A drama that should not have happened. On January 30, Estéban Vermeersch, 24, died of a pneumothorax after two calls to the SAMU remained without intervention. A few months later, his family announced that he wanted to file a complaint for manslaughter.
Two calls, but no intervention
On January 28 in Mamers (Sarthe), Dorothée Verove thus composed the 15th for her son Estéban, 24 years old, nailed to bed by strong chest pain. On the phone, he describes incomplete breathing and intense pain. And a ventoline that does not relieve it this time. However, the regulatory doctor concludes a simple muscle involvement, without a concept of emergency.
But the next day, Estéban’s state deteriorated. Exhausted and taken from discomfort, he struggles to breathe. His mother recalls the Samu. The muscle track is still mentioned. He is then recommended to go to the emergency room on his own. But on the road to the CHU du Man, the young man collapses. One hour resuscitation is not enough. Estéban dies from a pneumothorax under his mother’s eyes.
An intolerable sequence for the family who today wishes to file a complaint against the hospital center for manslaughter. She believes that if the Samu had reacted to the first call, and decided to intervene in the emergency room, Esteban would still be alive.
The Samu, a mission misguided
As intolerable as it is, the death of the young man today comes to illustrate once again a breathless system. Which can only be based on an error of appreciation. An inventory explained to us two emergency physicians.
Recall that at the origin, the SAMU had to focus on vital emergencies: cardiac stops, stroke, serious trauma, acute respiratory distress … but, as explained by Dr Gérald Kierzek, “The SAMU is designed to be the brain of emergency medicine, but it has become the number of health in panic.”
Today, according to the instructions (call before you go to the emergency room), the 15 receives calls for city medicine problems, social or psychiatric situations, even requests for simple medical advice. This drift, encouraged by the public authorities, saturated the lines.
“Call 15 has become the effective response in political communication (for ministers, etc.) but dangerous for patients because it is unable to respond to everything and above all hide and off from pauperization of the health system on all floors”
Excessive centralization
For Dr. Frédéric Garcia, also emergency artist, this shift mainly reflects a loss of medical proximity: “JI have seen the dismantling of proximity care, with the idea of centralizing demand. And Center 15 is the pictorial representation. At the heart of this excessive centralization, regulation, which is based solely on the patient’s voice, amounts to making “audioconsultation”, that is to say the degradation down of the teleconsultation “, while “Medicine is above all clinic”.
Without physical examination, regulators must rely on the statistics and the story of patients, at the risk of missing out of serious, but atypical cases.
And regulators put under pressure
This inflation of non -urgent requests has direct consequences. “Real emergencies may find it difficult to reach the 15th, undergoing unacceptable deadlines” alerts Dr. Kierzek. For their part, regulatory doctors live a mission that has become untenable: “We give them a huge mission with the only tool for the phone” Dr. Garcia adds, who also highlights the considerable medico-legal risk to which doctors on the front line are exposed. Result: exhaustion, feeling of not exercising their profession … and increased risk of errors.
A care system to be rebuilt
For the two emergency workers, the responsibility does not really incubate the doctors of the SAMU, but to the health system. But then what solutions to no longer cry a loved one, deceased because not taken care of in time? “What is missing is a link that allows people to be seen without going through the hospital, in accessible care centers without an appointment” evokes Dr. Garcia. “As long as proximity medicine remains victimized and alternative structures are insufficient, the 15 will continue to assume an impossible mission, with the risk of avoidable dramas”.