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The Top ER Was Next Door. Her Ambulance Couldn't Go There

How the practice of diversion might have hurt Tiffany Tate
By Kate Seamons,  Newser Staff
Posted Jan 21, 2019 4:18 PM CST
A stock photo of an ambulance.   (Getty Images)

(Newser) – When David Tate got word that his sister had suffered a medical emergency at work, he rushed to Froedtert Hospital in Wauwatosa, Wisconsin. Tiffany Tate wasn't there. That didn't make sense to him, and for good reason: Tate suffered a stroke while working in the cafeteria at the Medical College of Wisconsin, which John Diedrich writes for the Milwaukee Journal Sentinel is "less than four football fields" from Froedtert's ER. But the 37-year-old mother of two was instead taken three miles by ambulance to Aurora West Allis Medical Center, which offers a more basic level of stroke care; Froedtert offers Milwaukee County's most advanced. But on Aug. 19, 2014, it was on a diversion, a "little-known practice" in which ERs can decide they are too busy and turn away ambulances.

Due to federal law, they can't turn away patients who present themselves in the ER, so "had Tate been wheeled into the Froedtert emergency room," the ER would have had no choice but to treat her. Instead, the ambulance crew was alerted to Froedtert being on diversion, followed protocol, and took her to West Allis, which determined she should undergo a thrombectomy, in which a catheter is put into an artery to fetch a clot. West Allis couldn't do that. Froedtert was still on diversion. So she was taken to St. Luke's, arriving more than 3.5 hours after the first signs of her stroke emerged—outside of the 3-hour window in which interventions tend to be most successful. Her condition worsened, and she was ultimately transferred to a nursing home, where she died on Dec. 9, 2014. The full piece digs deep into diversions, which are now barred in the county but still practiced elsewhere in the state. (Read more Longform stories.)

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