Quick Tip for Families in Intensive Care: If LTAC (Long-Term Acute Care) in the U.S. Doesn't Provide ICU Care for a Ventilated & Tracheostomy Patient, Is It Medical Negligence?

Quick Tip for Families in Intensive Care: If LTAC (Long-Term Acute Care) in the U.S. Doesn’t Provide ICU Care for a Ventilated & Tracheostomy Patient, Is It Medical Negligence?

If an LTAC in the US fails to provide ICU level care for a ventilated patient with tracheostomy, and the patient dies because of it, is this medical negligence?

My name is Patrik Hutzel from intensivecarehotline.com.

This is a question we got from one of our clients that we have worked with. The client asked us for a medical record review, as part of one of their family members being in an LTAC and I will answer that question today.

Again, my name is Patrik Hutzel from intensivecarehotline.com and this is another quick tip for families in intensive care.

If an LTAC in the US fails to provide ICU-level care for a ventilated patient with tracheostomy, and the patient dies because of it, is this medical negligence?

Most likely, it is medical negligence. Whether it legally qualifies depends on several factors.
In the US, medical negligence, also known as malpractice, happens when a healthcare provider breaches the accepted standards of care, and that breach directly causes injury or death.

For this situation.

Number 1, duty of care. An LTAC, also known as a long-term acute care hospital, does have a duty to provide an appropriate level of care for ventilated patients, even if they are not in an ICU. For the record here, we always advise to stay clear of LTACs when it comes to transferring patients from ICU to an LTAC. It is a disaster area, and we have seen many patients die unnecessarily in LTAC that would not have died in an ICU. This is where this question is really coming about, and I encourage you to look up online reviews for LTACs in general if you’re in the US, and you will see what I mean. When you read the online reviews from patients or families, most of the time it’s families, look up their online reviews.

Number 2, Breach of duty. If the LTAC failed to monitor the patient properly, respond to emergencies, maintain the ventilator, or fail to recognize and treat critical conditions in ways a reasonably competent LTAC should have, that would likely be a breach. Bear in mind, if you look at the staffing levels in LTAC, the staffing levels don’t match ICU skill levels. In ICU, for a ventilated tracheostomy patient, you would have 1 to 1 nurse to patient ratio with a critical care nurse.

In an LTAC, you often have no critical care nurses, even though it is evidence based that only critical care nurses are competent to keep a patient on ventilation and tracheostomy safe. LTACs send registered nurses, even nursing aides to look after ventilated and tracheostomy patients, and it is simply negligence.

Number 3. Causation. Someone would have to show that the patient would likely not have died if the LTAC had provided ICU level care, but it was medically necessary. For example, if a patient needed urgent interventions and LTAC was unable to provide.

Number 4. Damages, there must be actual harm. In this case, the patient has passed away. What is important is that LTAs are not ICU level hospitals. They are designed for stable, very stable patients. I know they’re also designed for critically ill patients, but at the end of the day, we have seen so many patients over the years that go from ICU to LTAC, where ICUs say they’re ready to go to LTAC, and then they bounce back to ICU within less than 24 to 48 hours, and we are so not surprised. If a patient needs an ICU level intervention, then bear in mind, anyone that’s on a ventilator with a tracheostomy might need or does need ICU level interventions at all times because they’ve got an unstable airway, that can only be managed by critical care nurses.

For someone on a ventilator with a tracheostomy, this is very likely that they might have a medical emergency or need even rapid resuscitation. If the LTACs fail to recognize the need or arrange urgent transfer to an ICU hospital, that is definitely grounds for medical negligence.

It often comes down to expert testimony. Doctors and nurses, respiratory therapists would usually need to testify that LTAC care fell below acceptable standards, examples where it might be negligence would be that the staff is not trained to manage some ventilator failure. I can assure you from my extensive experience, that is not the case. Most of their staff wouldn’t know how to read ventilator parameters. They wouldn’t know how to manage a ventilator, let alone a tracheostomy.

If they delayed calling an ambulance in the US, it’s 911 or arranging an ICU transfer immediately when a patient destabilizes, if they ignored alarms or signs of respiratory failure. They improperly managed secretions leading to airway blockage. This is where the skill of critical care nurses comes in and is so important because most LTAC simply do not have that skill.

What should you be doing in a situation like that? Prevention is better than cure. You should never ever let your loved one go from an ICU to LTAC if you are in the US, and there are ways to stop ICUs from sending your loved one to LTAC.

We have helped so many clients over the years to exactly prevent that with our advocacy and our consulting. And that often includes requesting the full medical records immediately, including, nursing notes, ventilator logs, emergency response records, and everything. There’s nothing that hospitals or LTACs should hide. If you do feel like they do hide something, you’re probably on to something. What is it that you can’t see?

Get a second opinion and get an independent medical and nursing review, which is something we can help you with here at intensivecarehotline.com.

I hope that answers your questions and helps you to steer this difficult territory that is ICU and LTAC. Stay away from LTAC. Made a video a while ago, 10 reasons why LTACs in the US are a scam, and I’ll link to the video below the video in the written version of this blog, so you can have a look at that video.

I worked in critical care nursing for over 25 years in 3 different countries, where I worked as a nurse manager for over 5 years in critical care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com, and I can very confidently say, we have saved many lives for our clients in intensive care.

You can verify that on our testimonial section and you can verify it on our intensivecarehotline.com podcast or you can find that intensivecarehotline.com, where we’ve done client interviews. Our advice is absolutely life changing. If this video hasn’t helped you, let me know. Our advice is absolutely life changing because we have saved so many lives for our clients in intensive care that otherwise would have died.

Have a look at our testimonial and podcast section. You can find more information there. And you can join a growing number of members and clients that we have helped over the years, hundreds and hundreds of them, that we have helped to improve their lives instantly when they have a loved one critically in intensive care, so they can make informed decisions, have peace of mind, control, power, and influence, making sure their loved one gets best care and treatment always.

That’s why I do one-on-one consulting and advocacy and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I hand hold you through this once in a lifetime situation that you simply cannot afford to get wrong. I also talk to doctors and nurses directly. When I talk to doctors and nurses directly with you or on your behalf, I set you up with the right questions to ask. I ask all the questions that you haven’t even considered asking because of all my experience, and that will make all the difference.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time, so that you can get a second opinion in real time. We also do medical record reviews after intensive care, if you have unanswered questions, if you need closure, or if you are suspecting medical negligence

We also have a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com. If you click on the membership link or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team 24 hours a day in the membership area and via email, and we answer all questions intensive care related. In the membership, you also get exclusive access to 21 e-books and 21 videos that I’ve personally written and recorded. All of that will help you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment, always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to support at intensivecarehotline.com.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Like the video, click the notification bell, share the video with your friends and families, and comment below what you want to see next, what questions and insights you got from this video.

I also do a weekly YouTube live where I answer your questions live on a show, and you will get notification for the YouTube Live if you’re a subscriber to my YouTube channel or if you’re a subscriber to my intensivecarehotline.com email newsletter.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

BOOK YOUR FREE 15-MINUTE CONSULTATION NOW!

24/7 Phone Access

YOUR INTENSIVE CARE HOTLINE - Quick Tip for Families in Intensive Care: If LTAC (Long-Term Acute Care) in the U.S. Doesn’t Provide ICU Care for a Ventilated & Tracheostomy Patient, Is It Medical Negligence?

Quick Tip for Families in Intensive Care: If LTAC (Long-Term Acute Care) in the U.S. Doesn’t Provide ICU Care for a Ventilated & Tracheostomy Patient, Is It Medical Negligence?

YOUR INTENSIVE CARE HOTLINE - Quick Tip for Families in Intensive Care: If LTAC (Long-Term Acute Care) in the U.S. Doesn’t Provide ICU Care for a Ventilated & Tracheostomy Patient, Is It Medical Negligence?

Free Download INSTANT IMPACT REPORT

Related Articles: