Two lung masses, missed signals and inadequate testing. How the U.S. Indian Health Service failed one patient, with catastrophic results.
By Dan Frosch | Photographs by Adria Malcolm for The Wall Street Journal Dec. 23, 2019 10:40 am ET EAGLE BUTTE, S.D.— Kate Miner walked into the Indian Health Service hospital, seeking help for a cough that wouldn’t quit.What exactly the IHS doctor said to Ms. Miner about her exam remains in dispute. Notations in her medical file indicate the doctor told her to come back for a lung scan the next day.
At the Cheyenne River Health Center in Eagle Butte, a succession of IHS medical providers treated Ms. Miner’s symptoms but never followed up on initial concerns about her condition, making each visit effectively her first, medical records show. Operational problems such as mismanaged patient chart systems affected her care, those records show. When hospital staffers discovered serious health problems, the results weren’t clearly communicated to Ms.
In October, Ms. Tree Top sued the government over her mother’s care, alleging that the IHS never informed Ms. Miner of how sick she was and failed to treat her illness. Kate Miner’s family wasn’t used to seeing her feeble and helpless. She stood 4-foot-11 and weighed barely 120 pounds, but her knack for small talk and storytelling, her sharp tongue and her spectacles gave her an air of authority.
In the fall of 2016, Ms. Tree Top noticed her mother had a bad coughing bout while returning from shopping for groceries at Walmart in Pierre. Share Your Thoughts What can the Indian Health Service do to fix the problems Kate Miner’s family encountered? Join the conversation below. Dr. Khan didn’t speak with Ms. Miner or her family again, family members said. According to Ms. Tree Top, nobody from IHS ever contacted them about needing Ms. Miner back for a lung scan.The confusing records, and the seeming lack of follow-up, wasn’t a new problem at the Eagle Butte facility. The hospital was cited in at least nine reports between 2005 and 2009 by the Centers for Medicare and Medicaid Services, the U.S.
Over Christmas 2016, as family gathered at Ms. Miner’s home, her daughters noticed she ate less. Ms. Miner smiled at the police scanner Ms. Tree Top bought her so she could trail the emergency vehicles around the reservation the way she liked. She soon retreated to her room, saying she was exhausted.“Kali, my girl, I’m not feeling well,” she said, explaining she was nauseated, with body cramps.
A physician assistant examined Ms. Miner, wrote her a painkiller prescription and sent her home an hour after she arrived, the records show. Neither Mr. Katambwa nor the nurses who saw Ms. Miner mentioned in her charts that day the masses found months earlier. It isn’t clear whether they ever saw them in Ms. Miner’s records.A few days later, Ms. Tree Top gave her mom a hug.By May, Ms. Miner was in near-constant pain, family members said. One morning, she cried out to her son that her right side was hurting and shaking. Panicked, John called Ms. Tree Top and his other sister, Lisa, telling them to meet him at the IHS emergency room.
Ms. Miner’s daughters said Dr. Martin never physically examined her, instead popping his head into the exam room, saying she was very sick and needed to come back tomorrow for referrals. They said Dr. Martin had a nurse give Ms. Miner antipain and antinausea medication before discharging her. In an interview, Dr. Martin denied all the allegations, saying he was seeking to rescue the women from prostitution and was targeted by their pimp. He no longer works at the IHS. He provided the Journal with a 2018 letter from his IHS supervisor praising his work at Eagle Butte.
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