A 750 pound woman dies at home. According to police and the coroner’s office, there is no truck big enough to transport her to the morgue, so police call the towing company, they drag her out of her apartment on a mattress and load her onto a pickup truck to bring her to the morgue.
According to witnesses, the tow truck drivers threw a piece of carpet over her instead of a sheet. I’m assuming the reason for this is because not too many tow truck drivers or coroners carry extra large clean sheets in the backs of their vehicles, but that is purely speculation on my part.
Family members and neighbors were appalled. It was “like putting a cow up there,” said the deceased’s boyfriend. They don’t treat [dead dogs] that way,” stated a neighbor.
Supposedly the fire department has equipment that will handle patients up to 1000 pounds, but no one knew that.
Assuming that the fire department didn’t have the equipment available, what would the family have done to get the patient to the morgue?
If people allow themselves to get so obese that traditional transport mechanisms won’t work, then what duties should providers have?
[Thanks to Alexander for the link]
UPDATE JUNE 8, 2009
Amazing how posts take on a life of their own.
When I originally posted this, I did not intend for it to morph into a discussion of “political correctness,” but also agree that being “PC” has gone too far. Many thoughtful comments in this regard.
My original intent was to show how the medical system said “no.” “No we can’t transport your body in the coroner’s vehicle because you’re too large.” Patients need to understand that sometimes there are consequences to their actions. In some cases, providers will have to get the job done with what’s available to us, and you may not be happy with the results. In other cases, patients may not be able to receive appropriate treatment. What happens if a 750 pound person passes out on the second floor apartment and there is no elevator? What if it happens in a rural location and there are not enough volunteer EMTs to lift the patient? Will providers get sanctioned for saying “we can’t help you”?
As Shadowfax notes, there is an entire industry catering to the morbidly obese patients. We have “big boy” beds. Stretchers are now guaranteed to hold more than 500 pounds. But there are also limits to diagnostic equipment. MRI machines might not accommodate a patient’s girth. CT scan gurneys “only” hold 350 pounds.
So what happens if we suspect a morbidly obese patient has a pulmonary embolism, but we can’t do the diagnostic testing to confirm the diagnosis? What if we need to do a CT scan for a morbidly obese patient who has a head injury?
And what’s going to happen in the future medical delivery systems if there is not as much of an incentive to purchase expensive equipment necessary to cater to the morbidly obese population … or an incentive to risk the increased likelihood of bad medical outcomes in providing medical care?