Deported in Coma, Saved Back in U.S.
by Deborah Sontag
The New York Times
November 8, 2008
Soon after Antonio Torres, a husky 19-year-old farmworker, suffered catastrophic injuries in a car accident last June, a Phoenix hospital began making plans for his repatriation to Mexico.
Mr. Torres was comatose and connected to a ventilator. He was also a legal immigrant whose family lives and works in the purple alfalfa fields of this southwestern town. But he was uninsured. So the hospital disregarded the strenuous objections of his grief-stricken parents and sent Mr. Torres on a four-hour journey over the California border into Mexicali.
For days, Mr. Torres languished in a busy emergency room there, but his parents, Jesús and Gloria Torres, were not about to give up on him. Although many uninsured immigrants have been repatriated by American hospitals, few have seen their journey take the U-turn that the Torreses engineered for their son. They found a hospital in California willing to treat him, loaded him into a donated ambulance and drove him back into the United States as a potentially deadly infection raged through his system.
By summer’s end, despite the grimmest of prognoses from the hospital in Phoenix, Mr. Torres had not only survived but thrived. Newly discharged from rehabilitation in California, he was haltingly walking, talking and, hoisting his cane to his shoulder like a rifle, performing a silent, comic, effortful imitation of a marching soldier.
“In Arizona, apparently, they see us as beasts of burden that can be dumped back over the border when we have outlived our usefulness,” the elder Mr. Torres, who is 47, said in Spanish. “But we outwitted them. We were not going to let our son die. And look at him now!”
Antonio Torres’s experience sharply illustrates the haphazard way in which the American health care system handles cases involving uninsured immigrants who are gravely injured or seriously ill. Whether these patients receive sustained care in this country or are privately deported by a hospital depends on what emergency room they initially visit.
There is only limited federal financing for these fragile patients, and no governmental oversight of what happens to them. Instead, it is left to individual hospitals, many of whom see themselves as stranded at the crossroads of a failed immigration policy and a failed health care system, to cut through a thicket of financial, legal and ethical concerns.
That creates a burden. “It’s a killer,” said Brian Conway, spokesman for the Greater New York Hospital Association. But it also establishes the potential for neglectful and unethical if not illegal behavior by hospitals.
“The opportunity to turn your back is there,” said Dr. Stephen Larson, a migrant health expert and physician at the Hospital of the University of Pennsylvania. “You’re given an out by there not being formal regulations. The question is whether or not litigation, or prosecution, catches up and hospitals start to be held liable.”
In October, the California Medical Association, responding to an article in The New York Times about the medical deportation of a brain-injured Guatemalan, passed a resolution opposing the forced repatriation of patients. The American Medical Association is to take up the matter on Sunday at a national meeting in Orlando.
“While we empathize with hospitals that must provide uncompensated care to undocumented immigrants,” said Dr. Robert Margolin, a trustee of the California association, “we overwhelmingly oppose the practice of repatriating patients without their consent.”
An examination by The Times of cases across the country involving seriously injured and ill immigrants shows patients at the mercy of hospitals and hospitals at the mercy of a system that provides neither compensation nor guidance. Taken together, the cases reveal a playbook of improvised responses, from aggressive to compassionate.
In the case of Elliott Bustamante, a hospital in Tucson moved speedily, and ultimately unsuccessfully, to transfer a sickly infant to Mexico, ignoring the mother’s opposition and the fact that Elliott was an American citizen born with Down syndrome and a heart problem at that very hospital.
In the case of Kong Fong Yu, in contrast, a Manhattan hospital has proceeded less decisively, keeping Mr. Yu, a stroke victim, as a boarder for 18 months now as it grapples with whether to send him back to China or to subsidize him in a nursing home indefinitely.
Read more here.
The New York Times
November 8, 2008
Soon after Antonio Torres, a husky 19-year-old farmworker, suffered catastrophic injuries in a car accident last June, a Phoenix hospital began making plans for his repatriation to Mexico.
Mr. Torres was comatose and connected to a ventilator. He was also a legal immigrant whose family lives and works in the purple alfalfa fields of this southwestern town. But he was uninsured. So the hospital disregarded the strenuous objections of his grief-stricken parents and sent Mr. Torres on a four-hour journey over the California border into Mexicali.
For days, Mr. Torres languished in a busy emergency room there, but his parents, Jesús and Gloria Torres, were not about to give up on him. Although many uninsured immigrants have been repatriated by American hospitals, few have seen their journey take the U-turn that the Torreses engineered for their son. They found a hospital in California willing to treat him, loaded him into a donated ambulance and drove him back into the United States as a potentially deadly infection raged through his system.
By summer’s end, despite the grimmest of prognoses from the hospital in Phoenix, Mr. Torres had not only survived but thrived. Newly discharged from rehabilitation in California, he was haltingly walking, talking and, hoisting his cane to his shoulder like a rifle, performing a silent, comic, effortful imitation of a marching soldier.
“In Arizona, apparently, they see us as beasts of burden that can be dumped back over the border when we have outlived our usefulness,” the elder Mr. Torres, who is 47, said in Spanish. “But we outwitted them. We were not going to let our son die. And look at him now!”
Antonio Torres’s experience sharply illustrates the haphazard way in which the American health care system handles cases involving uninsured immigrants who are gravely injured or seriously ill. Whether these patients receive sustained care in this country or are privately deported by a hospital depends on what emergency room they initially visit.
There is only limited federal financing for these fragile patients, and no governmental oversight of what happens to them. Instead, it is left to individual hospitals, many of whom see themselves as stranded at the crossroads of a failed immigration policy and a failed health care system, to cut through a thicket of financial, legal and ethical concerns.
That creates a burden. “It’s a killer,” said Brian Conway, spokesman for the Greater New York Hospital Association. But it also establishes the potential for neglectful and unethical if not illegal behavior by hospitals.
“The opportunity to turn your back is there,” said Dr. Stephen Larson, a migrant health expert and physician at the Hospital of the University of Pennsylvania. “You’re given an out by there not being formal regulations. The question is whether or not litigation, or prosecution, catches up and hospitals start to be held liable.”
In October, the California Medical Association, responding to an article in The New York Times about the medical deportation of a brain-injured Guatemalan, passed a resolution opposing the forced repatriation of patients. The American Medical Association is to take up the matter on Sunday at a national meeting in Orlando.
“While we empathize with hospitals that must provide uncompensated care to undocumented immigrants,” said Dr. Robert Margolin, a trustee of the California association, “we overwhelmingly oppose the practice of repatriating patients without their consent.”
An examination by The Times of cases across the country involving seriously injured and ill immigrants shows patients at the mercy of hospitals and hospitals at the mercy of a system that provides neither compensation nor guidance. Taken together, the cases reveal a playbook of improvised responses, from aggressive to compassionate.
In the case of Elliott Bustamante, a hospital in Tucson moved speedily, and ultimately unsuccessfully, to transfer a sickly infant to Mexico, ignoring the mother’s opposition and the fact that Elliott was an American citizen born with Down syndrome and a heart problem at that very hospital.
In the case of Kong Fong Yu, in contrast, a Manhattan hospital has proceeded less decisively, keeping Mr. Yu, a stroke victim, as a boarder for 18 months now as it grapples with whether to send him back to China or to subsidize him in a nursing home indefinitely.
Read more here.
Copyright 2008 The New York Times Company
posted by Swallowtail at 18:14
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