Call for ER patient advocate is personal to ex-lawmaker

Fred Rohlfing, first elected to the Legislature when Hawaii became a state in 1959, was back at the Capitol last Wednesday.

He came thinking about his wife, Patty, but because Rohlfing spent most of his life as a legislator or judge, he also was battling for a new law.

First he told the Senate Health Committee about his wife and her death shortly after Christmas 2011.

"She was lying on the raised hospital bed in CCU at Kuakini Medical Center in Honolulu. She was paler than usual but still beautiful with her eyes closed," Rohlfing said in testimony.

"She had wires and tubes coming out of her body. I talked to her but she did not show any sign of recognition. I stroked her cheek — no recognition. I kissed her and said goodbye and aloha, my love. As I turned to leave, I was almost bowled over by the realization that this was it … I was saying goodbye forever to the love of my life — my beloved Patty — that I was now alone and she would be dead in a matter of minutes.

"How could this happen?" Rohlfing asked.

What happened was Rohlfing and his wife, Maui residents, were visiting friends here at Christmas at the time of the medical crisis engulfing Honolulu with the closure of the two Hawaii Medical Center hospitals. During a Christmas Eve party, Patty Rohlfing became sick and was in pain, so sick that Fred took her to a nearby hospital. She was examined, given a strong painkiller, a CT scan and discharged. Rohlfing pleaded that she remain but "the nurse said we were to take her (home) at about 3:30 a.m., and that was that."

She was still in pain the next day so Rohlfing took her to a physician who called EMS who took her to Queen’s Medical Center. Because Honolulu hospitals were overloaded with emergencies, she was rerouted to Kuakini Medical Center, where doctors said she was in septic shock from ischemic bowel disease, a deadly fast-acting condition.

While Rohlfing is exploring legal action regarding the hospital, he is hoping that something can be done now to help emergency room patients.

"What if I had some place or some person to turn to in the debate during that early morning discharge? What if a trained medical person could have seen my side of the argument about discharging the patient into the early morning blackness?" Rohlfing asked.

The state Health Department opposed the bill, saying it would be costly.

"The intent of this measure is good but the scope is too expensive," said Loretta Fuddy, state health director.

Sen. Josh Green, health committee chairman and an emergency room physician, says he agrees with Rohlfing, but is unsure if the state can afford a patient advocate for every emergency room in Hawaii.

"We are unsure of the size of the problem — are there problems 20 times a year, or 20 times a month?" Green said.

Nothing was said about Alzheimer’s patients in emergency rooms, or those too confused to help themselves or those without a guardian to question the decisions by a doctor, although Green added that if a program could be started, it would be within a health department elderly affairs unit.

He added that he planned to move the bill, Senate Bill 666, to the next committee with the suggestion that some effort be made to include a patient advocate in the Health Department.

For the aged, scared and confused in an intimidating emergency room in a time of crisis, there should be someone to listen with compassion, if the doctor and nurses are not.

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Richard Borreca writes on politics on Sundays, Tuesdays and Fridays. Reach him at rborreca@staradvertiser.com.