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May 16, 2019

'Weighing my daughter's life': Why one family rushed their 2-year-old to the ED—but never set foot inside

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    After her 2-year-old daughter accidentally swallowed anti-nausea medication, Lindsay Clark went to an ED—but rather than going inside, she chose to wait in the parking lot to see whether the child's health would worsen.

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    And Clark isn't alone: Her actions represent a surprisingly common, if risky, strategy that some families use to avoid high and unpredictable ED bills, Vox's Sarah Kliff reports.

    A potential overdose leads to a painful choice

    In 2017, Clark found her 2-year-old daughter Lily with an open bottle of Dramamine, an anti-nausea drug. 

    "It had a child lock on it, but I caught her sitting there with a bunch of white stuff in her mouth," Clark said. She "immediately swept [Lily's] mouth with [her] finger," but said it wasn't clear how many pills Lily had consumed.

    Clark called a poison control hotline, and the operator told her to take Lily to the ED because a Dramamine overdose could cause seizures. But the potential cost of an ED visit gave Clark pause. She was still paying off a $1,200 ED bill from when she fell down her friend's stairs a few months prior, Kliff reports.

    Clark asked the operator what the ED doctors would do to treat Lily, and she learned that a clinician would likely give her daughter activated charcoal and maybe pump her stomach, Kliff reports.

    Clark recalled that she began "weighing [her] options."

    Ultimately, Clark and her husband decided to give Lily activated charcoal at home and then drive her to the ED. Instead of taking her inside, they parked 100 feet from the entrance and waited to see if Lily would show signs of a seizure.

    After a few hours, Lily seemed fine, and the Clarks left.

    "It felt terrible, as a parent, to be in the position of having to do that," Clark said. "I was sitting there thinking, am I a bad person? I'm weighing my daughter’s life against how much the bill is going to cost."

    Clark isn't alone: Other patients share their stories

    After Kliff tweeted about the Clarks' story, a handful of other people came forward to say they'd also chosen to wait outside a hospital during a medical emergency.

    Martin Niemöller in a tweet wrote that his son had recently done this with his child because their last visit to the ED left them with a nearly $2,000 bill. "Even with their top-level insurance plan," he said in a tweet.

    Cruz Baisa in a tweet said his family had to make the same decision about nine years ago. "We sat on the curb outside the emergency room in case the situation got so bad life was at risk. Otherwise, the bills would've crippled my parents," he wrote.

    In these tweets, money is a common thread, according to Kliff.

    "[P]atients going to the emergency room generally know two things: The price will likely be high (as all American health prices are), and they won't be able to know what their treatment costs in advance," even when they have insurance, she writes.

    What happened to Lily

    After Lily's incident, Clark—who was uninsured at the time—looked into ways to purchase health insurance, but could not find an affordable option. She remains one of 5 million people in Texas who are uninsured.

    And Clark maintains that she and her husband made the right decision for Lily. "She should have health care, as a child," Clark said. "Children should not be put in these situations" (Kliff, Vox, 5/10).

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