responsible at SOS Alarm.

Story continues below…

"Our own investigation of what has happened and the health board's investigation isn't over yet, said Lars Engström, head doctor at SOS Alarm, to the TT news agency.

He added, however, that the nurse who took the call no longer works for the emergency call service.

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

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Your comments about this article

07:45 April 13, 2011 by logi
this is pure negligence, should they want to ascertain the nature of emergency first?for the boy to have called repeatedly, then is serious those involved should be fined and punished. may the soul of the boy rest in peace. Amen
07:57 April 13, 2011 by hjoian
its a good job this isnt America,or that call operator would be on the way to losing millions in a personal law suit. A similar thing happened to a friend of mine in the UK......he lost both his wife and unborn child due to a delay in sending an ambulance. A lot of these phone operators take instructions of a computer screen,and are in no way medically trained......sad situation, i just hope some lessons are learned and it never happens again.
09:09 April 13, 2011 by xcited?
swedish medical system follows one rule = if u can walk and talk then u dont need a doc :)
09:12 April 13, 2011 by liban91
thas not fair and something should be changed.
09:35 April 13, 2011 by aaww
sweden really sucks
09:38 April 13, 2011 by SimonDMontfort
...to be fair it can happen elsewhere too - when procedures in place, staff training, etc, are not quite as 'robust' asd they might be, and too much is left to a 'judgment call' by individuals
09:54 April 13, 2011 by Brtahan
The weak and the poor are always neglected ! how much would it cost to send an ambulans few hundreds crowns ? is that to much to pay for a 23 yr olds life!!! I feel very sad about this incident , where they say that human rights are respected in here ! basic right of sending an ambulance was refused to this young guy. In this world there are no humans rights even in europe where they say that they are an example to other countries, shame on all of you. If a dog was sick on the road they will send an ambulance plus they will put it on the news for weeks , i feel animals are much respected here than humans.
10:33 April 13, 2011 by Hauhr
It's almost one article a week these days about blunders in swedish healthcare. I'm just half-expecting for someone to come along now and comment in defence of the incompetent person at the heart of the matter - as in the recent story of the nurse who mixed up needles and reused a needle from an HIV-positive patient on another patient
11:02 April 13, 2011 by Keith #5083
So sorry for the young man,his family and friends.

It is not enough for the SOS Alarm org to say 'the nurse who took the call no longer works there'. She becomes the 'fall guy' for a faulty system! She did refer the matter to the on-duty doctor!

When a professionally trained person fails in their contractural duty of care, whether by ommission or commission, negligence is not an issue. If there had been just 1 call, maybe negligence could be considered a defence, but more than 1 call for help ignored implies a deliberate policy, a pre-meditated planned reaction, ergo, the police should thoroughly investigate this case with a view to manslaughter charges being brought against all those involved!

"...who called the 23-year-old several times, but never received an answer". Yet the doctor never thought to send emergency personnel to investigate a person who had complained of chestpains and fainting episodes?

Accidents happen.We can all have a 'bad day'. But when more than 1 emergency call is met with no response, or a doctor fails to sound alarm bells in such a case as this, that is neither accident nor negligence!
11:33 April 13, 2011 by technoviking
Someone needs their a$$ handed to them... Difficulty breathing and fainting is a serious symptom.
12:08 April 13, 2011 by Swedesmith
Wonder how the nurse could diagnose the patient's condition over the phone.
13:52 April 13, 2011 by J Jack
If the SOS nurse was actually qualified to assess the callers need (which I doubt) then that nurse must take some fault and be dealt with. If not qualified, then it is the failure of the system and a terrible thing for the nurse to live with, therefore, the system should compensate all the victims, including the nurse. Start by revoking the doctor's license.
15:17 April 13, 2011 by Decedo
$10 say the nurse is scheduled to get stress counselling and paid time off for emotional distress stemming from this incident.
17:26 April 13, 2011 by dobermann
The fastest way to get an ambulance is to fall down on the street, then it's doesn't matter what's wrong with you, they will come to you. When you call to emergency and they say, that you should take a taxi, this is more than amazing...USA should be more capitalist country, but in most cases even they can't compete with Sweden.. At least they could charge for ambulance car if they come to you, but god dam it, just send it!!
18:22 April 13, 2011 by Rishonim
I hope this negligence will haunt her and make her life miserable till the end of her days. And in the afterlife, may her soul wander tormented endlessly from garbage pile to garbage pile searching for that last maggot to eat.
18:39 April 13, 2011 by mkvgtired

"its a good job this isnt America,or that call operator would be on the way to losing millions in a personal law suit."

I completely disagree with frivolous lawsuits, but how is a lawsuit not warranted in this situation? A 23 year old is dead. It is not an unforeseen tragedy, he gave ample warning. My brother is the same age, and I would be pissed if he died because he called 911 (NA version of 112) and was ignored not once but SEVERAL times. That is insane. It seems in Sweden, if a company commits the slightest infraction everyone is calling for the heaviest punishments possible, yet when the government kills people an apology suffices? (Out of curiosity does anyone know what rights his parents have under Swedish law)?

"The nurse who took the call nevertheless judged the man's condition to not be life threatening." So the only way to get an ambulance is for your condition to be life threatening? If you got in a car accident with several broken bones that immobilized you, but your injuries were not life threatening, would they send one?
19:52 April 13, 2011 by RitaPita
This is ridiculous...

From the last barely few months that i've been following the news here, all that seems to pop up are extremely negligent healthcare "professionals".

Does anyone remember the incident where an entire group of med students were preparing to dissect a body... only to find out to their shock that it was the corpse of a former teacher??

No one knew, and nothing was said of it.


I'm friends with a large group of med students, and i can honestly tell you that I have never met so many people who party so much in my life! It's like the whole system is a joke!!

21:30 April 13, 2011 by dizzymoe33
Here in the States when you call 911 (our help emergency line) you get an ambulance, fire truck and police officer as soon as possible and yes they do bill us for the ambulance ride but if you call you can usually get help right away. This is such a tragedy it shouldn't happen in a well-developed country like Sweden.
22:06 April 13, 2011 by Swedesmith
Tell us how you really feel, Rishonim and don't hold back this time...
22:13 April 13, 2011 by planet.sweden
@dizzymoe33: "Here in the States when you call 911 (our help emergency line) you get an ambulance, fire truck and police officer as soon as possible"

You really believe that do you?


Not the first case I've read about either, a few years back a 911 operative in Florida was fired after arguing with a desperate woman as her husband lay dying rather than calling an ambulance as requested.
00:45 April 14, 2011 by Keith #5083
Criminally negligent manslaughter occurs where there is an omission to act when there is a duty to do so, or a failure to perform a duty owed, which leads to a death.

The existence of the duty is essential because the law does not impose criminal liability for a failure to act unless a specific duty is owed to the victim.

An example is where a doctor fails to notice a patient's oxygen supply has disconnected and the patient dies.

There is surely a duty to respond to an emergency call EVEN IF the patient is not clearly able to diagnose their own condition! It is enough a 23 year old was suffering blackouts and restricted breathing.

In some societies this is the law. If the behaviour here, especially of the doctor to whom the nurse referred the case, does not qualify under these terms of reference - then I am at a loss to know what would qualify.

Totally, totally shameful!
00:55 April 14, 2011 by princeally
well i have been in many country around the world, but sweden is worse place ever, when it comes in emmergencey, i have been the same situation as this poor young man, when i called SOS they told me that i need to open window and get fresh air, and that it was not something serious. and they didnt come..lol imagine, and after that i went to the hospital, and they told me just go and drink alot of water, without examining me....lol SHAME.
00:58 April 14, 2011 by Da Goat
This is sad beyond words,perhaps he belonged to the wrong political party !

probably too late to make it right now but it seems like everyone who was involved for the months previous also, needs to be given a good flogging, it was not only the emergency people but the on call doctor and the previous medical staff that made a dogs breakfast of it, NOBODY diagnosed him until he reached the pathologist post mortem! this is very poor accolade for the whole system, the biggest problem is they can't fire everyone as there would be none left!
01:26 April 14, 2011 by swedejane
You don't need a doctor, you're still alive!
09:18 April 14, 2011 by mkvgtired
And notice its crap like this that caused that hospital to loose its federal funding, forcing it to close its trauma center and other programs


And her children settled a lawsuit for $3 MM.


A little stronger incentive not to let something happen like that again instead of just telling someone they did a bad job. I have said, I am 100% against frivolous lawsuits, but in a in the situation you brought up I completely agree with a large settlement. I think the family of the 23 year old in this case are absolutely entitled to compensation as well. His death would have been easily prevented had an ambulance got him to a hospital. Very sad that someone so young (or any age for that matter) had to die from someone elses incompetence.

When I was 18 I drank several energy drinks to stay up while driving, when I got to my grandma's I (stupidly) took some sleeping pills so I could go to sleep. I fainted and was only conscious while laying down. I called 911 and an ambulance was there in less than 5 minutes. The longest Ive known one to take was 15 minutes and it was going out in the country. Obviously less efficient situations happen, but everyone I know has always gotten an ambulance in minutes after a 911 call.
12:45 April 14, 2011 by soultraveler3
It really is sick that Sweden is so @ss-backwards with this stuff. Something needs to be changed asap.

Sweden is a supposed to be a modern country but when it comes to many things it isn't. The people living here pay a ton of taxes for 3rd rate medical care and police care, many other things as well, but those two scare me the most.

A person answering an emergency phone shouldn't be in charge of deciding if the person on the other end really needs help. It's complete bs and costs people their lives, this isn't the first time we've read stories like this here. You see in the news multiple times per year about how someone died or was hurt because some idiot at the hospital or police station couldn't be bothered to send someone out.

I grew up in the states and it's policy that if someone calls the police or an ambulance that they HAVE to go check things out. Sure, sometimes it ends up being something small and people could argue that it wastes time and resources, but if it saves a life it's worth it.

It is horrific that stuff like this is allowed to happen. There's no excuse for it, especially in a country that loves to claim how advanced and humanitarian they are.
22:20 April 14, 2011 by Species125
Is it true that in Uppsala, nurses get bonuses if they recommend ambulences no more than one percent of cases, emergency care for children no more than four percent of the time, and other emergency care no more than five percent of the time?

Taken from 2009: http://www.aftonbladet.se/nyheter/article5142010.ab

Does anyone know if this is how things work in Uppsala and/or elsewhere in Sweden?
23:20 April 14, 2011 by dizzymoe33

Yes I believe it not only have I personally experienced this the many times I have had to call for an ambulance but I also have observed it on a regular basis. Where I used to live we had quite a few elderly living there and there was constantly 911 being called and every time there was an ambulance, firetruck and police car.
15:17 April 15, 2011 by Borilla
@aaww - Save your money and perhaps you can afford to buy a ticket to Iran,or maybe even Somalia or Uzbekistan. Then you can be happy.

I have nothing but good things to say about the care I have received from the Swedish health care system. However, that being said, it is disconcerting to see continued stories of negligence or bureaucratic failures in the health care system causing injury or death. One does note that problems seem to arise when an individual has to make a decision. Swedes seem to do better with a committee where no one has to take individual responsibility. If three or four people are available for emergency calls, they can have a meeting and the majority can "suggest" that an ambulance be sent whereupon the ambulance crew can then have a meeting to decide if they really want to go..

If in fact nurses are being rewarded for keeping people out of the system, that is criminal!
15:53 April 15, 2011 by Britt-Marie7
Is this the famous Swedish Healthcare system you hear so much about? Unfortunately, that was a long time ago.

The doctor should be removed from his post too, as well as the nurse. Complete neglect and indifference on both sides.

And they should be sued. How horrible for the family, when the young man needlessly died.
17:28 April 15, 2011 by zoroastrina
I second the judicious and well thought-out comments of Brtahan and Keith #5083.
00:49 April 16, 2011 by wxman
We're looking forward to this kind of quality medical care in the US as soon as Obamacare kicks in.
00:50 April 16, 2011 by nooshee
Seriously, I don't know why are you all surprised. This is how the med system works here: you don't feel well, you call the hospital, there is somebody (NOT a doctor) who will answer your call, you tell him/her what's your problem and in response he/she will suggest a few things (have a rest/take some vitamins...etc) and tell you to call again if nothing has changed within 3 days. Obviously, you can die in those days or just simply the situation could get a 1000 worst. But this is how it works, this is how they kinda filter out the people so that the only serious injuries could get in the system.

Oh, and about the "lying on the street would absolutely get you to the emergency" is not true. A friend of ours who is also a doctor slipped on the ice in front of the hospital she works in. She wasn't able to get up but she was conscious. Nobody helped, even though she worked there and was a doctor... they let her lie there for an hour on the ice, in the -10 degrees, during that time her husband was trying to get help but found no ears...when finally he got a stretcher and took her inside. Turned out, her backbone had broken.

So I would reduce "xcited?" 's rule: if you can talk, you don't need a doctor.. apparently...
03:34 April 16, 2011 by frankly.speaking
These nurses and untrained stuff really suck some time, simple fever and sickness can be ignored for 2 to 3 days but above kind of trouble need serious attention.

Better they sue the system accordingly.
05:21 April 16, 2011 by fredlave
What was the young man's underlying disease that caused his spleen to rupture? Why didn't his family get him to an emergency room by private auto, cab, etc.? Telephone medical support is very dicey and only works because 85% of illnesses are self-limited, i.e., the patient will get better regardless of treatment or no treatment. The other 15% are at risk that their complaints will not be correctly interpreted by the non-physician on the other end of the phone line. There is no perfect triage system but the more these decisions are delegated to non-physicians the more errors will occur.
08:41 April 16, 2011 by Keith #5083

Yeah, well, almost anything would be an improvement on what you have! Your comment implies these things - and worse - don't exist aplenty under the present USA 'half-system'.

If the emergency system had not been so abused, perhaps this kind of incident would not happen. Just search 'fake ambulance calls'.

That, however, does not in any way mitigate the circumstances of this case.
11:19 April 18, 2011 by DamnImmigrant
Is "SOS Alarm" what you get when you dial 112?

Why did a nurse answer the call? Did he call the doctors help line first or did he call 112?

Something I learned in the US, and I have done it in Sweden too. When I call 112 (911) and I know an ambulance needs to be dispatched. After saying "Send an ambulance to..." and why we need an ambulance. The VERY next thing I say is "HAS AN AMBULANCE BEEN DISPATCHED?" If I do not get a positive response, I again ask, "HAS AN AMBULANCE BEEN DISPATCHED?" If the operator says NO I will then demand to speak with the supervisor immediately.

Never had to speak to a supervisor yet. But have had to insist on ambulance being sent.

Interesting problem in Sweden was mentioning the location as being a well known shopping center only to find out that the 112 operator was NOT local and did not know my town. Also ran into a shocking problem of a 112 Swedish operator NOT UNDERSTANDING ENGLISH!?!?!
18:33 April 26, 2011 by Evrin
@Borilla: first go and solve your private problem with nations then come and speak like specialists. nobody said Somalia is better in medical care that you wanna arrange the world with you bean brain.

last thing...if the name of Iran is a bone in your throat you dont need to compare it with Somalia.

This is a problem and can happen every where. but we dont like it in Sweden because always things could be better.
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