Woman's death in hospital emergency department ruled a homicide

Doctors say the unusual case in Illinois is indicative of an overburdened emergency system and could set a dangerous precedent.

By Amy Lynn Sorrel, AMNews staff. Oct. 16, 2006.

"ED Homicide" may sound like a television thriller, but the term instead describes an Illinois coroner's jury's findings following the death of a heart attack patient who waited for two hours before emergency medical staff saw her.

The immediate cause of 49-year-old Beatrice Vance's death was a myocardial infarction. But a jury at a Sept. 14 coroner's inquest found that her death also was "a result of a gross deviation from the standard of care, which a reasonable person would exercise in the situation." With that, the jury determined "the manner of her death to be homicide," a ruling that physicians and state officials say is extremely rare and possibly the first in the state.

The case, at press time, was in the hands of the Lake County State's Attorneys Office to decide whether to pursue criminal charges and, if so, against whom.

While the case is under review, doctors worry that the threat of criminalizing emergency department care will endanger a specialty already burdened with high medical liability risk and limited resources.

"We are being asked to do more and more with less and less, and as that continues, we are going to be at risk to have more situations like this where we can't match the care to the demand," said Frederick C. Blum, MD, president of the American College of Emergency Physicians.

"It's one thing to get sued for malpractice and another to go to jail for doing your job," Dr. Blum said, adding that he has only seen criminal convictions in cases where doctors were impaired by drugs or alcohol. If criminal charges ensue in the Vance case, it could set a dangerous precedent that would have a "chilling effect" on doctors entering the specialty, he said.