Help came too late in the ER for stroke victim

A patient who was having a stroke waited nearly 90 minutes to be examined at the emergency room of St. John's Hospital in Maplewood, according to an investigative report released Thursday by the Minnesota Department of Health.

The patient, who was not identified in the report, lost consciousness shortly after he was taken to an exam room and died four days later.

He was identified as Raymond Newmaster, 62, of White Bear Lake, in a telephone interview Thursday night with his wife, Margaret.

An investigation by the Office of Health Facility Complaints found that the hospital violated its own policies in handling the case, which occurred in April 2007. The hospital agreed to make several changes, including improvements in staff training, as a result of the report.

Margaret Newmaster said the report doesn't bring her husband back and doesn't make up for all the family lost.

"But it does mean it's a matter of public record and they have to remedy their stroke protocol," she said, adding that she now urges everyone to get informed about local hospitals and what their strengths are.

In cases of stroke, patients must be treated quickly to limit brain damage. But in this case, Newmaster was not listed among the hospital's most urgent cases. He was assigned a "severity index" of 2, rather than 1 (most urgent), and left in the waiting room for about an hour and a half.

The investigation found that Newmaster arrived at the emergency room at 11:50 a.m. on April 1, 2007, and was assessed within three minutes.

According to the hospital records, he was having symptoms of a "potential stroke," including visual problems, a headache and "expressive aphasia" (difficulty speaking). At the same time, Kvasnicka said, the patient's wife told the nurse that he had a drinking problem, which can also cause similar symptoms.

"It can be very difficult to tell, when there are two things going on, what's causing what," he said. "They're making very difficult judgments under time pressure." At the time, he said, the emergency room was full.

Newmaster wasn't rechecked for more than 75 minutes, although the hospital requires such patients to be reassessed every 30 minutes, the report found. Shortly after he was placed in an exam room, he suffered a seizure and lost consciousness and was transferred to intensive care. He never regained consciousness and died on April 5, 2007.

The report said a family member disputed the timing in the hospital records, saying that the patient had been waiting since 10:30 a.m. to be examined. She also complained that the nurse's decision to keep him waiting was "based on the patient's alcohol use history, rather than his symptoms," the report said.