The ambulance refused to go to the scene on two occasions when called by the family, as well as the nurses from the Health Center, so the patient with heart surgery was transferred to the Clinical Center of Montenegro by a private ambulance, where she underwent emergency surgery due to her life-threatening condition.
The patient's husband, who filed a criminal complaint against the Emergency Medical Service and the director of the institution, demanded detailed information from the authorities about who refused to provide medical assistance and based on what assessment, even though he was twice informed about the patient's medical history, current condition, and complaints.
"I am ready to go to the end to achieve moral and every other satisfaction, because in the end it all comes down to the fact that my wife would not be alive today, and our minor children would be left without a mother, if I had not had the money to pay for the ambulance or found a free vehicle in a short period of time," it says in the documents and correspondence with the authorities that the family submitted to "Vijesti".
The Podgorica Basic State Prosecutor's Office (ODT) filed an indictment with the Basic Court in Podgorica about ten days ago against doctor SS. The report, as they announced, was filed due to reasonable suspicion that she committed a criminal offense - failure to provide medical assistance, by "contrary to her duty, refusing to provide medical assistance to person AV, who was in immediate danger of death."
The Emergency Medical Service did not respond to questions from Vijesti regarding this case and other complaints from patients who claim that doctors often explain to them that due to age or other reasons, they should come to the Emergency Room alone. They were also asked whether and how they had changed the internal triage rules.
Even a call from a colleague from the health center wasn't enough.
The patient's husband, in letters to the authorities, but also in the criminal complaint he filed with the ODT against the Emergency Medical Assistance Institute of Montenegro, director Vuk Niković as the responsible person in that health institution, and unidentified persons or more, who were contacted via the number 124 on two occasions, emphasizes that AV underwent cardiac surgery in September last year. Less than a month later, he specifies, in the early morning hours, she had a strong urge to vomit, and this situation repeated itself five times. AV, according to her husband, completely lost consciousness three times.
"At 06.18 I called the ambulance. At that moment my wife was completely exhausted, she couldn't even stay in a sitting position... I explained the situation to the person who answered the phone and I received a response that we had to take her to the ambulance ourselves. I explained that my wife had undergone surgery with the opening of the chest, that according to the doctor's instructions, she should not get up or lie down on her own without help, even when she is not in any pain... Unfortunately, I received instructions on how we should carry her. I thanked the person who answered because I found that the ambulance would not provide my wife with the medical assistance that she is entitled to according to her human and all other rights," he pointed out in his letters to the authorities.
He says that after that conversation, his wife lost consciousness again, so the situation stabilized a bit, while he and his neighbors tried to organize transport in a sitting position on a chair. However, AV lost consciousness again and they gave up on the transport and tried to find a private medical ambulance to the Emergency Center. Unsuccessfully, according to her husband, because everyone already had rides scheduled for the next two and a half hours.
He also says that during that period, a visiting nurse from the Health Center, who has been visiting the patient every day since she left the hospital to give her therapy, arrived. He claims that she also called the ambulance at around 8 a.m., introduced herself, said where she worked, and said that as a medical worker, she believed the patient needed urgent medical attention.
The patient's husband says that the same or a different person said they couldn't come and asked how old the patient was. With the help of a visiting nurse, they managed to find a private ambulance that was on the scene and arrived in about 45 minutes.
"In the Emergency Center, they diagnosed a probable pericardial tamponade and urgently took her to cardiac surgery, where they quickly (within five to ten minutes) took her to the operating room and saved her life, noting that she arrived at the last minute," he emphasized.
The family was sent for inspection.
In a response to the patient's husband, the Ombudsman for Emergency Patients Said Čekić and the director of the institution Vuk Niković inform that the doctor/dispatcher is obliged to take a medical history, i.e. conduct an informative interview with the patient about the main complaints, determine the order of urgency, examine the patient, determine therapy, direct the patient to further treatment, and transport life-threatening patients to the nearest emergency center for further diagnostics and treatment.
Furthermore, they explain that the doctor/dispatcher determines the order of urgency from the conversation and, depending on the assessment and availability of the team, issues an order to engage an emergency medical team to carry out a home visit or provides guidelines for the patient's further treatment. The notice also states that the patient has the right to refuse the proposed medical treatment, and in that case the doctor does not have the right to carry out procedures and actions determined by modern principles of treatment.
The response quotes the text of the complaint from the patient's husband, as well as the statement of the doctor, who claims that she did not refuse medical assistance, but rather explained that in accordance with the triage assessment, such a patient should be brought to the Emergency Room, with instructions given on how to immediately organize transport to the clinic where adequate medical assistance would be provided.
"Given that the symptoms were non-specific, I assessed that the patient with such complaints was not in a life-threatening condition and that she should therefore be brought to the clinic privately for initial diagnostics and treatment. The interlocutor was not interested in cooperation, but insisted that he proceed at his discretion and ended the telephone conversation," the doctor is quoted as saying.
The Ombudsman for Patients' Rights instructed the patient's family that if they are dissatisfied with the findings of the complaint, they can contact the health inspectorate in accordance with the Law on Patients' Rights.
AV's husband points out in the criminal complaint that "unfortunately, the evidence about my wife's health condition that day indicates that I, as the interlocutor (in the first conversation), was right in 'insisting that my discretion be acted upon', not to mention the second conversation when the assessment of the medical worker who came for a regular check-up visit was ignored."
"Whether it is just the vanity of the dispatcher we spoke to, ignorance, incompetence or carelessness about the condition of the patients, malicious intent, the business protocol of the Institute for the Emergency Medical Services of Montenegro not to go out into the field unless a death or something else is confirmed, I hope that the investigation will determine, with the belief that there are elements to initiate criminal proceedings," he stressed.
The Medical Chamber promised assistance within its jurisdiction.
AV's husband also contacted the Ministry of Health, the Protector of Human Rights and Freedoms, and the Medical Chamber. The Ministry of Health forwarded him the Institute's statement, in which they claimed that the procedure had been carried out with the Protector of Patients' Rights and provided an explanation that they had previously sent to the patient's wife.
The Medical Chamber promised that, within its powers, it would seek to determine the identity of the person with whom the patient's husband had communication during difficult times and that legal measures be taken against that person.
"Your experience indicates that the system must take certain preventive measures, such as recording calls made to the Emergency Medical Service by citizens, so that these life-threatening situations do not happen again," wrote, among other things, the president of the Medical Chamber, Žanka Cerović.
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