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Report slams denied ambulance call death

27 Mar 2012, 17:27

Published: 27 Mar 2012 17:27 GMT+02:00

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Söderberg died in her home in Timrå in the early hours of January 20th, 2011 shortly after having placed her third and final call to emergency services begging them to send an ambulance.

In previous calls, the first of which was placed several days before she died, Söderberg complained of chest pains and having trouble breathing.

But each time she called, operators at the SOS Alarm emergency services followed procedures by connecting her to nurses with the health advisory services provided by the health authorities in Västernorrland County.

In September, Söderberg's mother Annika reported the incident to Sweden's National Board of Health and Welfare (Socialstyrelsen) after reading transcripts from her daughter's calls to SOS Alarm.

“I can't breathe,” Jill told emergency operators.

“I want you to come and help me.”

But the operator's response came as a shock to Jill's mother.

“The operator considered her to still be communicating verbally and decided that she didn't need an ambulance,” Annika told The Local at the time she filed her complaint.

In a meeting with SOS Alarm, Jill's mother asked them to explain how it was possible to deny someone an ambulance simply because that person was talking.

“How could you even call for an ambulance in the first place?” she recalled asking them asked.

“No one could answer that one.”

Last week the health board concluded its investigation into Jill's death and issued a final report which slammed the way her case was handled, especially for the decision to not send an ambulance following her second or third phone calls.

"The woman clearly asked for help on three occasions and wanted an ambulance to be sent straight away in the third call. Based on what is included in the taped telephone calls to SOS Alarm, the National Board of Health and Welfare finds it remarkable that the woman's suffering was ignored on the second and third calls and that the option of sending an on-duty primary care physician or a duty nurse to the woman's home wasn't utilized because the instructions were lacking," the health board wrote in its report.

The agency also criticized local health authorities for deficiencies found in Jill's chart as well as a failure to ask relevant questions regarding her condition based on the symptoms Jill described.

The agency's Andrea Blömer, who co-authored the final report, was also stunned that Jill's calls were ignored.

"Health advisory services interpreted things as if she had some sort of stomach bug or other influensa and recommended that she visit a clinic the next day. But in the call it shows that she was gasping for air, had slurred speech and chest pains. That's a strong indication that an ambulance should have been sent in the first instance. It's remarkable that she didn't get any help," Blömer told the TT news agency.

An autopsy attributed Jill's death to breathing problems caused by her having taken anxiety medication in combination with muscle relaxers. While she had a prescription for the anxiety medication, Jill's mother wasn't sure where her daughter received the muscle relaxers.

While the Västernorrland County was criticized in the report, no fault was found with the actions of emergency services operator SOS Alarm because the company had an agreement with local health authorities requiring that operators connect calls to local health experts with "higher medical competence" when they were unsure how to proceed.

SOS Alarm has similar arrangements in many places across the country, something which some experts fear can put patient safety at risk by involving too many parties in making a quick medical decision.

Story continues below…

"Patients have called SOS Alarm which has redirected the call to health advisory services which have then directed them to local clinics where no one answers so people have to call back. It can take time and the patient suffers," health board inspector Maria Carlund told TT.

Speaking with the local Dagbladet newspaper, Jill's mother Annika said the past twelve months have been "a terrible year".

"Her dad and her brother found her dead in her apartment. It's been a terrible year – all the holidays and her birthday," she said.

TT/David Landes


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Your comments about this article

19:03 March 27, 2012 by kenton38
I think people, who is in charge of SOS alarm and "health assessments" the ones who is asking for help, should be fired and sentenced for life imprisonment - it would save a lot of innocent lives in future.
20:14 March 27, 2012 by dizzymoe33
This is so sad and so wrong!!! The SOS alarm people need better training and there should not be several calls made to the SOS company the first call should be enough to get help immediately!! This is scary I know what it is like to have lung disease and not to be able to breathe and minutes make a big difference in whether you live or die!! I guess we are now more valuable dead than alive these days!!
21:00 March 27, 2012 by Reason abd Realism
The magnitude of the incompetence in this case is absolutely staggering.

Is there no IQ test administered to these SOS operators? Not math skills necessarily, but at least some level of 'social IQ' to be able to sense when an adult caller is in real physical distress?

Or are these operators so brain-dead that they slobber all over themselves and do not even blink when someone shines a blinding bright light into their eyes?

Maybe not included in this article, but there should be a very detailed list of procedural recommendations that are published with this findings of this investigation, to ensure that this does not happen again. This should obviously include the dismissal of all employees and job applicants who are utterly clueless about reality.
21:18 March 27, 2012 by Douglas Garner
As the SOS calls for this particular community must be routed to the advice nurse, it sounds like the blame lies with the advisory service and the community representatives that participated in making the regulations.

Here in Gävle, I have had the need to request ambulance or police services 5 times in the couple of year and have found response to be exceptional. Perhaps we have a different provider network?
22:28 March 27, 2012 by darky
Why allow a lady with all this beauty to die?? Varför ??
23:29 March 27, 2012 by Radhus
Here we go again. How many of cases like this one does it take to make Swedes outraged and call for a better healthcare system? I know this happens in other countries, but I know if it happened this often in my country there would be protests on the streets. The Local is reporting cases like this about once a week now. In my country I hear of it only once or twice a year and it makes a lot of people angry even then.

This is a really sad story and I don't mean to make this girl's case sound like nothing more than a statistic. It happens so often where people die because of wrong diagnosis or an ambulance hasn't been sent that if nothing is done to stop people dying this way then they only become statistics.

I see that a couple of the healthcare departments have been "criticized". The operators should have at least been sacked and new measures need to be put in place, such as having only competent and knowledgable people to make decisions about sending ambulances. When someone calls for an ambulance they should only be talking to one of these people and not be transferred all over the place.

Furthermore, there should be some kind of punishment (if there isn't already) about people falsely calling for an ambulance. That's how it is in many other countries.
03:16 March 28, 2012 by Emerentia
@ darky. What has her looks do do with anything? Do you think that SOS Alarm should ask people to post them a photo before sending an ambulance, so they could prioritize the beatiful?

@radhus It's is a illegal to call SOS Alarm if there is no emergency, a person doing so could be fined and have to pay damage to emergency services. But intent ("uppsåt") must be proven. I person who really believe that they're having a heartattack, for exemple, wouldn't be accused of this.
08:50 March 28, 2012 by Dazzler
Why didnt her family help her for christsake? Not letting SOS off the hook here but come on, do people seriously count on social services for every aspect of their life, even if it is your life on the line?
11:13 March 28, 2012 by Borilla
Privatization people. SOS and their cronies have slipped another one by us. SOS provides an ambulance service and saves money on the contract by not dispatching ambulances. They pass the buck to the local authorities by allegedly turning the decision over to them. Great system - low bid gets the job and the local health authority saves money. SOS doesn't send ambulances so they have lower costs. Win-win situation for everyone except those who need help. She was able to speak, so no help necessary. What is next - no ambulance because the person making the call couldn't speak?Begins to look like the Swedish health care system is adopting the Sicilian protocol.
12:12 March 28, 2012 by Swedishmyth
Forced price controls lead to rationing. Healthcare is not an exception. Be careful what you vote for. There is no such thing as force without consequences.
12:31 March 28, 2012 by flintis
No good criticising SOS, charge the Directors with Manslaughter & make sure they are convicted for this incompetence
13:48 March 28, 2012 by mcarroll1
SOS Alarm (Shove Off Sister) Alarm. What a sick joke of a service. Next time ring after consuming a bottle of whiskey first so you can talk incoherently.
16:32 March 28, 2012 by libertarianism
Exactly #11. The state sets the budget. The politicians of each län decide how little to spend on healthcare in their respective län. Anyone outside the politicians' budget, suffers and/or dies. Problem doctors/departments never go out of business...
02:31 March 29, 2012 by Jeff10
Dear Swedes:

You get what you pay for in life. You bargained for state provided, single-payor health care that doesn't have to compete in the market place.

So, in effect, you've entered into an agreement with mindless bureaucrats who will provide to you health services, provided such services aren't demanded during union mandated breaks, after closing hours, holidays, and days when the bureaucrats simply don't feel that they should have to work so hard for the yahoos who were stupid enough to entrust them with providing health services.

For this reason, Odummy-care will die in the US, if not first nixed by the SCOTUS (Supreme Court of the United States).
05:57 March 29, 2012 by wendybTn
This is why US health care is first rate. If you call an ambulance, they come. If you are in the Grand Canyon and call 911, help comes. If you have a high risk birth, we take care of you. If you want Obamacare, look at how many stories on this site are related to," ambulance did not come." You get what you pay for, in everything.
07:07 March 29, 2012 by crackmonkeys4hire
And the American Democrats want the US to be just like this. In the US one call gets you an ambulance or emergency service and you don't need to prove you are sick. Many American cities have Paramedics that work for the Fire Dept. They are trained medical technicians whose job it is to stabilize you and get you ready for transport. They save lives often before you get to the hospital.
11:02 March 29, 2012 by Reason abd Realism
@ Jeff10

The real test is whether the incompetence/negligence/willful neglect inflicted upon Swedes by SOS will result in real change in how they must provide the service, which must be mandated by government, if they care about their citizenry. No system is perfect at birth.

You won't find a lot of fans of American healthcare here, given that the benefits are largely restricted to the haves, with little concern for the have-nots, or for people unfortunate enough to have a pre-existing health ailment.

If the US supreme courts nixes Obamacare (a. k. a. Romneycare) is will be because of the Supreme Court Republican Orchestrated Terrorist Uber Megalomaniacs (SCROTUM) of US society.
11:52 March 29, 2012 by cogito
#18. It is difficult to tell if you are willfully ignorant or just clueless.

Contrary to your falsehoods, 85% of Americans are happy with the healthcare they receive according to all polls and surveys.

Far from being restricted to the "haves" the Medicaid program covers healthcare for all those of limited means.

Are you unaware that according to federal law it is illegal to deny anyone medicare care, regardless of their lack of insurance or inability (or reluctance) to pay?
12:17 March 29, 2012 by libertarianism
Swedish doctors, the Swedish system, wrecked my body and my life. Private doctors in a neighboring European country and private doctors in the US saved what's left of me.

On top of crushing Swedish taxes for "healthcare" etc, I now have medical debt bc I was forced to seek care outside of Sweden, as are many others. My family now helps me financially, which I am thankful for but which also feels horrible, and humiliating. I have been reduced to such circumstances bc Swedish politicians are happy to leave people to rot and die. There is NO DIGNITY in this system.

My doctor in the US also gave me discounted rates, and his billing people said pay what you can, when you can. He still asks my family how I'm doing when they see him. I'm from a rural, blue-collar community. The US system needs work, but there's hope within it. The Swedish system is broken. There is no hope for it. Apathy reigns supreme. It's oppressive to caring medical personnel and patients.

I would also like to point out that time and time again, Swedish doctors refer to the New England Journal of Medicine, and time and time again, patient groups and medical professionals in Sweden refer to US medical procedures when they are citing positive practices (medications and treatment protocols) that they feel would benefit Swedish patients.

I daresay that the Swedish system greatly benefits from the knowledge and treatment protocals learned in the country that so many love to hate.

15:40 March 29, 2012 by Reason abd Realism
@ cogito #19

And 85% of Swedes (or more) would probably say that they do NOT want an American style health care system, which, despite being by far the most expensive in the world, has US life expectancy in 36th place, has no regular coverage for millions of American, and where children with pre-existing conditions can be denied coverage because they are unattractive from a for-profit industry perspective.

As for the laws that prevent people from being turned away who have no coverage, the fact that someone without coverage can get treatment for a broken leg in an emergency ward does not imply that this person would enjoy the same health and quality of life as someone who has a health plan that encourages regular checkups and screening and early treatment options for slow killers like heart disease, diabetes, and many cancers.

All health care systems generate the sorts of horror stories that #20 describes (sorry to hear about that L.). The film Sicko points out many of these horror stories for Americans that HAVE health insurance coverage, so no one should pretend that they live in a health care paradise.

The point here is that SOS needs to be improved, but this does not automatically imply that a nation's entire population is better served by private health care system than a public health care system.
19:21 March 29, 2012 by Jeff10
@18 et. seq., aka, Mr. R&R:

You just lost all credibility by citing a movie made by the biggest hypocritical phony in the US, Mikey Moore.

The US has the best healthcare, especially when broken down by race and ethnic group. For the most part, with a few exceptions, which exceptions are related to lifestyle and not health care, Asian-Americans have longer and healthier lives than non-American Asians, White Americans live longer and healthier lives than non-American Whites. This also applies to Afro-Americans.

Look at it this way, Mr. R&R. The true measure of US healthcare is the number of foreigners who come to the US when they have serious health issues. If one has a serious disease or illness, then one has a far, far, better chance of survival and recovery if treated under the US health care system than under any other health care system. Google it, my unknowledgeable friend.
07:20 April 3, 2012 by Se82340
UNACCEPTABLE. They are NOT doctors, and cannot judge if she needed attention simply based on her speech. And if she WAS gasping, what the F is wrong with that operator?!?! They ALL should lose their jobs and be held criminally responsible. They'd want the same done if it were THEIR family member, so.....
19:05 April 3, 2012 by Silverfawn
A death that should have been avoided, and, at the end of the day, there is no one who will actually bear any responsibility or penalty for it.
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