There are a few things the public needs to understand. First, the woman who died in the "ER waiting room" was NOT in a "ER" that medical patients go to, but one specifically for psychiatric patients. There was probably no medical care there, just psych. It is misleading to suggest otherwise. I do not think it justifies what happened to her, merely I am attempting to clarify a misconception that keeps going on.

Second, there is no incentive to not see patients in a ER waiting room. In fact, ER doctors do not like to know the waiting room is full. We would rather see everyone as quickly as possible because anyone in the waiting room could potentially be sick without our knowledge...and we are still responsible for them in the waiting room! We would rather have the patient in a room to evaluated to avoid any problem.

Third, while it is true that boarding is a large cause of ER waits, there are also many other causes. One is patients not going to their doctor first. People come to the ER with problems of 2 weeks duration. When asked if they called their doctor, they say "yes, but he was not in" or "he could not see me" because they waited 2 weeks and called at 2AM!!! Or at the end of the doctor's day when there were no more appointments left! Poor planning does not equal emergency. And, splinters in feet are not emergencies, nor is coming to the ER for a test you can get scheduled in a week or so, but it is not convenient for you because...(fill in: vacation, having a party...etc..we have heard them all!). This happens on a daily basis...and no one can be turned away from an ER.

Also, if hospitals were trying to divert care from the poor, you would think hospitals with a better payor mix (read: people with insurance) would not have waits, but they do. I am an ER doctor and I have friends that practice all over the country and we all have the same problems!

I also agree. I believe this event is unique. First, this "ER" is for Psychiatric patients only, Second, if this woman had been waiting for over 24 hours I would not find it unusual at all for her to be recumbent on the floor "sleeping". Sure, someone should have checked on her but if her fall was not witnessed I could understand the delay. Third, since this woman died of a Pulmonary Emboli, it is very unlikely ANYTHING could have been done to save her even if this event occurred while in a ER bed in a trauma center. I remember about 6 months ago working a 21 year old post-pardom PE who coded in our ER for over an hour and never once getting a viable rhythm or pulse. Tragic! This woman was most likely dead before she hit the floor. Death from a PE is not like an MI. You cant just shock the heart into functioning again. If a massive blood clot is occluding oxygen transfer through your lungs all the CPR and defibrillation in the world wont change that.