California man learns he’s dying from doctor on robot video

This 2009 photo provided by Catherine Quintana shows her father, Ernest Quintana, in Fremont, California. (Catherine Quintana via AP)
Updated 09 March 2019
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California man learns he’s dying from doctor on robot video

  • Hospital exec calls the situation highly unusual and said officials “regret falling short” of the patient’s expectations
  • But the hospital also defended its use of telemedicine and said its policy is to have a nurse or doctor in the room at the time of remote consultations

SAN FRANCISCO, California: Ernest Quintana’s family knew he was dying of chronic lung disease when he was taken by ambulance to a hospital, unable to breathe.
But they were devastated when a robot machine rolled into his room in the intensive care unit that night and a doctor told the 78-year-old patient by video call he would likely die within days.
“If you’re coming to tell us normal news, that’s fine, but if you’re coming to tell us there’s no lung left and we want to put you on a morphine drip until you die, it should be done by a human being and not a machine,” his daughter Catherine Quintana said Friday.
Ernest Quintana died Tuesday, two days after being taken to the Kaiser Permanente Medical Center emergency department in Fremont.
Michelle Gaskill-Hames, senior vice president of Kaiser Permanente Greater Southern Alameda County, called the situation highly unusual and said officials “regret falling short” of the patient’s expectations.
But the hospital also defended its use of telemedicine and said its policy is to have a nurse or doctor in the room at the time of remote consultations.
“The evening video tele-visit was a follow-up to earlier physician visits,” Gaskill-Hames said in a written response. “It did not replace previous conversations with patient and family members and was not used in the delivery of the initial diagnosis.”
Hospital officials say the technology doesn’t replace in-person conversations with the patient and loved ones.
Granddaughter Annalisia Wilharm, 33, was alone with Quintana when a nurse popped in to say a doctor would be making his rounds. A robot rolled in and a doctor appeared on the video screen.
Wilharm figured the visit was routine. She was astonished by what the doctor started saying.
“This guy cannot breathe, and he’s got this robot trying to talk to him,” she said. “Meanwhile, this guy is telling him, ‘So we’ve got your results back, and there’s no lung left. There’s no lung to work with.’“
Wilharm said she had to repeat what the doctor said to her grandfather, because he was hard of hearing in his right ear and the machine couldn’t get to the other side of the bed.
“So he’s saying that maybe your next step is going to hospice at home,” Wilharm is heard saying in a video she recorded of the visit. “Right?“
“You know, I don’t know if he’s going to get home,” the doctor says.
Steve Pantilat, chief of the palliative medicine division at University of California, San Francisco, said he doesn’t know the details in the case but that the robot technology has done wonders for patients and their families, some of whom are too far away for in-person visits.
The video meetings are warm and intimate, he said, adding that not all in-person discussions have empathy and compassion.
“No matter how well we deliver very difficult news, it’s sad and it’s hard to hear,” he said.
Wilharm said her grandfather, a family man who kept every childhood drawing he ever gave her, deserved better. She said that after the visit, he gave her instructions on who should get what and made her promise to look after her grandmother.
“He was such a sweet guy,” she said.


UN report: Sex abuse in UN peacekeeping drops, up elsewhere

A UN peacekeeping force in Lebanon (UNIFIL) liaison fixes her colleagues hat as they attend the UNIFLIS's 40th anniversary celebration at its base in Lebanon's southern border town of Naqura on the border with Israel, south of Beirut, on March 19, 2018. (AFP)
Updated 20 min 26 sec ago
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UN report: Sex abuse in UN peacekeeping drops, up elsewhere

  • Guterres said the increase in those allegations was possibly due to "awareness-raising" and improved reporting by the 30 U.N. agencies, funds and programs

UNITED NATIONS: Allegations of sexual exploitation and abuse in U.N. peacekeeping missions decreased in 2018 — but allegations against other U.N. personnel and against staff of organizations implementing U.N. programs increased, according to a U.N. report released Monday.
Secretary-General Antonio Guterres said in a report to the U.N. General Assembly circulated Monday that the alleged victims were mainly women and children.
The United Nations has long been in the spotlight over allegations of child rape and other sexual abuses by its peacekeepers, especially those based in Central African Republic and Congo. But the latest figures demonstrate again that sexual misconduct spans the entire U.N. system and beyond to outside organizations helping to implement its programs on the ground.
Guterres stressed the U.N.'s "zero-tolerance" policy and said he has embarked on "a cultural transformation" to eliminate sexual abuse and exploitation throughout the U.N. system, which comprises more than 90,000 staff and over 100,000 uniformed personnel.
According to the report, the number of cases in U.N. peacekeeping and political missions dropped to 54 in 2018 from 62 in 2017, and from 104 reported cases in 2016. It said 74 percent of the allegations in 2018 came from the U.N. peacekeeping forces in Central African Republic and Congo, and the remaining 24 percent from the peacekeeping missions in Mali, Haiti, Liberia and South Sudan.
By comparison, there were 94 reported cases of sexual exploitation elsewhere in the United Nations system, and 109 allegations involving U.N. partner organizations, the report said.
Guterres said the increase in those allegations was possibly due to "awareness-raising" and improved reporting by the 30 U.N. agencies, funds and programs.
The U.N. chief stressed that continuing allegations of sexual exploitation and abuse "harms those we serve, undermines the United Nations values and principles and tarnishes the reputation of the women and men who work with integrity and dedication to realize the objectives of the organization."