"I was scared for my life": Emergency care at Clark County hospital sparks concerns
May 16-Kali VonDrogan knew she needed emergency medical help after spending two days unable to keep down food or water. The pain across her abdomen, sides and lower back became so intense she could barely move.
After an ambulance delivered her to PeaceHealth Southwest Medical Center, the 30-year-old Vancouver resident spent 40 minutes restrained in a wheelchair as she wavered in and out of consciousness. After struggling to free herself from restraints of the wheelchair, she collapsed on the ground. Nurses and staff passed by her as she laid on the floor in the hallway.
"I'm afraid to go to anyone but my already established doctors," VonDrogan said. "I'm petrified of the time that I'm going to need to go to an emergency room."
Across the country, patients are upset about overflowing emergency rooms, and Clark County is no exception. Residents are increasingly seeking emergency care here instead of crossing the Columbia River to Portland. In addition, the county's aging population and lack of access to primary care have contributed to increased pressure on PeaceHealth's Vancouver emergency department, said Patrick Vogelsong, PeaceHealth's director of nursing for emergency services.
Vogelsong said the number of patients seeking care at PeaceHealth Southwest Medical Center's emergency department has typically grown about 6 to 8 percent, or even as much as 12 percent, a year. Earlier this year, it saw 300 patients in one day.
"Our teams of nurses and physicians look at the volume," said Jason Hanley, an emergency medicine physician and former PeaceHealth Southwest Emergency Services medical director. "We do whatever we need to do, day to day, month to month, to make sure we can meet that demand because you never quite know what's going to show up on a single day, but we have a rough idea what we need to do to take care of patients."
'Did not meet the expectations'
From VonDrogan's perspective, the hospital's approach isn't working.
Her husband and caregiver, Alexander, emailed a complaint March 4 to PeaceHealth's care department detailing the previous day's experience.
Alexander VonDrogan said that when he arrived at PeaceHealth's emergency department, he told the receptionist his wife was disabled and had a fainting disorder. He explained that he was her caretaker and needed to be present to help communicate for her, but he was denied entry into the hall where Kali VonDrogan was lying alone.
"I go to the double doors, and I can see her. There was no one around her," Alexander VonDrogan recounted. "The receptionist was just not listening to anything that I was saying. I had to sit down in frustration, because I know she was fainting, getting overheated and her pain is just going to get worse."
When Kali VonDrogan collapsed on the floor, she fell on her strained muscles and let out a scream of pain. Only then did she get staff's attention, she said.
"Within like five seconds of me screaming, there were voices behind me going, 'Kali, come on, we can't be on the floor. It's not appropriate. Come on, let's get off the floor,' " Kali VonDrogan said. "I am just sobbing. I'm in so much pain. I can't even lift my arms anymore, like my body is done."
Kali VonDrogan said she reacted strongly when the charge nurse told her she was being dramatic. Medical notes described her as becoming "increasingly verbally aggressive," a characterization she disputes.
"I no longer could control anything about what I was doing," Kali VonDrogan said. "I know it's not OK and it's not right, but I know how to perform for healthcare workers to get good care. I am polite. I do not scream. I do not yell. I try to hold myself with as much decorum as I possibly can, but I exploded in a scream so loud and I could not control it, because it was so much pain that I was feeling."
Shortly after, medical staff lifted Kali VonDrogan off the floor and wheeled her to her husband in the waiting area. Discouraged, the couple left.
Kali VonDrogan said it took her five weeks to fully recover at home with help from her husband and another caregiver.
An April 8 letter from the hospital stated the VonDrogans' concerns were reviewed with emergency department leadership, and staff present during the hospital visit were interviewed.
The letter described staff accounts of that night that mirrored Kali VonDrogan's observations: The triage area was very busy with limited staff available to juggle patients who needed immediate attention.
Staff were not aware of Kali VonDrogan's fainting episodes and did not receive handoff information from EMS indicating risk, according to the letter.
"While staff described the environment as chaotic and fast-moving, the experience you and your wife had was distressing and did not meet the expectations for communication, support or responsiveness," the letter stated.
The letter outlined recommendations shared with emergency department leadership to "support better quality of care moving forward," and concluded "this concern is now considered resolved."
Kirsten Elkins, 38, of Washougal, said her experience at PeaceHealth Southwest Medical Center's emergency department led her to seek palliative care, which focuses on relieving symptoms of serious illnesses.
Elkins said she went to the emergency department at the advice of her PeaceHealth gastroenterologist after experiencing extreme stomach pain.
Elkins said when she arrived at the ER, doctors repeatedly dismissed her pain and said there wasn't much they could do to help her, despite her history of serious chronic illness.
A healthcare worker's notes on her emergency visit that night describe a similar timeline of events.
"There was a message from her gastroenterologist discussing coming to the emergency department potentially for admission," the notes stated. "I spoke with on-call (gastroenterologist) who essentially said he really had no input or recommendations. His only thought was to have her stay in the emergency department until the morning when (her doctor) gets in clinic. However, unfortunately we are extremely busy and do not have the available space at this time."
Elkins said the hospital was ready to discharge her, but a nurse pushed to keep her there until her doctor arrived, as advised by the on-call gastroenterologist.
"I was scared for my life," Elkins said.
She said she hopes status as a palliative care patient will help her get the help she needs in the future.
Closer look needed
Leapfrog Hospital Safety Grade dropped its rating of PeaceHealth Southwest Medical Center from an "A" in 2024 to a "B" in 2026, with a "worse than average" score for responsiveness of hospital staff.
Vogelsong said that does not accurately represent day-to-day performance and that PeaceHealth prioritizes patient safety and quality of care.
"The improvements that we are doing both in our physical capacity within the department, as well as our quality efforts in the emergency department, have really spoken to how we're able to meet the demands of the community, as well as the treatment objectives for the patients," Vogelsong said.
Hanley, the emergency medicine physician, said it's difficult to hear about cases like Kali VonDrogan's and Elkins'. He's met with patients who have filed complaints against the hospital, which he says are reviewed every day and are followed-up with a phone call or letter.
"I always felt very blessed when I sat in that chair to have such a robust system giving patients a voice, us learning from that or sometimes us sharing with the patient of why that happened," Hanley said.
Kali and Alexander VonDrogan said they never received a call from PeaceHealth regarding their complaint. Still, they said they hope the hospital takes a closer look at its emergency department by improving staffing levels and ensuring patients receive appropriate care.
"Let the patient tell you who they are," Kali VonDrogan said.
This story was made possible by Community Funded Journalism, a project from The Columbian and the Local Media Foundation. Top donors include the Ed and Dollie Lynch Fund, Patricia, David and Jacob Nierenberg, Connie and Lee Kearney, Steve and Jan Oliva, The Cowlitz Tribal Foundation and the Mason E. Nolan Charitable Fund. The Columbian controls all content. For more information, visit columbian.com/cfj.
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