Alaska Patient Goes to ER Twice for Severe Pain, Dies After Being Left Untreated

May 04--In the days before her death, Amber Whitaker twice arrived at a Palmer emergency room complaining of excruciating pain. The second time she couldn't walk and entered the hospital in a wheelchair.

Both times doctors ran tests but couldn't determine the cause of the 29-year-old's agony, and sent her home with painkillers.

Four days after the second visit, Whitaker was admitted to the hospital. By then it was too late: A massive infection had spread throughout her body. She died within 24 hours.

This week in an Anchorage courtroom, a civil trial opened in a wrongful-death lawsuit filed by Whitaker's family against the doctor who saw her on her second visit to the ER and his employer, the Mat-Su Emergency Medicine Physicians Corp.

The lawsuit filed by Whitaker's family contends the doctor, Mark Lee, negligently failed to diagnose and treat her infection on Feb. 3, 2012.

They also say Whitaker, who had a history of drug use, was dismissed as a drug-seeking addict, and her complaints were consequently not taken as seriously or investigated as thoroughly as they should have been.

"Dr. Lee described her as 'unemployed, cigarette smoker, lives in Big Lake," the family's attorney, Richard Helms, told the jury during opening statements Tuesday. "He suspected she was seeking drugs rather than experiencing pain."

Whitaker's life surely had its share of trouble, her family's lawyer told the court. Her two daughters had been taken by the state Office of Children's Services and were living with their grandparents. She had been an injection drug user.

But when she arrived hysterical at the hospital two days in a row begging for help, the system let her down, her family said.

"Amber was not in there as an addict seeking drugs," said her sister Misty Kastar after the hearing. "She was there to get help. She did not get help. And as a result, she died."

Whitaker was born in Needles, California, a small Mojave Desert city on the Colorado River, across from Arizona. The family moved to Palmer when she was about 10, for her father's work in the construction industry.

Whitaker dropped out of high school after her junior year and hoped to follow her father into the construction field. Later, a car accident nearly led to an arm amputation.

Recovering from her injuries introduced her to strong prescription painkillers, her sister said. Harder drugs followed.

She had two daughters, Nevaeh and Olivia. Both lived with her parents, Sheila and Robert Whitaker, after the state OCS became involved because of allegations of drug use. Whitaker remained close to her girls, coming over often to cook steak dinners, draw pictures and go on walks, Whitaker's mother Sheila said.

In the months before her death, Whitaker had been living in a cabin with a friend and making plans to move to Colorado with her parents and daughters. She hoped to attend culinary school.

On Feb. 2, the first time she went to the ER at Mat-Su Regional Medical Center, she told doctors she was in severe pain from falling down stairs and had been bleeding, according to the account of Howard Lazar, an attorney for Dr. Lee, during opening statements of the trial Tuesday.

She was given an extensive workup that involved an X-ray, CT scan and a battery of tests, none of which signaled anything seriously amiss. Six hours after Whitaker arrived, she was sent home with Percocet, a narcotic pain medication, and instructions to follow up with a family physician or come back to the hospital if things got worse.

She was back at the hospital by the evening of Feb. 3, said her father, who came with her. This time, she had to be brought in with a wheelchair.

"She was wanting to be admitted," said Robert Whitaker. "She called me down there and said, 'They are not admitting me. There's something wrong with me. Help me, help me.'"

Lazar said in court that Lee appropriately relied on a workup done the day before by another doctor, and performed additional tests, including blood and metabolic screenings.

"Nothing came back on the panel that suggested there was an infection going on," Lazar told the jury.

In the ER, Whitaker was sobbing and hysterical, according to a nurse's notes introduced in court. Lee started her on an IV drip of fentanyl, a powerful opioid painkiller.

Later Lee discovered through the results of a toxicology screening that Whitaker had methamphetamine in her system, said a note in Whitaker's chart shown in court.

"The patient before I saw the tox screen was initially treated with opiate medication which helped for a little while and then the patient started asking for more," the note said. "Which I declined."

With no clear reason for her pain found, Lee sent her home with a prescription for a different painkiller, Ultracet, also known as Tramadol.

"I will provide the patient with Ultracet and strongly urged her to follow up with (a general practice physician)," the note said. She left the hospital as she had arrived, in a wheelchair, her family said.

Whitaker's death was a tragedy, Lazar told jurors. But Lee fulfilled his duties as a physician.

"This is not Dr. Lee's fault at all," he said.

Days passed. It wasn't until Feb. 7, when Whitaker went to the family's chiropractor, that the infection was discovered. By then her organs "were marbleizing," said Whitaker's sister Kastar. "They were shutting down."

This time Whitaker arrived at the Mat-Su medical center in an ambulance and was taken straight to the intensive care unit. A septic infection had infiltrated her bloodstream. Whitaker asked her sister to call in a pastor.

"He came and said The Lord's Prayer. She said the Lord's Prayer," Kastar said. "Then things went really downhill."

She died hours later, just a few days shy of what would have been her 30th birthday. Both sides in the lawsuit agree if she'd gotten antibiotics earlier, she could have been saved.

The next year, Whitaker's parents and daughters moved to Colorado. Nevaeh has been especially burdened by her mother's death, Sheila said. She was 8 years old when it happened.

They came back this spring for the trial. On Tuesday, Whitaker's mother, sister and daughters sat in the front row of the courtroom. Her father sat at the plaintiff's table. On the first day there was a lot of discussion of Amber's past and her drug use.

After a while, Kastar took the girls out of the courtroom.

"We needed to get some fresh air," she said.

Whitaker's family knows Amber may not have been the easiest patient. And they know the Valley hospital ER sees its share of people for whom pain is a front to obtain drugs. Some of them may have looked and acted a lot like Whitaker.

"Regardless of what they thought about or what she was doing, she should have been admitted," her sister said. "She would be alive if she had been."

The trial is expected to continue through next week.

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