“American Carnage”: Substandard Corporate Healthcare in Rural America
By: Hooman Noorchashm
Tags: Negligence, Death And Dying, Healthcare, Appalachia, Corbin Kentucky

Somewhere along the Appalachian trail — Corbin, KY.

In America, we do not provide substandard Healthcare products and services to the sick, to the elderly, to the socioeconomically challenged, or to the disabled — especially when it comes to life-saving healthcare.

Or, do we?

Recently, I had the privilege of advocating for a family in rural Kentucky — in a small town called Corbin, somewhere along the Appalachian trail.

Corbin, Kentucky is an unlikely place for me to be poking my nose around, but a Kentuckian family came to me and asked for help. So I looked.

Something had gone eerily wrong with the care of their beloved patriarch: Robert Rhoden.

So I looked — I admit wearily, at first, and then carefully.

Robert was an elderly man and his heart was weak.

In Corbin, this now “elderly” man had raised a family and made a life as a “young” man.

And in Corbin, he’d gotten into trouble and gone to the local hospital in September 2017. And, He had certainly died then.

But, as far as I could see, He hadn’t just died, He’d been left for dead — as an inpatient! In a private, federally funded, acute care hospital!

And, yes, Robert was, indeed, “elderly” and He had a weak heart— but He’d come to that hospital to be healed or to find relief…after a lifetime of life! Working and raising a family in the heart of middle America.

Instead, Robert Rhoden died acutely when His heart slowed down dangerously in the early morning that September — hours before He was supposed to be discharged to his home.

The trouble in Mr. Rhoden’s case was that no medical professional seems to have done ANYTHING adequate or standard or legal to try and prevent His death on that morning in 2017 when He lay dying — in a hospital.

I guess He was old and He was sick anyway, so why even try?! Everyone dies sometime — especially “elderly” people, especially people with frail hearts. No harm, no foul….It was his time! Move on!

Right?!

NO! NOT RIGHT!

To be clear, I do not believe for a minute that it was malice that caused Robert Rhoden’s death in Corbin. That would make the cause of His death criminal conduct. This death was not a crime, per se — though some physicians I know would argue that point.

Rather it was almost certainly a series of lax, substandard, negligent and illegal actions by a behemoth corporate Healthcare entity in small town America that conspired to cause Robert Rhoden’s death — from what was a likely reversible, and not uncommon heart condition, called bradycardia.

But, for now, that is just my personal and professional opinion, as a doctor and patient advocate, based on the record His family made available to me to review.

Of course, THEY will say, “mistakes happen. Healthcare professionals are only human too.” THEY will say, “Rhoden was ‘elderly’ and He had a frail heart anyway — He wasn’t long for this world. People die. Why blame anyone?”

Because, THEY, the rote defenders of corporate structures in America, are not in the business of doing justice or fixing broken or unjust corporate systems. THEY are in the business of defending man-made corporations and money interests — and at any cost, it would appear.

And, why would any public advocate, much less someone like me sitting in another state hundreds of miles away, harp on a Healthcare corporation operating in an underserved area — serving forgotten country, “doing God’s work”?

Right!! “Doing God’s work” and billing private and taxpayer funded federal insurance programs quite efficiently for services rendered — substandard, or not at all!

Of course, the answer to the above question is quite simple: I am harping on this corporation’s conduct because it’s exactly in the most underserved and susceptible parts of our country that polished businesses and Healthcare corporations have the very highest level of responsibility to ensure that their services are robust, fool-proof and well-regulated — because in the absence of economic pressure from external competitors to ensure the highest quality possible, anything goes in Corbin, KY!

And because the cost of delivering substandard or negligent health services to folks who are already susceptible and have no real safety margin in the heart of America can be catastrophic to irrecoverable lives — as it was to the “elderly” Mr. Robert Rhoden with a frail heart.

But there are others, too. Not just the “elderly”. There are others who are not “elderly”, but who have little to no socioeconomic margin for tolerating the damage done by substandard corporate entities in rural America — especially in healthcare, where lives literally hang in the balance.

The hospital where Robert Rhoden died is, in fact, part of a large, federally funded corporate health system that covers much of the Appalachian trail and the South. In fact, by design, its administrative structure mimics some of the best and most polished health systems in the Northeast and on the West coast: an efficient insurance and patient billing machine.

So when an “elderly” Kentuckian covered by federal Medicare dollars is left for dead in such an acute care hospital setting, without so much as even a nominal attempt at saving His life, and without much apparent regard for His consent or His family’s (or Kentucky state law — KRS 311.621–643 and KRS 311.625), the question becomes this: How widespread is this level of professional/corporate negligence in a behemoth American healthcare system, serving the underserved and the socioeconomically challenged? How many others have gone through this kind of substandard treatment — in the rural heart of America?

In fact the negligence that caused Rhoden’s death was such a basic process error, it is unlikely it would be a random occurrence in that Health system. The man had provided no legally adequate consent to be left to die, yet He was left to die. THEY know that proper and legally robust informed consent is a requirement in end-of-life or withdrawal/withholding of life-saving care — that, is a basic standard in American medicine, period!

Literally, and I kid you not reader, potentially life-saving treatment was withheld from Rhoden, while Medicare was being billed for His care…on an acute care hospital floor in Corbin Kentucky — NOT hospice, NOT comfort care, ACUTE CARE.

“WHAT?!”, you might ask. “Is Corbin, Kentucky still part of the United States?”

To repeat, it is a certainty that the healthcare facility in which Mr. Rhoden died, very efficiently charged federal Medicare insurance for services rendered — except the man was left for dead without ANY attempt at saving His life, and without ANY explicit or legally acceptable or documented consent from Him or His next of kin…to leave him for dead, that is — as is required by law in virtually every state in the Union, including Kentucky.

So now, it’s up to the civil court system in Kentucky to litigate Robert Rhoden’s death. In order to decide if a breach of duty and a legal violation took place in the care of an “elderly” Kentuckian, somewhere on the Appalachian trail on an early September morning in 2017.

It will only be by holding corporations and their administrators formally accountable for negligent failure that meaningful protective change for others can be achieved — this, I am convinced of beyond a doubt.

Lest, of course, the courts and the citizens of the United States are to accept that in rural and “underserved” America, shiny and well-funded corporate healthcare entities can be allowed to cause their version of “American carnage” unchecked by the law, by standards of professional conduct or by the public — because they simply claim to be doing “God’s work” for people who have access to few, if any, other options!

I don’t think so!

Because, on the receiving end of this kind of corporate carnage in rural America are the earth bound people of Kentucky, and the thousands of other places across America. Places, us “elitist” North-Easterners, have come to call “fly over country” — in our push to create increasingly efficient and well-fortified corporate structures capable of “benefiting the majority” and generating financial windfalls for investors and executives sitting in plush faraway places.

What is “flyover country” in America? Who lives there? Who profits there? Who leaves it for dead — “chewed up and spit out”?!?

To the thousands of Corbin Kentuckys around America….I see you! Many across America see you!

Know that you’re worth more than to be “chewed up, spit out and left for dead” by shiny corporations selling substandard wares.

You’re worth more than the con-artists who take your treasure, your labor, your lives and your votes for money’s sake.

Corbin, you’re worth more than that! I’m sure of it — and so should you be!

How long will you stay “chewed up and spit out”? How long will you tolerate corporate con-artists and substandard treatment?

I suppose time will tell. I suppose that is why we have “juries of our peers” standing to judge right from wrong in our court system.