Who pays for care she didn’t want?

Kerra Cameron first blacked out from panic attacks eight years ago. She would slip into a foggy state for about 15 minutes before returning to normal. She's been tested for everything from epilepsy to multiple sclerosis, but the only thing doctors have determined is that she has low blood pressure.

The attacks were never a big problem until May, when Cameron, 34, passed out in a Coon Rapids Target store and soon found herself in the back of an ambulance. Over the loud protests of Cameron and her fiancé, who insisted she didn't need medical treatment, Cameron was rushed to nearby Mercy Hospital.

When she got there, Cameron once again tried to explain her condition and get the doctors to let her go home. But she was ignored again. Doctors conducted more than $2,000 worth of tests before concluding there was nothing wrong with her. An hour after she arrived, Cameron was finally allowed to leave.

Cameron doesn't think she should have to pay for medical treatment she repeatedly tried to refuse. But the police and hospital officials say it wasn't her decision to make. They say state law gives them the right to force medical treatment on anyone who poses a threat to themselves or others.

Roberta Opheim, the state's mental health ombudsman, said the law is supposed to apply to individuals suffering from mental illness.

"It raises a serious question about the use of a law intended for one purpose that is applied in a situation where it isn't clear that it meets the criteria of that statute," Opheim said. "I understand the difficulty of making a field judgment, but that still doesn't negate the situation of whether someone's rights were violated."

Pleas ignored

Justin and Kerra Cameron, who live in Ramsey, went to Target on May 18 to fill out their wedding registry. Justin said Kerra seemed fine until about 8:30 p.m., when she suddenly got tired and collapsed. Another shopper thought she was having a seizure and called 911.

"It might seem alarming to some people," Kerra Cameron said. "But I've been told I don't need to come into the hospital when it happens."

By the time paramedics rushed into the store, Kerra was trying to stand up. Justin told the paramedics that his groggy fiancée would be fine in a few minutes, but they wanted to examine her in the ambulance. They made Justin stand outside, so he got Kerra's mom on his cell phone. He figured she could explain the situation, but the paramedics wouldn't talk to her either.

Kerra said she panicked while she was in the ambulance because she couldn't see Justin. She began to yell that she didn't want to go to the hospital.

A Coon Rapids police officer showed up. Paramedics told him they were concerned Kerra might be having a stroke. They asked the officer to sign a form authorizing a so-called "emergency hold," allowing them to transfer Kerra to the hospital against her wishes, Coon Rapids police Capt. Cary Parks said.

"The paramedics are the experts," Parks said. "It was their opinion that she needed to go to the hospital."

According to a copy of the form used throughout the state, such a hold is allowable when an officer believes a person is publicly intoxicated, chemically dependent or a danger to themselves or others "if not immediately detained."

Opheim, whose office created the form, said someone screwed up. To qualify for hold, she said, someone would have to be mentally ill and pose a threat to themselves or others. She said Cameron's condition does not seem to fit the bill.

Opheim said the form, which does not address a patient's mental condition, would be changed immediately.

Still required to pay

Once the ambulance arrived at Mercy, Kerra was taken to the ER and put in a wheelchair. She tried to get someone to understand her situation, that this was no big deal, that she didn't need treatment. No one would listen. Staff made her fill out an intake form and provide her insurance information. They took her in for an EKG and a CAT scan before she was allowed to see a doctor.

After the tests, Kerra waited for about 45 minutes. A doctor came to her bed and told her what she expected to hear: "Everything looks fine." She was free to go.

A few weeks later, while Kerra and Justin were preparing for their Aug. 1 wedding, the other shoe dropped. They got a bill from the ambulance company for $536. The hospital wanted $934, the amount not covered by Kerra Cameron's health insurer.

After Justin complained that his fiancée tried to refuse treatment, Allina Medical Transportation agreed to dismiss the bill. The couple weren't as lucky with Mercy, which also is owned by Allina Hospitals & Clinics.

In an Aug. 20 letter from Andrea Bailey, the hospital's patient safety risk manager, Kerra was told that there would be no adjustment in her bill, even though the hospital's review revealed that she did not qualify for an emergency hold.

"We understand that unexpected health care costs are challenging for many patients,'' Bailey wrote. "We would be happy to work with you on a payment plan."

Allina spokeswoman Gloria O'Connell said the actions of the paramedics and the hospital's physicians "were appropriate and in accordance with the law." She said the tests were necessary to determine whether Cameron required further treatment or met the criteria for an emergency hold, and she said it was up to the police to determine if a hold was necessary.

"Obviously, the police had reason to believe she needed to come, and doctors had reason to think that she needed these tests," O'Connell said.

The Camerons maintain that both the police and the medical team overreacted.

"All you had to do was have someone take a look at her and determine she was capable of making her own decisions," Justin Cameron said. "She was conscious. She was cooperating and still actively telling them not to do anything. Her rights were violated."

The Camerons said they are planning to file a complaint with the state Health Department.

Opheim said she has never heard of a situation where the emergency hold statute was used to obtain medical treatment for someone who wasn't suspected of having a mental illness.

"The hospital clearly should have known what to do in this case," she said.

Lora Pabst • 612-673-4628